Thank you, Dr. Tator, that was a great presentation and history.
While I think Dr. Tator precedes me in age, I'm also of a similar ilk. I think we predate concussion being a concern. Early on in our careers when we started off, concussion wasn't identified.
What I want to focus on in my presentation is that I think the emphasis has been on identification and prevention of concussion. Where we have come into the fold and where we've done a lot of our work is on, I think, something very important mentioned by Dr. Tator, which is the management of a concussion after it's occurred.
There's acute management, and there's that minority of persons who had a sport-related concussion or a concussion outside of that. Generally it's 15% to 20% in a study for pediatrics, and it exceeds 30% if we go longer than 30 days. If we go beyond six months, it's probably 15% to 20% of the population. Again, sport concussion is a subset of concussion. I think concussion affects everyone in their daily lives.
The tack I take from it is that we as clinicians were recognizing that people were having concussion, and these individuals weren't necessarily completely recovering, which is what the expectation was: complete recovery. My main area has been moderate and severe brain injury. We were in rehabilitation and finding that these patients were not completely recovering.
Akin to guidelines that talk about management of concussions, or concussions more clearly, Canada has been a lead. Another area that we have focused on has been the management of symptoms following that, to try to standardize practice for how we manage people who have ongoing symptoms following concussion, primarily focusing on those with persistent post-concussion symptoms.
Through the work of the Ontario Neurotrauma Foundation, there have been two sets of guidelines created, one for pediatric, ages 18 and under, and another for adults. These have been published nationally and internationally. They have been presented as such and are recognized as very solid guidelines. We're currently in the third edition for the adult concussion guidelines. The aim of this is to standardize practice to provide care. As Dr. Tator mentioned, 200,000 Canadians per year sustain concussions. If 20% are not better after 30 days, then we're looking at people who need help and support. This needs to be improved in care and where we're focusing our research.
The other thing I will comment on specifically is that there have been initiatives that, to date, have not been successful, but have tried to harness the expertise here nationally in the country. Led in Calgary by Keith Yeates, there was an application for a national centre of excellence for concussion management through the University of Calgary. It was not successful in the letter of intent stage, but it harnessed experts throughout the country to focus on sport-related concussion and concussion in general, both pediatric and adult.
Another initiative that has been successful, but has not received full funding through the Ontario government, is the Ontario Brain Institute in relation to the Connect group studying concussion from all elements, from pre-concussion to concussion, looking at even chronic encephalopathy through all stages, including acute management and post-concussion management.
These are things that should be pursued further to standardize practice of care. Clearly, Canada and Ontario are leading in this area in trying to set these standards, and this has been well recognized internationally.
I believe that support on setting those guidelines and standards and allowing for further research will help us better serve our patients.
Thank you.