Concussion injury in Olympic-style Taekwondo: a systematic review

Sports-related concussion is recognized as a major and increasing public health issue. In response to growing concern about sports-related concussion and the potential long-term sequelae of repeated concussions, the sports medicine community has increasingly developed and updated concussion guidelines and consensus statements. The objectives of this review were to systematically review and synthesize the current best available concussion injury data in Taekwondo and to elucidate the recent sports-related concussion guidelines and discuss their implications for evidence-informed safety and injury prevention policy development in Taekwondo. The concussion incidence rate per 1,000 athlete-exposures varied considerably across the included studies (range: 0.0 to 50.2; median: 4.9). This is greater than in other contact and collision sports (e.g., American football and ice hockey), but smaller than in boxing. Young adolescent Taekwondo athletes are at a greater risk of sustaining concussion injury than both younger (children) and older (adult) athletes. There was insufficient evidence to establish any other risk factors for concussion injury in Taekwondo. Taekwondo governing bodies have an ethical obligation to develop and implement sport-specific safety policies that adhere to current concussion guidelines, and, moreover, to adequately educate on-site medical personnel, referees, coaches, athletes, and the athletes’ parents or guardians. It is vital that athletes do not return to play on the day of concussive injury. It is also imperative that concussion diagnosis and fitness to play (i.e., both removal from and return to play) is a medical decision based on sound clinical judgment exercised by independent health care professionals with experience and specific training in concussion evaluation and management.