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

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.