スポーツ脳振盪とその一次，二次，三次予防法

抄録

Sport-related concussions (SRCs) are common, and the consequences of SRCs are multi-layered. In addition to its immediate effects, a SRC can lead to the development of long-lasting symptoms (i.e. postconcussion syndrome) and the increased risk of other musculoskeletal injuries. Repetitive head impacts may result in, in some cases, potentially irreversible and even fatal changes in the brain such as diffuse cerebral swelling and chronic traumatic encephalopathy. Due to its complexity, the prevention of SRCs must be considered at three different levels - primary, secondary and tertiary. For the primary prevention, the protective equipment such as helmets, headgears, and mouth guards does not reduce the risk of SRCs. While the effects of policy and rule changes to allow less physical contact are inconclusive, the education of proper tackling techniques and its implementation (i.e. practicing without helmets and pads) may be effective in preventing SRCs. Regarding the secondary and tertiary prevention, literature does not support the use of prolonged, strict rest. A brief period (24-48 hours) of physical and cognitive rest followed by a gradual increase of activities will likely facilitate a better recovery. The subthreshold exercise protocol has shown to be safe and reliable, and it seems to minimize the chronic symptoms related to SRCs. Although high-level evidence has yet to be established, early resumption of the monitored, controlled aerobic exercise may become the standard for future SRC recovery.