Scoping Review of Concussion Guidelines in Wheelchair Rugby, Wheelchair Basketball, Sitting Volleyball and Goalball

Background: Concussion is a recognised risk in sport; however, most existing tools and guidelines have been designed for able-bodied athletes, raising concerns about their effectiveness and applicability in para sport. Aim: This scoping review aimed to map and examine the availability, accessibility and characteristics of concussion guidelines in four team Paralympic sports: wheelchair rugby, wheelchair basketball, sitting volleyball and goalball. These sports were selected as they are established Paralympic team sports that represent a range of impairments and injury risk profiles. Methods: The scoping review was conducted using the Arksey and O’Malley framework with PRISMA-ScR. Forty-four organisation–sport combinations were identified, their websites were searched for concussion guidelines and they were contacted via email three times when guidelines could not be identified from December 2025 to March 2026. Data were charted and summarised descriptively. Results: Variation was identified across the four sports in the presence and availability of concussion guidelines: 19/44 organisation–sport combinations were identified with concussion guidance, 1/44 with partial guidance, 4/44 with confirmed absence of guidance and 20/44 had unknown status. Some organisations referenced established tools, such as 6/44 referencing SCAT5 and 10/44 referencing SCAT6, but overall relied on non-impairment-specific guidelines. In addition, inconsistencies in public availability were observed, and twenty organisations failed to respond to requests for information. Conclusion: In para sport, concussion guidance is inconsistent and largely lacks impairment-specific adaptations. There is potential scope for the development of para sport-specific concussion frameworks that are more readily available for diverse para sport populations.