What are the evidence-based medical management approaches for the concussed youth athlete? A scoping review

Background: Concussion management in youth sport relies on the experience of adults pitch-side as to injury recognition, removal, and management decisions. Little consensus exists on the consistency of pitch-side and medical pathway management approaches.Objectives: A scoping review was completed to identify and synthesise primary research as to the management of the concussed youth athlete.Methods: A systematic search was completed in Medline, CINAHL, PubMed, SPORTDiscus, OVID emcare, Web of Science, ScienceDirect, and Cochrane Library databases and Google Scholar from inception to 1st March 2025 according to PRISMA-ScR guidelines. Primary research studies that provided outcome data on management approaches for concussed youth athletes at all stages post-injury were included. Articles were synthesised and reported in themes.Results: 36 studies were included and four themes identified: Exercise, activity, and neuromuscular training interventions (n = 14), Pitch-side, sub-acute management and monitoring (n = 6), Novel treatment interventions (n = 5), and individual management in specific populations (n = 11).Conclusion: Published primary research for concussed youth athlete management approaches with outcome data supports early activity recommendations and sub-threshold exercise programmes. Few data exist for alternative management approaches. Case reports/ series saturated this review, with limited generalisable data reported on. Further transparency on concussion injury reporting and management, with outcome data, is warranted.