Circus-specific extension of the 6th International Consensus Statement on Concussion in Sport

While sport-related concussion (SRC) is a known risk in circus arts, no published guidelines exist to guide post-concussion return to circus, contributing to inadequate management in this population. The Concussion in Sport Group (CISG) published the 6th international consensus statement in 2023, providing updated guidance and assessment tools for the management of SRC. Sport and dance organisations have adapted these recommendations for their specific settings. The aim of this extension statement was to extend the CISG guideline to the circus arts training and performance context. Development included a review of literature, creation of the initial drafts by the working group, feedback from external reviewers and integration of the feedback into a final draft approved by the working group. This statement includes circus-specific recommendations for: (1) baseline testing; (2) immediate postinjury management including adapted Maddocks questions; (3) a criterion-based return-to-circus progression including guidance by circus discipline; (4) prognostic considerations; (5) risk reduction/prevention. While ongoing research specific to SRC in circus is needed, this guideline supports and advises circus organisations to develop concussion management protocols and policies. It also informs clinicians to assist their understanding of the unique aspects and demands of circus arts to provide tailored clinical care in the rehabilitation of circus artists as they return to training and performance following SRC.