Munakomi, S; Puckett, Y
Repetitive Head Injury Syndrome Book Chapter
In: StatPearls, StatPearls Publishing Copyright © 2020, StatPearls Publishing LLC., Treasure Island (FL), 2020.
BibTeX | Tags:
@inbook{RN1042,
title = {Repetitive Head Injury Syndrome},
author = {S Munakomi and Y Puckett},
year = {2020},
date = {2020-01-01},
booktitle = {StatPearls},
publisher = {StatPearls Publishing
Copyright © 2020, StatPearls Publishing LLC.},
address = {Treasure Island (FL)},
keywords = {},
pubstate = {published},
tppubtype = {inbook}
}
Inserra, C J; DeVrieze, B W
Chronic Traumatic Encephalopathy Book Chapter
In: StatPearls, StatPearls Publishing Copyright © 2020, StatPearls Publishing LLC., Treasure Island (FL), 2020.
BibTeX | Tags:
@inbook{RN1043,
title = {Chronic Traumatic Encephalopathy},
author = {C J Inserra and B W DeVrieze},
year = {2020},
date = {2020-01-01},
booktitle = {StatPearls},
publisher = {StatPearls Publishing
Copyright © 2020, StatPearls Publishing LLC.},
address = {Treasure Island (FL)},
keywords = {},
pubstate = {published},
tppubtype = {inbook}
}
Gaudet, C E; Weyandt, L L
Immediate Post-Concussion and Cognitive Testing (ImPACT): a systematic review of the prevalence and assessment of invalid performance Journal Article
In: Clinical Neuropsychologist, vol. 31, no. 1, pp. 43–58, 2017.
Abstract | Links | BibTeX | Tags: Concussion assessment, ImPACT, invalid performance, malingering
@article{Gaudet2017,
title = {Immediate Post-Concussion and Cognitive Testing (ImPACT): a systematic review of the prevalence and assessment of invalid performance},
author = {Gaudet, C E and Weyandt, L L},
doi = {10.1080/13854046.2016.1220622},
year = {2017},
date = {2017-01-01},
journal = {Clinical Neuropsychologist},
volume = {31},
number = {1},
pages = {43--58},
abstract = {Objective: Computerized neuropsychological assessment of concussion has rapidly expanded and Immediate Post-Concussion and Cognitive Testing (ImPACT) is among the most commonly used measures in this domain. ImPACT was primarily developed for use with athletic populations but continues to expand beyond athletics to settings such as the workplace and schools where motivational dispositions may vary. The purpose of the present study was to conduct a systematic review of existing research investigating the prevalence of invalid baseline results and the effectiveness of ImPACT’s embedded invalidity indicators in detecting suspect effort. Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in order to systematically structure a search across four databases and analysis of studies that presented data related to the prevalence of invalid performance and/or the effectiveness of ImPACT’s embedded invalidity indicators. Results: A total of 17 studies included prevalence rates of invalid performances or examined the effectiveness of ImPACT’s invalidity indicators. Of the 17 studies, 12 included prevalence rates of invalid baseline results; and across this group of studies (after removing an outlier), the weighted prevalence rate of invalid baseline results was 6%. Four of the 17 studies examined the effectiveness of ImPACT’s embedded invalidity indicators. ImPACT’s embedded invalidity indicators correctly identified suboptimal effort in approximately 80% of individuals instructed to perform poorly and avoid detection (‘coached’) or instructed to perform poorly (‘na\"{i}ve’). Conclusions: These findings raise a number of issues pertaining to the use of ImPACT. Invalid performance incidence may increase with large group versus individual administration, use in nonclinical settings, and among those with Attention Deficit-Hyperactivity Disorder or learning disability. Additionally, the older desktop version of ImPACT appears to be associated with a higher rate of invalid performances than the online version. Although ImPACT’s embedded invalidity indicators detect invalid performance at a rate of 6% on average, known group validity studies suggest that these measures miss invalid performance approximately 20% of the time when individuals purposefully underperform. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {Concussion assessment, ImPACT, invalid performance, malingering},
pubstate = {published},
tppubtype = {article}
}
Reynolds, B B; Patrie, J; Henry, E J; Goodkin, H P; Broshek, D K; Wintermark, M; Druzgal, T J
Comparative Analysis of Head Impact in Contact and Collision Sports Journal Article
In: Journal of Neurotrauma, vol. 34, no. 1, pp. 38–49, 2017.
@article{Reynolds2017,
title = {Comparative Analysis of Head Impact in Contact and Collision Sports},
author = {Reynolds, B B and Patrie, J and Henry, E J and Goodkin, H P and Broshek, D K and Wintermark, M and Druzgal, T J},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {1},
pages = {38--49},
abstract = {As concerns about head impact in American football have grown, similar concerns have started to extend to other sports thought to experience less head impact, such as soccer and lacrosse. However, the amount of head impact experienced in soccer and lacrosse is relatively unknown, particularly compared with the substantial amount of data from football. This pilot study quantifies and compares head impact from four different types of sports teams: college football, high school football, college soccer, and college lacrosse. During the 2013 and 2014 seasons, 61 players wore mastoid patch accelerometers to quantify head impact during official athletic events (i.e., practices and games). In both practices and games, college football players experienced the most or second-most impacts per athletic event, highest average peak resultant linear and rotational acceleration per impact, and highest cumulative linear and rotational acceleration per athletic event. For average peak resultant linear and rotational acceleration per individual impact, college football was followed by high school football, then college lacrosse, and then college soccer, with similar trends in both practices and games. In the four teams under study, college football players experienced a categorically higher burden of head impact. However, for cumulative impact burden, the high school football cohort was not significantly different from the college soccer cohort. The results suggest that head impact in sport substantially varies by both the type of sport (football vs. soccer vs. lacrosse) and level of play (college vs. high school).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gardner, R M; Yengo-Kahn, A; Bonfield, C M; Solomon, G S
Comparison of baseline and post-concussion ImPACT test scores in young athletes with stimulant-treated and untreated ADHD Journal Article
In: Physician & Sportsmedicine, vol. 45, no. 1, pp. 1–10, 2017.
@article{Gardner2017a,
title = {Comparison of baseline and post-concussion ImPACT test scores in young athletes with stimulant-treated and untreated ADHD},
author = {Gardner, R M and Yengo-Kahn, A and Bonfield, C M and Solomon, G S},
year = {2017},
date = {2017-01-01},
journal = {Physician \& Sportsmedicine},
volume = {45},
number = {1},
pages = {1--10},
abstract = {OBJECTIVES: Baseline and post-concussion neurocognitive testing is useful in managing concussed athletes. Attention deficit hyperactivity disorder (ADHD) and stimulant medications are recognized as potential modifiers of performance on neurocognitive testing by the Concussion in Sport Group. Our goal was to assess whether individuals with ADHD perform differently on post-concussion testing and if this difference is related to the use of stimulants. METHODS: Retrospective case-control study in which 4373 athletes underwent baseline and post-concussion testing using the ImPACT battery. 277 athletes self-reported a history of ADHD, of which, 206 reported no stimulant treatment and 69 reported stimulant treatment. Each group was matched with participants reporting no history of ADHD or stimulant use on several biopsychosocial characteristics. Non-parametric tests were used to assess ImPACT composite score differences between groups. RESULTS: Participants with ADHD had worse verbal memory, visual memory, visual motor speed, and reaction time scores than matched controls at baseline and post-concussion, all with p \< .001 and r \> 0.100. Athletes without stimulant treatment had lower verbal memory, visual memory, visual motor speed, and reaction time scores than controls at baseline (p \< 0.01 \> 0.100 [except verbal memory},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Swanson, M W; Weise, K K; Dreer, L E; Johnston, J; Davis, R D; Ferguson, D; Hale, M H; Gould, S J; Christy, J B; Busettini, C; Lee, S D; Swanson, E
Academic Difficulty and Vision Symptoms in Children with Concussion Journal Article
In: Optometry & Vision Science, vol. 94, no. 1, pp. 60–67, 2017.
@article{Swanson2017,
title = {Academic Difficulty and Vision Symptoms in Children with Concussion},
author = {Swanson, M W and Weise, K K and Dreer, L E and Johnston, J and Davis, R D and Ferguson, D and Hale, M H and Gould, S J and Christy, J B and Busettini, C and Lee, S D and Swanson, E},
year = {2017},
date = {2017-01-01},
journal = {Optometry \& Vision Science},
volume = {94},
number = {1},
pages = {60--67},
abstract = {PURPOSE: Academic difficulty is reported in children with prolonged post-concussive symptoms. Despite growing evidence that vestibular-ocular and vision-specific dysfunction are common in children after concussion, vision is rarely mentioned in return-to-learn protocols. The purpose of this project was to evaluate a cohort of children with prolonged post-concussive symptoms to determine if vision symptoms are associated with those reporting academic difficulty. METHODS: Data were obtained from the Children's of Alabama Concussion Clinic REDCap dataset from the period January 2007 to October 2013. From this dataset of 1033 concussion events, a cohort of 276 children aged 5 to 18 years with three or more concussion-related symptoms present for 10 days or more was identified. A cross-sectional cohort study was undertaken to evaluate the association of concussion symptoms, SCAT2 scores, and demographic and concussion severity markers to reported educational difficulty among children with prolonged post-concussive symptoms. Univariate and multivariate logistic regression techniques were used to model the association of reported educational difficulty to self-reported vision abnormalities. RESULTS: Mean age was 13.8 years. Median time since the concussive event was 21 days, with 33% (95/276) reporting their concussion more than 30 days before data collection. Academic difficulty was reported by 29% (79/270) and vision abnormalities in 46% (128/274). After model reduction, vision symptoms (OR 2.17, 95% CI 1.02, 4.62), hearing disturbance (OR 2.39, 95% CI 1.06, 5.36), and concentration difficulty (OR 21.62, 95% CI 9.50, 44.47) remained associated with academic difficulty. For those with symptoms 30 days or more after concussion, only vision (OR 3.15, 95% CI 1.06, 9.38) and concentration difficulty (OR 15.33, 95% CI 4.99, 47.05) remained statistically significant. CONCLUSIONS: Vision problems were commonly reported in children with concussions and were independently associated with those reporting academic difficulty. Comprehensive vision assessment should be considered in children reporting academic difficulty and in the development of return-to-learn protocols.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Oldham, J R; DiFabio, M; Vallabhajosula, S; Hall, E E; Ketcham, C J; Meehan 3rd, W P; Buckley, T A
Single-Task and Dual-Task Gait Among Collegiate Athletes of Different Sport Classifications: Implications for Concussion Management Journal Article
In: Journal of Applied Biomechanics, vol. 33, no. 1, pp. 24–31, 2017.
@article{Howell2017b,
title = {Single-Task and Dual-Task Gait Among Collegiate Athletes of Different Sport Classifications: Implications for Concussion Management},
author = {Howell, D R and Oldham, J R and DiFabio, M and Vallabhajosula, S and Hall, E E and Ketcham, C J and {Meehan 3rd}, W P and Buckley, T A},
year = {2017},
date = {2017-01-01},
journal = {Journal of Applied Biomechanics},
volume = {33},
number = {1},
pages = {24--31},
abstract = {Gait impairments have been documented following sport-related concussion. Whether preexisting gait pattern differences exist among athletes who participate in different sport classifications, however, remains unclear. Dual-task gait examinations probe the simultaneous performance of everyday tasks (ie, walking and thinking), and can quantify gait performance using inertial sensors. The purpose of this study was to compare the single-task and dual-task gait performance of collision/contact and noncontact athletes. A group of collegiate athletes (n = 265) were tested before their season at 3 institutions (mean age= 19.1 +/- 1.1 years). All participants stood still (single-task standing) and walked while simultaneously completing a cognitive test (dual-task gait), and completed walking trials without the cognitive test (single-task gait). Spatial-temporal gait parameters were compared between collision/contact and noncontact athletes using MANCOVAs; cognitive task performance was compared using ANCOVAs. No significant single-task or dual-task gait differences were found between collision/contact and noncontact athletes. Noncontact athletes demonstrated higher cognitive task accuracy during single-task standing (P = .001) and dual-task gait conditions (P = .02) than collision/contact athletes. These data demonstrate the utility of a dual-task gait assessment outside of a laboratory and suggest that preinjury cognitive task performance during dual-tasks may differ between athletes of different sport classifications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Brennan, J H; Mitra, B; Synnot, A; McKenzie, J; Willmott, C; McIntosh, A S; Maller, J J; Rosenfeld, J V
Accelerometers for the Assessment of Concussion in Male Athletes: A Systematic Review and Meta-Analysis Journal Article
In: Sports Medicine, vol. 47, no. 3, pp. 469–478, 2017.
@article{Brennan2017,
title = {Accelerometers for the Assessment of Concussion in Male Athletes: A Systematic Review and Meta-Analysis},
author = {Brennan, J H and Mitra, B and Synnot, A and McKenzie, J and Willmott, C and McIntosh, A S and Maller, J J and Rosenfeld, J V},
year = {2017},
date = {2017-01-01},
journal = {Sports Medicine},
volume = {47},
number = {3},
pages = {469--478},
abstract = {BACKGROUND: Concussion is common in the sporting arena and is often challenging to diagnose. The development of wearable head impact measurement systems has enabled measurement of head kinematics in contact sports. OBJECTIVES: The objective of this systematic review was to determine the characteristics of head kinematics measured by an accelerometer system among male athletes diagnosed with concussion. METHODS: A systematic search was conducted in July 2015. Inclusion criteria were English-language studies published after 1990 with a study population of male athletes, in any sport, where objectively measured biomechanical forces were reported in the setting of a concussive event. The random effects meta-analysis model was used to combine estimates of biomechanical force measurements in concussed athletes. RESULTS: Thirteen studies met the inclusion criteria, the majority of which were conducted with high school and college football teams in the US. Included studies measured a combination of linear and rotational acceleration. The meta-analysed mean peak linear head acceleration associated with a concussive episode was 98.68 g (95 % CI 82.36-115.00) and mean peak rotational head acceleration was 5776.60 rads/s^{2} (95 % CI 4583.53-6969.67). The estimates of the biomechanical forces were consistent across studies, with I ^{2} values of 0 % for both meta-analyses. CONCLUSIONS: Head impact monitoring through accelerometery has been shown to be useful with regard to characterising the kinematic load to the head associated with concussion. Future research with improved clinical outcome measures and head kinematic data may improve accuracy when evaluating concussion, and may assist with both interpretation of biomechanical data and the development and utilisation of implementation strategies for the technology.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lopez, K C; Leary, J B; Pham, D L; Chou, Y Y; Dsurney, J; Chan, L
Brain Volume, Connectivity, and Neuropsychological Performance in Mild Traumatic Brain Injury: The Impact of Post-Traumatic Stress Disorder Symptoms Journal Article
In: Journal of Neurotrauma, vol. 34, no. 1, pp. 16–22, 2017.
@article{Lopez2017,
title = {Brain Volume, Connectivity, and Neuropsychological Performance in Mild Traumatic Brain Injury: The Impact of Post-Traumatic Stress Disorder Symptoms},
author = {Lopez, K C and Leary, J B and Pham, D L and Chou, Y Y and Dsurney, J and Chan, L},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {1},
pages = {16--22},
abstract = {Post-traumatic stress disorder (PTSD) is commonly associated with mild traumatic brain injury (mTBI). To better understand their relationship, we examined neuroanatomical structures and neuropsychological performance in a sample of individuals with mTBI, with and without PTSD symptoms. Thirty-nine subjects with mTBI were dichotomized into those with (n=12) and without (n=27) significant PTSD symptoms based on scores on the PTSD Checklist. Using a region-of-interest approach, fronto-temporal volumes, fiber bundles obtained by diffusion tensor imaging, and neuropsychological scores were compared between the two groups. After controlling for total intracranial volume and age, subjects with mTBI and PTSD symptoms exhibited volumetric differences in the entorhinal cortex, an area associated with memory networks, relative to mTBI-only patients (F=4.28; p=0.046). Additionally, subjects with PTSD symptoms showed reduced white matter integrity in the right cingulum bundle (axial diffusivity},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Coughlin, J M; Wang, Y; Minn, I; Bienko, N; Ambinder, E B; Xu, X; Peters, M E; Dougherty, J W; Vranesic, M; Koo, S M; Ahn, H H; Lee, M; Cottrell, C; Sair, H I; Sawa, A; Munro, C A; Nowinski, C J; Dannals, R F; Lyketsos, C G; Kassiou, M; Smith, G; Caffo, B; Mori, S; Guilarte, T R; Pomper, M G
Imaging of Glial Cell Activation and White Matter Integrity in Brains of Active and Recently Retired National Football League Players Journal Article
In: JAMA Neurology, vol. 74, no. 1, pp. 67–74, 2017.
@article{Coughlin2017,
title = {Imaging of Glial Cell Activation and White Matter Integrity in Brains of Active and Recently Retired National Football League Players},
author = {Coughlin, J M and Wang, Y and Minn, I and Bienko, N and Ambinder, E B and Xu, X and Peters, M E and Dougherty, J W and Vranesic, M and Koo, S M and Ahn, H H and Lee, M and Cottrell, C and Sair, H I and Sawa, A and Munro, C A and Nowinski, C J and Dannals, R F and Lyketsos, C G and Kassiou, M and Smith, G and Caffo, B and Mori, S and Guilarte, T R and Pomper, M G},
year = {2017},
date = {2017-01-01},
journal = {JAMA Neurology},
volume = {74},
number = {1},
pages = {67--74},
abstract = {Importance: Microglia, the resident immune cells of the central nervous system, play an important role in the brain's response to injury and neurodegenerative processes. It has been proposed that prolonged microglial activation occurs after single and repeated traumatic brain injury, possibly through sports-related concussive and subconcussive injuries. Limited in vivo brain imaging studies months to years after individuals experience a single moderate to severe traumatic brain injury suggest widespread persistent microglial activation, but there has been little study of persistent glial cell activity in brains of athletes with sports-related traumatic brain injury. Objective: To measure translocator protein 18 kDa (TSPO), a marker of activated glial cell response, in a cohort of National Football League (NFL) players and control participants, and to report measures of white matter integrity. Design, Setting, and Participants: This cross-sectional, case-control study included young active (n=4) or former (n=10) NFL players recruited from across the United States, and 16 age-, sex-, highest educational level-, and body mass index-matched control participants. This study was conducted at an academic research institution in Baltimore, Maryland, from January 29, 2015, to February 18, 2016. Main Outcomes and Measures: Positron emission tomography-based regional measures of TSPO using [11C]DPA-713, diffusion tensor imaging measures of regional white matter integrity, regional volumes on structural magnetic resonance imaging, and neuropsychological performance. Results: The mean (SD) ages of the 14 NFL participants and 16 control participants were 31.3 (6.1) years and 27.6 (4.9) years, respectively. Players reported a mean (SD) of 7.0 (6.4) years (range, 1-21 years) since the last self-reported concussion. Using [11C]DPA-713 positron emission tomographic data from 12 active or former NFL players and 11 matched control participants, the NFL players showed higher total distribution volume in 8 of the 12 brain regions examined (P\<.004). We also observed limited change in white matter fractional anisotropy and mean diffusivity in 13 players compared with 15 control participants. In contrast, these young players did not differ from control participants in regional brain volumes or in neuropsychological performance. Conclusions and Relevance: The results suggest that localized brain injury and repair, indicated by higher TSPO signal and white matter changes, may be associated with NFL play. Further study is needed to confirm these findings and to determine whether TSPO signal and white matter changes in young NFL athletes are related to later onset of neuropsychiatric symptoms.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Loosemore, Michael P; Butler, Charles F; Khadri, Abdelhamid; McDonagh, David; Patel, Vimal A; Bailes, Julian E
Use of Head Guards in AIBA Boxing Tournaments--A Cross-Sectional Observational Study Journal Article
In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 86–88, 2017, ISBN: 1050642X.
Abstract | BibTeX | Tags: acute brain injuries, Boxing, BOXING injuries, Concussion, CONFIDENCE intervals, CROSS-sectional method, DISEASE incidence, Head Protective Devices, LONGITUDINAL method, Poisson distribution, PREVENTION, PROBABILITY theory, Relative risk (Medicine), SAFETY hats, SPORTS events, STATISTICAL hypothesis testing, traumatic brain injury, WOUNDS & injuries
@article{Loosemore2017,
title = {Use of Head Guards in AIBA Boxing Tournaments--A Cross-Sectional Observational Study},
author = {Loosemore, Michael P and Butler, Charles F and Khadri, Abdelhamid and McDonagh, David and Patel, Vimal A and Bailes, Julian E},
isbn = {1050642X},
year = {2017},
date = {2017-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {27},
number = {1},
pages = {86--88},
abstract = {Objective: This study looks at the changes in injuries after the implementation of a new rule by the International Boxing Association (AIBA) to remove head guards from its competitions. Design: A cross-sectional observational study performed prospectively. This brief report examines the removal of head guards in 2 different ways. The first was to examine the stoppages due to blows to the head by comparing World Series Boxing (WSB), without head guards, to other AIBA competitions with head guards. Secondly, we examined the last 3 world championships: 2009 and 2011 (with head guards) and 2013 (without head guards). Setting: World Series Boxing and AIBA world championship boxing. Participants: Boxers from WSB and AIBA world championships. Interventions: The information was recorded by ringside medical physicians. Main Outcome Measures: Stoppages per 10 000 rounds; stoppages per 1000 hours. Results: Both studies show that the number of stoppages due to head blows was significantly decreased without head guards. The studies also showed that there was a notable increase in cuts. Conclusions: Removing head guards may reduce the already small risk of acute brain injury in amateur boxing. [ABSTRACT FROM AUTHOR]},
keywords = {acute brain injuries, Boxing, BOXING injuries, Concussion, CONFIDENCE intervals, CROSS-sectional method, DISEASE incidence, Head Protective Devices, LONGITUDINAL method, Poisson distribution, PREVENTION, PROBABILITY theory, Relative risk (Medicine), SAFETY hats, SPORTS events, STATISTICAL hypothesis testing, traumatic brain injury, WOUNDS \& injuries},
pubstate = {published},
tppubtype = {article}
}
Taylor, Mary Ellen; Sanner, Jennifer E
The Relationship Between Concussion Knowledge and the High School Athlete’s Intention to Report Traumatic Brain Injury Symptoms Journal Article
In: Journal of School Nursing, vol. 33, no. 1, pp. 73–81, 2017, ISBN: 1059-8405.
Abstract | Links | BibTeX | Tags: Athletes, Athletic Injuries, brain, brain concussion, Intention, knowledge, Schools, Sports, Students
@article{Taylor2017,
title = {The Relationship Between Concussion Knowledge and the High School Athlete’s Intention to Report Traumatic Brain Injury Symptoms},
author = {Taylor, Mary Ellen and Sanner, Jennifer E},
doi = {10.1177/1059840515619683},
isbn = {1059-8405},
year = {2017},
date = {2017-01-01},
journal = {Journal of School Nursing},
volume = {33},
number = {1},
pages = {73--81},
abstract = {Sports-related concussion or traumatic brain injury (TBI) is a frequent occurrence among high school athletes. Long-term and short-term effects of TBI on the athlete’s developing brain can be minimized if the athlete reports and is effectively treated for TBI symptoms. Knowledge of concussion symptoms and a school culture of support are critical in order to promote the student’s intention to report TBI symptoms. The purpose of this systematic review is to examine the relationship between the high school athlete’s concussion knowledge and an intention to report TBI symptoms. One hundred eleven articles were retrieved and four articles met established criteria and were included in this systematic review. A link appears to exist between high school athlete concussion knowledge and an intention to report TBI symptoms. School nurses can provide a supportive environment and concussion knowledge to the high school athlete in order to ultimately facilitate TBI symptom reporting.},
keywords = {Athletes, Athletic Injuries, brain, brain concussion, Intention, knowledge, Schools, Sports, Students},
pubstate = {published},
tppubtype = {article}
}
Hansen, C; Cushman, D; Chen, W; Bounsanga, J; Hung, M
Reliability testing of the balance error scoring system in children between the ages of 5 and 14 Journal Article
In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 64–68, 2017.
Abstract | Links | BibTeX | Tags: brain concussion, Child, pediatrics, Reproducibility of Results, Sports
@article{Hansen2017,
title = {Reliability testing of the balance error scoring system in children between the ages of 5 and 14},
author = {Hansen, C and Cushman, D and Chen, W and Bounsanga, J and Hung, M},
doi = {10.1097/JSM.0000000000000293},
year = {2017},
date = {2017-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {27},
number = {1},
pages = {64--68},
abstract = {Objective: Pediatric concussion is an extensive public health concern with a complex clinical presentation. Balance assessment has been well-studied in the adult population, but has been limited in children. We aimed to assess the reliability and minimum detectable change (MDC) of the Balance Error Scoring System (BESS) in healthy children. Design: This prospective observational study included 373 healthy children aged 5 to 14. Interrater reliability was assessed by having 4 assessors review videos of 50 random subjects distributed evenly by age and sex across the entire cohort. Intrarater reliability was performed by having assessors review videos of other assessors' live evaluations. Test-retest reliability was obtained by comparing BESS scores as recorded live at the 2 separate time points by the same rater. Setting: Local elementary and junior high schools. Participants: Three hundred and seventy three healthy children between the ages of 5 and 14. Interventions: The BESS was performed on all children. Main Outcome Measures: Intraclass Correlation Coefficients (ICCs) and MDC Scores. Results: The overall interrater ICC was determined to be 0.93 [95% confidence interval (CI), 0.79-0.97] and intrarater ICC was 0.96 (95% CI, 0.95-0.97) with individual intrarater ICCs ranging between 0.69 and 0.99. The test-retest reliability was 0.90 (95% CI, 0.88- 0.92). The MDCs were 9.6, 4.6, and 7.3 points at the 95% CIs for interrater, intrarater, and test-retest comparisons, respectively. No learning effect was seen. Conclusions: The BESS demonstrates excellent reliability in the pediatric population without evidence of a learning effect. © 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {brain concussion, Child, pediatrics, Reproducibility of Results, Sports},
pubstate = {published},
tppubtype = {article}
}
Tuominen, M; Hanninen, T; Parkkari, J; Stuart, M J; Luoto, T; Kannus, P; Aubry, M
Concussion in the international ice hockey World Championships and Olympic Winter Games between 2006 and 2015 Journal Article
In: British Journal of Sports Medicine, vol. 51, no. 4, pp. 244–252, 2017.
@article{Tuominen2017b,
title = {Concussion in the international ice hockey World Championships and Olympic Winter Games between 2006 and 2015},
author = {Tuominen, M and Hanninen, T and Parkkari, J and Stuart, M J and Luoto, T and Kannus, P and Aubry, M},
year = {2017},
date = {2017-01-01},
journal = {British Journal of Sports Medicine},
volume = {51},
number = {4},
pages = {244--252},
abstract = {BACKGROUND: Concussions in sports are a growing concern. This study describes the incidence, injury characteristics and time trends of concussions in international ice hockey. METHODS: All concussions in the International Ice Hockey Federation (IIHF) World Championships (WC) and Olympic Winter Games were analysed over 9 ice hockey seasons between 2006 and 2015 using a standardised injury reporting system and diagnoses made by the team physicians. RESULTS: A total of 3293 games were played (169 tournaments, 1212 teams, 26 130 players) comprising 142 244 athletic game exposures. The average injury rate (IR) for concussion was 1.1 per 1000 ice hockey player-games for all IIHF WC tournaments. The IR was the highest in the men's WC A-pool tournaments and Olympic Games (IR 1.6). However, the annual IR for concussion in the men's tournaments has been lower than that in the World Junior tournaments since 2012. When a concussion occurred with contact to a flexible board, the IR was 0.2 per 1000 player games. In contrast, the IR was 1.1, if the board and glass were traditional (for the latter, RR 6.44 (95% CI 1.50 to 27.61)). In the men's tournaments, the trend of concussions caused by illegal hits decreased over the study period. After the 4th Consensus Statement on Concussion in Sport was published (2013), none of the concussed players in the men's WC returned to play on the day of injury. CONCLUSIONS: The annual risk of concussion in the men's WC has decreased during the study period. This was most likely due to a reduction in illegal hits. The risk of concussion was significantly lower if games were played on rinks with flexible boards and glass. Rink modifications, improved education and strict rule enforcement should be considered by policymakers in international ice hockey. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cole, W R; Arrieux, J P; Dennison, E M; Ivins, B J
The impact of administration order in studies of computerized neurocognitive assessment tools (NCATs) Journal Article
In: Journal of Clinical & Experimental Neuropsychology, vol. 39, no. 1, pp. 35–45, 2017.
