8.9 Which psychosocial factors are associated with return to sport following concussion? A systematic review
Bibliographic record
Abstract
Objective To examine the criteria used to assess psychological readiness to return-to-sport following concussion to support graduated stepwise recommendations. Design Scoping review. Setting MEDLINE, Embase, PsycINFO, SPORTDiscus, CINAHL were searched using database-specific MeSH terms and keywords. Reference lists were manually searched. Participants Eligibility criteria included original publications describing psychological factors related to return-to-sport (at any level) following a diagnosed concussion. PRISMA-ScR guidelines were followed; two independent reviewers selected studies, extracted data, and assessed evidence level using Oxford Centre for Evidence-Based Medicine (OCEBM). Outcome Measures Scale or measure employed (quantitative studies) and/or key thematic concepts (qualitative studies) related to psychological readiness to return-to-sport. Main Results Of 1469 studies, 2 quantitative cohort studies (OCEBM level-3) representing 112 athletes (71% male; high-school and collegiate collision/contact athletes) and 2 qualitative studies representing 45 athletes (89% male; 89% football players; aged 9–25 years) were included. Quantitative assessments included the Tampa Scale of Kinesiophobia modified for concussion and a single-item Likert scale question each for fear of reinjury and fear of return-to-sport. Main qualitative themes included fear of replacement or letting down the team, stigma, knowledge of consequences, social support, and peer pressure as influential. Conclusions Despite recommendations to assess psychological readiness to return-to-sport following concussion, there is insufficient evidence upon which to make clinical decisions. Future research should identify key concepts and themes using qualitative studies, with subsequent development and validation of a concussion-specific outcome measure to identify athletes who might benefit from psychological intervention to resume sporting activities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.091 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.005 | 0.009 |
| Bibliometrics | 0.014 | 0.012 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".