Results

• 18 studies consisting of journals, prospective cohort studies, systematic literature reviews, manuscripts, the NCAA website, the NATA website, and college websites met the criteria for this paper

• One large prospective cohort study compared the NCAA Concussion Study to a more recent Concussion Assessment, Research and Education (CARE) Clinical Study. This study concluded that an extended recovery time period of a concussed athlete along with a lengthier rehabilitation period correlated with a 41% lower rate of same-season repeat concussions.

• It is near-universal that a longer recovery stage and symptom-free waiting periods before returning an athlete to play are a vital component of concussion management (Burnsed, 2019)

• State-based concussion statutes do not normally apply to college athlete's health and well-being. Thus, league-level rules governing concussion management are utilized (Baugh et al., 2016)

• Management of concussions in college football has grown to include more in its protocols. The revised policy by the NCAA includes a multifaceted objective-testing protocol which shifted from the previous subjective grading scale-based guidelines (Buckley et al., 2015)

• There are six main components within the new NCAA policy which include:

  1. • 1. The college must conduct a multifaceted baseline assessment on each athlete before participating, which must be utilized post-injury as well. It should include at minimum a symptom checklist, cognitive assessment, and balance test. A neuropsychological test interpreted by a neuropsychologist could also be included

       2. Annual athlete concussion education

       3. A process for student-athlete acknowledgement of symptom reporting

       4. Immediate removal from participation for all athletes exhibiting concussion signs or symptoms, as well as evaluation of these athletes by medical personnel

       5. No same day return once a concussion is suspected or diagnosed

       6. Ensure that there is an institutional rule requiring medical clearance from a physician in order to return to play

Between each stage there must be 24 hours to ensure the athlete does not provoke any concussion symptoms with exercise. If symptoms do occur in any stage, the athlete must return to the previous stage at which they were symptom-free and try to progress after another 24-hour period has passed (NCAA, 2017)