@article{Cole2017,
title = {The impact of administration order in studies of computerized neurocognitive assessment tools (NCATs)},
author = {Cole, W R and Arrieux, J P and Dennison, E M and Ivins, B J},
year = {2017},
date = {2017-01-01},
journal = {Journal of Clinical \& Experimental Neuropsychology},
volume = {39},
number = {1},
pages = {35--45},
abstract = {Computerized neurocognitive assessment tools (NCATs) have become a common way to assess postconcussion symptoms. As there is increasing research directly comparing multiple NCATs to each other, it is important to consider the impact that order of test administration may have on the integrity of the results. This study investigates the impact of administration order in a study of four different NCATs; Automated Neuropsychological Assessment Metrics (ANAM4), CNS Vital Signs (CNS-VS), CogState, and Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). A total of 272 healthy active duty Service Members were enrolled into this study. All participants were randomly assigned to take two of the four NCATs with order of administration counterbalanced. Analyses attempted to investigate the effect of administration order alone (e.g., Time 1 versus Time 2), the effect of administration order combined with the impact of the specific NCAT received at Time 1, and only the impact of the Time 1 NCAT on Time 2 score variability. Specifically, independent samples t tests were used to compare Time 1 and Time 2 scores within each NCAT. Additional t tests compared Time 1 to Time 2 scores with Time 2 scores grouped by the NCAT received at Time 1. One-way analysis of variance (ANOVA) was used to compare only an NCAT's Time 2 scores grouped by the NCAT received at Time 1. Cohen's d effect sizes were calculated for all comparisons. The results from this study revealed statistically significant order effects for CogState and CNS-VS, though with effect sizes generally indicating minimum practical value, and marginal or absent order effects for ANAM4 and ImPACT with no clinically meaningful implications. Despite finding minimal order effects, clinicians should be mindful of the impact of administering multiple NCATs in a single session. Future studies should continue to be designed to minimize the potential effect of test administration order.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gerrard, Paul B; Iverson, Grant L; Atkins, Joseph E; Maxwell, Bruce A; Zafonte, Ross; Schatz, Philip; Berkner, Paul D
Factor Structure of ImPACT® in Adolescent Student Athletes Journal Article
In: Archives of Clinical Neuropsychology, vol. 32, no. 1, pp. 117–122, 2017, ISBN: 08876177.
Abstract | Links | BibTeX | Tags: Athletes -- Psychology, ATTENTION-deficit hyperactivity disorder, Cognitive, COGNITIVE testing, Concussion, FACTOR analysis, Headache -- Treatment, Memory, Neuropsychological Tests, Sports
@article{Gerrard2017,
title = {Factor Structure of ImPACT® in Adolescent Student Athletes},
author = {Gerrard, Paul B and Iverson, Grant L and Atkins, Joseph E and Maxwell, Bruce A and Zafonte, Ross and Schatz, Philip and Berkner, Paul D},
doi = {10.1093/arclin/acw097},
isbn = {08876177},
year = {2017},
date = {2017-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {32},
number = {1},
pages = {117--122},
abstract = {Objective: ImPACT® (Immediate Post-Concussion Assessment and Cognitive Testing) is a computerized neuropsychological screening battery, which is widely used to measure the acute effects of sport-related concussion and to monitor recovery from injury. This study examined the factor structure of ImPACT® in several samples of high school student athletes. We hypothesized that a 2-factor structure would be present in all samples. Method: A sample of 4,809 adolescent student athletes was included, and subgroups with a history of treatment for headaches or a self-reported history of learning problems or attention-deficit hyperactivity disorder were analyzed separately. Exploratory principal axis factor analyses with Promax rotations were used. Results: As hypothesized, both the combination of Verbal Memory and Visual Memory Composite scores loaded on one (Memory) factor, while Visual Motor Speed and Reaction Time loaded on a different (Speed) factor, in the total sample and in all subgroups. Conclusion: These results provide reasonably compelling evidence, across multiple samples, which ImPACT® measures 2 distinct factors: memory and speed. [ABSTRACT FROM AUTHOR]},
keywords = {Athletes -- Psychology, ATTENTION-deficit hyperactivity disorder, Cognitive, COGNITIVE testing, Concussion, FACTOR analysis, Headache -- Treatment, Memory, Neuropsychological Tests, Sports},
pubstate = {published},
tppubtype = {article}
}
Capo-Aponte, J E; Jorgensen-Wagers, K L; Sosa, J A; Walsh, D V; Goodrich, G L; Temme, L A; Riggs, D W
Visual Dysfunctions at Different Stages after Blast and Non-blast Mild Traumatic Brain Injury Journal Article
In: Optometry & Vision Science, vol. 94, no. 1, pp. 7–15, 2017.
@article{Capo-Aponte2017,
title = {Visual Dysfunctions at Different Stages after Blast and Non-blast Mild Traumatic Brain Injury},
author = {Capo-Aponte, J E and Jorgensen-Wagers, K L and Sosa, J A and Walsh, D V and Goodrich, G L and Temme, L A and Riggs, D W},
year = {2017},
date = {2017-01-01},
journal = {Optometry \& Vision Science},
volume = {94},
number = {1},
pages = {7--15},
abstract = {PURPOSE: To assess the prevalence of visual dysfunctions and associated symptoms in war fighters at different stages after non-blast- or blast-induced mild traumatic brain injury (mTBI). METHODS: A comprehensive retrospective review of the electronic health records of 500 U.S. military personnel with a diagnosis of deployment-related mTBI who received eye care at the Landstuhl Regional Medical Center. For analysis, the data were grouped by mechanism of injury, and each group was further divided in three subgroups based on the number of days between injury and initial eye examination. RESULTS: The data showed a high frequency of visual symptoms and visual dysfunctions. However, the prevalence of visual symptoms and visual dysfunctions did not differ significantly between mechanism of injury and postinjury stage, except for eye pain and diplopia. Among visual symptoms, binocular dysfunctions were more common, including higher near vertical phoria, reduced negative fusional vergence break at near, receded near point of convergence, decreased stereoacuity, and reduced positive relative accommodation. CONCLUSIONS: The lack of difference in terms of visual sequelae between subgroups (blast vs. nonblast) suggests that research addressing the assessment and management of mTBI visual sequelae resulting from civilian nonblast events is relevant to military personnel where combat injury results primarily from a blast event.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kalkstein, S; Scott, J C; Biester, R; Brownlow, J A; Harpaz-Rotem, I; Gur, R C
Comparison of blast-exposed OEF/OIF veterans with and without a history of TBI symptoms on a brief computerized neuropsychological battery Journal Article
In: Applied Neuropsychology. Adult, vol. 24, no. 1, pp. 92–97, 2017.
@article{Kalkstein2017,
title = {Comparison of blast-exposed OEF/OIF veterans with and without a history of TBI symptoms on a brief computerized neuropsychological battery},
author = {Kalkstein, S and Scott, J C and Biester, R and Brownlow, J A and Harpaz-Rotem, I and Gur, R C},
year = {2017},
date = {2017-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {24},
number = {1},
pages = {92--97},
abstract = {Mild traumatic brain injuries (mild TBIs) resulting from exposure to Improvised Explosive Devices (IEDs) are highly prevalent among veterans of the wars in Iraq and Afghanistan. This exploratory study compared the neurocognitive performance of blast-exposed veterans with (n = 19) and without (n = 15) reported symptoms of mild TBI. All subjects had diagnoses of posttraumatic stress disorder (PTSD). Neurocognitive testing was administered using a well-established computerized battery, the Penn Computerized Neuropsychological Battery (CNB), and groups were well matched on age, race, education, and time since most recent blast exposure. Although differences were not observed on CNB accuracy scores, MANOVAs revealed slower processing speed in the mTBI group when answering correctly on tests of simple and sustained attention, with large effect sizes. Results suggest a potential speed-accuracy tradeoff in blast-related mild TBI, which should be further examined in larger samples.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Strain, J F; Didehbani, N; Spence, J; Conover, H; Bartz, E K; Mansinghani, S; Jeroudi, M K; Rao, N K; Fields, L M; Kraut, M A; Cullum, C M; Hart, J; Womack, K B
White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes Journal Article
In: Journal of Neurotrauma, vol. 34, no. 2, pp. 372–379, 2017.
Abstract | Links | BibTeX | Tags: Concussion, DTI, naming, NATIONAL Football League, TBSS, white matter
@article{Strain2017,
title = {White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes},
author = {Strain, J F and Didehbani, N and Spence, J and Conover, H and Bartz, E K and Mansinghani, S and Jeroudi, M K and Rao, N K and Fields, L M and Kraut, M A and Cullum, C M and Hart, J and Womack, K B},
doi = {10.1089/neu.2016.4446},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {2},
pages = {372--379},
abstract = {Using diffusion tensor imaging (DTI), we assessed the relationship of white matter integrity and performance on the Boston Naming Test (BNT) in a group of retired professional football players and a control group. We examined correlations between fractional anisotropy (FA) and mean diffusivity (MD) with BNT T-scores in an unbiased voxelwise analysis processed with tract-based spatial statistics (TBSS). We also analyzed the DTI data by grouping voxels together as white matter tracts and testing each tract's association with BNT T-scores. Significant voxelwise correlations between FA and BNT performance were only seen in the retired football players (p \< 0.02). Two tracts had mean FA values that significantly correlated with BNT performance: forceps minor and forceps major. White matter integrity is important for distributed cognitive processes, and disruption correlates with diminished performance in athletes exposed to concussive and subconcussive brain injuries, but not in controls without such exposure. Copyright © 2017, Mary Ann Liebert, Inc. 2017.},
keywords = {Concussion, DTI, naming, NATIONAL Football League, TBSS, white matter},
pubstate = {published},
tppubtype = {article}
}
Olympia, R P
School Nurses on the Front Lines of Medicine Journal Article
In: NASN School Nurse, vol. 32, no. 1, pp. 25–29, 2017.
@article{Olympia2017,
title = {School Nurses on the Front Lines of Medicine},
author = {Olympia, R P},
year = {2017},
date = {2017-01-01},
journal = {NASN School Nurse},
volume = {32},
number = {1},
pages = {25--29},
abstract = {Head trauma is a common chief complaint encountered by school nurses. This article describes the initial assessment and management of head trauma in children and adolescents, delineates reasons that may prompt the school nurse to transfer a student to a local emergency department, and discusses the role of the school nurse when a student is diagnosed with a concussion.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Vestberg, Torbjörn; Reinebo, Gustaf; Maurex, Liselotte; Ingvar, Martin; Petrovic, Predrag
Core executive functions are associated with success in young elite soccer players Journal Article
In: PLoS ONE, vol. 12, no. 2, pp. 1–13, 2017, ISBN: 19326203.
Abstract | Links | BibTeX | Tags: adolescents, Age groups, attention, behavior, Biology and life sciences, cognition, Cognitive neuroscience, Cognitive psychology, Cognitive science, Creativity, Inhibitions, Learning and memory, Memory, Neuroscience, People and places, Population groupings, psychology, recreation, Research Article, Social sciences, Sports, Sports science, working memory
@article{Vestberg2017,
title = {Core executive functions are associated with success in young elite soccer players},
author = {Vestberg, Torbj\"{o}rn and Reinebo, Gustaf and Maurex, Liselotte and Ingvar, Martin and Petrovic, Predrag},
doi = {10.1371/journal.pone.0170845},
isbn = {19326203},
year = {2017},
date = {2017-01-01},
journal = {PLoS ONE},
volume = {12},
number = {2},
pages = {1--13},
publisher = {Public Library of Science},
abstract = {Physical capacity and coordination cannot alone predict success in team sports such as soccer. Instead, more focus has been directed towards the importance of cognitive abilities, and it has been suggested that executive functions (EF) are fundamentally important for success in soccer. However, executive functions are going through a steep development from adolescence to adulthood. Moreover, more complex EF involving manipulation of information (higher level EF) develop later than simple executive functions such as those linked to simple working memory capacity (Core EF). The link between EF and success in young soccer players is therefore not obvious. In the present study we investigated whether EF are associated with success in soccer in young elite soccer players. We performed tests measuring core EF (a demanding working memory task involving a variable n-back task; dWM) and higher level EF (Design Fluency test; DF). Color-Word Interference Test and Trail Making Test were performed on an exploratory level as they contain a linguistic element. The lower level EF test (dWM) was taken from CogStateSport computerized concussion testing and the higher level EF test (DF) was from Delis-Kaplan Executive Function System test battery (D-KEFS). In a group of young elite soccer players (n = 30; aged 12\textendash19 years) we show that they perform better than the norm in both the dWM (+0.49 SD) and DF (+0.86 SD). Moreover, we could show that both dWM and DF correlate with the number of goals the players perform during the season. The effect was more prominent for dWM (r = 0.437) than for DF (r = 0.349), but strongest for a combined measurement (r = 0.550). The effect was still present when we controlled for intelligence, length and age in a partial correlation analysis. Thus, our study suggests that both core and higher level EF may predict success in soccer also in young players. [ABSTRACT FROM AUTHOR]},
keywords = {adolescents, Age groups, attention, behavior, Biology and life sciences, cognition, Cognitive neuroscience, Cognitive psychology, Cognitive science, Creativity, Inhibitions, Learning and memory, Memory, Neuroscience, People and places, Population groupings, psychology, recreation, Research Article, Social sciences, Sports, Sports science, working memory},
pubstate = {published},
tppubtype = {article}
}
Neal, T; McKeon, P O
Ethical issues in concussion management Journal Article
In: International Journal of Athletic Therapy & Training, vol. 22, no. 1, pp. 24–32, 2017.
Abstract | Links | BibTeX | Tags: Disqualification, Social contract, Standard of care
@article{Neal2017,
title = {Ethical issues in concussion management},
author = {Neal, T and McKeon, P O},
doi = {10.1123/ijatt.2016-0020},
year = {2017},
date = {2017-01-01},
journal = {International Journal of Athletic Therapy \& Training},
volume = {22},
number = {1},
pages = {24--32},
abstract = {Athletic health care professionals, team physicians, and athletic trainers have an ethical obligation to safeguard the short-and long-term well-being of the athlete they care for. The potential long-term negative consequences to the student-athlete’s physical, cognitive, and mental health as a result of concussions and their mismanagement is a reality. How the athletic health care professional attends to this top priority of providing optimal health care to the concussed athlete while navigating the mitigating circumstances and influences of nonmedical entities found in competitive athletics is one of the great ethical challenges of present day sports medicine. Effectively navigating the complex challenges faced by athletic health care professionals is as important as the care delivered. Understanding the ethical challenges faced by athletic health care decision makers should be a central focus in providing the optimal care the patient deserves. © 2017 Human Kinetics \textendash IJATT.},
keywords = {Disqualification, Social contract, Standard of care},
pubstate = {published},
tppubtype = {article}
}
Weise, K K; Swanson, M W; Penix, K; Hale, M H; Ferguson, D
King-Devick and Pre-season Visual Function in Adolescent Athletes Journal Article
In: Optometry and Vision Science, vol. 94, no. 1, pp. 89–95, 2017.
Abstract | Links | BibTeX | Tags: Adolescent, Alignment, Concussion, Convergence, Correlation coefficient, cross-sectional study, King-Devick, Ophthalmology, Optometers, Pupil function, Pupillometer, Repeated Measures, Sport, Time-differences, Vision screening, visual acuity, Visual functions
@article{Weise2017,
title = {King-Devick and Pre-season Visual Function in Adolescent Athletes},
author = {Weise, K K and Swanson, M W and Penix, K and Hale, M H and Ferguson, D},
doi = {10.1097/OPX.0000000000000938},
year = {2017},
date = {2017-01-01},
journal = {Optometry and Vision Science},
volume = {94},
number = {1},
pages = {89--95},
abstract = {Purpose The King-Devick test (KD) has been studied as a remove-from-play sideline test in college-age athletes and older; however, studies in younger athletes are limited. A cross-sectional study of the KD and other vision correlates was completed on school-aged athletes during pre-season physicals for a variety of sports to determine the repeatability of the KD. The study also evaluated how convergence, alignment, or pupil function contributed to a slower King-Devick baseline reading. Methods Seven hundred eighty-five athletes underwent vision screenings in a hospital or school setting by trained/certified staff as part of pre-season physicals. Six hundred nineteen had KD testing completed per the manufacturer's suggested protocol and repeated. Other baseline vision testing included visual acuity, Modified Thorington testing for alignment, convergence testing, and pupil function using the NeurOptics (NPI-200) NPi. Results The mean fastest, error-minimized KD time for all participants was 43.9 seconds(s) (SD ± 11.6, range 24-120). Median KD time got faster (+) with age (p \< 0.0001). The inter-class correlation coefficient for all scores was 0.92. The absolute mean time difference for any two tests was 3.5 s (SD ± 2.5, range 0-23). There was no association between the best KD time and reduced NPC (p = 0.63), Modified Thorington measure of alignment (p = 0.55), or NPi pupil function (p = 0.79). The Bland Altman repeated measure limits of agreement was ±6.5 seconds for those in the 10th to12th grades, and ±10.2 seconds for those in the 6th to 9th grades. Conclusions King-Devick score in junior high and high school athletes is variable but gets faster and more repeatable with increasing age. The KD does not correlate significantly with reduced convergence, alignment, or pupil function. Based on grouped data, a slowing of 10 seconds for younger athletes and 6 seconds for older athletes on a second administration represents a true difference in testing speed. Within-player variability should be considered when removal-from-play decisions are influenced by KD results. © 2016 American Academy of Optometry.},
keywords = {Adolescent, Alignment, Concussion, Convergence, Correlation coefficient, cross-sectional study, King-Devick, Ophthalmology, Optometers, Pupil function, Pupillometer, Repeated Measures, Sport, Time-differences, Vision screening, visual acuity, Visual functions},
pubstate = {published},
tppubtype = {article}
}
Gardner, A J; Kohler, R M N; Levi, C R; Iverson, G L
Usefulness of Video Review of Possible Concussions in National Youth Rugby League Journal Article
In: International Journal of Sports Medicine, vol. 38, no. 1, pp. 71–75, 2017.
Abstract | Links | BibTeX | Tags: Concussion, Injury management, Return to Play, Video analysis
@article{Gardner2017,
title = {Usefulness of Video Review of Possible Concussions in National Youth Rugby League},
author = {Gardner, A J and Kohler, R M N and Levi, C R and Iverson, G L},
doi = {10.1055/s-0042-116072},
year = {2017},
date = {2017-01-01},
journal = {International Journal of Sports Medicine},
volume = {38},
number = {1},
pages = {71--75},
abstract = {A new concussion interchange rule (CIR) was introduced in 2014 for the National Rugby League and National Youth Competition (NYC). The CIR allows a player suspected of having sustained a concussion to be removed from play and assessed without an interchange being tallied against the player's team. Participants included all NYC players who used the CIR during the 2014 season. 2 raters completed video analysis of 131 (of a total of 156 reported) uses of the CIR, describing injury characteristics, situational factors, and concussion signs. The incidence rate was 44.9 (95% CI: 38.5-52.3) uses of the CIR per 1 000 NYC player match hours, or approximately one CIR use every 1.3 games. Apparent loss of consciousness/unresponsiveness was observed in 13% of cases, clutching the head in 65%, unsteadiness of gait in 60%, and a vacant stare in 23%. Most incidences occurred from a hit-up (82%). There appeared to be some instances of video evidence of injury but the athlete was cleared to return to play in the same game. Video review appears to be a useful adjunct for identifying players suffering possible concussion. Further research is required on the usefulness of video review for identifying signs of concussive injury.},
keywords = {Concussion, Injury management, Return to Play, Video analysis},
pubstate = {published},
tppubtype = {article}
}
Dickson, T J; Trathen, S; Terwiel, F A; Waddington, G; Adams, R
Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study Journal Article
In: Scandinavian Journal of Medicine & Science in Sports, vol. 27, no. 2, pp. 236–244, 2017, ISBN: 09057188.
Abstract | Links | BibTeX | Tags: CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries
@article{Dickson2017,
title = {Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study},
author = {Dickson, T J and Trathen, S and Terwiel, F A and Waddington, G and Adams, R},
doi = {10.1111/sms.12642},
isbn = {09057188},
year = {2017},
date = {2017-01-01},
journal = {Scandinavian Journal of Medicine \& Science in Sports},
volume = {27},
number = {2},
pages = {236--244},
abstract = {This research explored associations between helmet use and head injuries in snowsports by investigating reported snowsport injuries in Western Canada from 2008-2009 to 2012-2013. The key finding was that increased helmet use (from 69% to 80%) was not associated with a reduction in reported head injuries. Over the study period, the average rate of reported head injuries was 0.2/1000 skier visits, with a statistically significant variation ( P \< 0.001). The line of best fit showed an non-significant upward trend ( P = 0.13). Lacerations were the only subcategory of head injuries that decreased significantly with helmet use. A higher proportion of people who reported a head injury were wearing a helmet than for injuries other than to the head. Skiers were more likely to report a head injury when wearing a helmet than snowboarders ( P \< 0.001 cf. P = 0.22). There were significant differences in characteristics of helmet and non-helmet wearers. Helmet wearers were more likely to be: young adults ( P \< 0.001); beginner/novices ( P = 0.004); and snowboarders ( P \< 0.001), but helmet wearing was not associated with gender ( P = 0.191). Further research is needed to explore the possible reasons for the failure of helmets to reduce head injuries, for example, increased reporting of head injuries and increased risk-taking combined with over-rating of the helmets' protection.},
keywords = {CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries},
pubstate = {published},
tppubtype = {article}
}
Conley, Quincy; Savenye, Willi
Brainbook: An Impact Study of a Statewide Concussion Awareness Training for High School Athletes Journal Article
In: Performance Improvement, vol. 56, no. 1, pp. 28–36, 2017, ISBN: 10908811.
Abstract | Links | BibTeX | Tags: BRAIN -- Wounds & injuries, Internet in education, Mobile communication systems in education, SPORTS injuries, Student engagement
@article{Conley2017,
title = {Brainbook: An Impact Study of a Statewide Concussion Awareness Training for High School Athletes},
author = {Conley, Quincy and Savenye, Willi},
doi = {10.1002/pfi.21628},
isbn = {10908811},
year = {2017},
date = {2017-01-01},
journal = {Performance Improvement},
volume = {56},
number = {1},
pages = {28--36},
abstract = {With so much recent attention given to the diagnosis and treatment of and recovery from brain injuries, the sports world is now recognizing concussions as a major public health concern. This article examines the impact of an e-learning course designed to improve student engagement by replicating popular social network features such as blog posts, videos, and the like. In addition, this article outlines the program overview, evaluation procedures, results, implications of the resulting data, and recommendations for further action. [ABSTRACT FROM AUTHOR]},
keywords = {BRAIN -- Wounds \& injuries, Internet in education, Mobile communication systems in education, SPORTS injuries, Student engagement},
pubstate = {published},
tppubtype = {article}
}
Roberts, Simon P; Trewartha, Grant; England, Michael; Goodison, William; Stokes, Keith A
Concussions and Head Injuries in English Community Rugby Union Match Play Journal Article
In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 480–487, 2017, ISBN: 03635465.
Abstract | Links | BibTeX | Tags: Concussion, EPIDEMIOLOGY, injury, Rugby Union
@article{Roberts2017,
title = {Concussions and Head Injuries in English Community Rugby Union Match Play},
author = {Roberts, Simon P and Trewartha, Grant and England, Michael and Goodison, William and Stokes, Keith A},
doi = {10.1177/0363546516668296},
isbn = {03635465},
year = {2017},
date = {2017-01-01},
journal = {American Journal of Sports Medicine},
volume = {45},
number = {2},
pages = {480--487},
abstract = {Background: Previous research has described general injury patterns in community-level rugby union, but specific information on time-loss head injuries has not been reported. Purpose: To establish the incidence and nature of significant time-loss head injuries in English community rugby match play, and to identify the injury risk for specific contact events. Study Design: Descriptive epidemiology study. Methods: Over 6 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), 76 (2011-2012), 50 (2012-2013), 67 (2013-2014), and 58 (2014-2015) English community rugby clubs (Rugby Football Union levels 3-9) over a total of 175,940 hours of player match exposure. Club injury management staff reported information for all head injuries sustained during match play whereby the player was absent for 8 days or greater. Clubs were subdivided into semiprofessional (mean player age, 24.6 ± 4.7 years), amateur (24.9 ± 5.1 years), and recreational (25.6 ± 6.1 years) playing levels. Contact events from a sample of 30 matches filmed over seasons 2009-2010, 2010-2011, and 2011-2012 provided mean values for the frequency of contact events. Results: The overall incidence for time-loss head injuries was 2.43 injuries per 1000 player match hours, with a higher incidence for the amateur (2.78; 95% CI, 2.37-3.20) compared with recreational (2.20; 95% CI, 1.86-2.53) (P = .032) playing level but not different to the semiprofessional (2.31; 95% CI, 1.83-2.79) playing level. Concussion was the most common time-loss head injury, with 1.46 per 1000 player match hours. The tackle event was associated with 64% of all head injuries and 74% of all concussions. There was also a higher risk of injuries per tackle (0.33 per 1000 events; 95% CI, 0.30-0.37) compared with all other contact events. Conclusion: Concussion was the most common head injury diagnosis, although it is likely that this injury was underreported. Continuing education programs for medical staff and players are essential for the improved identification and management of these injuries. With the majority of head injuries occurring during a tackle, an improved technique in this contact event through coach and player education may be effective in reducing these injuries. [ABSTRACT FROM AUTHOR].},
keywords = {Concussion, EPIDEMIOLOGY, injury, Rugby Union},
pubstate = {published},
tppubtype = {article}
}
Collins-Praino, L E; Corrigan, F
Does neuroinflammation drive the relationship between tau hyperphosphorylation and dementia development following traumatic brain injury? Journal Article
In: Brain, Behavior, & Immunity, vol. 60, pp. 369–382, 2017.
@article{Collins-Praino2017,
title = {Does neuroinflammation drive the relationship between tau hyperphosphorylation and dementia development following traumatic brain injury?},
author = {Collins-Praino, L E and Corrigan, F},
year = {2017},
date = {2017-01-01},
journal = {Brain, Behavior, \& Immunity},
volume = {60},
pages = {369--382},
abstract = {A history of traumatic brain injury (TBI) is linked to an increased risk for the later development of dementia. This encompasses a variety of neurodegenerative diseases including Alzheimer's Disease (AD) and chronic traumatic encephalopathy (CTE), with AD linked to history of moderate-severe TBI and CTE to a history of repeated concussion. Of note, both AD and CTE are characterized by the abnormal accumulation of hyperphosphorylated tau aggregates, which are thought to play an important role in the development of neurodegeneration. Hyperphosphorylation of tau leads to destabilization of microtubules, interrupting axonal transport, whilst tau aggregates are associated with synaptic dysfunction. The exact mechanisms via which TBI may promote the later tauopathy and its role in the later development of dementia are yet to be fully determined. Following TBI, it is proposed that axonal injury may provide the initial perturbation of tau, by promoting its dissociation from microtubules, facilitating its phosphorylation and aggregation. Altered tau dynamics may then be exacerbated by the chronic persistent inflammatory response that has been shown to persist for decades following the initial impact. Importantly, immune activation has been shown to play a role in accelerating disease progression in other tauopathies, with pro-inflammatory cytokines, like IL-1beta, shown to activate kinases that promote tau hyperphosphorylation. Thus, targeting the inflammatory response in the sub-acute phase following TBI may represent a promising target to halt the alterations in tau dynamics that may precede overt neurodegeneration and later development of dementia. Copyright © 2016 Elsevier Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fuller, C W; Fuller, G W; Kemp, S P; Raftery, M
Evaluation of World Rugby's concussion management process: results from Rugby World Cup 2015 Journal Article
In: British Journal of Sports Medicine, vol. 51, no. 1, pp. 64–69, 2017.
@article{Fuller2017,
title = {Evaluation of World Rugby's concussion management process: results from Rugby World Cup 2015},
author = {Fuller, C W and Fuller, G W and Kemp, S P and Raftery, M},
year = {2017},
date = {2017-01-01},
journal = {British Journal of Sports Medicine},
volume = {51},
number = {1},
pages = {64--69},
abstract = {OBJECTIVE: To evaluate World Rugby's concussion management process during Rugby World Cup (RWC) 2015. DESIGN: A prospective, whole population study. POPULATION: 639 international rugby players representing 20 countries. METHOD: The concussion management process consisted of 3 time-based, multifaceted stages: an initial on-pitch and/or pitch-side assessment of the injury, a follow-up assessment within 3 hours and an assessment at 36-48 hours. The initial on-pitch assessment targeted obvious signs of concussion, which, if identified, lead to a 'permanent removal from play' decision and a diagnosis of concussion. If the on-pitch diagnosis was unclear, a 10-min off-pitch assessment was undertaken for signs and symptoms of concussion leading to a 'suspected concussion with permanent removal from play' or a 'no indication of concussion with return to play' decision. Evaluations at 3 and 36-48 hours postmatch lead to diagnoses of 'confirmed concussion' or 'no concussion'. Medical staff's decision-making was supported during each stage by real-time video review of events. Players diagnosed with confirmed concussion followed a 5-stage graduated-return-to-play protocol before being allowed to return to training and/or competition. RESULTS: Players were evaluated for concussion on 49 occasions, of which 24 resulted in diagnoses of concussion. Fourteen players showing on-pitch signs of concussion were permanently removed from play: 4 of the 5 players removed from play following off-pitch medical room evaluation were later diagnosed with a confirmed concussion. Five players not exhibiting in-match signs or symptoms of concussion were later diagnosed with concussion. The overall incidence of concussion during RWC 2015 was 12.5 concussions/1000 player-match-hours. CONCLUSIONS: This study supports the implementation of a multimodal, multitime-based concussion evaluation process to ensure that immediate and late developing concussions are captured.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Smoliga, J M; Zavorsky, G S
"Tighter fit" theory-physiologists explain why "higher altitude" and jugular occlusion are unlikely to reduce risks for sports concussion and brain injuries Journal Article
In: Journal of Applied Physiology, vol. 122, no. 1, pp. 215–217, 2017.
BibTeX | Tags:
@article{Smoliga2017,
title = {"Tighter fit" theory-physiologists explain why "higher altitude" and jugular occlusion are unlikely to reduce risks for sports concussion and brain injuries},
author = {Smoliga, J M and Zavorsky, G S},
year = {2017},
date = {2017-01-01},
journal = {Journal of Applied Physiology},
volume = {122},
number = {1},
pages = {215--217},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Wojtowicz, M; Iverson, G L; Silverberg, N D; Mannix, R; Zafonte, R; Maxwell, B; Berkner, P D
Consistency of Self-Reported Concussion History in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 34, no. 2, pp. 322–327, 2017.
Abstract | Links | BibTeX | Tags: assessment tools, Head trauma, pediatric brain injury
@article{Wojtowicz2017,
title = {Consistency of Self-Reported Concussion History in Adolescent Athletes},
author = {Wojtowicz, M and Iverson, G L and Silverberg, N D and Mannix, R and Zafonte, R and Maxwell, B and Berkner, P D},
doi = {10.1089/neu.2016.4412},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {2},
pages = {322--327},
abstract = {Relying on self-reported concussion injury history is common in both clinical care and research. However, young athletes may not provide consistent medical information. To date, little is known about the reliability of self-reported concussion history in high school students. This study examined whether student athletes reported their lifetime history of concussions consistently over time. Self-reported concussion history was examined in 4792 student athletes (ages 13-18) from Maine who completed a preseason health survey on two occasions (median re-test interval = 23.7 months; standard deviation = 7.3; interquartile range = 12.4-24.5). Consistency of self-reported concussion history was determined by differences in the number of concussions reported during the second survey. Inconsistent concussion history was defined primarily by a decrease in the number of lifetime concussions reported at the second testing, compared with at the first testing. The majority of the sample (80.3%) reported no change in the number of concussions between the two baseline assessments. A minority (15.9%; n = 763) reported more concussions during the second assessment. Only 3.8% (n = 181) of student athletes provided inconsistent concussion histories, defined as fewer concussions at the second assessment. Boys provided inconsistent concussion histories a little more frequently, compared with girls (5.3% and 2.0%, respectively; p \< 0.001). Similarly, athletes with self-reported attention-deficit hyperactivity disorder (ADHD) provided inconsistent concussion histories somewhat more frequently, compared with those without ADHD (7.8% and 3.5%, respectively; p \< 0.001). Of the athletes with inconsistent concussion histories, greater degree of inconsistency was associated with a greater number of concussions initially reported at baseline (rs = 0.54; p \< 0.001). Only a small proportion of student athletes provided inconsistent concussion histories. Male gender, ADHD, and greater number of baseline concussions were significantly associated with inconsistency in reporting. Overall, these findings suggest that student athletes are quite consistent when reporting their concussion history when surveyed twice during high school. Copyright © 2017, Mary Ann Liebert, Inc. 2017.},
keywords = {assessment tools, Head trauma, pediatric brain injury},
pubstate = {published},
tppubtype = {article}
}
Hayter, C; Meares, S; Shores, E A
The Abbreviated Westmead Post-traumatic Amnesia Scale and Pocket Concussion Recognition Tool: Data from amateur sports players in live-match conditions Journal Article
In: Applied Neuropsychology. Adult, vol. 24, no. 1, pp. 30–41, 2017.
@article{Hayter2017,
title = {The Abbreviated Westmead Post-traumatic Amnesia Scale and Pocket Concussion Recognition Tool: Data from amateur sports players in live-match conditions},
author = {Hayter, C and Meares, S and Shores, E A},
year = {2017},
date = {2017-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {24},
number = {1},
pages = {30--41},
abstract = {Sports-related concussion is a growing public health concern. A short, simple sideline assessment tool is essential for evaluation of concussion at an amateur participation level. The current study examined responses to sideline assessment measures in a sample of amateur Australian Rules Football players competing in real-time live matches who had not sustained a concussion on the day of testing. Participants (N = 127) completed the Abbreviated Westmead Post-traumatic Amnesia Scale (A-WPTAS) and the Pocket Concussion Recognition Tool (Pocket CRT), which contains the Maddocks Questions (assessing orientation and recent memory) and the Postconcussion Symptom Scale (PCSS). The study showed 98.4% of participants passed the A-WPTAS, while 81.9% passed the Maddocks Questions. Participants endorsed a mean of 4.16 (SD = 4.02) symptoms on the PCSS, with 86.6% endorsing at least 1 symptom at a mild level or greater and 40.2% endorsing at least 1 symptom at a moderate or severe level. The current results suggest the Maddocks Questions may not be sufficient for use in an amateur sports context. To reduce the risk for a false positive diagnosis of concussion, it is recommended that the Pocket CRT be complemented with the A-WPTAS for use in an amateur sports context.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Moore, R D; Lepine, J; Ellemberg, D
The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function Journal Article
In: International Journal of Psychophysiology, vol. 112, pp. 22–30, 2017.
Abstract | Links | BibTeX | Tags: Concussion, ERPs, Neurophysiology, neuropsychology, Sub-concussion
@article{Moore2017,
title = {The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function},
author = {Moore, R D and Lepine, J and Ellemberg, D},
doi = {10.1016/j.ijpsycho.2016.11.011},
year = {2017},
date = {2017-01-01},
journal = {International Journal of Psychophysiology},
volume = {112},
pages = {22--30},
abstract = {Accumulating research demonstrates that repetitive sub-concussive impacts can alter the structure, function and connectivity of the brain. However, the functional significance of these alterations as well as the independent contribution of concussive and sub-concussive impacts to neurophysiological and neuropsychological health are unclear. Accordingly, we compared the neurophysiological and neuropsychological function of contact athletes with (concussion group) and without (sub-concussion group) a history of concussion, to non-contact athletes. We evaluated event-related brain potentials (ERPs) elicited during an oddball task and performance on a targeted battery of neuropsychological tasks. Athletes in the sub-concussion and concussion groups exhibited similar amplitude reductions in the ERP indices of attentional resource allocation (P3b) and attentional orienting (P3a) relative to non-contact athletes. However, only athletes in the concussion group exhibited reduced amplitude in the ERP index of perceptual attention (N1). Athletes in the sub-concussion and concussion groups also exhibited deficits in memory recall relative to non-contact athletes, but athletes in the concussion group also exhibited significantly more recall errors than athletes in the sub-concussion group. Additionally, only athletes in the concussion group exhibited response delays during the oddball task. The current findings suggest that sub-concussive impacts are associated with alterations in the neurophysiological and neuropsychological indices of essential cognitive functions, albeit to a lesser degree than the combination of sub-concussive and concussive impacts. © 2016 Elsevier B.V.},
keywords = {Concussion, ERPs, Neurophysiology, neuropsychology, Sub-concussion},
pubstate = {published},
tppubtype = {article}
}
Terrell, T R; Bostick, R; Barth, J; Sloane, R; Cantu, R C; Bennett, E; Galloway, L; Laskowitz, D; Erlanger, D; McKeag, D; Valentine, V; Nichols, G
Multicenter cohort study on association of genotypes with prospective sports concussion: methods, lessons learned, and recommendations Journal Article
In: Journal of Sports Medicine & Physical Fitness, vol. 57, no. 1-2, pp. 77–89, 2017.
@article{Terrell2017,
title = {Multicenter cohort study on association of genotypes with prospective sports concussion: methods, lessons learned, and recommendations},
author = {Terrell, T R and Bostick, R and Barth, J and Sloane, R and Cantu, R C and Bennett, E and Galloway, L and Laskowitz, D and Erlanger, D and McKeag, D and Valentine, V and Nichols, G},
year = {2017},
date = {2017-01-01},
journal = {Journal of Sports Medicine \& Physical Fitness},
volume = {57},
number = {1-2},
pages = {77--89},
abstract = {BACKGROUND: Approximately 3.8 million sports related TBIs occur per year. Genetic variation may affect both TBI risk and post-TBI clinical outcome. Limited research has focused on genetic risk for concussion among athletes. We describe the design, methods, and baseline characteristics of this prospective cohort study designed to investigate a potential association between genetic polymorphisms of apolipoprotein E gene, APOE promoter G-219T, and Tau gene exon 6 polymorphisms (Ser53 Pro and Hist47Tyr) with: 1) the risk of prospective concussion; 2) concussion severity; and 3) postconcussion neurocognitive recovery. METHODS: The prospective cohort study included a final population of 2947 college, high school, and professional athletes. Baseline data collection included a concussion/medical history questionnaire, neuropsychological (NP) testing, and genetic sampling for the genetic polymorphisms. Data collection on new concussions experienced utilized post-concussion history/mental status form, Lovell post-concussion symptom score, Standardized Assessment of Concussion (SAC) and/or the Sports Concussion Assessment Tool (SCAT)-1/SCAT-2, and post-concussion NP testing. RESULTS: This paper is focused on discussing the important methodological considerations, organizational challenges and lessons learned in the completion of a multi-center prospective cohort study. A total of 3740 subjects enrolled, with a total of 335 concussions experienced. CONCLUSIONS: Of critical importance to the success of a study of this type is to successfully recruit committed institutions with qualified local study personnel, obtain "buy-in" from study sites, and cultivate strong working relationships with study sites. The use of approved incentives may improve study site recruitment, enhance retention, and enhance compliance with study protocols. Future publications will detail the specific findings of this study. Collaborative research is very likely needed given the nature of this study population.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bailly, N; Afquir, S; Laporte, J D; Melot, A; Savary, D; Seigneuret, E; Delay, J B; Donnadieu, T; Masson, C; Arnoux, P J
Analysis of Injury Mechanisms in Head Injuries in Skiers and Snowboarders Journal Article
In: Medicine & Science in Sports & Exercise, vol. 49, no. 1, pp. 1–10, 2017.
Abstract | Links | BibTeX | Tags: Concussion, head injury, Helmet, SKI, snowboard
@article{Bailly2017,
title = {Analysis of Injury Mechanisms in Head Injuries in Skiers and Snowboarders},
author = {Bailly, N and Afquir, S and Laporte, J D and Melot, A and Savary, D and Seigneuret, E and Delay, J B and Donnadieu, T and Masson, C and Arnoux, P J},
doi = {10.1249/MSS.0000000000001078},
year = {2017},
date = {2017-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {49},
number = {1},
pages = {1--10},
abstract = {Purpose Mechanisms of injury and description of head impacts leading to traumatic brain injury (TBI) in skiers and snowboarders have not been extensively documented. We investigate snow sport crashes leading to TBI 1) to identify typical mechanisms leading to TBI to better target prevention measures and 2) to identify the injury mechanisms and the head impact conditions. Methods The subjects were skiers and snowboarders diagnosed of TBI and admitted between 2013 and 2015 to one of the 15 medical offices and three hospital centers involved in the study. The survey includes the description of the patients (age, sex, practice, skill level, and helmet use), the crash (type, location, estimated speed, causes, and fall description), and the injuries sustained (symptoms, head trauma scores, and other injuries). Sketches were used to describe the crash and impact locations. Clustering methods were used to distinguish profiles of injured participants. Results A total of 295 skiers and 71 snowboarders were interviewed. The most frequent type of mechanism was falls (54%), followed by collision between users (18%) and jumps (15%). Collision with obstacle (13%) caused the most serious TBI. Three categories of patients were identified. First, men age 16-25 yr are more involved in crash at high speed or in connection with a jump. Second, women, children (\<16 yr), and beginners are particularly injured in collisions between users. Third, those older than 50 yr, usually nonhelmeted, are frequently involved in falls. Ten crash scenarios were identified. Falling head first is the most frequent of skiers' falls (28%). Conclusion Crash scenarios leading to TBI were identified and associated with profiles of injured participants. Those results should help to better target TBI prevention and protection campaigns. © 2016 by the American College of Sports Medicine.},
keywords = {Concussion, head injury, Helmet, SKI, snowboard},
pubstate = {published},
tppubtype = {article}
}
Salisbury, David; Kolessar, Michael; Callender, Librada; Bennett, Monica
Concussion knowledge among rehabilitation staff Journal Article
In: Baylor University Medical Center Proceedings, vol. 30, no. 1, pp. 33–37, 2017, ISBN: 0899-8280.
BibTeX | Tags:
@article{Salisbury2017,
title = {Concussion knowledge among rehabilitation staff},
author = {Salisbury, David and Kolessar, Michael and Callender, Librada and Bennett, Monica},
isbn = {0899-8280},
year = {2017},
date = {2017-01-01},
journal = {Baylor University Medical Center Proceedings},
volume = {30},
number = {1},
pages = {33--37},
publisher = {Baylor University Medical Center},
address = {Dallas, Texas},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Imhoff, S; Malenfant, S; Nadreau, É; Poirier, P; Bailey, D M; Brassard, P
Uncoupling between cerebral perfusion and oxygenation during incremental exercise in an athlete with postconcussion syndrome: a case report Journal Article
In: Physiological Reports, vol. 5, no. 2, 2017.
Abstract | Links | BibTeX | Tags: Cerebral oxygenation, cerebral perfusion, exercise, postconcussion syndrome
@article{Imhoff2017,
title = {Uncoupling between cerebral perfusion and oxygenation during incremental exercise in an athlete with postconcussion syndrome: a case report},
author = {Imhoff, S and Malenfant, S and Nadreau, \'{E} and Poirier, P and Bailey, D M and Brassard, P},
doi = {10.14814/phy2.13131},
year = {2017},
date = {2017-01-01},
journal = {Physiological Reports},
volume = {5},
number = {2},
abstract = {High-intensity exercise may pose a risk to patients with postconcussion syndrome (PCS) when symptomatic during exertion. The case of a paralympic athlete with PCS who experienced a succession of convulsion-awakening periods and reported a marked increase in postconcussion symptoms after undergoing a graded symptom-limited aerobic exercise protocol is presented. Potential mechanisms of cerebrovascular function failure are then discussed. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.},
keywords = {Cerebral oxygenation, cerebral perfusion, exercise, postconcussion syndrome},
pubstate = {published},
tppubtype = {article}
}
Kroshus, E; Baugh, C M; Stein, C J; Austin, S B; Calzo, J P
Concussion reporting, sex, and conformity to traditional gender norms in young adults Journal Article
In: Journal of Adolescence, vol. 54, pp. 110–119, 2017.
Abstract | Links | BibTeX | Tags: college, Concussion, gender, Help-seeking, Sport
@article{Kroshus2017,
title = {Concussion reporting, sex, and conformity to traditional gender norms in young adults},
author = {Kroshus, E and Baugh, C M and Stein, C J and Austin, S B and Calzo, J P},
doi = {10.1016/j.adolescence.2016.11.002},
year = {2017},
date = {2017-01-01},
journal = {Journal of Adolescence},
volume = {54},
pages = {110--119},
abstract = {This study assessed whether between-sex differences in concussion reporting intention and behavior among young adults are explained by the extent to which the individual conforms to traditional masculine norms that often characterize contemporary sport culture. A survey of college athletes in the United States (n = 328) found greater symptom reporting intention among females as compared to males, but no difference in their likelihood continued play while experiencing symptoms of a possible concussion. Greater conformity to the norms of risk-taking was associated with greater likelihood of continued play while symptomatic among female athletes but not among male athletes. These findings suggest that gendered behavior, rather than biologically determined sex, is an important consideration for concussion safety in this age group. Addressing elements of the contemporary sport ethos that reinforce risk taking in service of athletic achievement may be a relevant direction for interventions aimed at improving injury reporting among all athletes. © 2016},
keywords = {college, Concussion, gender, Help-seeking, Sport},
pubstate = {published},
tppubtype = {article}
}
Margolis, L H; Canty, G; Halstead, M; Lantos, J D
Should School Boards Discontinue Support for High School Football? Journal Article
In: Pediatrics, vol. 139, no. 1, 2017.
@article{Margolis2017,
title = {Should School Boards Discontinue Support for High School Football?},
author = {Margolis, L H and Canty, G and Halstead, M and Lantos, J D},
year = {2017},
date = {2017-01-01},
journal = {Pediatrics},
volume = {139},
number = {1},
abstract = {A pediatrician is asked by her local school board to help them decide whether to discontinue their high school football program. She reviews the available evidence on the risks of football and finds it hopelessly contradictory. Some scholars claim that football is clearly more dangerous than other sports. Others suggest that the risks of football are comparable to other sports, such as lacrosse, ice hockey, or soccer. She finds very little data on the long-term sequelae of concussions. She sees claims that good coaching and a school culture that prioritizes the health of athletes over winning can reduce morbidity from sports injuries. In this paper, 3 experts also review the evidence about sports risks and discuss what is known and not known about the science and the ethics of high school football.Copyright © 2017 by the American Academy of Pediatrics.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Horris, Hannah B; Elmer, Carlie; McLeod, Tamara C Valovich
Premorbid Diagnosis of Attention Deficit Hyperactivity Disorder and the Association of Concussion Risk and Prolonged Recovery Journal Article
In: Athletic Training & Sports Health Care, vol. 9, no. 1, pp. 39–44, 2017, ISBN: 19425864.
Abstract | BibTeX | Tags: *ATTENTION-deficit hyperactivity disorder, *BRAIN -- Concussion, *COLLEGE students, *EVIDENCE-based medicine, *HIGH school students, *MEDICAL care, *MEDLINE, *PHYSICAL therapy, *POSTCONCUSSION syndrome, CINAHL (Information retrieval system), DESCRIPTIVE statistics, INFORMATION storage & retrieval systems, ONLINE information services, Professional Practice, Risk Factors, SYSTEMATIC reviews (Medical research)
@article{Horris2017,
title = {Premorbid Diagnosis of Attention Deficit Hyperactivity Disorder and the Association of Concussion Risk and Prolonged Recovery},
author = {Horris, Hannah B and Elmer, Carlie and McLeod, Tamara C Valovich},
isbn = {19425864},
year = {2017},
date = {2017-01-01},
journal = {Athletic Training \& Sports Health Care},
volume = {9},
number = {1},
pages = {39--44},
abstract = {Attention deficit hyperactivity disorder (ADHD) has been identified as a risk factor for concussion or delayed recovery. However, these recommendations are often based on anecdotal or limited evidence. This critically appraised topic aimed to address the clinical question of whether a premorbid diagnosis of ADHD increases the risk for a concussion and prolonged symptoms. A search strategy using PICO terminology related to the clinical question was conducted in several electronic databases. Seven studies were identified and five met the inclusion criteria. The clinical bottom line suggests there is moderate evidence to support the relationship between patients who are diagnosed as having ADHD and the incident rate of concussion, as well as a prolonged recovery time. The findings of this critically appraised topic suggest strength of recommendation of grade B to support that ADHD is a risk factor for concussion and a predictor of prolonged recovery. ABSTRACT FROM AUTHOR},
keywords = {*ATTENTION-deficit hyperactivity disorder, *BRAIN -- Concussion, *COLLEGE students, *EVIDENCE-based medicine, *HIGH school students, *MEDICAL care, *MEDLINE, *PHYSICAL therapy, *POSTCONCUSSION syndrome, CINAHL (Information retrieval system), DESCRIPTIVE statistics, INFORMATION storage \& retrieval systems, ONLINE information services, Professional Practice, Risk Factors, SYSTEMATIC reviews (Medical research)},
pubstate = {published},
tppubtype = {article}
}
Hwang, Sungjae; Ma, Lei; Kawata, Keisuke; Tierney, Ryan; Jeka, John J
Vestibular dysfunction after subconcussive head impact Journal Article
In: Journal of Neurotrauma, vol. 34, no. 1, pp. 8–15, 2017, ISBN: 0897-7151 1557-9042.
Abstract | Links | BibTeX | Tags: 2017, BEHAVIORAL assessment, Behavioral assessments, Head trauma, Human studies, Outcome measures, Sensory Feedback, sensory function, Soccer, traumatic brain injury
@article{Hwang2017,
title = {Vestibular dysfunction after subconcussive head impact},
author = {Hwang, Sungjae and Ma, Lei and Kawata, Keisuke and Tierney, Ryan and Jeka, John J},
doi = {10.1089/neu.2015.4238},
isbn = {0897-7151
1557-9042},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {1},
pages = {8--15},
publisher = {Mary Ann Liebert, Inc.},
address = {US},
abstract = {Current thinking views mild head impact (i.e., subconcussion) as an underrecognized phenomenon that has the ability to cause significant current and future detrimental neurological effects. Repeated mild impacts to the head, however, often display no observable behavioral deficits based on standard clinical tests, which may lack sensitivity. The current study investigates the effects of subconcussive impacts from soccer heading with innovative measures of vestibular function and walking stability in a pre- 0\textendash2 h, post- 24 h post-heading repeated measures design. The heading group (n = 10) executed 10 headers with soccer balls projected at a velocity of 25 mph (11.2 m/sec) over 10 min. Subjects were evaluated 24 h before, immediately after, and 24 h after soccer heading with: the modified Balance Error Scoring System (mBESS); a walking stability task with visual feedback of trunk movement; and galvanic vestibular stimulation (GVS) while standing with eyes closed on foam. A control group (n = 10) followed the same protocol with no heading. The results showed significant decrease in trunk angle, leg angle gain, and center of mass gain relative to GVS for the heading group compared with controls. Medial-lateral trunk orientation displacement and velocity during treadmill walking increased immediately after mild head impact for the heading group compared with controls. Controls showed an improvement in mBESS scores over time, indicating a learning effect, which was not observed with the heading group. These results suggest that mild head impact leads to a transient dysfunction in vestibular processing, which deters walking stability during task performance. (PsycINFO Database Record (c) 2017 APA, all rights reserved)},
keywords = {2017, BEHAVIORAL assessment, Behavioral assessments, Head trauma, Human studies, Outcome measures, Sensory Feedback, sensory function, Soccer, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Yeh, P H; Guan Koay, C; Wang, B; Morissette, J; Sham, E; Senseney, J; Joy, D; Kubli, A; Yeh, C H; Eskay, V; Liu, W; French, L M; Oakes, T R; Riedy, G; Ollinger, J
Compromised Neurocircuitry in Chronic Blast-Related Mild Traumatic Brain Injury Journal Article
In: Human Brain Mapping, vol. 38, no. 1, pp. 352–369, 2017.
@article{Yeh2017,
title = {Compromised Neurocircuitry in Chronic Blast-Related Mild Traumatic Brain Injury},
author = {Yeh, P H and {Guan Koay}, C and Wang, B and Morissette, J and Sham, E and Senseney, J and Joy, D and Kubli, A and Yeh, C H and Eskay, V and Liu, W and French, L M and Oakes, T R and Riedy, G and Ollinger, J},
year = {2017},
date = {2017-01-01},
journal = {Human Brain Mapping},
volume = {38},
number = {1},
pages = {352--369},
abstract = {The aim of this study was to apply recently developed automated fiber segmentation and quantification methods using diffusion tensor imaging (DTI) and DTI-based deterministic and probabilistic tractography to access local and global diffusion changes in blast-induced mild traumatic brain injury (bmTBI). Two hundred and two (202) male active US service members who reported persistent post-concussion symptoms for more than 6 months after injury were recruited. An additional forty (40) male military controls were included for comparison. DTI results were examined in relation to post-concussion and post-traumatic stress disorder (PTSD) symptoms. No significant group difference in DTI metrics was found using voxel-wise analysis. However, group comparison using tract profile analysis and tract specific analysis, as well as single subject analysis using tract profile analysis revealed the most prominent white matter microstructural injury in chronic bmTBI patients over the frontal fiber tracts, that is, the front-limbic projection fibers (cingulum bundle, uncinate fasciculus), the fronto-parieto-temporal association fibers (superior longitudinal fasciculus), and the fronto-striatal pathways (anterior thalamic radiation). Effects were noted to be sensitive to the number of previous blast exposures, with a negative association between fractional anisotropy (FA) and time since most severe blast exposure in a subset of the multiple blast-exposed group. However, these patterns were not observed in the subgroups classified using macrostructural changes (T2 white matter hyperintensities). Moreover, post-concussion symptoms and PTSD symptoms, as well as neuropsychological function were associated with low FA in the major nodes of compromised neurocircuitry. Hum Brain Mapp 38:352-369, 2017. © 2016 Wiley Periodicals, Inc.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Alosco, M L; Mez, J; Kowall, N W; Stein, T D; Goldstein, L E; Cantu, R C; Katz, D I; Solomon, T M; Kiernan, P T; Murphy, L; Abdolmohammadi, B; Daneshvar, D; Montenigro, P H; Nowinski, C J; Stern, R A; McKee, A C
Cognitive Reserve as a Modifier of Clinical Expression in Chronic Traumatic Encephalopathy: A Preliminary Examination Journal Article
In: Journal of Neuropsychiatry & Clinical Neurosciences, vol. 29, no. 1, pp. 6–12, 2017.
@article{Alosco2017b,
title = {Cognitive Reserve as a Modifier of Clinical Expression in Chronic Traumatic Encephalopathy: A Preliminary Examination},
author = {Alosco, M L and Mez, J and Kowall, N W and Stein, T D and Goldstein, L E and Cantu, R C and Katz, D I and Solomon, T M and Kiernan, P T and Murphy, L and Abdolmohammadi, B and Daneshvar, D and Montenigro, P H and Nowinski, C J and Stern, R A and McKee, A C},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neuropsychiatry \& Clinical Neurosciences},
volume = {29},
number = {1},
pages = {6--12},
abstract = {This study conducted a preliminary examination on cognitive reserve (CR) as a modifier of symptom expression in subjects with autopsy-confirmed chronic traumatic encephalopathy (CTE). The sample included 25 former professional football players neuropathologically diagnosed with CTE stage III or IV. Next of kin interviews ascertained age at cognitive and behavioral/mood symptom onset and demographic/athletic characteristics. Years of education and occupational attainment defined CR. High occupational achievement predicted later age at cognitive (p=0.02) and behavioral/mood (p=0.02) onset. Education was not an individual predictor. These preliminary findings suggest that CR may forestall the clinical manifestation of CTE.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bires, A M; Leonard, A L; Thurber, B
Educating Providers in Return-to-Play Suggested Guidelines Postconcussion Journal Article
In: Critical Care Nursing Quarterly, vol. 40, no. 1, pp. 49–58, 2017.
@article{Bires2017,
title = {Educating Providers in Return-to-Play Suggested Guidelines Postconcussion},
author = {Bires, A M and Leonard, A L and Thurber, B},
year = {2017},
date = {2017-01-01},
journal = {Critical Care Nursing Quarterly},
volume = {40},
number = {1},
pages = {49--58},
abstract = {As the awareness of concussions increases, it is imperative to be able to evaluate, diagnose, and treat concussed individuals properly to prevent further complications or death. The primary purpose of this study was to compare a provider's current awareness and comfort level as it relates to the return-to-play guidelines for concussions. A secondary aim was to evaluate current protocols that are in use and determine whether they coincide with the suggested guidelines. An educational intervention was implemented to assess the knowledge and confidence of health care providers. The study design was a quantitative, convenient sample, pretest/posttest questionnaire. The questionnaire was administered to participants who were nurse practitioners prior to an educational PowerPoint presentation. At 8 weeks, the posttest was administered. Approximately 19% of individuals were not aware of a graded return-to-play protocols. The findings suggest that the educational intervention increased their confidence levels in making a diagnosis of a concussion, in assessing danger signs, and in understanding when to refer to a specialist. Additional supporting evidence from this study indicates that the educational intervention allowed the participants to achieve a greater comfort level in finding appropriate resources for them and their patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stone, S; Lee, B; Garrison, J C; Blueitt, D; Creed, K
Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion Journal Article
In: Sports Health, vol. 9, no. 1, pp. 41–44, 2017.
Abstract | Links | BibTeX | Tags: Concussion, return-to-play progression, sex
@article{Stone2017,
title = {Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion},
author = {Stone, S and Lee, B and Garrison, J C and Blueitt, D and Creed, K},
doi = {10.1177/1941738116672184},
year = {2017},
date = {2017-01-01},
journal = {Sports Health},
volume = {9},
number = {1},
pages = {41--44},
abstract = {Background: Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC. Hypothesis: After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non\textendashsport-related activity were excluded. Results: Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002). Conclusion: On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, aged 11 to 20 years, with regard to initiation of an RTP progression after SRC. Clinical Relevance: Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population. © 2016, © 2016 The Author(s).},
keywords = {Concussion, return-to-play progression, sex},
pubstate = {published},
tppubtype = {article}
}
Elkington, L J; Hughes, D C
Australian institute of sport and Australian medical association position statement on concussion in sport Journal Article
In: Medical Journal of Australia, vol. 206, no. 1, pp. 46–50, 2017.
Abstract | Links | BibTeX | Tags:
@article{Elkington2017,
title = {Australian institute of sport and Australian medical association position statement on concussion in sport},
author = {Elkington, L J and Hughes, D C},
doi = {10.5694/mja16.00741},
year = {2017},
date = {2017-01-01},
journal = {Medical Journal of Australia},
volume = {206},
number = {1},
pages = {46--50},
abstract = {Introduction: Sport-related concussion is a growing health concern in Australia. Public concern is focused on the incidence and potential long term consequences of concussion. Children may be more prone to concussion and take longer to recover. The Australian Institute of Sport and the Australian Medical Association have collaborated to present the most contemporary evidence-based information in a format appropriate for all stakeholders. This position statement aims to ensure that participant safety and welfare is paramount when dealing with concussion in sport. Main recommendations: First aid principles apply in the management of the athlete with suspected concussion, including protection of the cervical spine. Tools exist for use by members of the community, allowing identification of key symptoms and signs that raise the suspicion of concussion. Medical professionals should use the Sport Concussion Assessment Tool 3, in conjunction with clinical assessment for the diagnosis of concussion. Clinical assessment includes mechanism of injury, symptoms and signs, cognitive functioning, and neurological assessment including balance testing. In any situation where concussion is suspected, the athlete must be immediately removed from sport and not be allowed to return to activity until they have been assessed by a medical practitioner. "If in doubt, sit them out." Changes in management: A diagnosis of concussion requires immediate physical and cognitive rest, followed by a structured, graduated return to physical activity. Children require a longer period of recovery from concussion. Algorithms are provided for use by medical and non-medically trained stakeholders in the recognition and management of concussion. © 2017 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Concussions-The Role of the School Nurse Journal Article
In: NASN School Nurse, vol. 32, no. 1, pp. 59–60, 2017.
BibTeX | Tags:
@article{Anonymous2017,
title = {Concussions-The Role of the School Nurse},
author = {Anonymous},
year = {2017},
date = {2017-01-01},
journal = {NASN School Nurse},
volume = {32},
number = {1},
pages = {59--60},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Patterson, J N; Murphy, A M; Honaker, J A
Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes Journal Article
In: Journal of the American Academy of Audiology, vol. 28, no. 1, pp. 36–45, 2017.
Abstract | Links | BibTeX | Tags: Athletes, Concussion, DVAT, Dynamic visual acuity, Physical Exertion, Sport-related head injury, Vestibular function, Vestibulo-ocular reflex, Visual-vestibular, Vor
@article{Patterson2017,
title = {Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes},
author = {Patterson, J N and Murphy, A M and Honaker, J A},
doi = {10.3766/jaaa.15110},
year = {2017},
date = {2017-01-01},
journal = {Journal of the American Academy of Audiology},
volume = {28},
number = {1},
pages = {36--45},
abstract = {Background: Acute symptoms of dizziness and/or imbalance commonly experienced in athletes postconcussion are speculated to arise from dysfunction at multiple levels (i.e., inner ear or central vestibular system) to appropriately integrate afferent sensory information. Disruption along any pathway of the balance system can result in symptoms of dizziness, decreased postural control function (vestibulospinal reflex), and reduced vestibulo-ocular reflex function. This may also lead to decreased gaze stability with movements of the head and may account for symptoms of blurred vision or diplopia reported in almost half of athletes sustaining a concussion. Current concussion position statements include measures of postural control to examine changes to the balance system postconcussion. The Balance Error Scoring System (BESS) is a commonly used lowcost postural control measure for concussion assessment. Although this is a widely used measure for documenting balance function on both immediate (sideline) and recovery monitoring, the BESS has been shown to be affected by physical exertion. Therefore, the BESS may not be the most efficient means of examining functional changes to the balance system immediately after head injury. Dynamic Visual Acuity Test (DVAT) has been found to effectively evaluate and monitor changes to the gaze stability system postinjury. Thus, DVAT may be an additional measure in the concussion assessment battery, as well as an alternative for more immediate sideline assessment to help make objective return-To-play decisions. Purpose: The aim of the study was to determine the effects of physical exertion on a clinical vestibular assessment, the DVAT, in collegiate athletes, as a first step in defining the role of this measure in the concussion assessment battery. Research Design: Cross-sectional, repeated-measures design. Study Sample: Twenty-eight healthy collegiate athletes (20 males, 8 females; age = 20.25 ± 1.46 yr},
keywords = {Athletes, Concussion, DVAT, Dynamic visual acuity, Physical Exertion, Sport-related head injury, Vestibular function, Vestibulo-ocular reflex, Visual-vestibular, Vor},
pubstate = {published},
tppubtype = {article}
}
Dubose, D F; Herman, D C; Jones, D L; Tillman, S M; Clugston, J R; Pass, A; Hernandez, J A; Vasilopoulos, T; Horodyski, M; Chmielewski, T L
Lower Extremity Stiffness Changes after Concussion in Collegiate Football Players Journal Article
In: Medicine & Science in Sports & Exercise, vol. 49, no. 1, pp. 167–172, 2017.
@article{Dubose2017,
title = {Lower Extremity Stiffness Changes after Concussion in Collegiate Football Players},
author = {Dubose, D F and Herman, D C and Jones, D L and Tillman, S M and Clugston, J R and Pass, A and Hernandez, J A and Vasilopoulos, T and Horodyski, M and Chmielewski, T L},
year = {2017},
date = {2017-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {49},
number = {1},
pages = {167--172},
abstract = {PURPOSE: Recent research indicates that a concussion increases the risk of musculoskeletal injury. Neuromuscular changes after concussion might contribute to the increased risk of injury. Many studies have examined gait postconcussion, but few studies have examined more demanding tasks. This study compared changes in stiffness across the lower extremity, a measure of neuromuscular function, during a jump-landing task in athletes with a concussion (CONC) to uninjured athletes (UNINJ). METHODS: Division I football players (13 CONC and 26 UNINJ) were tested pre- and postseason. A motion capture system recorded subjects jumping on one limb from a 25.4-cm step onto a force plate. Hip, knee, and ankle joint stiffness were calculated from initial contact to peak joint flexion using the regression line slopes of the joint moment versus the joint angle plots. Leg stiffness was (peak vertical ground reaction force [PVGRF]/lower extremity vertical displacement) from initial contact to peak vertical ground reaction force. All stiffness values were normalized to body weight. Values from both limbs were averaged. General linear models compared group (CONC, UNINJ) differences in the changes of pre- and postseason stiffness values. RESULTS: Average time from concussion to postseason testing was 49.9 d. The CONC group showed an increase in hip stiffness (P = 0.03), a decrease in knee (P = 0.03) and leg stiffness (P = 0.03), but no change in ankle stiffness (P = 0.65) from pre- to postseason. CONCLUSION: Lower extremity stiffness is altered after concussion, which could contribute to an increased risk of lower extremity injury. These data provide further evidence of altered neuromuscular function after concussion.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Churchill, N; Hutchison, M; Richards, D; Leung, G; Graham, S; Schweizer, T A
Brain Structure and Function Associated with a History of Sport Concussion: A Multi-Modal Magnetic Resonance Imaging Study Journal Article
In: Journal of Neurotrauma, vol. 34, no. 4, pp. 765–771, 2017.
@article{Churchill2017a,
title = {Brain Structure and Function Associated with a History of Sport Concussion: A Multi-Modal Magnetic Resonance Imaging Study},
author = {Churchill, N and Hutchison, M and Richards, D and Leung, G and Graham, S and Schweizer, T A},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {4},
pages = {765--771},
abstract = {There is growing concern about the potential long-term consequences of sport concussion for young, currently active athletes. However, there remains limited information about brain abnormalities associated with a history of concussion and how they relate to clinical factors. In this study, advanced MRI was used to comprehensively describe abnormalities in brain structure and function associated with a history of sport concussion. Forty-three athletes (21 male, 22 female) were recruited from interuniversity teams at the beginning of the season, including 21 with a history of concussion and 22 without prior concussion; both groups also contained a balanced sample of contact and noncontact sports. Multi-modal MRI was used to evaluate abnormalities in brain structure and function. Athletes with a history of concussion showed frontal decreases in brain volume and blood flow. However, they also demonstrated increased posterior cortical volume and elevated markers of white matter microstructure. A greater number of prior concussions was associated with more extensive decreases in cerebral blood flow and insular volume, whereas recovery time from most recent concussion was correlated with reduced frontotemporal volume. White matter showed limited correlations with clinical factors, predominantly in the anterior corona radiata. This study provides the first evidence of the long-term effects of concussion on gray matter volume, blood flow, and white matter microstructure within a single athlete cohort. This was examined for a mixture of male and female athletes in both contact and noncontact sports, demonstrating the relevance of these findings for the overall sporting community.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Munakomi, S; Puckett, Y
Repetitive Head Injury Syndrome Book Chapter
In: StatPearls, StatPearls Publishing Copyright © 2020, StatPearls Publishing LLC., Treasure Island (FL), 2020.
@inbook{RN1042,
title = {Repetitive Head Injury Syndrome},
author = {S Munakomi and Y Puckett},
year = {2020},
date = {2020-01-01},
booktitle = {StatPearls},
publisher = {StatPearls Publishing
Copyright © 2020, StatPearls Publishing LLC.},
address = {Treasure Island (FL)},
keywords = {},
pubstate = {published},
tppubtype = {inbook}
}
Inserra, C J; DeVrieze, B W
Chronic Traumatic Encephalopathy Book Chapter
In: StatPearls, StatPearls Publishing Copyright © 2020, StatPearls Publishing LLC., Treasure Island (FL), 2020.
@inbook{RN1043,
title = {Chronic Traumatic Encephalopathy},
author = {C J Inserra and B W DeVrieze},
year = {2020},
date = {2020-01-01},
booktitle = {StatPearls},
publisher = {StatPearls Publishing
Copyright © 2020, StatPearls Publishing LLC.},
address = {Treasure Island (FL)},
keywords = {},
pubstate = {published},
tppubtype = {inbook}
}
Gaudet, C E; Weyandt, L L
Immediate Post-Concussion and Cognitive Testing (ImPACT): a systematic review of the prevalence and assessment of invalid performance Journal Article
In: Clinical Neuropsychologist, vol. 31, no. 1, pp. 43–58, 2017.
@article{Gaudet2017,
title = {Immediate Post-Concussion and Cognitive Testing (ImPACT): a systematic review of the prevalence and assessment of invalid performance},
author = {Gaudet, C E and Weyandt, L L},
doi = {10.1080/13854046.2016.1220622},
year = {2017},
date = {2017-01-01},
journal = {Clinical Neuropsychologist},
volume = {31},
number = {1},
pages = {43--58},
abstract = {Objective: Computerized neuropsychological assessment of concussion has rapidly expanded and Immediate Post-Concussion and Cognitive Testing (ImPACT) is among the most commonly used measures in this domain. ImPACT was primarily developed for use with athletic populations but continues to expand beyond athletics to settings such as the workplace and schools where motivational dispositions may vary. The purpose of the present study was to conduct a systematic review of existing research investigating the prevalence of invalid baseline results and the effectiveness of ImPACT’s embedded invalidity indicators in detecting suspect effort. Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in order to systematically structure a search across four databases and analysis of studies that presented data related to the prevalence of invalid performance and/or the effectiveness of ImPACT’s embedded invalidity indicators. Results: A total of 17 studies included prevalence rates of invalid performances or examined the effectiveness of ImPACT’s invalidity indicators. Of the 17 studies, 12 included prevalence rates of invalid baseline results; and across this group of studies (after removing an outlier), the weighted prevalence rate of invalid baseline results was 6%. Four of the 17 studies examined the effectiveness of ImPACT’s embedded invalidity indicators. ImPACT’s embedded invalidity indicators correctly identified suboptimal effort in approximately 80% of individuals instructed to perform poorly and avoid detection (‘coached’) or instructed to perform poorly (‘na\"{i}ve’). Conclusions: These findings raise a number of issues pertaining to the use of ImPACT. Invalid performance incidence may increase with large group versus individual administration, use in nonclinical settings, and among those with Attention Deficit-Hyperactivity Disorder or learning disability. Additionally, the older desktop version of ImPACT appears to be associated with a higher rate of invalid performances than the online version. Although ImPACT’s embedded invalidity indicators detect invalid performance at a rate of 6% on average, known group validity studies suggest that these measures miss invalid performance approximately 20% of the time when individuals purposefully underperform. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Reynolds, B B; Patrie, J; Henry, E J; Goodkin, H P; Broshek, D K; Wintermark, M; Druzgal, T J
Comparative Analysis of Head Impact in Contact and Collision Sports Journal Article
In: Journal of Neurotrauma, vol. 34, no. 1, pp. 38–49, 2017.
@article{Reynolds2017,
title = {Comparative Analysis of Head Impact in Contact and Collision Sports},
author = {Reynolds, B B and Patrie, J and Henry, E J and Goodkin, H P and Broshek, D K and Wintermark, M and Druzgal, T J},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {1},
pages = {38--49},
abstract = {As concerns about head impact in American football have grown, similar concerns have started to extend to other sports thought to experience less head impact, such as soccer and lacrosse. However, the amount of head impact experienced in soccer and lacrosse is relatively unknown, particularly compared with the substantial amount of data from football. This pilot study quantifies and compares head impact from four different types of sports teams: college football, high school football, college soccer, and college lacrosse. During the 2013 and 2014 seasons, 61 players wore mastoid patch accelerometers to quantify head impact during official athletic events (i.e., practices and games). In both practices and games, college football players experienced the most or second-most impacts per athletic event, highest average peak resultant linear and rotational acceleration per impact, and highest cumulative linear and rotational acceleration per athletic event. For average peak resultant linear and rotational acceleration per individual impact, college football was followed by high school football, then college lacrosse, and then college soccer, with similar trends in both practices and games. In the four teams under study, college football players experienced a categorically higher burden of head impact. However, for cumulative impact burden, the high school football cohort was not significantly different from the college soccer cohort. The results suggest that head impact in sport substantially varies by both the type of sport (football vs. soccer vs. lacrosse) and level of play (college vs. high school).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gardner, R M; Yengo-Kahn, A; Bonfield, C M; Solomon, G S
Comparison of baseline and post-concussion ImPACT test scores in young athletes with stimulant-treated and untreated ADHD Journal Article
In: Physician & Sportsmedicine, vol. 45, no. 1, pp. 1–10, 2017.
@article{Gardner2017a,
title = {Comparison of baseline and post-concussion ImPACT test scores in young athletes with stimulant-treated and untreated ADHD},
author = {Gardner, R M and Yengo-Kahn, A and Bonfield, C M and Solomon, G S},
year = {2017},
date = {2017-01-01},
journal = {Physician \& Sportsmedicine},
volume = {45},
number = {1},
pages = {1--10},
abstract = {OBJECTIVES: Baseline and post-concussion neurocognitive testing is useful in managing concussed athletes. Attention deficit hyperactivity disorder (ADHD) and stimulant medications are recognized as potential modifiers of performance on neurocognitive testing by the Concussion in Sport Group. Our goal was to assess whether individuals with ADHD perform differently on post-concussion testing and if this difference is related to the use of stimulants. METHODS: Retrospective case-control study in which 4373 athletes underwent baseline and post-concussion testing using the ImPACT battery. 277 athletes self-reported a history of ADHD, of which, 206 reported no stimulant treatment and 69 reported stimulant treatment. Each group was matched with participants reporting no history of ADHD or stimulant use on several biopsychosocial characteristics. Non-parametric tests were used to assess ImPACT composite score differences between groups. RESULTS: Participants with ADHD had worse verbal memory, visual memory, visual motor speed, and reaction time scores than matched controls at baseline and post-concussion, all with p \< .001 and r \> 0.100. Athletes without stimulant treatment had lower verbal memory, visual memory, visual motor speed, and reaction time scores than controls at baseline (p \< 0.01 \> 0.100 [except verbal memory},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Swanson, M W; Weise, K K; Dreer, L E; Johnston, J; Davis, R D; Ferguson, D; Hale, M H; Gould, S J; Christy, J B; Busettini, C; Lee, S D; Swanson, E
Academic Difficulty and Vision Symptoms in Children with Concussion Journal Article
In: Optometry & Vision Science, vol. 94, no. 1, pp. 60–67, 2017.
@article{Swanson2017,
title = {Academic Difficulty and Vision Symptoms in Children with Concussion},
author = {Swanson, M W and Weise, K K and Dreer, L E and Johnston, J and Davis, R D and Ferguson, D and Hale, M H and Gould, S J and Christy, J B and Busettini, C and Lee, S D and Swanson, E},
year = {2017},
date = {2017-01-01},
journal = {Optometry \& Vision Science},
volume = {94},
number = {1},
pages = {60--67},
abstract = {PURPOSE: Academic difficulty is reported in children with prolonged post-concussive symptoms. Despite growing evidence that vestibular-ocular and vision-specific dysfunction are common in children after concussion, vision is rarely mentioned in return-to-learn protocols. The purpose of this project was to evaluate a cohort of children with prolonged post-concussive symptoms to determine if vision symptoms are associated with those reporting academic difficulty. METHODS: Data were obtained from the Children's of Alabama Concussion Clinic REDCap dataset from the period January 2007 to October 2013. From this dataset of 1033 concussion events, a cohort of 276 children aged 5 to 18 years with three or more concussion-related symptoms present for 10 days or more was identified. A cross-sectional cohort study was undertaken to evaluate the association of concussion symptoms, SCAT2 scores, and demographic and concussion severity markers to reported educational difficulty among children with prolonged post-concussive symptoms. Univariate and multivariate logistic regression techniques were used to model the association of reported educational difficulty to self-reported vision abnormalities. RESULTS: Mean age was 13.8 years. Median time since the concussive event was 21 days, with 33% (95/276) reporting their concussion more than 30 days before data collection. Academic difficulty was reported by 29% (79/270) and vision abnormalities in 46% (128/274). After model reduction, vision symptoms (OR 2.17, 95% CI 1.02, 4.62), hearing disturbance (OR 2.39, 95% CI 1.06, 5.36), and concentration difficulty (OR 21.62, 95% CI 9.50, 44.47) remained associated with academic difficulty. For those with symptoms 30 days or more after concussion, only vision (OR 3.15, 95% CI 1.06, 9.38) and concentration difficulty (OR 15.33, 95% CI 4.99, 47.05) remained statistically significant. CONCLUSIONS: Vision problems were commonly reported in children with concussions and were independently associated with those reporting academic difficulty. Comprehensive vision assessment should be considered in children reporting academic difficulty and in the development of return-to-learn protocols.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Oldham, J R; DiFabio, M; Vallabhajosula, S; Hall, E E; Ketcham, C J; Meehan 3rd, W P; Buckley, T A
Single-Task and Dual-Task Gait Among Collegiate Athletes of Different Sport Classifications: Implications for Concussion Management Journal Article
In: Journal of Applied Biomechanics, vol. 33, no. 1, pp. 24–31, 2017.
@article{Howell2017b,
title = {Single-Task and Dual-Task Gait Among Collegiate Athletes of Different Sport Classifications: Implications for Concussion Management},
author = {Howell, D R and Oldham, J R and DiFabio, M and Vallabhajosula, S and Hall, E E and Ketcham, C J and {Meehan 3rd}, W P and Buckley, T A},
year = {2017},
date = {2017-01-01},
journal = {Journal of Applied Biomechanics},
volume = {33},
number = {1},
pages = {24--31},
abstract = {Gait impairments have been documented following sport-related concussion. Whether preexisting gait pattern differences exist among athletes who participate in different sport classifications, however, remains unclear. Dual-task gait examinations probe the simultaneous performance of everyday tasks (ie, walking and thinking), and can quantify gait performance using inertial sensors. The purpose of this study was to compare the single-task and dual-task gait performance of collision/contact and noncontact athletes. A group of collegiate athletes (n = 265) were tested before their season at 3 institutions (mean age= 19.1 +/- 1.1 years). All participants stood still (single-task standing) and walked while simultaneously completing a cognitive test (dual-task gait), and completed walking trials without the cognitive test (single-task gait). Spatial-temporal gait parameters were compared between collision/contact and noncontact athletes using MANCOVAs; cognitive task performance was compared using ANCOVAs. No significant single-task or dual-task gait differences were found between collision/contact and noncontact athletes. Noncontact athletes demonstrated higher cognitive task accuracy during single-task standing (P = .001) and dual-task gait conditions (P = .02) than collision/contact athletes. These data demonstrate the utility of a dual-task gait assessment outside of a laboratory and suggest that preinjury cognitive task performance during dual-tasks may differ between athletes of different sport classifications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Brennan, J H; Mitra, B; Synnot, A; McKenzie, J; Willmott, C; McIntosh, A S; Maller, J J; Rosenfeld, J V
Accelerometers for the Assessment of Concussion in Male Athletes: A Systematic Review and Meta-Analysis Journal Article
In: Sports Medicine, vol. 47, no. 3, pp. 469–478, 2017.
@article{Brennan2017,
title = {Accelerometers for the Assessment of Concussion in Male Athletes: A Systematic Review and Meta-Analysis},
author = {Brennan, J H and Mitra, B and Synnot, A and McKenzie, J and Willmott, C and McIntosh, A S and Maller, J J and Rosenfeld, J V},
year = {2017},
date = {2017-01-01},
journal = {Sports Medicine},
volume = {47},
number = {3},
pages = {469--478},
abstract = {BACKGROUND: Concussion is common in the sporting arena and is often challenging to diagnose. The development of wearable head impact measurement systems has enabled measurement of head kinematics in contact sports. OBJECTIVES: The objective of this systematic review was to determine the characteristics of head kinematics measured by an accelerometer system among male athletes diagnosed with concussion. METHODS: A systematic search was conducted in July 2015. Inclusion criteria were English-language studies published after 1990 with a study population of male athletes, in any sport, where objectively measured biomechanical forces were reported in the setting of a concussive event. The random effects meta-analysis model was used to combine estimates of biomechanical force measurements in concussed athletes. RESULTS: Thirteen studies met the inclusion criteria, the majority of which were conducted with high school and college football teams in the US. Included studies measured a combination of linear and rotational acceleration. The meta-analysed mean peak linear head acceleration associated with a concussive episode was 98.68 g (95 % CI 82.36-115.00) and mean peak rotational head acceleration was 5776.60 rads/s^{2} (95 % CI 4583.53-6969.67). The estimates of the biomechanical forces were consistent across studies, with I ^{2} values of 0 % for both meta-analyses. CONCLUSIONS: Head impact monitoring through accelerometery has been shown to be useful with regard to characterising the kinematic load to the head associated with concussion. Future research with improved clinical outcome measures and head kinematic data may improve accuracy when evaluating concussion, and may assist with both interpretation of biomechanical data and the development and utilisation of implementation strategies for the technology.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lopez, K C; Leary, J B; Pham, D L; Chou, Y Y; Dsurney, J; Chan, L
Brain Volume, Connectivity, and Neuropsychological Performance in Mild Traumatic Brain Injury: The Impact of Post-Traumatic Stress Disorder Symptoms Journal Article
In: Journal of Neurotrauma, vol. 34, no. 1, pp. 16–22, 2017.
@article{Lopez2017,
title = {Brain Volume, Connectivity, and Neuropsychological Performance in Mild Traumatic Brain Injury: The Impact of Post-Traumatic Stress Disorder Symptoms},
author = {Lopez, K C and Leary, J B and Pham, D L and Chou, Y Y and Dsurney, J and Chan, L},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {1},
pages = {16--22},
abstract = {Post-traumatic stress disorder (PTSD) is commonly associated with mild traumatic brain injury (mTBI). To better understand their relationship, we examined neuroanatomical structures and neuropsychological performance in a sample of individuals with mTBI, with and without PTSD symptoms. Thirty-nine subjects with mTBI were dichotomized into those with (n=12) and without (n=27) significant PTSD symptoms based on scores on the PTSD Checklist. Using a region-of-interest approach, fronto-temporal volumes, fiber bundles obtained by diffusion tensor imaging, and neuropsychological scores were compared between the two groups. After controlling for total intracranial volume and age, subjects with mTBI and PTSD symptoms exhibited volumetric differences in the entorhinal cortex, an area associated with memory networks, relative to mTBI-only patients (F=4.28; p=0.046). Additionally, subjects with PTSD symptoms showed reduced white matter integrity in the right cingulum bundle (axial diffusivity},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Coughlin, J M; Wang, Y; Minn, I; Bienko, N; Ambinder, E B; Xu, X; Peters, M E; Dougherty, J W; Vranesic, M; Koo, S M; Ahn, H H; Lee, M; Cottrell, C; Sair, H I; Sawa, A; Munro, C A; Nowinski, C J; Dannals, R F; Lyketsos, C G; Kassiou, M; Smith, G; Caffo, B; Mori, S; Guilarte, T R; Pomper, M G
Imaging of Glial Cell Activation and White Matter Integrity in Brains of Active and Recently Retired National Football League Players Journal Article
In: JAMA Neurology, vol. 74, no. 1, pp. 67–74, 2017.
@article{Coughlin2017,
title = {Imaging of Glial Cell Activation and White Matter Integrity in Brains of Active and Recently Retired National Football League Players},
author = {Coughlin, J M and Wang, Y and Minn, I and Bienko, N and Ambinder, E B and Xu, X and Peters, M E and Dougherty, J W and Vranesic, M and Koo, S M and Ahn, H H and Lee, M and Cottrell, C and Sair, H I and Sawa, A and Munro, C A and Nowinski, C J and Dannals, R F and Lyketsos, C G and Kassiou, M and Smith, G and Caffo, B and Mori, S and Guilarte, T R and Pomper, M G},
year = {2017},
date = {2017-01-01},
journal = {JAMA Neurology},
volume = {74},
number = {1},
pages = {67--74},
abstract = {Importance: Microglia, the resident immune cells of the central nervous system, play an important role in the brain's response to injury and neurodegenerative processes. It has been proposed that prolonged microglial activation occurs after single and repeated traumatic brain injury, possibly through sports-related concussive and subconcussive injuries. Limited in vivo brain imaging studies months to years after individuals experience a single moderate to severe traumatic brain injury suggest widespread persistent microglial activation, but there has been little study of persistent glial cell activity in brains of athletes with sports-related traumatic brain injury. Objective: To measure translocator protein 18 kDa (TSPO), a marker of activated glial cell response, in a cohort of National Football League (NFL) players and control participants, and to report measures of white matter integrity. Design, Setting, and Participants: This cross-sectional, case-control study included young active (n=4) or former (n=10) NFL players recruited from across the United States, and 16 age-, sex-, highest educational level-, and body mass index-matched control participants. This study was conducted at an academic research institution in Baltimore, Maryland, from January 29, 2015, to February 18, 2016. Main Outcomes and Measures: Positron emission tomography-based regional measures of TSPO using [11C]DPA-713, diffusion tensor imaging measures of regional white matter integrity, regional volumes on structural magnetic resonance imaging, and neuropsychological performance. Results: The mean (SD) ages of the 14 NFL participants and 16 control participants were 31.3 (6.1) years and 27.6 (4.9) years, respectively. Players reported a mean (SD) of 7.0 (6.4) years (range, 1-21 years) since the last self-reported concussion. Using [11C]DPA-713 positron emission tomographic data from 12 active or former NFL players and 11 matched control participants, the NFL players showed higher total distribution volume in 8 of the 12 brain regions examined (P\<.004). We also observed limited change in white matter fractional anisotropy and mean diffusivity in 13 players compared with 15 control participants. In contrast, these young players did not differ from control participants in regional brain volumes or in neuropsychological performance. Conclusions and Relevance: The results suggest that localized brain injury and repair, indicated by higher TSPO signal and white matter changes, may be associated with NFL play. Further study is needed to confirm these findings and to determine whether TSPO signal and white matter changes in young NFL athletes are related to later onset of neuropsychiatric symptoms.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Loosemore, Michael P; Butler, Charles F; Khadri, Abdelhamid; McDonagh, David; Patel, Vimal A; Bailes, Julian E
Use of Head Guards in AIBA Boxing Tournaments--A Cross-Sectional Observational Study Journal Article
In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 86–88, 2017, ISBN: 1050642X.
@article{Loosemore2017,
title = {Use of Head Guards in AIBA Boxing Tournaments--A Cross-Sectional Observational Study},
author = {Loosemore, Michael P and Butler, Charles F and Khadri, Abdelhamid and McDonagh, David and Patel, Vimal A and Bailes, Julian E},
isbn = {1050642X},
year = {2017},
date = {2017-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {27},
number = {1},
pages = {86--88},
abstract = {Objective: This study looks at the changes in injuries after the implementation of a new rule by the International Boxing Association (AIBA) to remove head guards from its competitions. Design: A cross-sectional observational study performed prospectively. This brief report examines the removal of head guards in 2 different ways. The first was to examine the stoppages due to blows to the head by comparing World Series Boxing (WSB), without head guards, to other AIBA competitions with head guards. Secondly, we examined the last 3 world championships: 2009 and 2011 (with head guards) and 2013 (without head guards). Setting: World Series Boxing and AIBA world championship boxing. Participants: Boxers from WSB and AIBA world championships. Interventions: The information was recorded by ringside medical physicians. Main Outcome Measures: Stoppages per 10 000 rounds; stoppages per 1000 hours. Results: Both studies show that the number of stoppages due to head blows was significantly decreased without head guards. The studies also showed that there was a notable increase in cuts. Conclusions: Removing head guards may reduce the already small risk of acute brain injury in amateur boxing. [ABSTRACT FROM AUTHOR]},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Taylor, Mary Ellen; Sanner, Jennifer E
The Relationship Between Concussion Knowledge and the High School Athlete’s Intention to Report Traumatic Brain Injury Symptoms Journal Article
In: Journal of School Nursing, vol. 33, no. 1, pp. 73–81, 2017, ISBN: 1059-8405.
@article{Taylor2017,
title = {The Relationship Between Concussion Knowledge and the High School Athlete’s Intention to Report Traumatic Brain Injury Symptoms},
author = {Taylor, Mary Ellen and Sanner, Jennifer E},
doi = {10.1177/1059840515619683},
isbn = {1059-8405},
year = {2017},
date = {2017-01-01},
journal = {Journal of School Nursing},
volume = {33},
number = {1},
pages = {73--81},
abstract = {Sports-related concussion or traumatic brain injury (TBI) is a frequent occurrence among high school athletes. Long-term and short-term effects of TBI on the athlete’s developing brain can be minimized if the athlete reports and is effectively treated for TBI symptoms. Knowledge of concussion symptoms and a school culture of support are critical in order to promote the student’s intention to report TBI symptoms. The purpose of this systematic review is to examine the relationship between the high school athlete’s concussion knowledge and an intention to report TBI symptoms. One hundred eleven articles were retrieved and four articles met established criteria and were included in this systematic review. A link appears to exist between high school athlete concussion knowledge and an intention to report TBI symptoms. School nurses can provide a supportive environment and concussion knowledge to the high school athlete in order to ultimately facilitate TBI symptom reporting.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hansen, C; Cushman, D; Chen, W; Bounsanga, J; Hung, M
Reliability testing of the balance error scoring system in children between the ages of 5 and 14 Journal Article
In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 64–68, 2017.
@article{Hansen2017,
title = {Reliability testing of the balance error scoring system in children between the ages of 5 and 14},
author = {Hansen, C and Cushman, D and Chen, W and Bounsanga, J and Hung, M},
doi = {10.1097/JSM.0000000000000293},
year = {2017},
date = {2017-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {27},
number = {1},
pages = {64--68},
abstract = {Objective: Pediatric concussion is an extensive public health concern with a complex clinical presentation. Balance assessment has been well-studied in the adult population, but has been limited in children. We aimed to assess the reliability and minimum detectable change (MDC) of the Balance Error Scoring System (BESS) in healthy children. Design: This prospective observational study included 373 healthy children aged 5 to 14. Interrater reliability was assessed by having 4 assessors review videos of 50 random subjects distributed evenly by age and sex across the entire cohort. Intrarater reliability was performed by having assessors review videos of other assessors' live evaluations. Test-retest reliability was obtained by comparing BESS scores as recorded live at the 2 separate time points by the same rater. Setting: Local elementary and junior high schools. Participants: Three hundred and seventy three healthy children between the ages of 5 and 14. Interventions: The BESS was performed on all children. Main Outcome Measures: Intraclass Correlation Coefficients (ICCs) and MDC Scores. Results: The overall interrater ICC was determined to be 0.93 [95% confidence interval (CI), 0.79-0.97] and intrarater ICC was 0.96 (95% CI, 0.95-0.97) with individual intrarater ICCs ranging between 0.69 and 0.99. The test-retest reliability was 0.90 (95% CI, 0.88- 0.92). The MDCs were 9.6, 4.6, and 7.3 points at the 95% CIs for interrater, intrarater, and test-retest comparisons, respectively. No learning effect was seen. Conclusions: The BESS demonstrates excellent reliability in the pediatric population without evidence of a learning effect. © 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Tuominen, M; Hanninen, T; Parkkari, J; Stuart, M J; Luoto, T; Kannus, P; Aubry, M
Concussion in the international ice hockey World Championships and Olympic Winter Games between 2006 and 2015 Journal Article
In: British Journal of Sports Medicine, vol. 51, no. 4, pp. 244–252, 2017.
@article{Tuominen2017b,
title = {Concussion in the international ice hockey World Championships and Olympic Winter Games between 2006 and 2015},
author = {Tuominen, M and Hanninen, T and Parkkari, J and Stuart, M J and Luoto, T and Kannus, P and Aubry, M},
year = {2017},
date = {2017-01-01},
journal = {British Journal of Sports Medicine},
volume = {51},
number = {4},
pages = {244--252},
abstract = {BACKGROUND: Concussions in sports are a growing concern. This study describes the incidence, injury characteristics and time trends of concussions in international ice hockey. METHODS: All concussions in the International Ice Hockey Federation (IIHF) World Championships (WC) and Olympic Winter Games were analysed over 9 ice hockey seasons between 2006 and 2015 using a standardised injury reporting system and diagnoses made by the team physicians. RESULTS: A total of 3293 games were played (169 tournaments, 1212 teams, 26 130 players) comprising 142 244 athletic game exposures. The average injury rate (IR) for concussion was 1.1 per 1000 ice hockey player-games for all IIHF WC tournaments. The IR was the highest in the men's WC A-pool tournaments and Olympic Games (IR 1.6). However, the annual IR for concussion in the men's tournaments has been lower than that in the World Junior tournaments since 2012. When a concussion occurred with contact to a flexible board, the IR was 0.2 per 1000 player games. In contrast, the IR was 1.1, if the board and glass were traditional (for the latter, RR 6.44 (95% CI 1.50 to 27.61)). In the men's tournaments, the trend of concussions caused by illegal hits decreased over the study period. After the 4th Consensus Statement on Concussion in Sport was published (2013), none of the concussed players in the men's WC returned to play on the day of injury. CONCLUSIONS: The annual risk of concussion in the men's WC has decreased during the study period. This was most likely due to a reduction in illegal hits. The risk of concussion was significantly lower if games were played on rinks with flexible boards and glass. Rink modifications, improved education and strict rule enforcement should be considered by policymakers in international ice hockey. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cole, W R; Arrieux, J P; Dennison, E M; Ivins, B J
The impact of administration order in studies of computerized neurocognitive assessment tools (NCATs) Journal Article
In: Journal of Clinical & Experimental Neuropsychology, vol. 39, no. 1, pp. 35–45, 2017.
@article{Cole2017,
title = {The impact of administration order in studies of computerized neurocognitive assessment tools (NCATs)},
author = {Cole, W R and Arrieux, J P and Dennison, E M and Ivins, B J},
year = {2017},
date = {2017-01-01},
journal = {Journal of Clinical \& Experimental Neuropsychology},
volume = {39},
number = {1},
pages = {35--45},
abstract = {Computerized neurocognitive assessment tools (NCATs) have become a common way to assess postconcussion symptoms. As there is increasing research directly comparing multiple NCATs to each other, it is important to consider the impact that order of test administration may have on the integrity of the results. This study investigates the impact of administration order in a study of four different NCATs; Automated Neuropsychological Assessment Metrics (ANAM4), CNS Vital Signs (CNS-VS), CogState, and Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). A total of 272 healthy active duty Service Members were enrolled into this study. All participants were randomly assigned to take two of the four NCATs with order of administration counterbalanced. Analyses attempted to investigate the effect of administration order alone (e.g., Time 1 versus Time 2), the effect of administration order combined with the impact of the specific NCAT received at Time 1, and only the impact of the Time 1 NCAT on Time 2 score variability. Specifically, independent samples t tests were used to compare Time 1 and Time 2 scores within each NCAT. Additional t tests compared Time 1 to Time 2 scores with Time 2 scores grouped by the NCAT received at Time 1. One-way analysis of variance (ANOVA) was used to compare only an NCAT's Time 2 scores grouped by the NCAT received at Time 1. Cohen's d effect sizes were calculated for all comparisons. The results from this study revealed statistically significant order effects for CogState and CNS-VS, though with effect sizes generally indicating minimum practical value, and marginal or absent order effects for ANAM4 and ImPACT with no clinically meaningful implications. Despite finding minimal order effects, clinicians should be mindful of the impact of administering multiple NCATs in a single session. Future studies should continue to be designed to minimize the potential effect of test administration order.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gerrard, Paul B; Iverson, Grant L; Atkins, Joseph E; Maxwell, Bruce A; Zafonte, Ross; Schatz, Philip; Berkner, Paul D
Factor Structure of ImPACT® in Adolescent Student Athletes Journal Article
In: Archives of Clinical Neuropsychology, vol. 32, no. 1, pp. 117–122, 2017, ISBN: 08876177.
@article{Gerrard2017,
title = {Factor Structure of ImPACT® in Adolescent Student Athletes},
author = {Gerrard, Paul B and Iverson, Grant L and Atkins, Joseph E and Maxwell, Bruce A and Zafonte, Ross and Schatz, Philip and Berkner, Paul D},
doi = {10.1093/arclin/acw097},
isbn = {08876177},
year = {2017},
date = {2017-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {32},
number = {1},
pages = {117--122},
abstract = {Objective: ImPACT® (Immediate Post-Concussion Assessment and Cognitive Testing) is a computerized neuropsychological screening battery, which is widely used to measure the acute effects of sport-related concussion and to monitor recovery from injury. This study examined the factor structure of ImPACT® in several samples of high school student athletes. We hypothesized that a 2-factor structure would be present in all samples. Method: A sample of 4,809 adolescent student athletes was included, and subgroups with a history of treatment for headaches or a self-reported history of learning problems or attention-deficit hyperactivity disorder were analyzed separately. Exploratory principal axis factor analyses with Promax rotations were used. Results: As hypothesized, both the combination of Verbal Memory and Visual Memory Composite scores loaded on one (Memory) factor, while Visual Motor Speed and Reaction Time loaded on a different (Speed) factor, in the total sample and in all subgroups. Conclusion: These results provide reasonably compelling evidence, across multiple samples, which ImPACT® measures 2 distinct factors: memory and speed. [ABSTRACT FROM AUTHOR]},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Capo-Aponte, J E; Jorgensen-Wagers, K L; Sosa, J A; Walsh, D V; Goodrich, G L; Temme, L A; Riggs, D W
Visual Dysfunctions at Different Stages after Blast and Non-blast Mild Traumatic Brain Injury Journal Article
In: Optometry & Vision Science, vol. 94, no. 1, pp. 7–15, 2017.
@article{Capo-Aponte2017,
title = {Visual Dysfunctions at Different Stages after Blast and Non-blast Mild Traumatic Brain Injury},
author = {Capo-Aponte, J E and Jorgensen-Wagers, K L and Sosa, J A and Walsh, D V and Goodrich, G L and Temme, L A and Riggs, D W},
year = {2017},
date = {2017-01-01},
journal = {Optometry \& Vision Science},
volume = {94},
number = {1},
pages = {7--15},
abstract = {PURPOSE: To assess the prevalence of visual dysfunctions and associated symptoms in war fighters at different stages after non-blast- or blast-induced mild traumatic brain injury (mTBI). METHODS: A comprehensive retrospective review of the electronic health records of 500 U.S. military personnel with a diagnosis of deployment-related mTBI who received eye care at the Landstuhl Regional Medical Center. For analysis, the data were grouped by mechanism of injury, and each group was further divided in three subgroups based on the number of days between injury and initial eye examination. RESULTS: The data showed a high frequency of visual symptoms and visual dysfunctions. However, the prevalence of visual symptoms and visual dysfunctions did not differ significantly between mechanism of injury and postinjury stage, except for eye pain and diplopia. Among visual symptoms, binocular dysfunctions were more common, including higher near vertical phoria, reduced negative fusional vergence break at near, receded near point of convergence, decreased stereoacuity, and reduced positive relative accommodation. CONCLUSIONS: The lack of difference in terms of visual sequelae between subgroups (blast vs. nonblast) suggests that research addressing the assessment and management of mTBI visual sequelae resulting from civilian nonblast events is relevant to military personnel where combat injury results primarily from a blast event.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kalkstein, S; Scott, J C; Biester, R; Brownlow, J A; Harpaz-Rotem, I; Gur, R C
Comparison of blast-exposed OEF/OIF veterans with and without a history of TBI symptoms on a brief computerized neuropsychological battery Journal Article
In: Applied Neuropsychology. Adult, vol. 24, no. 1, pp. 92–97, 2017.
@article{Kalkstein2017,
title = {Comparison of blast-exposed OEF/OIF veterans with and without a history of TBI symptoms on a brief computerized neuropsychological battery},
author = {Kalkstein, S and Scott, J C and Biester, R and Brownlow, J A and Harpaz-Rotem, I and Gur, R C},
year = {2017},
date = {2017-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {24},
number = {1},
pages = {92--97},
abstract = {Mild traumatic brain injuries (mild TBIs) resulting from exposure to Improvised Explosive Devices (IEDs) are highly prevalent among veterans of the wars in Iraq and Afghanistan. This exploratory study compared the neurocognitive performance of blast-exposed veterans with (n = 19) and without (n = 15) reported symptoms of mild TBI. All subjects had diagnoses of posttraumatic stress disorder (PTSD). Neurocognitive testing was administered using a well-established computerized battery, the Penn Computerized Neuropsychological Battery (CNB), and groups were well matched on age, race, education, and time since most recent blast exposure. Although differences were not observed on CNB accuracy scores, MANOVAs revealed slower processing speed in the mTBI group when answering correctly on tests of simple and sustained attention, with large effect sizes. Results suggest a potential speed-accuracy tradeoff in blast-related mild TBI, which should be further examined in larger samples.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Strain, J F; Didehbani, N; Spence, J; Conover, H; Bartz, E K; Mansinghani, S; Jeroudi, M K; Rao, N K; Fields, L M; Kraut, M A; Cullum, C M; Hart, J; Womack, K B
White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes Journal Article
In: Journal of Neurotrauma, vol. 34, no. 2, pp. 372–379, 2017.
@article{Strain2017,
title = {White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes},
author = {Strain, J F and Didehbani, N and Spence, J and Conover, H and Bartz, E K and Mansinghani, S and Jeroudi, M K and Rao, N K and Fields, L M and Kraut, M A and Cullum, C M and Hart, J and Womack, K B},
doi = {10.1089/neu.2016.4446},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {2},
pages = {372--379},
abstract = {Using diffusion tensor imaging (DTI), we assessed the relationship of white matter integrity and performance on the Boston Naming Test (BNT) in a group of retired professional football players and a control group. We examined correlations between fractional anisotropy (FA) and mean diffusivity (MD) with BNT T-scores in an unbiased voxelwise analysis processed with tract-based spatial statistics (TBSS). We also analyzed the DTI data by grouping voxels together as white matter tracts and testing each tract's association with BNT T-scores. Significant voxelwise correlations between FA and BNT performance were only seen in the retired football players (p \< 0.02). Two tracts had mean FA values that significantly correlated with BNT performance: forceps minor and forceps major. White matter integrity is important for distributed cognitive processes, and disruption correlates with diminished performance in athletes exposed to concussive and subconcussive brain injuries, but not in controls without such exposure. Copyright © 2017, Mary Ann Liebert, Inc. 2017.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Olympia, R P
School Nurses on the Front Lines of Medicine Journal Article
In: NASN School Nurse, vol. 32, no. 1, pp. 25–29, 2017.
@article{Olympia2017,
title = {School Nurses on the Front Lines of Medicine},
author = {Olympia, R P},
year = {2017},
date = {2017-01-01},
journal = {NASN School Nurse},
volume = {32},
number = {1},
pages = {25--29},
abstract = {Head trauma is a common chief complaint encountered by school nurses. This article describes the initial assessment and management of head trauma in children and adolescents, delineates reasons that may prompt the school nurse to transfer a student to a local emergency department, and discusses the role of the school nurse when a student is diagnosed with a concussion.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Munakomi, S; Puckett, Y
Repetitive Head Injury Syndrome Book Chapter
In: StatPearls, StatPearls Publishing Copyright © 2020, StatPearls Publishing LLC., Treasure Island (FL), 2020.
BibTeX | Tags:
@inbook{RN1042,
title = {Repetitive Head Injury Syndrome},
author = {S Munakomi and Y Puckett},
year = {2020},
date = {2020-01-01},
booktitle = {StatPearls},
publisher = {StatPearls Publishing
Copyright © 2020, StatPearls Publishing LLC.},
address = {Treasure Island (FL)},
keywords = {},
pubstate = {published},
tppubtype = {inbook}
}
Inserra, C J; DeVrieze, B W
Chronic Traumatic Encephalopathy Book Chapter
In: StatPearls, StatPearls Publishing Copyright © 2020, StatPearls Publishing LLC., Treasure Island (FL), 2020.
BibTeX | Tags:
@inbook{RN1043,
title = {Chronic Traumatic Encephalopathy},
author = {C J Inserra and B W DeVrieze},
year = {2020},
date = {2020-01-01},
booktitle = {StatPearls},
publisher = {StatPearls Publishing
Copyright © 2020, StatPearls Publishing LLC.},
address = {Treasure Island (FL)},
keywords = {},
pubstate = {published},
tppubtype = {inbook}
}
Gaudet, C E; Weyandt, L L
Immediate Post-Concussion and Cognitive Testing (ImPACT): a systematic review of the prevalence and assessment of invalid performance Journal Article
In: Clinical Neuropsychologist, vol. 31, no. 1, pp. 43–58, 2017.
Abstract | Links | BibTeX | Tags: Concussion assessment, ImPACT, invalid performance, malingering
@article{Gaudet2017,
title = {Immediate Post-Concussion and Cognitive Testing (ImPACT): a systematic review of the prevalence and assessment of invalid performance},
author = {Gaudet, C E and Weyandt, L L},
doi = {10.1080/13854046.2016.1220622},
year = {2017},
date = {2017-01-01},
journal = {Clinical Neuropsychologist},
volume = {31},
number = {1},
pages = {43--58},
abstract = {Objective: Computerized neuropsychological assessment of concussion has rapidly expanded and Immediate Post-Concussion and Cognitive Testing (ImPACT) is among the most commonly used measures in this domain. ImPACT was primarily developed for use with athletic populations but continues to expand beyond athletics to settings such as the workplace and schools where motivational dispositions may vary. The purpose of the present study was to conduct a systematic review of existing research investigating the prevalence of invalid baseline results and the effectiveness of ImPACT’s embedded invalidity indicators in detecting suspect effort. Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in order to systematically structure a search across four databases and analysis of studies that presented data related to the prevalence of invalid performance and/or the effectiveness of ImPACT’s embedded invalidity indicators. Results: A total of 17 studies included prevalence rates of invalid performances or examined the effectiveness of ImPACT’s invalidity indicators. Of the 17 studies, 12 included prevalence rates of invalid baseline results; and across this group of studies (after removing an outlier), the weighted prevalence rate of invalid baseline results was 6%. Four of the 17 studies examined the effectiveness of ImPACT’s embedded invalidity indicators. ImPACT’s embedded invalidity indicators correctly identified suboptimal effort in approximately 80% of individuals instructed to perform poorly and avoid detection (‘coached’) or instructed to perform poorly (‘na\"{i}ve’). Conclusions: These findings raise a number of issues pertaining to the use of ImPACT. Invalid performance incidence may increase with large group versus individual administration, use in nonclinical settings, and among those with Attention Deficit-Hyperactivity Disorder or learning disability. Additionally, the older desktop version of ImPACT appears to be associated with a higher rate of invalid performances than the online version. Although ImPACT’s embedded invalidity indicators detect invalid performance at a rate of 6% on average, known group validity studies suggest that these measures miss invalid performance approximately 20% of the time when individuals purposefully underperform. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {Concussion assessment, ImPACT, invalid performance, malingering},
pubstate = {published},
tppubtype = {article}
}
Reynolds, B B; Patrie, J; Henry, E J; Goodkin, H P; Broshek, D K; Wintermark, M; Druzgal, T J
Comparative Analysis of Head Impact in Contact and Collision Sports Journal Article
In: Journal of Neurotrauma, vol. 34, no. 1, pp. 38–49, 2017.
@article{Reynolds2017,
title = {Comparative Analysis of Head Impact in Contact and Collision Sports},
author = {Reynolds, B B and Patrie, J and Henry, E J and Goodkin, H P and Broshek, D K and Wintermark, M and Druzgal, T J},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {1},
pages = {38--49},
abstract = {As concerns about head impact in American football have grown, similar concerns have started to extend to other sports thought to experience less head impact, such as soccer and lacrosse. However, the amount of head impact experienced in soccer and lacrosse is relatively unknown, particularly compared with the substantial amount of data from football. This pilot study quantifies and compares head impact from four different types of sports teams: college football, high school football, college soccer, and college lacrosse. During the 2013 and 2014 seasons, 61 players wore mastoid patch accelerometers to quantify head impact during official athletic events (i.e., practices and games). In both practices and games, college football players experienced the most or second-most impacts per athletic event, highest average peak resultant linear and rotational acceleration per impact, and highest cumulative linear and rotational acceleration per athletic event. For average peak resultant linear and rotational acceleration per individual impact, college football was followed by high school football, then college lacrosse, and then college soccer, with similar trends in both practices and games. In the four teams under study, college football players experienced a categorically higher burden of head impact. However, for cumulative impact burden, the high school football cohort was not significantly different from the college soccer cohort. The results suggest that head impact in sport substantially varies by both the type of sport (football vs. soccer vs. lacrosse) and level of play (college vs. high school).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gardner, R M; Yengo-Kahn, A; Bonfield, C M; Solomon, G S
Comparison of baseline and post-concussion ImPACT test scores in young athletes with stimulant-treated and untreated ADHD Journal Article
In: Physician & Sportsmedicine, vol. 45, no. 1, pp. 1–10, 2017.
@article{Gardner2017a,
title = {Comparison of baseline and post-concussion ImPACT test scores in young athletes with stimulant-treated and untreated ADHD},
author = {Gardner, R M and Yengo-Kahn, A and Bonfield, C M and Solomon, G S},
year = {2017},
date = {2017-01-01},
journal = {Physician \& Sportsmedicine},
volume = {45},
number = {1},
pages = {1--10},
abstract = {OBJECTIVES: Baseline and post-concussion neurocognitive testing is useful in managing concussed athletes. Attention deficit hyperactivity disorder (ADHD) and stimulant medications are recognized as potential modifiers of performance on neurocognitive testing by the Concussion in Sport Group. Our goal was to assess whether individuals with ADHD perform differently on post-concussion testing and if this difference is related to the use of stimulants. METHODS: Retrospective case-control study in which 4373 athletes underwent baseline and post-concussion testing using the ImPACT battery. 277 athletes self-reported a history of ADHD, of which, 206 reported no stimulant treatment and 69 reported stimulant treatment. Each group was matched with participants reporting no history of ADHD or stimulant use on several biopsychosocial characteristics. Non-parametric tests were used to assess ImPACT composite score differences between groups. RESULTS: Participants with ADHD had worse verbal memory, visual memory, visual motor speed, and reaction time scores than matched controls at baseline and post-concussion, all with p \< .001 and r \> 0.100. Athletes without stimulant treatment had lower verbal memory, visual memory, visual motor speed, and reaction time scores than controls at baseline (p \< 0.01 \> 0.100 [except verbal memory},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Swanson, M W; Weise, K K; Dreer, L E; Johnston, J; Davis, R D; Ferguson, D; Hale, M H; Gould, S J; Christy, J B; Busettini, C; Lee, S D; Swanson, E
Academic Difficulty and Vision Symptoms in Children with Concussion Journal Article
In: Optometry & Vision Science, vol. 94, no. 1, pp. 60–67, 2017.
@article{Swanson2017,
title = {Academic Difficulty and Vision Symptoms in Children with Concussion},
author = {Swanson, M W and Weise, K K and Dreer, L E and Johnston, J and Davis, R D and Ferguson, D and Hale, M H and Gould, S J and Christy, J B and Busettini, C and Lee, S D and Swanson, E},
year = {2017},
date = {2017-01-01},
journal = {Optometry \& Vision Science},
volume = {94},
number = {1},
pages = {60--67},
abstract = {PURPOSE: Academic difficulty is reported in children with prolonged post-concussive symptoms. Despite growing evidence that vestibular-ocular and vision-specific dysfunction are common in children after concussion, vision is rarely mentioned in return-to-learn protocols. The purpose of this project was to evaluate a cohort of children with prolonged post-concussive symptoms to determine if vision symptoms are associated with those reporting academic difficulty. METHODS: Data were obtained from the Children's of Alabama Concussion Clinic REDCap dataset from the period January 2007 to October 2013. From this dataset of 1033 concussion events, a cohort of 276 children aged 5 to 18 years with three or more concussion-related symptoms present for 10 days or more was identified. A cross-sectional cohort study was undertaken to evaluate the association of concussion symptoms, SCAT2 scores, and demographic and concussion severity markers to reported educational difficulty among children with prolonged post-concussive symptoms. Univariate and multivariate logistic regression techniques were used to model the association of reported educational difficulty to self-reported vision abnormalities. RESULTS: Mean age was 13.8 years. Median time since the concussive event was 21 days, with 33% (95/276) reporting their concussion more than 30 days before data collection. Academic difficulty was reported by 29% (79/270) and vision abnormalities in 46% (128/274). After model reduction, vision symptoms (OR 2.17, 95% CI 1.02, 4.62), hearing disturbance (OR 2.39, 95% CI 1.06, 5.36), and concentration difficulty (OR 21.62, 95% CI 9.50, 44.47) remained associated with academic difficulty. For those with symptoms 30 days or more after concussion, only vision (OR 3.15, 95% CI 1.06, 9.38) and concentration difficulty (OR 15.33, 95% CI 4.99, 47.05) remained statistically significant. CONCLUSIONS: Vision problems were commonly reported in children with concussions and were independently associated with those reporting academic difficulty. Comprehensive vision assessment should be considered in children reporting academic difficulty and in the development of return-to-learn protocols.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Oldham, J R; DiFabio, M; Vallabhajosula, S; Hall, E E; Ketcham, C J; Meehan 3rd, W P; Buckley, T A
Single-Task and Dual-Task Gait Among Collegiate Athletes of Different Sport Classifications: Implications for Concussion Management Journal Article
In: Journal of Applied Biomechanics, vol. 33, no. 1, pp. 24–31, 2017.
@article{Howell2017b,
title = {Single-Task and Dual-Task Gait Among Collegiate Athletes of Different Sport Classifications: Implications for Concussion Management},
author = {Howell, D R and Oldham, J R and DiFabio, M and Vallabhajosula, S and Hall, E E and Ketcham, C J and {Meehan 3rd}, W P and Buckley, T A},
year = {2017},
date = {2017-01-01},
journal = {Journal of Applied Biomechanics},
volume = {33},
number = {1},
pages = {24--31},
abstract = {Gait impairments have been documented following sport-related concussion. Whether preexisting gait pattern differences exist among athletes who participate in different sport classifications, however, remains unclear. Dual-task gait examinations probe the simultaneous performance of everyday tasks (ie, walking and thinking), and can quantify gait performance using inertial sensors. The purpose of this study was to compare the single-task and dual-task gait performance of collision/contact and noncontact athletes. A group of collegiate athletes (n = 265) were tested before their season at 3 institutions (mean age= 19.1 +/- 1.1 years). All participants stood still (single-task standing) and walked while simultaneously completing a cognitive test (dual-task gait), and completed walking trials without the cognitive test (single-task gait). Spatial-temporal gait parameters were compared between collision/contact and noncontact athletes using MANCOVAs; cognitive task performance was compared using ANCOVAs. No significant single-task or dual-task gait differences were found between collision/contact and noncontact athletes. Noncontact athletes demonstrated higher cognitive task accuracy during single-task standing (P = .001) and dual-task gait conditions (P = .02) than collision/contact athletes. These data demonstrate the utility of a dual-task gait assessment outside of a laboratory and suggest that preinjury cognitive task performance during dual-tasks may differ between athletes of different sport classifications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Brennan, J H; Mitra, B; Synnot, A; McKenzie, J; Willmott, C; McIntosh, A S; Maller, J J; Rosenfeld, J V
Accelerometers for the Assessment of Concussion in Male Athletes: A Systematic Review and Meta-Analysis Journal Article
In: Sports Medicine, vol. 47, no. 3, pp. 469–478, 2017.
@article{Brennan2017,
title = {Accelerometers for the Assessment of Concussion in Male Athletes: A Systematic Review and Meta-Analysis},
author = {Brennan, J H and Mitra, B and Synnot, A and McKenzie, J and Willmott, C and McIntosh, A S and Maller, J J and Rosenfeld, J V},
year = {2017},
date = {2017-01-01},
journal = {Sports Medicine},
volume = {47},
number = {3},
pages = {469--478},
abstract = {BACKGROUND: Concussion is common in the sporting arena and is often challenging to diagnose. The development of wearable head impact measurement systems has enabled measurement of head kinematics in contact sports. OBJECTIVES: The objective of this systematic review was to determine the characteristics of head kinematics measured by an accelerometer system among male athletes diagnosed with concussion. METHODS: A systematic search was conducted in July 2015. Inclusion criteria were English-language studies published after 1990 with a study population of male athletes, in any sport, where objectively measured biomechanical forces were reported in the setting of a concussive event. The random effects meta-analysis model was used to combine estimates of biomechanical force measurements in concussed athletes. RESULTS: Thirteen studies met the inclusion criteria, the majority of which were conducted with high school and college football teams in the US. Included studies measured a combination of linear and rotational acceleration. The meta-analysed mean peak linear head acceleration associated with a concussive episode was 98.68 g (95 % CI 82.36-115.00) and mean peak rotational head acceleration was 5776.60 rads/s^{2} (95 % CI 4583.53-6969.67). The estimates of the biomechanical forces were consistent across studies, with I ^{2} values of 0 % for both meta-analyses. CONCLUSIONS: Head impact monitoring through accelerometery has been shown to be useful with regard to characterising the kinematic load to the head associated with concussion. Future research with improved clinical outcome measures and head kinematic data may improve accuracy when evaluating concussion, and may assist with both interpretation of biomechanical data and the development and utilisation of implementation strategies for the technology.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lopez, K C; Leary, J B; Pham, D L; Chou, Y Y; Dsurney, J; Chan, L
Brain Volume, Connectivity, and Neuropsychological Performance in Mild Traumatic Brain Injury: The Impact of Post-Traumatic Stress Disorder Symptoms Journal Article
In: Journal of Neurotrauma, vol. 34, no. 1, pp. 16–22, 2017.
@article{Lopez2017,
title = {Brain Volume, Connectivity, and Neuropsychological Performance in Mild Traumatic Brain Injury: The Impact of Post-Traumatic Stress Disorder Symptoms},
author = {Lopez, K C and Leary, J B and Pham, D L and Chou, Y Y and Dsurney, J and Chan, L},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {1},
pages = {16--22},
abstract = {Post-traumatic stress disorder (PTSD) is commonly associated with mild traumatic brain injury (mTBI). To better understand their relationship, we examined neuroanatomical structures and neuropsychological performance in a sample of individuals with mTBI, with and without PTSD symptoms. Thirty-nine subjects with mTBI were dichotomized into those with (n=12) and without (n=27) significant PTSD symptoms based on scores on the PTSD Checklist. Using a region-of-interest approach, fronto-temporal volumes, fiber bundles obtained by diffusion tensor imaging, and neuropsychological scores were compared between the two groups. After controlling for total intracranial volume and age, subjects with mTBI and PTSD symptoms exhibited volumetric differences in the entorhinal cortex, an area associated with memory networks, relative to mTBI-only patients (F=4.28; p=0.046). Additionally, subjects with PTSD symptoms showed reduced white matter integrity in the right cingulum bundle (axial diffusivity},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Coughlin, J M; Wang, Y; Minn, I; Bienko, N; Ambinder, E B; Xu, X; Peters, M E; Dougherty, J W; Vranesic, M; Koo, S M; Ahn, H H; Lee, M; Cottrell, C; Sair, H I; Sawa, A; Munro, C A; Nowinski, C J; Dannals, R F; Lyketsos, C G; Kassiou, M; Smith, G; Caffo, B; Mori, S; Guilarte, T R; Pomper, M G
Imaging of Glial Cell Activation and White Matter Integrity in Brains of Active and Recently Retired National Football League Players Journal Article
In: JAMA Neurology, vol. 74, no. 1, pp. 67–74, 2017.
@article{Coughlin2017,
title = {Imaging of Glial Cell Activation and White Matter Integrity in Brains of Active and Recently Retired National Football League Players},
author = {Coughlin, J M and Wang, Y and Minn, I and Bienko, N and Ambinder, E B and Xu, X and Peters, M E and Dougherty, J W and Vranesic, M and Koo, S M and Ahn, H H and Lee, M and Cottrell, C and Sair, H I and Sawa, A and Munro, C A and Nowinski, C J and Dannals, R F and Lyketsos, C G and Kassiou, M and Smith, G and Caffo, B and Mori, S and Guilarte, T R and Pomper, M G},
year = {2017},
date = {2017-01-01},
journal = {JAMA Neurology},
volume = {74},
number = {1},
pages = {67--74},
abstract = {Importance: Microglia, the resident immune cells of the central nervous system, play an important role in the brain's response to injury and neurodegenerative processes. It has been proposed that prolonged microglial activation occurs after single and repeated traumatic brain injury, possibly through sports-related concussive and subconcussive injuries. Limited in vivo brain imaging studies months to years after individuals experience a single moderate to severe traumatic brain injury suggest widespread persistent microglial activation, but there has been little study of persistent glial cell activity in brains of athletes with sports-related traumatic brain injury. Objective: To measure translocator protein 18 kDa (TSPO), a marker of activated glial cell response, in a cohort of National Football League (NFL) players and control participants, and to report measures of white matter integrity. Design, Setting, and Participants: This cross-sectional, case-control study included young active (n=4) or former (n=10) NFL players recruited from across the United States, and 16 age-, sex-, highest educational level-, and body mass index-matched control participants. This study was conducted at an academic research institution in Baltimore, Maryland, from January 29, 2015, to February 18, 2016. Main Outcomes and Measures: Positron emission tomography-based regional measures of TSPO using [11C]DPA-713, diffusion tensor imaging measures of regional white matter integrity, regional volumes on structural magnetic resonance imaging, and neuropsychological performance. Results: The mean (SD) ages of the 14 NFL participants and 16 control participants were 31.3 (6.1) years and 27.6 (4.9) years, respectively. Players reported a mean (SD) of 7.0 (6.4) years (range, 1-21 years) since the last self-reported concussion. Using [11C]DPA-713 positron emission tomographic data from 12 active or former NFL players and 11 matched control participants, the NFL players showed higher total distribution volume in 8 of the 12 brain regions examined (P\<.004). We also observed limited change in white matter fractional anisotropy and mean diffusivity in 13 players compared with 15 control participants. In contrast, these young players did not differ from control participants in regional brain volumes or in neuropsychological performance. Conclusions and Relevance: The results suggest that localized brain injury and repair, indicated by higher TSPO signal and white matter changes, may be associated with NFL play. Further study is needed to confirm these findings and to determine whether TSPO signal and white matter changes in young NFL athletes are related to later onset of neuropsychiatric symptoms.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Loosemore, Michael P; Butler, Charles F; Khadri, Abdelhamid; McDonagh, David; Patel, Vimal A; Bailes, Julian E
Use of Head Guards in AIBA Boxing Tournaments--A Cross-Sectional Observational Study Journal Article
In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 86–88, 2017, ISBN: 1050642X.
Abstract | BibTeX | Tags: acute brain injuries, Boxing, BOXING injuries, Concussion, CONFIDENCE intervals, CROSS-sectional method, DISEASE incidence, Head Protective Devices, LONGITUDINAL method, Poisson distribution, PREVENTION, PROBABILITY theory, Relative risk (Medicine), SAFETY hats, SPORTS events, STATISTICAL hypothesis testing, traumatic brain injury, WOUNDS & injuries
@article{Loosemore2017,
title = {Use of Head Guards in AIBA Boxing Tournaments--A Cross-Sectional Observational Study},
author = {Loosemore, Michael P and Butler, Charles F and Khadri, Abdelhamid and McDonagh, David and Patel, Vimal A and Bailes, Julian E},
isbn = {1050642X},
year = {2017},
date = {2017-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {27},
number = {1},
pages = {86--88},
abstract = {Objective: This study looks at the changes in injuries after the implementation of a new rule by the International Boxing Association (AIBA) to remove head guards from its competitions. Design: A cross-sectional observational study performed prospectively. This brief report examines the removal of head guards in 2 different ways. The first was to examine the stoppages due to blows to the head by comparing World Series Boxing (WSB), without head guards, to other AIBA competitions with head guards. Secondly, we examined the last 3 world championships: 2009 and 2011 (with head guards) and 2013 (without head guards). Setting: World Series Boxing and AIBA world championship boxing. Participants: Boxers from WSB and AIBA world championships. Interventions: The information was recorded by ringside medical physicians. Main Outcome Measures: Stoppages per 10 000 rounds; stoppages per 1000 hours. Results: Both studies show that the number of stoppages due to head blows was significantly decreased without head guards. The studies also showed that there was a notable increase in cuts. Conclusions: Removing head guards may reduce the already small risk of acute brain injury in amateur boxing. [ABSTRACT FROM AUTHOR]},
keywords = {acute brain injuries, Boxing, BOXING injuries, Concussion, CONFIDENCE intervals, CROSS-sectional method, DISEASE incidence, Head Protective Devices, LONGITUDINAL method, Poisson distribution, PREVENTION, PROBABILITY theory, Relative risk (Medicine), SAFETY hats, SPORTS events, STATISTICAL hypothesis testing, traumatic brain injury, WOUNDS \& injuries},
pubstate = {published},
tppubtype = {article}
}
Taylor, Mary Ellen; Sanner, Jennifer E
The Relationship Between Concussion Knowledge and the High School Athlete’s Intention to Report Traumatic Brain Injury Symptoms Journal Article
In: Journal of School Nursing, vol. 33, no. 1, pp. 73–81, 2017, ISBN: 1059-8405.
Abstract | Links | BibTeX | Tags: Athletes, Athletic Injuries, brain, brain concussion, Intention, knowledge, Schools, Sports, Students
@article{Taylor2017,
title = {The Relationship Between Concussion Knowledge and the High School Athlete’s Intention to Report Traumatic Brain Injury Symptoms},
author = {Taylor, Mary Ellen and Sanner, Jennifer E},
doi = {10.1177/1059840515619683},
isbn = {1059-8405},
year = {2017},
date = {2017-01-01},
journal = {Journal of School Nursing},
volume = {33},
number = {1},
pages = {73--81},
abstract = {Sports-related concussion or traumatic brain injury (TBI) is a frequent occurrence among high school athletes. Long-term and short-term effects of TBI on the athlete’s developing brain can be minimized if the athlete reports and is effectively treated for TBI symptoms. Knowledge of concussion symptoms and a school culture of support are critical in order to promote the student’s intention to report TBI symptoms. The purpose of this systematic review is to examine the relationship between the high school athlete’s concussion knowledge and an intention to report TBI symptoms. One hundred eleven articles were retrieved and four articles met established criteria and were included in this systematic review. A link appears to exist between high school athlete concussion knowledge and an intention to report TBI symptoms. School nurses can provide a supportive environment and concussion knowledge to the high school athlete in order to ultimately facilitate TBI symptom reporting.},
keywords = {Athletes, Athletic Injuries, brain, brain concussion, Intention, knowledge, Schools, Sports, Students},
pubstate = {published},
tppubtype = {article}
}
Hansen, C; Cushman, D; Chen, W; Bounsanga, J; Hung, M
Reliability testing of the balance error scoring system in children between the ages of 5 and 14 Journal Article
In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 64–68, 2017.
Abstract | Links | BibTeX | Tags: brain concussion, Child, pediatrics, Reproducibility of Results, Sports
@article{Hansen2017,
title = {Reliability testing of the balance error scoring system in children between the ages of 5 and 14},
author = {Hansen, C and Cushman, D and Chen, W and Bounsanga, J and Hung, M},
doi = {10.1097/JSM.0000000000000293},
year = {2017},
date = {2017-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {27},
number = {1},
pages = {64--68},
abstract = {Objective: Pediatric concussion is an extensive public health concern with a complex clinical presentation. Balance assessment has been well-studied in the adult population, but has been limited in children. We aimed to assess the reliability and minimum detectable change (MDC) of the Balance Error Scoring System (BESS) in healthy children. Design: This prospective observational study included 373 healthy children aged 5 to 14. Interrater reliability was assessed by having 4 assessors review videos of 50 random subjects distributed evenly by age and sex across the entire cohort. Intrarater reliability was performed by having assessors review videos of other assessors' live evaluations. Test-retest reliability was obtained by comparing BESS scores as recorded live at the 2 separate time points by the same rater. Setting: Local elementary and junior high schools. Participants: Three hundred and seventy three healthy children between the ages of 5 and 14. Interventions: The BESS was performed on all children. Main Outcome Measures: Intraclass Correlation Coefficients (ICCs) and MDC Scores. Results: The overall interrater ICC was determined to be 0.93 [95% confidence interval (CI), 0.79-0.97] and intrarater ICC was 0.96 (95% CI, 0.95-0.97) with individual intrarater ICCs ranging between 0.69 and 0.99. The test-retest reliability was 0.90 (95% CI, 0.88- 0.92). The MDCs were 9.6, 4.6, and 7.3 points at the 95% CIs for interrater, intrarater, and test-retest comparisons, respectively. No learning effect was seen. Conclusions: The BESS demonstrates excellent reliability in the pediatric population without evidence of a learning effect. © 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {brain concussion, Child, pediatrics, Reproducibility of Results, Sports},
pubstate = {published},
tppubtype = {article}
}
Tuominen, M; Hanninen, T; Parkkari, J; Stuart, M J; Luoto, T; Kannus, P; Aubry, M
Concussion in the international ice hockey World Championships and Olympic Winter Games between 2006 and 2015 Journal Article
In: British Journal of Sports Medicine, vol. 51, no. 4, pp. 244–252, 2017.
@article{Tuominen2017b,
title = {Concussion in the international ice hockey World Championships and Olympic Winter Games between 2006 and 2015},
author = {Tuominen, M and Hanninen, T and Parkkari, J and Stuart, M J and Luoto, T and Kannus, P and Aubry, M},
year = {2017},
date = {2017-01-01},
journal = {British Journal of Sports Medicine},
volume = {51},
number = {4},
pages = {244--252},
abstract = {BACKGROUND: Concussions in sports are a growing concern. This study describes the incidence, injury characteristics and time trends of concussions in international ice hockey. METHODS: All concussions in the International Ice Hockey Federation (IIHF) World Championships (WC) and Olympic Winter Games were analysed over 9 ice hockey seasons between 2006 and 2015 using a standardised injury reporting system and diagnoses made by the team physicians. RESULTS: A total of 3293 games were played (169 tournaments, 1212 teams, 26 130 players) comprising 142 244 athletic game exposures. The average injury rate (IR) for concussion was 1.1 per 1000 ice hockey player-games for all IIHF WC tournaments. The IR was the highest in the men's WC A-pool tournaments and Olympic Games (IR 1.6). However, the annual IR for concussion in the men's tournaments has been lower than that in the World Junior tournaments since 2012. When a concussion occurred with contact to a flexible board, the IR was 0.2 per 1000 player games. In contrast, the IR was 1.1, if the board and glass were traditional (for the latter, RR 6.44 (95% CI 1.50 to 27.61)). In the men's tournaments, the trend of concussions caused by illegal hits decreased over the study period. After the 4th Consensus Statement on Concussion in Sport was published (2013), none of the concussed players in the men's WC returned to play on the day of injury. CONCLUSIONS: The annual risk of concussion in the men's WC has decreased during the study period. This was most likely due to a reduction in illegal hits. The risk of concussion was significantly lower if games were played on rinks with flexible boards and glass. Rink modifications, improved education and strict rule enforcement should be considered by policymakers in international ice hockey. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cole, W R; Arrieux, J P; Dennison, E M; Ivins, B J
The impact of administration order in studies of computerized neurocognitive assessment tools (NCATs) Journal Article
In: Journal of Clinical & Experimental Neuropsychology, vol. 39, no. 1, pp. 35–45, 2017.
@article{Cole2017,
title = {The impact of administration order in studies of computerized neurocognitive assessment tools (NCATs)},
author = {Cole, W R and Arrieux, J P and Dennison, E M and Ivins, B J},
year = {2017},
date = {2017-01-01},
journal = {Journal of Clinical \& Experimental Neuropsychology},
volume = {39},
number = {1},
pages = {35--45},
abstract = {Computerized neurocognitive assessment tools (NCATs) have become a common way to assess postconcussion symptoms. As there is increasing research directly comparing multiple NCATs to each other, it is important to consider the impact that order of test administration may have on the integrity of the results. This study investigates the impact of administration order in a study of four different NCATs; Automated Neuropsychological Assessment Metrics (ANAM4), CNS Vital Signs (CNS-VS), CogState, and Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). A total of 272 healthy active duty Service Members were enrolled into this study. All participants were randomly assigned to take two of the four NCATs with order of administration counterbalanced. Analyses attempted to investigate the effect of administration order alone (e.g., Time 1 versus Time 2), the effect of administration order combined with the impact of the specific NCAT received at Time 1, and only the impact of the Time 1 NCAT on Time 2 score variability. Specifically, independent samples t tests were used to compare Time 1 and Time 2 scores within each NCAT. Additional t tests compared Time 1 to Time 2 scores with Time 2 scores grouped by the NCAT received at Time 1. One-way analysis of variance (ANOVA) was used to compare only an NCAT's Time 2 scores grouped by the NCAT received at Time 1. Cohen's d effect sizes were calculated for all comparisons. The results from this study revealed statistically significant order effects for CogState and CNS-VS, though with effect sizes generally indicating minimum practical value, and marginal or absent order effects for ANAM4 and ImPACT with no clinically meaningful implications. Despite finding minimal order effects, clinicians should be mindful of the impact of administering multiple NCATs in a single session. Future studies should continue to be designed to minimize the potential effect of test administration order.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gerrard, Paul B; Iverson, Grant L; Atkins, Joseph E; Maxwell, Bruce A; Zafonte, Ross; Schatz, Philip; Berkner, Paul D
Factor Structure of ImPACT® in Adolescent Student Athletes Journal Article
In: Archives of Clinical Neuropsychology, vol. 32, no. 1, pp. 117–122, 2017, ISBN: 08876177.
Abstract | Links | BibTeX | Tags: Athletes -- Psychology, ATTENTION-deficit hyperactivity disorder, Cognitive, COGNITIVE testing, Concussion, FACTOR analysis, Headache -- Treatment, Memory, Neuropsychological Tests, Sports
@article{Gerrard2017,
title = {Factor Structure of ImPACT® in Adolescent Student Athletes},
author = {Gerrard, Paul B and Iverson, Grant L and Atkins, Joseph E and Maxwell, Bruce A and Zafonte, Ross and Schatz, Philip and Berkner, Paul D},
doi = {10.1093/arclin/acw097},
isbn = {08876177},
year = {2017},
date = {2017-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {32},
number = {1},
pages = {117--122},
abstract = {Objective: ImPACT® (Immediate Post-Concussion Assessment and Cognitive Testing) is a computerized neuropsychological screening battery, which is widely used to measure the acute effects of sport-related concussion and to monitor recovery from injury. This study examined the factor structure of ImPACT® in several samples of high school student athletes. We hypothesized that a 2-factor structure would be present in all samples. Method: A sample of 4,809 adolescent student athletes was included, and subgroups with a history of treatment for headaches or a self-reported history of learning problems or attention-deficit hyperactivity disorder were analyzed separately. Exploratory principal axis factor analyses with Promax rotations were used. Results: As hypothesized, both the combination of Verbal Memory and Visual Memory Composite scores loaded on one (Memory) factor, while Visual Motor Speed and Reaction Time loaded on a different (Speed) factor, in the total sample and in all subgroups. Conclusion: These results provide reasonably compelling evidence, across multiple samples, which ImPACT® measures 2 distinct factors: memory and speed. [ABSTRACT FROM AUTHOR]},
keywords = {Athletes -- Psychology, ATTENTION-deficit hyperactivity disorder, Cognitive, COGNITIVE testing, Concussion, FACTOR analysis, Headache -- Treatment, Memory, Neuropsychological Tests, Sports},
pubstate = {published},
tppubtype = {article}
}
Capo-Aponte, J E; Jorgensen-Wagers, K L; Sosa, J A; Walsh, D V; Goodrich, G L; Temme, L A; Riggs, D W
Visual Dysfunctions at Different Stages after Blast and Non-blast Mild Traumatic Brain Injury Journal Article
In: Optometry & Vision Science, vol. 94, no. 1, pp. 7–15, 2017.
@article{Capo-Aponte2017,
title = {Visual Dysfunctions at Different Stages after Blast and Non-blast Mild Traumatic Brain Injury},
author = {Capo-Aponte, J E and Jorgensen-Wagers, K L and Sosa, J A and Walsh, D V and Goodrich, G L and Temme, L A and Riggs, D W},
year = {2017},
date = {2017-01-01},
journal = {Optometry \& Vision Science},
volume = {94},
number = {1},
pages = {7--15},
abstract = {PURPOSE: To assess the prevalence of visual dysfunctions and associated symptoms in war fighters at different stages after non-blast- or blast-induced mild traumatic brain injury (mTBI). METHODS: A comprehensive retrospective review of the electronic health records of 500 U.S. military personnel with a diagnosis of deployment-related mTBI who received eye care at the Landstuhl Regional Medical Center. For analysis, the data were grouped by mechanism of injury, and each group was further divided in three subgroups based on the number of days between injury and initial eye examination. RESULTS: The data showed a high frequency of visual symptoms and visual dysfunctions. However, the prevalence of visual symptoms and visual dysfunctions did not differ significantly between mechanism of injury and postinjury stage, except for eye pain and diplopia. Among visual symptoms, binocular dysfunctions were more common, including higher near vertical phoria, reduced negative fusional vergence break at near, receded near point of convergence, decreased stereoacuity, and reduced positive relative accommodation. CONCLUSIONS: The lack of difference in terms of visual sequelae between subgroups (blast vs. nonblast) suggests that research addressing the assessment and management of mTBI visual sequelae resulting from civilian nonblast events is relevant to military personnel where combat injury results primarily from a blast event.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kalkstein, S; Scott, J C; Biester, R; Brownlow, J A; Harpaz-Rotem, I; Gur, R C
Comparison of blast-exposed OEF/OIF veterans with and without a history of TBI symptoms on a brief computerized neuropsychological battery Journal Article
In: Applied Neuropsychology. Adult, vol. 24, no. 1, pp. 92–97, 2017.
@article{Kalkstein2017,
title = {Comparison of blast-exposed OEF/OIF veterans with and without a history of TBI symptoms on a brief computerized neuropsychological battery},
author = {Kalkstein, S and Scott, J C and Biester, R and Brownlow, J A and Harpaz-Rotem, I and Gur, R C},
year = {2017},
date = {2017-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {24},
number = {1},
pages = {92--97},
abstract = {Mild traumatic brain injuries (mild TBIs) resulting from exposure to Improvised Explosive Devices (IEDs) are highly prevalent among veterans of the wars in Iraq and Afghanistan. This exploratory study compared the neurocognitive performance of blast-exposed veterans with (n = 19) and without (n = 15) reported symptoms of mild TBI. All subjects had diagnoses of posttraumatic stress disorder (PTSD). Neurocognitive testing was administered using a well-established computerized battery, the Penn Computerized Neuropsychological Battery (CNB), and groups were well matched on age, race, education, and time since most recent blast exposure. Although differences were not observed on CNB accuracy scores, MANOVAs revealed slower processing speed in the mTBI group when answering correctly on tests of simple and sustained attention, with large effect sizes. Results suggest a potential speed-accuracy tradeoff in blast-related mild TBI, which should be further examined in larger samples.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Strain, J F; Didehbani, N; Spence, J; Conover, H; Bartz, E K; Mansinghani, S; Jeroudi, M K; Rao, N K; Fields, L M; Kraut, M A; Cullum, C M; Hart, J; Womack, K B
White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes Journal Article
In: Journal of Neurotrauma, vol. 34, no. 2, pp. 372–379, 2017.
Abstract | Links | BibTeX | Tags: Concussion, DTI, naming, NATIONAL Football League, TBSS, white matter
@article{Strain2017,
title = {White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes},
author = {Strain, J F and Didehbani, N and Spence, J and Conover, H and Bartz, E K and Mansinghani, S and Jeroudi, M K and Rao, N K and Fields, L M and Kraut, M A and Cullum, C M and Hart, J and Womack, K B},
doi = {10.1089/neu.2016.4446},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {2},
pages = {372--379},
abstract = {Using diffusion tensor imaging (DTI), we assessed the relationship of white matter integrity and performance on the Boston Naming Test (BNT) in a group of retired professional football players and a control group. We examined correlations between fractional anisotropy (FA) and mean diffusivity (MD) with BNT T-scores in an unbiased voxelwise analysis processed with tract-based spatial statistics (TBSS). We also analyzed the DTI data by grouping voxels together as white matter tracts and testing each tract's association with BNT T-scores. Significant voxelwise correlations between FA and BNT performance were only seen in the retired football players (p \< 0.02). Two tracts had mean FA values that significantly correlated with BNT performance: forceps minor and forceps major. White matter integrity is important for distributed cognitive processes, and disruption correlates with diminished performance in athletes exposed to concussive and subconcussive brain injuries, but not in controls without such exposure. Copyright © 2017, Mary Ann Liebert, Inc. 2017.},
keywords = {Concussion, DTI, naming, NATIONAL Football League, TBSS, white matter},
pubstate = {published},
tppubtype = {article}
}
Olympia, R P
School Nurses on the Front Lines of Medicine Journal Article
In: NASN School Nurse, vol. 32, no. 1, pp. 25–29, 2017.
@article{Olympia2017,
title = {School Nurses on the Front Lines of Medicine},
author = {Olympia, R P},
year = {2017},
date = {2017-01-01},
journal = {NASN School Nurse},
volume = {32},
number = {1},
pages = {25--29},
abstract = {Head trauma is a common chief complaint encountered by school nurses. This article describes the initial assessment and management of head trauma in children and adolescents, delineates reasons that may prompt the school nurse to transfer a student to a local emergency department, and discusses the role of the school nurse when a student is diagnosed with a concussion.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Vestberg, Torbjörn; Reinebo, Gustaf; Maurex, Liselotte; Ingvar, Martin; Petrovic, Predrag
Core executive functions are associated with success in young elite soccer players Journal Article
In: PLoS ONE, vol. 12, no. 2, pp. 1–13, 2017, ISBN: 19326203.
Abstract | Links | BibTeX | Tags: adolescents, Age groups, attention, behavior, Biology and life sciences, cognition, Cognitive neuroscience, Cognitive psychology, Cognitive science, Creativity, Inhibitions, Learning and memory, Memory, Neuroscience, People and places, Population groupings, psychology, recreation, Research Article, Social sciences, Sports, Sports science, working memory
@article{Vestberg2017,
title = {Core executive functions are associated with success in young elite soccer players},
author = {Vestberg, Torbj\"{o}rn and Reinebo, Gustaf and Maurex, Liselotte and Ingvar, Martin and Petrovic, Predrag},
doi = {10.1371/journal.pone.0170845},
isbn = {19326203},
year = {2017},
date = {2017-01-01},
journal = {PLoS ONE},
volume = {12},
number = {2},
pages = {1--13},
publisher = {Public Library of Science},
abstract = {Physical capacity and coordination cannot alone predict success in team sports such as soccer. Instead, more focus has been directed towards the importance of cognitive abilities, and it has been suggested that executive functions (EF) are fundamentally important for success in soccer. However, executive functions are going through a steep development from adolescence to adulthood. Moreover, more complex EF involving manipulation of information (higher level EF) develop later than simple executive functions such as those linked to simple working memory capacity (Core EF). The link between EF and success in young soccer players is therefore not obvious. In the present study we investigated whether EF are associated with success in soccer in young elite soccer players. We performed tests measuring core EF (a demanding working memory task involving a variable n-back task; dWM) and higher level EF (Design Fluency test; DF). Color-Word Interference Test and Trail Making Test were performed on an exploratory level as they contain a linguistic element. The lower level EF test (dWM) was taken from CogStateSport computerized concussion testing and the higher level EF test (DF) was from Delis-Kaplan Executive Function System test battery (D-KEFS). In a group of young elite soccer players (n = 30; aged 12\textendash19 years) we show that they perform better than the norm in both the dWM (+0.49 SD) and DF (+0.86 SD). Moreover, we could show that both dWM and DF correlate with the number of goals the players perform during the season. The effect was more prominent for dWM (r = 0.437) than for DF (r = 0.349), but strongest for a combined measurement (r = 0.550). The effect was still present when we controlled for intelligence, length and age in a partial correlation analysis. Thus, our study suggests that both core and higher level EF may predict success in soccer also in young players. [ABSTRACT FROM AUTHOR]},
keywords = {adolescents, Age groups, attention, behavior, Biology and life sciences, cognition, Cognitive neuroscience, Cognitive psychology, Cognitive science, Creativity, Inhibitions, Learning and memory, Memory, Neuroscience, People and places, Population groupings, psychology, recreation, Research Article, Social sciences, Sports, Sports science, working memory},
pubstate = {published},
tppubtype = {article}
}
Neal, T; McKeon, P O
Ethical issues in concussion management Journal Article
In: International Journal of Athletic Therapy & Training, vol. 22, no. 1, pp. 24–32, 2017.
Abstract | Links | BibTeX | Tags: Disqualification, Social contract, Standard of care
@article{Neal2017,
title = {Ethical issues in concussion management},
author = {Neal, T and McKeon, P O},
doi = {10.1123/ijatt.2016-0020},
year = {2017},
date = {2017-01-01},
journal = {International Journal of Athletic Therapy \& Training},
volume = {22},
number = {1},
pages = {24--32},
abstract = {Athletic health care professionals, team physicians, and athletic trainers have an ethical obligation to safeguard the short-and long-term well-being of the athlete they care for. The potential long-term negative consequences to the student-athlete’s physical, cognitive, and mental health as a result of concussions and their mismanagement is a reality. How the athletic health care professional attends to this top priority of providing optimal health care to the concussed athlete while navigating the mitigating circumstances and influences of nonmedical entities found in competitive athletics is one of the great ethical challenges of present day sports medicine. Effectively navigating the complex challenges faced by athletic health care professionals is as important as the care delivered. Understanding the ethical challenges faced by athletic health care decision makers should be a central focus in providing the optimal care the patient deserves. © 2017 Human Kinetics \textendash IJATT.},
keywords = {Disqualification, Social contract, Standard of care},
pubstate = {published},
tppubtype = {article}
}
Weise, K K; Swanson, M W; Penix, K; Hale, M H; Ferguson, D
King-Devick and Pre-season Visual Function in Adolescent Athletes Journal Article
In: Optometry and Vision Science, vol. 94, no. 1, pp. 89–95, 2017.
Abstract | Links | BibTeX | Tags: Adolescent, Alignment, Concussion, Convergence, Correlation coefficient, cross-sectional study, King-Devick, Ophthalmology, Optometers, Pupil function, Pupillometer, Repeated Measures, Sport, Time-differences, Vision screening, visual acuity, Visual functions
@article{Weise2017,
title = {King-Devick and Pre-season Visual Function in Adolescent Athletes},
author = {Weise, K K and Swanson, M W and Penix, K and Hale, M H and Ferguson, D},
doi = {10.1097/OPX.0000000000000938},
year = {2017},
date = {2017-01-01},
journal = {Optometry and Vision Science},
volume = {94},
number = {1},
pages = {89--95},
abstract = {Purpose The King-Devick test (KD) has been studied as a remove-from-play sideline test in college-age athletes and older; however, studies in younger athletes are limited. A cross-sectional study of the KD and other vision correlates was completed on school-aged athletes during pre-season physicals for a variety of sports to determine the repeatability of the KD. The study also evaluated how convergence, alignment, or pupil function contributed to a slower King-Devick baseline reading. Methods Seven hundred eighty-five athletes underwent vision screenings in a hospital or school setting by trained/certified staff as part of pre-season physicals. Six hundred nineteen had KD testing completed per the manufacturer's suggested protocol and repeated. Other baseline vision testing included visual acuity, Modified Thorington testing for alignment, convergence testing, and pupil function using the NeurOptics (NPI-200) NPi. Results The mean fastest, error-minimized KD time for all participants was 43.9 seconds(s) (SD ± 11.6, range 24-120). Median KD time got faster (+) with age (p \< 0.0001). The inter-class correlation coefficient for all scores was 0.92. The absolute mean time difference for any two tests was 3.5 s (SD ± 2.5, range 0-23). There was no association between the best KD time and reduced NPC (p = 0.63), Modified Thorington measure of alignment (p = 0.55), or NPi pupil function (p = 0.79). The Bland Altman repeated measure limits of agreement was ±6.5 seconds for those in the 10th to12th grades, and ±10.2 seconds for those in the 6th to 9th grades. Conclusions King-Devick score in junior high and high school athletes is variable but gets faster and more repeatable with increasing age. The KD does not correlate significantly with reduced convergence, alignment, or pupil function. Based on grouped data, a slowing of 10 seconds for younger athletes and 6 seconds for older athletes on a second administration represents a true difference in testing speed. Within-player variability should be considered when removal-from-play decisions are influenced by KD results. © 2016 American Academy of Optometry.},
keywords = {Adolescent, Alignment, Concussion, Convergence, Correlation coefficient, cross-sectional study, King-Devick, Ophthalmology, Optometers, Pupil function, Pupillometer, Repeated Measures, Sport, Time-differences, Vision screening, visual acuity, Visual functions},
pubstate = {published},
tppubtype = {article}
}
Gardner, A J; Kohler, R M N; Levi, C R; Iverson, G L
Usefulness of Video Review of Possible Concussions in National Youth Rugby League Journal Article
In: International Journal of Sports Medicine, vol. 38, no. 1, pp. 71–75, 2017.
Abstract | Links | BibTeX | Tags: Concussion, Injury management, Return to Play, Video analysis
@article{Gardner2017,
title = {Usefulness of Video Review of Possible Concussions in National Youth Rugby League},
author = {Gardner, A J and Kohler, R M N and Levi, C R and Iverson, G L},
doi = {10.1055/s-0042-116072},
year = {2017},
date = {2017-01-01},
journal = {International Journal of Sports Medicine},
volume = {38},
number = {1},
pages = {71--75},
abstract = {A new concussion interchange rule (CIR) was introduced in 2014 for the National Rugby League and National Youth Competition (NYC). The CIR allows a player suspected of having sustained a concussion to be removed from play and assessed without an interchange being tallied against the player's team. Participants included all NYC players who used the CIR during the 2014 season. 2 raters completed video analysis of 131 (of a total of 156 reported) uses of the CIR, describing injury characteristics, situational factors, and concussion signs. The incidence rate was 44.9 (95% CI: 38.5-52.3) uses of the CIR per 1 000 NYC player match hours, or approximately one CIR use every 1.3 games. Apparent loss of consciousness/unresponsiveness was observed in 13% of cases, clutching the head in 65%, unsteadiness of gait in 60%, and a vacant stare in 23%. Most incidences occurred from a hit-up (82%). There appeared to be some instances of video evidence of injury but the athlete was cleared to return to play in the same game. Video review appears to be a useful adjunct for identifying players suffering possible concussion. Further research is required on the usefulness of video review for identifying signs of concussive injury.},
keywords = {Concussion, Injury management, Return to Play, Video analysis},
pubstate = {published},
tppubtype = {article}
}
Dickson, T J; Trathen, S; Terwiel, F A; Waddington, G; Adams, R
Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study Journal Article
In: Scandinavian Journal of Medicine & Science in Sports, vol. 27, no. 2, pp. 236–244, 2017, ISBN: 09057188.
Abstract | Links | BibTeX | Tags: CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries
@article{Dickson2017,
title = {Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study},
author = {Dickson, T J and Trathen, S and Terwiel, F A and Waddington, G and Adams, R},
doi = {10.1111/sms.12642},
isbn = {09057188},
year = {2017},
date = {2017-01-01},
journal = {Scandinavian Journal of Medicine \& Science in Sports},
volume = {27},
number = {2},
pages = {236--244},
abstract = {This research explored associations between helmet use and head injuries in snowsports by investigating reported snowsport injuries in Western Canada from 2008-2009 to 2012-2013. The key finding was that increased helmet use (from 69% to 80%) was not associated with a reduction in reported head injuries. Over the study period, the average rate of reported head injuries was 0.2/1000 skier visits, with a statistically significant variation ( P \< 0.001). The line of best fit showed an non-significant upward trend ( P = 0.13). Lacerations were the only subcategory of head injuries that decreased significantly with helmet use. A higher proportion of people who reported a head injury were wearing a helmet than for injuries other than to the head. Skiers were more likely to report a head injury when wearing a helmet than snowboarders ( P \< 0.001 cf. P = 0.22). There were significant differences in characteristics of helmet and non-helmet wearers. Helmet wearers were more likely to be: young adults ( P \< 0.001); beginner/novices ( P = 0.004); and snowboarders ( P \< 0.001), but helmet wearing was not associated with gender ( P = 0.191). Further research is needed to explore the possible reasons for the failure of helmets to reduce head injuries, for example, increased reporting of head injuries and increased risk-taking combined with over-rating of the helmets' protection.},
keywords = {CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries},
pubstate = {published},
tppubtype = {article}
}
Conley, Quincy; Savenye, Willi
Brainbook: An Impact Study of a Statewide Concussion Awareness Training for High School Athletes Journal Article
In: Performance Improvement, vol. 56, no. 1, pp. 28–36, 2017, ISBN: 10908811.
Abstract | Links | BibTeX | Tags: BRAIN -- Wounds & injuries, Internet in education, Mobile communication systems in education, SPORTS injuries, Student engagement
@article{Conley2017,
title = {Brainbook: An Impact Study of a Statewide Concussion Awareness Training for High School Athletes},
author = {Conley, Quincy and Savenye, Willi},
doi = {10.1002/pfi.21628},
isbn = {10908811},
year = {2017},
date = {2017-01-01},
journal = {Performance Improvement},
volume = {56},
number = {1},
pages = {28--36},
abstract = {With so much recent attention given to the diagnosis and treatment of and recovery from brain injuries, the sports world is now recognizing concussions as a major public health concern. This article examines the impact of an e-learning course designed to improve student engagement by replicating popular social network features such as blog posts, videos, and the like. In addition, this article outlines the program overview, evaluation procedures, results, implications of the resulting data, and recommendations for further action. [ABSTRACT FROM AUTHOR]},
keywords = {BRAIN -- Wounds \& injuries, Internet in education, Mobile communication systems in education, SPORTS injuries, Student engagement},
pubstate = {published},
tppubtype = {article}
}
Roberts, Simon P; Trewartha, Grant; England, Michael; Goodison, William; Stokes, Keith A
Concussions and Head Injuries in English Community Rugby Union Match Play Journal Article
In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 480–487, 2017, ISBN: 03635465.
Abstract | Links | BibTeX | Tags: Concussion, EPIDEMIOLOGY, injury, Rugby Union
@article{Roberts2017,
title = {Concussions and Head Injuries in English Community Rugby Union Match Play},
author = {Roberts, Simon P and Trewartha, Grant and England, Michael and Goodison, William and Stokes, Keith A},
doi = {10.1177/0363546516668296},
isbn = {03635465},
year = {2017},
date = {2017-01-01},
journal = {American Journal of Sports Medicine},
volume = {45},
number = {2},
pages = {480--487},
abstract = {Background: Previous research has described general injury patterns in community-level rugby union, but specific information on time-loss head injuries has not been reported. Purpose: To establish the incidence and nature of significant time-loss head injuries in English community rugby match play, and to identify the injury risk for specific contact events. Study Design: Descriptive epidemiology study. Methods: Over 6 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), 76 (2011-2012), 50 (2012-2013), 67 (2013-2014), and 58 (2014-2015) English community rugby clubs (Rugby Football Union levels 3-9) over a total of 175,940 hours of player match exposure. Club injury management staff reported information for all head injuries sustained during match play whereby the player was absent for 8 days or greater. Clubs were subdivided into semiprofessional (mean player age, 24.6 ± 4.7 years), amateur (24.9 ± 5.1 years), and recreational (25.6 ± 6.1 years) playing levels. Contact events from a sample of 30 matches filmed over seasons 2009-2010, 2010-2011, and 2011-2012 provided mean values for the frequency of contact events. Results: The overall incidence for time-loss head injuries was 2.43 injuries per 1000 player match hours, with a higher incidence for the amateur (2.78; 95% CI, 2.37-3.20) compared with recreational (2.20; 95% CI, 1.86-2.53) (P = .032) playing level but not different to the semiprofessional (2.31; 95% CI, 1.83-2.79) playing level. Concussion was the most common time-loss head injury, with 1.46 per 1000 player match hours. The tackle event was associated with 64% of all head injuries and 74% of all concussions. There was also a higher risk of injuries per tackle (0.33 per 1000 events; 95% CI, 0.30-0.37) compared with all other contact events. Conclusion: Concussion was the most common head injury diagnosis, although it is likely that this injury was underreported. Continuing education programs for medical staff and players are essential for the improved identification and management of these injuries. With the majority of head injuries occurring during a tackle, an improved technique in this contact event through coach and player education may be effective in reducing these injuries. [ABSTRACT FROM AUTHOR].},
keywords = {Concussion, EPIDEMIOLOGY, injury, Rugby Union},
pubstate = {published},
tppubtype = {article}
}
Collins-Praino, L E; Corrigan, F
Does neuroinflammation drive the relationship between tau hyperphosphorylation and dementia development following traumatic brain injury? Journal Article
In: Brain, Behavior, & Immunity, vol. 60, pp. 369–382, 2017.
@article{Collins-Praino2017,
title = {Does neuroinflammation drive the relationship between tau hyperphosphorylation and dementia development following traumatic brain injury?},
author = {Collins-Praino, L E and Corrigan, F},
year = {2017},
date = {2017-01-01},
journal = {Brain, Behavior, \& Immunity},
volume = {60},
pages = {369--382},
abstract = {A history of traumatic brain injury (TBI) is linked to an increased risk for the later development of dementia. This encompasses a variety of neurodegenerative diseases including Alzheimer's Disease (AD) and chronic traumatic encephalopathy (CTE), with AD linked to history of moderate-severe TBI and CTE to a history of repeated concussion. Of note, both AD and CTE are characterized by the abnormal accumulation of hyperphosphorylated tau aggregates, which are thought to play an important role in the development of neurodegeneration. Hyperphosphorylation of tau leads to destabilization of microtubules, interrupting axonal transport, whilst tau aggregates are associated with synaptic dysfunction. The exact mechanisms via which TBI may promote the later tauopathy and its role in the later development of dementia are yet to be fully determined. Following TBI, it is proposed that axonal injury may provide the initial perturbation of tau, by promoting its dissociation from microtubules, facilitating its phosphorylation and aggregation. Altered tau dynamics may then be exacerbated by the chronic persistent inflammatory response that has been shown to persist for decades following the initial impact. Importantly, immune activation has been shown to play a role in accelerating disease progression in other tauopathies, with pro-inflammatory cytokines, like IL-1beta, shown to activate kinases that promote tau hyperphosphorylation. Thus, targeting the inflammatory response in the sub-acute phase following TBI may represent a promising target to halt the alterations in tau dynamics that may precede overt neurodegeneration and later development of dementia. Copyright © 2016 Elsevier Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fuller, C W; Fuller, G W; Kemp, S P; Raftery, M
Evaluation of World Rugby's concussion management process: results from Rugby World Cup 2015 Journal Article
In: British Journal of Sports Medicine, vol. 51, no. 1, pp. 64–69, 2017.
@article{Fuller2017,
title = {Evaluation of World Rugby's concussion management process: results from Rugby World Cup 2015},
author = {Fuller, C W and Fuller, G W and Kemp, S P and Raftery, M},
year = {2017},
date = {2017-01-01},
journal = {British Journal of Sports Medicine},
volume = {51},
number = {1},
pages = {64--69},
abstract = {OBJECTIVE: To evaluate World Rugby's concussion management process during Rugby World Cup (RWC) 2015. DESIGN: A prospective, whole population study. POPULATION: 639 international rugby players representing 20 countries. METHOD: The concussion management process consisted of 3 time-based, multifaceted stages: an initial on-pitch and/or pitch-side assessment of the injury, a follow-up assessment within 3 hours and an assessment at 36-48 hours. The initial on-pitch assessment targeted obvious signs of concussion, which, if identified, lead to a 'permanent removal from play' decision and a diagnosis of concussion. If the on-pitch diagnosis was unclear, a 10-min off-pitch assessment was undertaken for signs and symptoms of concussion leading to a 'suspected concussion with permanent removal from play' or a 'no indication of concussion with return to play' decision. Evaluations at 3 and 36-48 hours postmatch lead to diagnoses of 'confirmed concussion' or 'no concussion'. Medical staff's decision-making was supported during each stage by real-time video review of events. Players diagnosed with confirmed concussion followed a 5-stage graduated-return-to-play protocol before being allowed to return to training and/or competition. RESULTS: Players were evaluated for concussion on 49 occasions, of which 24 resulted in diagnoses of concussion. Fourteen players showing on-pitch signs of concussion were permanently removed from play: 4 of the 5 players removed from play following off-pitch medical room evaluation were later diagnosed with a confirmed concussion. Five players not exhibiting in-match signs or symptoms of concussion were later diagnosed with concussion. The overall incidence of concussion during RWC 2015 was 12.5 concussions/1000 player-match-hours. CONCLUSIONS: This study supports the implementation of a multimodal, multitime-based concussion evaluation process to ensure that immediate and late developing concussions are captured.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Smoliga, J M; Zavorsky, G S
"Tighter fit" theory-physiologists explain why "higher altitude" and jugular occlusion are unlikely to reduce risks for sports concussion and brain injuries Journal Article
In: Journal of Applied Physiology, vol. 122, no. 1, pp. 215–217, 2017.
BibTeX | Tags:
@article{Smoliga2017,
title = {"Tighter fit" theory-physiologists explain why "higher altitude" and jugular occlusion are unlikely to reduce risks for sports concussion and brain injuries},
author = {Smoliga, J M and Zavorsky, G S},
year = {2017},
date = {2017-01-01},
journal = {Journal of Applied Physiology},
volume = {122},
number = {1},
pages = {215--217},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Wojtowicz, M; Iverson, G L; Silverberg, N D; Mannix, R; Zafonte, R; Maxwell, B; Berkner, P D
Consistency of Self-Reported Concussion History in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 34, no. 2, pp. 322–327, 2017.
Abstract | Links | BibTeX | Tags: assessment tools, Head trauma, pediatric brain injury
@article{Wojtowicz2017,
title = {Consistency of Self-Reported Concussion History in Adolescent Athletes},
author = {Wojtowicz, M and Iverson, G L and Silverberg, N D and Mannix, R and Zafonte, R and Maxwell, B and Berkner, P D},
doi = {10.1089/neu.2016.4412},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {2},
pages = {322--327},
abstract = {Relying on self-reported concussion injury history is common in both clinical care and research. However, young athletes may not provide consistent medical information. To date, little is known about the reliability of self-reported concussion history in high school students. This study examined whether student athletes reported their lifetime history of concussions consistently over time. Self-reported concussion history was examined in 4792 student athletes (ages 13-18) from Maine who completed a preseason health survey on two occasions (median re-test interval = 23.7 months; standard deviation = 7.3; interquartile range = 12.4-24.5). Consistency of self-reported concussion history was determined by differences in the number of concussions reported during the second survey. Inconsistent concussion history was defined primarily by a decrease in the number of lifetime concussions reported at the second testing, compared with at the first testing. The majority of the sample (80.3%) reported no change in the number of concussions between the two baseline assessments. A minority (15.9%; n = 763) reported more concussions during the second assessment. Only 3.8% (n = 181) of student athletes provided inconsistent concussion histories, defined as fewer concussions at the second assessment. Boys provided inconsistent concussion histories a little more frequently, compared with girls (5.3% and 2.0%, respectively; p \< 0.001). Similarly, athletes with self-reported attention-deficit hyperactivity disorder (ADHD) provided inconsistent concussion histories somewhat more frequently, compared with those without ADHD (7.8% and 3.5%, respectively; p \< 0.001). Of the athletes with inconsistent concussion histories, greater degree of inconsistency was associated with a greater number of concussions initially reported at baseline (rs = 0.54; p \< 0.001). Only a small proportion of student athletes provided inconsistent concussion histories. Male gender, ADHD, and greater number of baseline concussions were significantly associated with inconsistency in reporting. Overall, these findings suggest that student athletes are quite consistent when reporting their concussion history when surveyed twice during high school. Copyright © 2017, Mary Ann Liebert, Inc. 2017.},
keywords = {assessment tools, Head trauma, pediatric brain injury},
pubstate = {published},
tppubtype = {article}
}
Hayter, C; Meares, S; Shores, E A
The Abbreviated Westmead Post-traumatic Amnesia Scale and Pocket Concussion Recognition Tool: Data from amateur sports players in live-match conditions Journal Article
In: Applied Neuropsychology. Adult, vol. 24, no. 1, pp. 30–41, 2017.
@article{Hayter2017,
title = {The Abbreviated Westmead Post-traumatic Amnesia Scale and Pocket Concussion Recognition Tool: Data from amateur sports players in live-match conditions},
author = {Hayter, C and Meares, S and Shores, E A},
year = {2017},
date = {2017-01-01},
journal = {Applied Neuropsychology. Adult},
volume = {24},
number = {1},
pages = {30--41},
abstract = {Sports-related concussion is a growing public health concern. A short, simple sideline assessment tool is essential for evaluation of concussion at an amateur participation level. The current study examined responses to sideline assessment measures in a sample of amateur Australian Rules Football players competing in real-time live matches who had not sustained a concussion on the day of testing. Participants (N = 127) completed the Abbreviated Westmead Post-traumatic Amnesia Scale (A-WPTAS) and the Pocket Concussion Recognition Tool (Pocket CRT), which contains the Maddocks Questions (assessing orientation and recent memory) and the Postconcussion Symptom Scale (PCSS). The study showed 98.4% of participants passed the A-WPTAS, while 81.9% passed the Maddocks Questions. Participants endorsed a mean of 4.16 (SD = 4.02) symptoms on the PCSS, with 86.6% endorsing at least 1 symptom at a mild level or greater and 40.2% endorsing at least 1 symptom at a moderate or severe level. The current results suggest the Maddocks Questions may not be sufficient for use in an amateur sports context. To reduce the risk for a false positive diagnosis of concussion, it is recommended that the Pocket CRT be complemented with the A-WPTAS for use in an amateur sports context.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Moore, R D; Lepine, J; Ellemberg, D
The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function Journal Article
In: International Journal of Psychophysiology, vol. 112, pp. 22–30, 2017.
Abstract | Links | BibTeX | Tags: Concussion, ERPs, Neurophysiology, neuropsychology, Sub-concussion
@article{Moore2017,
title = {The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function},
author = {Moore, R D and Lepine, J and Ellemberg, D},
doi = {10.1016/j.ijpsycho.2016.11.011},
year = {2017},
date = {2017-01-01},
journal = {International Journal of Psychophysiology},
volume = {112},
pages = {22--30},
abstract = {Accumulating research demonstrates that repetitive sub-concussive impacts can alter the structure, function and connectivity of the brain. However, the functional significance of these alterations as well as the independent contribution of concussive and sub-concussive impacts to neurophysiological and neuropsychological health are unclear. Accordingly, we compared the neurophysiological and neuropsychological function of contact athletes with (concussion group) and without (sub-concussion group) a history of concussion, to non-contact athletes. We evaluated event-related brain potentials (ERPs) elicited during an oddball task and performance on a targeted battery of neuropsychological tasks. Athletes in the sub-concussion and concussion groups exhibited similar amplitude reductions in the ERP indices of attentional resource allocation (P3b) and attentional orienting (P3a) relative to non-contact athletes. However, only athletes in the concussion group exhibited reduced amplitude in the ERP index of perceptual attention (N1). Athletes in the sub-concussion and concussion groups also exhibited deficits in memory recall relative to non-contact athletes, but athletes in the concussion group also exhibited significantly more recall errors than athletes in the sub-concussion group. Additionally, only athletes in the concussion group exhibited response delays during the oddball task. The current findings suggest that sub-concussive impacts are associated with alterations in the neurophysiological and neuropsychological indices of essential cognitive functions, albeit to a lesser degree than the combination of sub-concussive and concussive impacts. © 2016 Elsevier B.V.},
keywords = {Concussion, ERPs, Neurophysiology, neuropsychology, Sub-concussion},
pubstate = {published},
tppubtype = {article}
}
Terrell, T R; Bostick, R; Barth, J; Sloane, R; Cantu, R C; Bennett, E; Galloway, L; Laskowitz, D; Erlanger, D; McKeag, D; Valentine, V; Nichols, G
Multicenter cohort study on association of genotypes with prospective sports concussion: methods, lessons learned, and recommendations Journal Article
In: Journal of Sports Medicine & Physical Fitness, vol. 57, no. 1-2, pp. 77–89, 2017.
@article{Terrell2017,
title = {Multicenter cohort study on association of genotypes with prospective sports concussion: methods, lessons learned, and recommendations},
author = {Terrell, T R and Bostick, R and Barth, J and Sloane, R and Cantu, R C and Bennett, E and Galloway, L and Laskowitz, D and Erlanger, D and McKeag, D and Valentine, V and Nichols, G},
year = {2017},
date = {2017-01-01},
journal = {Journal of Sports Medicine \& Physical Fitness},
volume = {57},
number = {1-2},
pages = {77--89},
abstract = {BACKGROUND: Approximately 3.8 million sports related TBIs occur per year. Genetic variation may affect both TBI risk and post-TBI clinical outcome. Limited research has focused on genetic risk for concussion among athletes. We describe the design, methods, and baseline characteristics of this prospective cohort study designed to investigate a potential association between genetic polymorphisms of apolipoprotein E gene, APOE promoter G-219T, and Tau gene exon 6 polymorphisms (Ser53 Pro and Hist47Tyr) with: 1) the risk of prospective concussion; 2) concussion severity; and 3) postconcussion neurocognitive recovery. METHODS: The prospective cohort study included a final population of 2947 college, high school, and professional athletes. Baseline data collection included a concussion/medical history questionnaire, neuropsychological (NP) testing, and genetic sampling for the genetic polymorphisms. Data collection on new concussions experienced utilized post-concussion history/mental status form, Lovell post-concussion symptom score, Standardized Assessment of Concussion (SAC) and/or the Sports Concussion Assessment Tool (SCAT)-1/SCAT-2, and post-concussion NP testing. RESULTS: This paper is focused on discussing the important methodological considerations, organizational challenges and lessons learned in the completion of a multi-center prospective cohort study. A total of 3740 subjects enrolled, with a total of 335 concussions experienced. CONCLUSIONS: Of critical importance to the success of a study of this type is to successfully recruit committed institutions with qualified local study personnel, obtain "buy-in" from study sites, and cultivate strong working relationships with study sites. The use of approved incentives may improve study site recruitment, enhance retention, and enhance compliance with study protocols. Future publications will detail the specific findings of this study. Collaborative research is very likely needed given the nature of this study population.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bailly, N; Afquir, S; Laporte, J D; Melot, A; Savary, D; Seigneuret, E; Delay, J B; Donnadieu, T; Masson, C; Arnoux, P J
Analysis of Injury Mechanisms in Head Injuries in Skiers and Snowboarders Journal Article
In: Medicine & Science in Sports & Exercise, vol. 49, no. 1, pp. 1–10, 2017.
Abstract | Links | BibTeX | Tags: Concussion, head injury, Helmet, SKI, snowboard
@article{Bailly2017,
title = {Analysis of Injury Mechanisms in Head Injuries in Skiers and Snowboarders},
author = {Bailly, N and Afquir, S and Laporte, J D and Melot, A and Savary, D and Seigneuret, E and Delay, J B and Donnadieu, T and Masson, C and Arnoux, P J},
doi = {10.1249/MSS.0000000000001078},
year = {2017},
date = {2017-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {49},
number = {1},
pages = {1--10},
abstract = {Purpose Mechanisms of injury and description of head impacts leading to traumatic brain injury (TBI) in skiers and snowboarders have not been extensively documented. We investigate snow sport crashes leading to TBI 1) to identify typical mechanisms leading to TBI to better target prevention measures and 2) to identify the injury mechanisms and the head impact conditions. Methods The subjects were skiers and snowboarders diagnosed of TBI and admitted between 2013 and 2015 to one of the 15 medical offices and three hospital centers involved in the study. The survey includes the description of the patients (age, sex, practice, skill level, and helmet use), the crash (type, location, estimated speed, causes, and fall description), and the injuries sustained (symptoms, head trauma scores, and other injuries). Sketches were used to describe the crash and impact locations. Clustering methods were used to distinguish profiles of injured participants. Results A total of 295 skiers and 71 snowboarders were interviewed. The most frequent type of mechanism was falls (54%), followed by collision between users (18%) and jumps (15%). Collision with obstacle (13%) caused the most serious TBI. Three categories of patients were identified. First, men age 16-25 yr are more involved in crash at high speed or in connection with a jump. Second, women, children (\<16 yr), and beginners are particularly injured in collisions between users. Third, those older than 50 yr, usually nonhelmeted, are frequently involved in falls. Ten crash scenarios were identified. Falling head first is the most frequent of skiers' falls (28%). Conclusion Crash scenarios leading to TBI were identified and associated with profiles of injured participants. Those results should help to better target TBI prevention and protection campaigns. © 2016 by the American College of Sports Medicine.},
keywords = {Concussion, head injury, Helmet, SKI, snowboard},
pubstate = {published},
tppubtype = {article}
}
Salisbury, David; Kolessar, Michael; Callender, Librada; Bennett, Monica
Concussion knowledge among rehabilitation staff Journal Article
In: Baylor University Medical Center Proceedings, vol. 30, no. 1, pp. 33–37, 2017, ISBN: 0899-8280.
BibTeX | Tags:
@article{Salisbury2017,
title = {Concussion knowledge among rehabilitation staff},
author = {Salisbury, David and Kolessar, Michael and Callender, Librada and Bennett, Monica},
isbn = {0899-8280},
year = {2017},
date = {2017-01-01},
journal = {Baylor University Medical Center Proceedings},
volume = {30},
number = {1},
pages = {33--37},
publisher = {Baylor University Medical Center},
address = {Dallas, Texas},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Imhoff, S; Malenfant, S; Nadreau, É; Poirier, P; Bailey, D M; Brassard, P
Uncoupling between cerebral perfusion and oxygenation during incremental exercise in an athlete with postconcussion syndrome: a case report Journal Article
In: Physiological Reports, vol. 5, no. 2, 2017.
Abstract | Links | BibTeX | Tags: Cerebral oxygenation, cerebral perfusion, exercise, postconcussion syndrome
@article{Imhoff2017,
title = {Uncoupling between cerebral perfusion and oxygenation during incremental exercise in an athlete with postconcussion syndrome: a case report},
author = {Imhoff, S and Malenfant, S and Nadreau, \'{E} and Poirier, P and Bailey, D M and Brassard, P},
doi = {10.14814/phy2.13131},
year = {2017},
date = {2017-01-01},
journal = {Physiological Reports},
volume = {5},
number = {2},
abstract = {High-intensity exercise may pose a risk to patients with postconcussion syndrome (PCS) when symptomatic during exertion. The case of a paralympic athlete with PCS who experienced a succession of convulsion-awakening periods and reported a marked increase in postconcussion symptoms after undergoing a graded symptom-limited aerobic exercise protocol is presented. Potential mechanisms of cerebrovascular function failure are then discussed. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.},
keywords = {Cerebral oxygenation, cerebral perfusion, exercise, postconcussion syndrome},
pubstate = {published},
tppubtype = {article}
}
Kroshus, E; Baugh, C M; Stein, C J; Austin, S B; Calzo, J P
Concussion reporting, sex, and conformity to traditional gender norms in young adults Journal Article
In: Journal of Adolescence, vol. 54, pp. 110–119, 2017.
Abstract | Links | BibTeX | Tags: college, Concussion, gender, Help-seeking, Sport
@article{Kroshus2017,
title = {Concussion reporting, sex, and conformity to traditional gender norms in young adults},
author = {Kroshus, E and Baugh, C M and Stein, C J and Austin, S B and Calzo, J P},
doi = {10.1016/j.adolescence.2016.11.002},
year = {2017},
date = {2017-01-01},
journal = {Journal of Adolescence},
volume = {54},
pages = {110--119},
abstract = {This study assessed whether between-sex differences in concussion reporting intention and behavior among young adults are explained by the extent to which the individual conforms to traditional masculine norms that often characterize contemporary sport culture. A survey of college athletes in the United States (n = 328) found greater symptom reporting intention among females as compared to males, but no difference in their likelihood continued play while experiencing symptoms of a possible concussion. Greater conformity to the norms of risk-taking was associated with greater likelihood of continued play while symptomatic among female athletes but not among male athletes. These findings suggest that gendered behavior, rather than biologically determined sex, is an important consideration for concussion safety in this age group. Addressing elements of the contemporary sport ethos that reinforce risk taking in service of athletic achievement may be a relevant direction for interventions aimed at improving injury reporting among all athletes. © 2016},
keywords = {college, Concussion, gender, Help-seeking, Sport},
pubstate = {published},
tppubtype = {article}
}
Margolis, L H; Canty, G; Halstead, M; Lantos, J D
Should School Boards Discontinue Support for High School Football? Journal Article
In: Pediatrics, vol. 139, no. 1, 2017.
@article{Margolis2017,
title = {Should School Boards Discontinue Support for High School Football?},
author = {Margolis, L H and Canty, G and Halstead, M and Lantos, J D},
year = {2017},
date = {2017-01-01},
journal = {Pediatrics},
volume = {139},
number = {1},
abstract = {A pediatrician is asked by her local school board to help them decide whether to discontinue their high school football program. She reviews the available evidence on the risks of football and finds it hopelessly contradictory. Some scholars claim that football is clearly more dangerous than other sports. Others suggest that the risks of football are comparable to other sports, such as lacrosse, ice hockey, or soccer. She finds very little data on the long-term sequelae of concussions. She sees claims that good coaching and a school culture that prioritizes the health of athletes over winning can reduce morbidity from sports injuries. In this paper, 3 experts also review the evidence about sports risks and discuss what is known and not known about the science and the ethics of high school football.Copyright © 2017 by the American Academy of Pediatrics.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Horris, Hannah B; Elmer, Carlie; McLeod, Tamara C Valovich
Premorbid Diagnosis of Attention Deficit Hyperactivity Disorder and the Association of Concussion Risk and Prolonged Recovery Journal Article
In: Athletic Training & Sports Health Care, vol. 9, no. 1, pp. 39–44, 2017, ISBN: 19425864.
Abstract | BibTeX | Tags: *ATTENTION-deficit hyperactivity disorder, *BRAIN -- Concussion, *COLLEGE students, *EVIDENCE-based medicine, *HIGH school students, *MEDICAL care, *MEDLINE, *PHYSICAL therapy, *POSTCONCUSSION syndrome, CINAHL (Information retrieval system), DESCRIPTIVE statistics, INFORMATION storage & retrieval systems, ONLINE information services, Professional Practice, Risk Factors, SYSTEMATIC reviews (Medical research)
@article{Horris2017,
title = {Premorbid Diagnosis of Attention Deficit Hyperactivity Disorder and the Association of Concussion Risk and Prolonged Recovery},
author = {Horris, Hannah B and Elmer, Carlie and McLeod, Tamara C Valovich},
isbn = {19425864},
year = {2017},
date = {2017-01-01},
journal = {Athletic Training \& Sports Health Care},
volume = {9},
number = {1},
pages = {39--44},
abstract = {Attention deficit hyperactivity disorder (ADHD) has been identified as a risk factor for concussion or delayed recovery. However, these recommendations are often based on anecdotal or limited evidence. This critically appraised topic aimed to address the clinical question of whether a premorbid diagnosis of ADHD increases the risk for a concussion and prolonged symptoms. A search strategy using PICO terminology related to the clinical question was conducted in several electronic databases. Seven studies were identified and five met the inclusion criteria. The clinical bottom line suggests there is moderate evidence to support the relationship between patients who are diagnosed as having ADHD and the incident rate of concussion, as well as a prolonged recovery time. The findings of this critically appraised topic suggest strength of recommendation of grade B to support that ADHD is a risk factor for concussion and a predictor of prolonged recovery. ABSTRACT FROM AUTHOR},
keywords = {*ATTENTION-deficit hyperactivity disorder, *BRAIN -- Concussion, *COLLEGE students, *EVIDENCE-based medicine, *HIGH school students, *MEDICAL care, *MEDLINE, *PHYSICAL therapy, *POSTCONCUSSION syndrome, CINAHL (Information retrieval system), DESCRIPTIVE statistics, INFORMATION storage \& retrieval systems, ONLINE information services, Professional Practice, Risk Factors, SYSTEMATIC reviews (Medical research)},
pubstate = {published},
tppubtype = {article}
}
Hwang, Sungjae; Ma, Lei; Kawata, Keisuke; Tierney, Ryan; Jeka, John J
Vestibular dysfunction after subconcussive head impact Journal Article
In: Journal of Neurotrauma, vol. 34, no. 1, pp. 8–15, 2017, ISBN: 0897-7151 1557-9042.
Abstract | Links | BibTeX | Tags: 2017, BEHAVIORAL assessment, Behavioral assessments, Head trauma, Human studies, Outcome measures, Sensory Feedback, sensory function, Soccer, traumatic brain injury
@article{Hwang2017,
title = {Vestibular dysfunction after subconcussive head impact},
author = {Hwang, Sungjae and Ma, Lei and Kawata, Keisuke and Tierney, Ryan and Jeka, John J},
doi = {10.1089/neu.2015.4238},
isbn = {0897-7151
1557-9042},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {1},
pages = {8--15},
publisher = {Mary Ann Liebert, Inc.},
address = {US},
abstract = {Current thinking views mild head impact (i.e., subconcussion) as an underrecognized phenomenon that has the ability to cause significant current and future detrimental neurological effects. Repeated mild impacts to the head, however, often display no observable behavioral deficits based on standard clinical tests, which may lack sensitivity. The current study investigates the effects of subconcussive impacts from soccer heading with innovative measures of vestibular function and walking stability in a pre- 0\textendash2 h, post- 24 h post-heading repeated measures design. The heading group (n = 10) executed 10 headers with soccer balls projected at a velocity of 25 mph (11.2 m/sec) over 10 min. Subjects were evaluated 24 h before, immediately after, and 24 h after soccer heading with: the modified Balance Error Scoring System (mBESS); a walking stability task with visual feedback of trunk movement; and galvanic vestibular stimulation (GVS) while standing with eyes closed on foam. A control group (n = 10) followed the same protocol with no heading. The results showed significant decrease in trunk angle, leg angle gain, and center of mass gain relative to GVS for the heading group compared with controls. Medial-lateral trunk orientation displacement and velocity during treadmill walking increased immediately after mild head impact for the heading group compared with controls. Controls showed an improvement in mBESS scores over time, indicating a learning effect, which was not observed with the heading group. These results suggest that mild head impact leads to a transient dysfunction in vestibular processing, which deters walking stability during task performance. (PsycINFO Database Record (c) 2017 APA, all rights reserved)},
keywords = {2017, BEHAVIORAL assessment, Behavioral assessments, Head trauma, Human studies, Outcome measures, Sensory Feedback, sensory function, Soccer, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Yeh, P H; Guan Koay, C; Wang, B; Morissette, J; Sham, E; Senseney, J; Joy, D; Kubli, A; Yeh, C H; Eskay, V; Liu, W; French, L M; Oakes, T R; Riedy, G; Ollinger, J
Compromised Neurocircuitry in Chronic Blast-Related Mild Traumatic Brain Injury Journal Article
In: Human Brain Mapping, vol. 38, no. 1, pp. 352–369, 2017.
@article{Yeh2017,
title = {Compromised Neurocircuitry in Chronic Blast-Related Mild Traumatic Brain Injury},
author = {Yeh, P H and {Guan Koay}, C and Wang, B and Morissette, J and Sham, E and Senseney, J and Joy, D and Kubli, A and Yeh, C H and Eskay, V and Liu, W and French, L M and Oakes, T R and Riedy, G and Ollinger, J},
year = {2017},
date = {2017-01-01},
journal = {Human Brain Mapping},
volume = {38},
number = {1},
pages = {352--369},
abstract = {The aim of this study was to apply recently developed automated fiber segmentation and quantification methods using diffusion tensor imaging (DTI) and DTI-based deterministic and probabilistic tractography to access local and global diffusion changes in blast-induced mild traumatic brain injury (bmTBI). Two hundred and two (202) male active US service members who reported persistent post-concussion symptoms for more than 6 months after injury were recruited. An additional forty (40) male military controls were included for comparison. DTI results were examined in relation to post-concussion and post-traumatic stress disorder (PTSD) symptoms. No significant group difference in DTI metrics was found using voxel-wise analysis. However, group comparison using tract profile analysis and tract specific analysis, as well as single subject analysis using tract profile analysis revealed the most prominent white matter microstructural injury in chronic bmTBI patients over the frontal fiber tracts, that is, the front-limbic projection fibers (cingulum bundle, uncinate fasciculus), the fronto-parieto-temporal association fibers (superior longitudinal fasciculus), and the fronto-striatal pathways (anterior thalamic radiation). Effects were noted to be sensitive to the number of previous blast exposures, with a negative association between fractional anisotropy (FA) and time since most severe blast exposure in a subset of the multiple blast-exposed group. However, these patterns were not observed in the subgroups classified using macrostructural changes (T2 white matter hyperintensities). Moreover, post-concussion symptoms and PTSD symptoms, as well as neuropsychological function were associated with low FA in the major nodes of compromised neurocircuitry. Hum Brain Mapp 38:352-369, 2017. © 2016 Wiley Periodicals, Inc.Copyright © 2016 Wiley Periodicals, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Alosco, M L; Mez, J; Kowall, N W; Stein, T D; Goldstein, L E; Cantu, R C; Katz, D I; Solomon, T M; Kiernan, P T; Murphy, L; Abdolmohammadi, B; Daneshvar, D; Montenigro, P H; Nowinski, C J; Stern, R A; McKee, A C
Cognitive Reserve as a Modifier of Clinical Expression in Chronic Traumatic Encephalopathy: A Preliminary Examination Journal Article
In: Journal of Neuropsychiatry & Clinical Neurosciences, vol. 29, no. 1, pp. 6–12, 2017.
@article{Alosco2017b,
title = {Cognitive Reserve as a Modifier of Clinical Expression in Chronic Traumatic Encephalopathy: A Preliminary Examination},
author = {Alosco, M L and Mez, J and Kowall, N W and Stein, T D and Goldstein, L E and Cantu, R C and Katz, D I and Solomon, T M and Kiernan, P T and Murphy, L and Abdolmohammadi, B and Daneshvar, D and Montenigro, P H and Nowinski, C J and Stern, R A and McKee, A C},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neuropsychiatry \& Clinical Neurosciences},
volume = {29},
number = {1},
pages = {6--12},
abstract = {This study conducted a preliminary examination on cognitive reserve (CR) as a modifier of symptom expression in subjects with autopsy-confirmed chronic traumatic encephalopathy (CTE). The sample included 25 former professional football players neuropathologically diagnosed with CTE stage III or IV. Next of kin interviews ascertained age at cognitive and behavioral/mood symptom onset and demographic/athletic characteristics. Years of education and occupational attainment defined CR. High occupational achievement predicted later age at cognitive (p=0.02) and behavioral/mood (p=0.02) onset. Education was not an individual predictor. These preliminary findings suggest that CR may forestall the clinical manifestation of CTE.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bires, A M; Leonard, A L; Thurber, B
Educating Providers in Return-to-Play Suggested Guidelines Postconcussion Journal Article
In: Critical Care Nursing Quarterly, vol. 40, no. 1, pp. 49–58, 2017.
@article{Bires2017,
title = {Educating Providers in Return-to-Play Suggested Guidelines Postconcussion},
author = {Bires, A M and Leonard, A L and Thurber, B},
year = {2017},
date = {2017-01-01},
journal = {Critical Care Nursing Quarterly},
volume = {40},
number = {1},
pages = {49--58},
abstract = {As the awareness of concussions increases, it is imperative to be able to evaluate, diagnose, and treat concussed individuals properly to prevent further complications or death. The primary purpose of this study was to compare a provider's current awareness and comfort level as it relates to the return-to-play guidelines for concussions. A secondary aim was to evaluate current protocols that are in use and determine whether they coincide with the suggested guidelines. An educational intervention was implemented to assess the knowledge and confidence of health care providers. The study design was a quantitative, convenient sample, pretest/posttest questionnaire. The questionnaire was administered to participants who were nurse practitioners prior to an educational PowerPoint presentation. At 8 weeks, the posttest was administered. Approximately 19% of individuals were not aware of a graded return-to-play protocols. The findings suggest that the educational intervention increased their confidence levels in making a diagnosis of a concussion, in assessing danger signs, and in understanding when to refer to a specialist. Additional supporting evidence from this study indicates that the educational intervention allowed the participants to achieve a greater comfort level in finding appropriate resources for them and their patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stone, S; Lee, B; Garrison, J C; Blueitt, D; Creed, K
Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion Journal Article
In: Sports Health, vol. 9, no. 1, pp. 41–44, 2017.
Abstract | Links | BibTeX | Tags: Concussion, return-to-play progression, sex
@article{Stone2017,
title = {Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion},
author = {Stone, S and Lee, B and Garrison, J C and Blueitt, D and Creed, K},
doi = {10.1177/1941738116672184},
year = {2017},
date = {2017-01-01},
journal = {Sports Health},
volume = {9},
number = {1},
pages = {41--44},
abstract = {Background: Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC. Hypothesis: After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non\textendashsport-related activity were excluded. Results: Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002). Conclusion: On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, aged 11 to 20 years, with regard to initiation of an RTP progression after SRC. Clinical Relevance: Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population. © 2016, © 2016 The Author(s).},
keywords = {Concussion, return-to-play progression, sex},
pubstate = {published},
tppubtype = {article}
}
Elkington, L J; Hughes, D C
Australian institute of sport and Australian medical association position statement on concussion in sport Journal Article
In: Medical Journal of Australia, vol. 206, no. 1, pp. 46–50, 2017.
Abstract | Links | BibTeX | Tags:
@article{Elkington2017,
title = {Australian institute of sport and Australian medical association position statement on concussion in sport},
author = {Elkington, L J and Hughes, D C},
doi = {10.5694/mja16.00741},
year = {2017},
date = {2017-01-01},
journal = {Medical Journal of Australia},
volume = {206},
number = {1},
pages = {46--50},
abstract = {Introduction: Sport-related concussion is a growing health concern in Australia. Public concern is focused on the incidence and potential long term consequences of concussion. Children may be more prone to concussion and take longer to recover. The Australian Institute of Sport and the Australian Medical Association have collaborated to present the most contemporary evidence-based information in a format appropriate for all stakeholders. This position statement aims to ensure that participant safety and welfare is paramount when dealing with concussion in sport. Main recommendations: First aid principles apply in the management of the athlete with suspected concussion, including protection of the cervical spine. Tools exist for use by members of the community, allowing identification of key symptoms and signs that raise the suspicion of concussion. Medical professionals should use the Sport Concussion Assessment Tool 3, in conjunction with clinical assessment for the diagnosis of concussion. Clinical assessment includes mechanism of injury, symptoms and signs, cognitive functioning, and neurological assessment including balance testing. In any situation where concussion is suspected, the athlete must be immediately removed from sport and not be allowed to return to activity until they have been assessed by a medical practitioner. "If in doubt, sit them out." Changes in management: A diagnosis of concussion requires immediate physical and cognitive rest, followed by a structured, graduated return to physical activity. Children require a longer period of recovery from concussion. Algorithms are provided for use by medical and non-medically trained stakeholders in the recognition and management of concussion. © 2017 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Concussions-The Role of the School Nurse Journal Article
In: NASN School Nurse, vol. 32, no. 1, pp. 59–60, 2017.
BibTeX | Tags:
@article{Anonymous2017,
title = {Concussions-The Role of the School Nurse},
author = {Anonymous},
year = {2017},
date = {2017-01-01},
journal = {NASN School Nurse},
volume = {32},
number = {1},
pages = {59--60},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Patterson, J N; Murphy, A M; Honaker, J A
Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes Journal Article
In: Journal of the American Academy of Audiology, vol. 28, no. 1, pp. 36–45, 2017.
Abstract | Links | BibTeX | Tags: Athletes, Concussion, DVAT, Dynamic visual acuity, Physical Exertion, Sport-related head injury, Vestibular function, Vestibulo-ocular reflex, Visual-vestibular, Vor
@article{Patterson2017,
title = {Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes},
author = {Patterson, J N and Murphy, A M and Honaker, J A},
doi = {10.3766/jaaa.15110},
year = {2017},
date = {2017-01-01},
journal = {Journal of the American Academy of Audiology},
volume = {28},
number = {1},
pages = {36--45},
abstract = {Background: Acute symptoms of dizziness and/or imbalance commonly experienced in athletes postconcussion are speculated to arise from dysfunction at multiple levels (i.e., inner ear or central vestibular system) to appropriately integrate afferent sensory information. Disruption along any pathway of the balance system can result in symptoms of dizziness, decreased postural control function (vestibulospinal reflex), and reduced vestibulo-ocular reflex function. This may also lead to decreased gaze stability with movements of the head and may account for symptoms of blurred vision or diplopia reported in almost half of athletes sustaining a concussion. Current concussion position statements include measures of postural control to examine changes to the balance system postconcussion. The Balance Error Scoring System (BESS) is a commonly used lowcost postural control measure for concussion assessment. Although this is a widely used measure for documenting balance function on both immediate (sideline) and recovery monitoring, the BESS has been shown to be affected by physical exertion. Therefore, the BESS may not be the most efficient means of examining functional changes to the balance system immediately after head injury. Dynamic Visual Acuity Test (DVAT) has been found to effectively evaluate and monitor changes to the gaze stability system postinjury. Thus, DVAT may be an additional measure in the concussion assessment battery, as well as an alternative for more immediate sideline assessment to help make objective return-To-play decisions. Purpose: The aim of the study was to determine the effects of physical exertion on a clinical vestibular assessment, the DVAT, in collegiate athletes, as a first step in defining the role of this measure in the concussion assessment battery. Research Design: Cross-sectional, repeated-measures design. Study Sample: Twenty-eight healthy collegiate athletes (20 males, 8 females; age = 20.25 ± 1.46 yr},
keywords = {Athletes, Concussion, DVAT, Dynamic visual acuity, Physical Exertion, Sport-related head injury, Vestibular function, Vestibulo-ocular reflex, Visual-vestibular, Vor},
pubstate = {published},
tppubtype = {article}
}
Dubose, D F; Herman, D C; Jones, D L; Tillman, S M; Clugston, J R; Pass, A; Hernandez, J A; Vasilopoulos, T; Horodyski, M; Chmielewski, T L
Lower Extremity Stiffness Changes after Concussion in Collegiate Football Players Journal Article
In: Medicine & Science in Sports & Exercise, vol. 49, no. 1, pp. 167–172, 2017.
@article{Dubose2017,
title = {Lower Extremity Stiffness Changes after Concussion in Collegiate Football Players},
author = {Dubose, D F and Herman, D C and Jones, D L and Tillman, S M and Clugston, J R and Pass, A and Hernandez, J A and Vasilopoulos, T and Horodyski, M and Chmielewski, T L},
year = {2017},
date = {2017-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {49},
number = {1},
pages = {167--172},
abstract = {PURPOSE: Recent research indicates that a concussion increases the risk of musculoskeletal injury. Neuromuscular changes after concussion might contribute to the increased risk of injury. Many studies have examined gait postconcussion, but few studies have examined more demanding tasks. This study compared changes in stiffness across the lower extremity, a measure of neuromuscular function, during a jump-landing task in athletes with a concussion (CONC) to uninjured athletes (UNINJ). METHODS: Division I football players (13 CONC and 26 UNINJ) were tested pre- and postseason. A motion capture system recorded subjects jumping on one limb from a 25.4-cm step onto a force plate. Hip, knee, and ankle joint stiffness were calculated from initial contact to peak joint flexion using the regression line slopes of the joint moment versus the joint angle plots. Leg stiffness was (peak vertical ground reaction force [PVGRF]/lower extremity vertical displacement) from initial contact to peak vertical ground reaction force. All stiffness values were normalized to body weight. Values from both limbs were averaged. General linear models compared group (CONC, UNINJ) differences in the changes of pre- and postseason stiffness values. RESULTS: Average time from concussion to postseason testing was 49.9 d. The CONC group showed an increase in hip stiffness (P = 0.03), a decrease in knee (P = 0.03) and leg stiffness (P = 0.03), but no change in ankle stiffness (P = 0.65) from pre- to postseason. CONCLUSION: Lower extremity stiffness is altered after concussion, which could contribute to an increased risk of lower extremity injury. These data provide further evidence of altered neuromuscular function after concussion.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Churchill, N; Hutchison, M; Richards, D; Leung, G; Graham, S; Schweizer, T A
Brain Structure and Function Associated with a History of Sport Concussion: A Multi-Modal Magnetic Resonance Imaging Study Journal Article
In: Journal of Neurotrauma, vol. 34, no. 4, pp. 765–771, 2017.
@article{Churchill2017a,
title = {Brain Structure and Function Associated with a History of Sport Concussion: A Multi-Modal Magnetic Resonance Imaging Study},
author = {Churchill, N and Hutchison, M and Richards, D and Leung, G and Graham, S and Schweizer, T A},
year = {2017},
date = {2017-01-01},
journal = {Journal of Neurotrauma},
volume = {34},
number = {4},
pages = {765--771},
abstract = {There is growing concern about the potential long-term consequences of sport concussion for young, currently active athletes. However, there remains limited information about brain abnormalities associated with a history of concussion and how they relate to clinical factors. In this study, advanced MRI was used to comprehensively describe abnormalities in brain structure and function associated with a history of sport concussion. Forty-three athletes (21 male, 22 female) were recruited from interuniversity teams at the beginning of the season, including 21 with a history of concussion and 22 without prior concussion; both groups also contained a balanced sample of contact and noncontact sports. Multi-modal MRI was used to evaluate abnormalities in brain structure and function. Athletes with a history of concussion showed frontal decreases in brain volume and blood flow. However, they also demonstrated increased posterior cortical volume and elevated markers of white matter microstructure. A greater number of prior concussions was associated with more extensive decreases in cerebral blood flow and insular volume, whereas recovery time from most recent concussion was correlated with reduced frontotemporal volume. White matter showed limited correlations with clinical factors, predominantly in the anterior corona radiata. This study provides the first evidence of the long-term effects of concussion on gray matter volume, blood flow, and white matter microstructure within a single athlete cohort. This was examined for a mixture of male and female athletes in both contact and noncontact sports, demonstrating the relevance of these findings for the overall sporting community.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}