International Consensus Definition of 'Sport & Exercise' in Toddlers and Young Children, Children, and Adolescents

Gavin A Davis¹, Nicholas Anderson¹, Franz E Babl^{1

2}, Dustin W Ballard³, Karen M Barlow⁴, Michael J Barrett^{5

6}, Miriam H Beauchamp⁷, Meredith L Borland⁸, Silvia Bressan⁹, Louise Crowe¹, Shu-Ling Chong^{10

11}, Daniel J Corwin¹², Stuart R Dalziel^{13

14}, Carolyn A Emery¹⁵, Emmanuelle Fauteux-Lamarre¹⁶, Gerard A Gioia¹⁷, Juliet Haarbauer-Krupa¹⁸, Michael W Kirkwood¹⁹, Ruth Mari Caroline Löllgen^{20

21}, Christina L Master²², Audrey McKinlay²³, John Olver²⁴, Santiago Mintegi²⁵, Viviana Pavlicich²⁶, Laura Purcell²⁷, Radhika Raman²⁸, Pedro Rino²⁹, Stacy J Suskauer³⁰, Itai Shavit³¹, Emma J Tavender^{1

32

33}, Jacqueline van Ierssel³⁴, Keith Owen Yeates³⁵, Scott L Zuckerman³⁶, Vicki Anderson¹

Affiliations

¹ Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
² Departments of Paediatrics and Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
³ Emergency Department, Kaiser Permanente (KP) Northern California, San Rafael, California, USA.
⁴ Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia.
⁵ Department of Paediatric Emergency Medicine, Children's Health Ireland, Dublin, Ireland.
⁶ Women's and Children's Health, School of Medicine, University College Dublin, Dublin, Ireland.
⁷ Department of Psychology, University of Montreal & CHU Sainte-Justine Azrieli Research Center, Montreal, Quebec, Canada.
⁸ Emergency Department, Perth Children's Hospital and University of Western Australia, Perth, Western Australia, Australia.
⁹ Pediatric Emergency Department, University of Padova, Padova, Italy.
¹⁰ Emergency Department, KK Women's and Children's Hospital, Singapore City, Singapore.
¹¹ Duke-NUS Medical School, Singapore City, Singapore.
¹² Emergency Department, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
¹³ Emergency Department, University of Auckland, Auckland, New Zealand.
¹⁴ Department of Surgery and Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.
¹⁵ Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
¹⁶ Emergency Department, Cork University Hospital, Cork, Ireland.
¹⁷ Division of Neuropsychology, Children's National Hospital & George Washington University School of Medicine & Health Sciences, Rockville, Maryland, USA.
¹⁸ Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
¹⁹ Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA.
²⁰ Paediatric Emergency Department, Astrid Lindgrens Childrens Hospital, Karolinska University Hospital, Stockholm, Sweden.
²¹ Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
²² Pediatrics and Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine and the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
²³ School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand.
²⁴ Department of Rehabilitation Medicine, Monash University, Melbourne, Victoria, Australia.
²⁵ Pediatric Emergency Department, Hospital Universitario Cruces, University of the Basque Country, Bilbao, Basque Country, Spain.
²⁶ Emergency Department, Hospital General Pediátrico Niños de Acosta Ñu, Asunción, Paraguay.
²⁷ Department of Sport Medicine, McMaster University, Brantford, Canada.
²⁸ Emergency Medicine, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India.
²⁹ Emergency Department, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina.
³⁰ Pediatric Rehabilitation Medicine, Kennedy Krieger Institute, Baltimore, Maryland, USA.
³¹ Division of Pediatrics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
³² Department of Paediatrics and Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
³³ Department of Paediatrics and Critical Care, Australian Catholic University (ACU), Melbourne, Victoria, Australia.
³⁴ Physiotherapy Department, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
³⁵ Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
³⁶ Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

PMID: 39962915
DOI: 10.1111/apa.70013

International Consensus Definition of 'Sport & Exercise' in Toddlers and Young Children, Children, and Adolescents

Gavin A Davis et al. Acta Paediatr. 2025 Jul.

. 2025 Jul;114(7):1653-1659.

doi: 10.1111/apa.70013. Epub 2025 Feb 17.

