**5. Conclusion**

Given the increasing public awareness and attention revolving sports concussion and the long-term consequences of contact sport and traumatic brain injury exposure, there is growing interest in understanding the complex and concerning issues surrounding sport-related concussion. From what we understand about the pathophysiology of concussion, it is complex and involves a multifactorial process. Many mechanisms that are currently understood from the available literature were described however there is still much more to explore and understand. For example, it is unclear what the role of various factors is in the pathophysiological process. These include the role of genetics, age, gender, premorbid conditions and environmental factors and how they may affect and alter both the underlying pathophysiology, the outward clinical symptomatology experienced by the athlete and the recovery and rehabilitation course of a particular injury. Improved global understanding of these factors will be vital to understanding how best to use an individualized approach to the treatment and management of these patients.

Similarly, the ideal methodology for optimal detection and diagnosis of concussion is multifaceted requiring the use of a suite of tools to evaluate multiple systems. In the acute setting it is highly important that these assessments be quick, efficient and accurate in detecting deficits in performance that are associated with concussion. Likewise, these evaluations need to be able to be practically implemented on the sidelines therefore cost and efficient are heavily weighted. Simultaneously, concussion awareness by all stakeholders will aid in improving outcomes from this injury. Athletes, coaches, officials and other stakeholders need to be educated on the signs and symptoms of concussion, the long-term risks of continuing to participate in sports activity with a brain injury and therefore the importance of timely removal from play as well as the equally imperativeness of appropriate clearance for return to play.

Rehabilitation of sports-related concussion is ever changing given continued ongoing research which gives insights into the latest and best recommended approaches to caring and managing patients during their recovery to improve overall outcomes. The current method is a targeted and individualized approach. Additionally, active rehabilitation has been shown to be beneficial, particularly in patients with extended recovery durations and prolonged symptomatology. Continued investigations will help answer the questions of how treatments should vary among individuals based on their makeup, for example, their concussion history, outset signs and symptoms, as well as children vs. adults. These likely all play a role and can assist in developing more targeted rehabilitation programs for individuals to advance therapies.
