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When is it safe to return to sport after a concussion? Studies show that as many as 85% of concussed athletes return to play within seven days of injury, but new research suggests that concussion-related reductions in balance, gait and posture can linger after normal activity levels have resumed, increasing the risk of suffering other injuries.

Researchers at the University of North Carolina in Chapel Hill evaluated health data for 102 students in their early 20s who participated in a variety of sports, including football, American football, swimming and basketball, from 2010 to 2013.

Those who suffered concussions were matched to control participants by age, sport, body type and the number of practices or games that could potentially lead to injury.

The researchers measured musculoskeletal injuries at three and six months and one year after the initial head injury.

In the year before the concussion there were 61 injuries such as strains, sprains and fractures, and the concussion group accounted for 34% of these injuries. In the year after concussion, however, 97 such injuries were recorded and 58% occurred in the concussion group.

The report, published in Medicine & Science in Sports & Exercise, says that there was no significant difference in injury rates between the two groups in the year before concussion. However, over the following year the concussion group was 1.6 times more likely to experience an injury compared to the control group.

The findings of the study underscore the need to explore functional movement and dynamic postural control assessments in post-concussion injury assessment protocols, the researchers said.