Authors

Affiliations

¹ Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
² Departments of Paediatrics and Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
³ Emergency Department, Kaiser Permanente (KP) Northern California, San Rafael, California, USA.
⁴ Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia.
⁵ Department of Paediatric Emergency Medicine, Children's Health Ireland, Dublin, Ireland.
⁶ Women's and Children's Health, School of Medicine, University College Dublin, Dublin, Ireland.
⁷ Department of Psychology, University of Montreal & CHU Sainte-Justine Azrieli Research Center, Montreal, Quebec, Canada.
⁸ Emergency Department, Perth Children's Hospital and University of Western Australia, Perth, Western Australia, Australia.
⁹ Pediatric Emergency Department, University of Padova, Padova, Italy.
¹⁰ Emergency Department, KK Women's and Children's Hospital, Singapore City, Singapore.
¹¹ Duke-NUS Medical School, Singapore City, Singapore.
¹² Emergency Department, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
¹³ Emergency Department, University of Auckland, Auckland, New Zealand.
¹⁴ Department of Surgery and Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.
¹⁵ Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
¹⁶ Emergency Department, Cork University Hospital, Cork, Ireland.
¹⁷ Division of Neuropsychology, Children's National Hospital & George Washington University School of Medicine & Health Sciences, Rockville, Maryland, USA.
¹⁸ Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
¹⁹ Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA.
²⁰ Paediatric Emergency Department, Astrid Lindgrens Childrens Hospital, Karolinska University Hospital, Stockholm, Sweden.
²¹ Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
²² Pediatrics and Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine and the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
²³ School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand.
²⁴ Department of Rehabilitation Medicine, Monash University, Melbourne, Victoria, Australia.
²⁵ Pediatric Emergency Department, Hospital Universitario Cruces, University of the Basque Country, Bilbao, Basque Country, Spain.
²⁶ Emergency Department, Hospital General Pediátrico Niños de Acosta Ñu, Asunción, Paraguay.
²⁷ Department of Sport Medicine, McMaster University, Brantford, Canada.
²⁸ Emergency Medicine, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India.
²⁹ Emergency Department, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina.
³⁰ Pediatric Rehabilitation Medicine, Kennedy Krieger Institute, Baltimore, Maryland, USA.
³¹ Division of Pediatrics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
³² Department of Paediatrics and Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
³³ Department of Paediatrics and Critical Care, Australian Catholic University (ACU), Melbourne, Victoria, Australia.
³⁴ Physiotherapy Department, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
³⁵ Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
³⁶ Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

PMID: 39962915
DOI: 10.1111/apa.70013

Abstract

Aim: The study aim was to develop an age-appropriate definition of sport and exercise in children and adolescents for use in concussion research and management.

Methods: A modified Delphi methodology, with three rounds and consensus defined a priori as ≥ 80% agreement.

Results: Thirty-one participants (13 male, 18 female) from 13 countries, including clinical psychologists, epidemiologists, implementation scientists, neurologists, neuropsychologists, neurosurgeons, paediatric emergency physicians, paediatricians, physiotherapists, rehabilitation physicians, speech-language pathologists, and sports medicine physicians came to a consensus that sport-related paediatric concussion extends beyond the sporting arena, and includes the school yard, playground, park, street, recreational site, and home; excludes non-accidental violence, assault, and passenger vehicle road trauma; may include falls; and age-group terminology includes Toddlers and Young Children (1-4 years), Children (5-12 years), and Adolescents (13 to < 18 years). Sport and exercise categories and individual examples are provided.

Conclusions: This consensus definition of sport and exercise in paediatrics for concussion research and management will enable researchers and guideline development groups to expand paediatric concussion research and management guidelines to encompass the broad range of activities commonly associated with sport- and exercise-related concussion in children and adolescents and thus limit exclusion of relevant studies from systematic reviews and guideline development.

Keywords: adolescent; children; exercise; sport; toddler.

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References

1. J. S. Patricios, K. J. Schneider, J. Dvorak, et al., “Consensus Statement on Concussion in Sport: The 6th International Conference on Concussion in Sport–Amsterdam, October 2022,” British Journal of Sports Medicine 57, no. 11 (2023): 695–711, https://doi.org/10.1136/bjsports‐2023‐106898.
1. R. J. Echemendia, J. S. Burma, J. M. Bruce, et al., “Acute Evaluation of Sport‐Related Concussion and Implications for the Sport Concussion Assessment Tool (SCAT6) for Adults, Adolescents and Children: A Systematic Review,” British Journal of Sports Medicine 57, no. 11 (2023): 722–735, https://doi.org/10.1136/bjsports‐2022‐106661.
1. R. J. Echemendia, B. L. Brett, S. Broglio, et al., “Introducing the Sport Concussion Assessment Tool 6 (SCAT6),” British Journal of Sports Medicine 57, no. 11 (2023): 619–621, https://doi.org/10.1136/bjsports‐2023‐106849.
1. R. J. Echemendia, B. L. Brett, S. Broglio, et al., “Sport Concussion Assessment Tool™ – 6 (SCAT6),” British Journal of Sports Medicine 57, no. 11 (2023): 622–631, https://doi.org/10.1136/bjsports‐2023‐107036.
1. G. A. Davis, R. J. Echemendia, O. H. Ahmed, et al., “Introducing the Child Sport Concussion Assessment Tool 6 (Child SCAT6),” British Journal of Sports Medicine 57, no. 11 (2023): 632–635, https://doi.org/10.1136/bjsports‐2023‐106853.

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International Consensus Definition of 'Sport & Exercise' in Toddlers and Young Children, Children, and Adolescents

Affiliations

International Consensus Definition of 'Sport & Exercise' in Toddlers and Young Children, Children, and Adolescents

Authors

Affiliations

Abstract

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical