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2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern
  1. Clare L Ardern1,2,3,
  2. Philip Glasgow4,5,
  3. Anthony Schneiders6,
  4. Erik Witvrouw1,7,
  5. Benjamin Clarsen8,9,
  6. Ann Cools7,
  7. Boris Gojanovic10,11,
  8. Steffan Griffin12,
  9. Karim M Khan13,
  10. Håvard Moksnes8,9,
  11. Stephen A Mutch14,15,
  12. Nicola Phillips16,
  13. Gustaaf Reurink17,
  14. Robin Sadler18,
  15. Karin Grävare Silbernagel19,
  16. Kristian Thorborg20,21,
  17. Arnlaug Wangensteen1,8,
  18. Kevin E Wilk22,
  19. Mario Bizzini23
  1. 1Aspetar Orthopaedic & Sports Medicine Hospital, Doha, Qatar
  2. 2Division of Physiotherapy, Linköping University, Linköping, Sweden
  3. 3School of Allied Health, La Trobe University, Melbourne, Australia
  4. 4Sport Northern Ireland Sports Institute, Newtownabbey, UK
  5. 5School of Sport, Ulster University, Newtownabbey, UK
  6. 6School of Human, Health & Social Sciences, Central Queensland University, Branyan, Queensland, Australia
  7. 7Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
  8. 8Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
  9. 9The Olympic Elite Sports Program (Olympiatoppen), Oslo, Norway
  10. 10Hôpital de La Tour, Swiss Olympic Medical Center, Meyrin, Switzerland
  11. 11Sports Medicine, Department for Human Locomotion, Lausanne University and Hospital, Lausanne, Switzerland
  12. 12College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
  13. 13Center for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada
  14. 14SPACE Clinics, Edinburgh, UK
  15. 15Scottish Rugby, Murrayfield Stadium, UK
  16. 16School of Healthcare Sciences, Cardiff University, Cardiff, UK
  17. 17The Sports Physicians Group, Amsterdam, The Netherlands
  18. 18Manchester City Football Club, Manchester, UK
  19. 19Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
  20. 20Department of Orthopedic Surgery, Sports Orthopedic Research Center—Copenhagen (SORC-C), Amager-Hvidovre Hospital, Copenhagen University, Copenhagen, Denmark
  21. 21Department of Orthopedic Surgery and Physical Therapy, Physical Medicine Rehabilitation Research—Copenhagen, Amager-Hvidovre Hospital, Copenhagen University, Copenhagen, Denmark
  22. 22Champion Sports Medicine, Birmingham, Alabama, USA
  23. 23FIFA—Medical Assessment & Research Centre (F-MARC), Schulthess Clinic, Zürich, Switzerland
  1. Correspondence to Dr Clare Ardern, Aspetar Orthopaedic & Sports Medicine Hospital, P.O. Box 29222, Doha, Qatar; c.ardern{at}latrobe.edu.au

Abstract

Deciding when to return to sport after injury is complex and multifactorial—an exercise in risk management. Return to sport decisions are made every day by clinicians, athletes and coaches, ideally in a collaborative way. The purpose of this consensus statement was to present and synthesise current evidence to make recommendations for return to sport decision-making, clinical practice and future research directions related to returning athletes to sport. A half day meeting was held in Bern, Switzerland, after the First World Congress in Sports Physical Therapy. 17 expert clinicians participated. 4 main sections were initially agreed upon, then participants elected to join 1 of the 4 groups—each group focused on 1 section of the consensus statement. Participants in each group discussed and summarised the key issues for their section before the 17-member group met again for discussion to reach consensus on the content of the 4 sections. Return to sport is not a decision taken in isolation at the end of the recovery and rehabilitation process. Instead, return to sport should be viewed as a continuum, paralleled with recovery and rehabilitation. Biopsychosocial models may help the clinician make sense of individual factors that may influence the athlete's return to sport, and the Strategic Assessment of Risk and Risk Tolerance framework may help decision-makers synthesise information to make an optimal return to sport decision. Research evidence to support return to sport decisions in clinical practice is scarce. Future research should focus on a standardised approach to defining, measuring and reporting return to sport outcomes, and identifying valuable prognostic factors for returning to sport.

  • Consensus statement
  • Sports physiotherapy
  • Sport
  • Sports and exercise medicine
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