Table 5.

Methods of post-recovery follow-up and conclusion

First author	Method of post-recovery follow-up	Conclusion
Crowe 42	On day 30 when the athletes were recovered (except 1), the BRIEF-P/SR and CHQ were completed to measure executive function in day to day environments and functional health status and well-being respectively.	The questionnaires did not identify persistent impairments in the participants after recovery had taken place, with majority of the results falling in normal range.
Darling 35	A structured telephone follow-up interview of the athletes was conducted a minimum of 2 months after they were cleared for return to play. The interview asked about difficulty in school after they returned and presence of concussion symptoms.	All had successfully returned to sport without recurrent symptoms. 38.5% of the athletes reported new or increased problems in school, mainly decreased ability to concentrate, but the timing of cognitive symptoms was not assessed (may have been during natural recovery phase).
Lynall 60	Repeat baseline testing was performed on the athletes 169.5 (range 37–333) days after last post-injury test. Repeat baseline testing included computerized neurocognitive testing, balance testing and a graded symptom checklist. Scores in repeat baseline testing were compared with original pre-season baseline testing.	There is limited usefulness for repeat baseline testing in concussion management. It is time consuming and costly and has no significant difference to original pre-season baseline scores.
Maugans 81	Although not included in the criteria for recovery, MRI, diffusion tensor imaging, H-MRS and phase contrast angiography was performed at days 3, 14 and 30 post-injury.	There was no evidence of structural or metabolic injury in MRI or H-MRS. In 36% of the participants the CBF values had not normalised by day 30 post-injury.
McGrath 45	Post exertion ImPACT testing was done after recovery and compared with baseline pre-injury ImPACT scores.	27.7% of the concussed student athletes who were determined to be recovered exhibited cognitive decline following moderate physical exertion.
Newsome 66	Functional connectivity was measured 1 month post-sport-related concussion in athletes who were cleared to return to play using the Hopkins Verbal Learning Test during fMRI.	The injured and control groups did not differ in verbal memory after 1 month but differed in functional connectivity.
Slobounov 84	Postural sway was assessed using a virtual reality device that displayed a “moving room” condition on day 30.	Balance problems (trunk sway during the “moving room” condition) persisted 30 days after injury, indicating that symptom and cognitive recovery did not coincide with balance recovery. Balance problems persisted significantly longer in those sustaining two concussions within 30 days when compared with a single concussion.
Slobounov 82	EEG was performed alongside the measures used to determine recovery at day 7, 15 and 30 and months 6 and 12. EEG was recorded while sitting, standing on a force plate and then on a foam base of support with eyes open/closed conditions.	There was no significant change in neurological assessment and symptoms after the return to play decision was made but 85% of those who showed suppression in the acute phase did not return to pre-injury baseline up to 12 months post injury.