FROM PREVENTION TO RETURN TO SPORT: A LITERATURE INTEGRATIVE REVIEW ON CONCUSSION IN YOUNG ATHLETES

Abstract

This integrative review aimed to synthesize the scientific evidence regarding prevention, rehabilitation, return to sport, and neurobiological monitoring in young athletes aged 5 to 21 years with sport-related concussion. A total of 25 primary studies were selected from the PubMed and Science Direct databases, published between 2021 and 2025, with screening conducted using Rayyan. The findings were organized into three thematic groups: prevention, epidemiology, and risk factors; rehabilitation interventions and post-concussion exercise; and biomarkers and neurobiological monitoring. Early supervised aerobic exercise significantly accelerated symptomatic recovery, while neuromuscular training reduced the incidence of new sports injuries by 52%. Psychosocial factors such as anxiety and academic workload were shown to be relevant determinants of recovery, and a history of concussion was associated with a higher risk of depression and suicidal ideation. Plasma biomarkers such as GFAP, UCH-L1, NfL, and t-tau, in addition to retinal markers, emerged as promising tools for objective monitoring of brain health. It is concluded that concussion management in young athletes should be early, active, and multidimensional, integrating rehabilitation, prevention of subsequent injuries, mental health screening, and neurobiological monitoring.