Disclosures: Marc J. Heronemus, MD: No financial relationships or conflicts of interest

Objective: To assess the differences in compliance with consensus return to play guidelines before and after state concussion law passage.

Design: Descriptive epidemiologic study. The National High School Sports-Related Injury Surveillance System (High School RIO) to assess injury and return to play data. LawAtlas was used to capture information regarding specific language in the concussion laws and date of law passage.Setting : Convenience sample of high schools in the United States during the 2005/06 through 2018/19 academic years.Participants : Male and female athletes participating in high school-sponsored sports.

Interventions: Not applicable

Main Outcome Measures: Pre- and post-concussion law compliance with return to play guidelines overall and by state laws that specify what type of healthcare provider can manage concussions; Recurrent concussion rates pre- and post-law implementation.

Results: 17,526 reported concussions had associated return to play and symptom resolution time data. Prior to state concussion law passage, 31.6% of players returned to play too early compared to 25.1% post-legislation. States that specified the category of heath care provider had an 8% decrease in percentage of athletes that returned too early compared to 5% for states that did not from pre-legislation to post-legislation. Rates of recurrent concussions increased from 2.84 per 100,000 athlete exposures pre-legislation to 3.36 post-legislation.Conclusions: State concussion laws may have had an effect on compliance with consensus return to play guidelines and lead to an increase in recurrent rates, in part, due to increased knowledge, identification and reporting of concussion symptoms.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/effects-of-state-concussion-laws-on-compliance-with-consensus-return-to-play-guidelines/