Terwilliger, V K; Pratson, L; Vaughan, C G; Gioia, G A
Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 33, no. 8, pp. 761–765, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury
@article{Terwilliger2016,
title = {Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes},
author = {Terwilliger, V K and Pratson, L and Vaughan, C G and Gioia, G A},
doi = {10.1089/neu.2015.4082},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {8},
pages = {761--765},
abstract = {Repeat concussion has been associated with risk for prolonged and pronounced clinical recovery in athletes. In this study of adolescent athletes, we examined whether an additional head impact within 24 h of a sports-related concussion (SRC) is associated with higher symptom burden and prolonged clinical recovery compared with a single-injury group. Forty-two student-athletes (52% male, mean age = 14.9 years) diagnosed with an SRC in a concussion clinic were selected for this study: (1) 21 athletes who sustained an additional significant head impact within 24 h of the initial injury (additional-impact group); (2) 21 single-injury athletes, age and gender matched, who sustained only one discrete concussive blow to the head (single-injury group). Groups did not differ on initial injury characteristics or pre-injury risk factors. The effect of injury status (single-vs. additional-impact) was examined on athlete-and parent-reported symptom burden (at first clinic visit) and length of recovery (LOR). Higher symptom burden was reported by the athletes and parents in the additional-impact group at the time of first visit. The additional-impact group also had a significantly longer LOR compared with the single-injury group. These findings provide preliminary, hypothesis-generating evidence for the importance of immediate removal from play following an SRC to protect athletes from re-injury, which may worsen symptoms and prolong recovery. The retrospective study design from a specialized clinical sample points to the need for future prospective studies of the relationship between single-and additional-impact injuries on symptom burden and LOR. © 2016 Mary Ann Liebert, Inc.},
keywords = {Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Slaboda, J C; King, L A; Wright, W G; Houlihan, D; Norris, J N
Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment Journal Article
In: Journal of Neurotrauma, vol. 33, no. 7, pp. 705–711, 2016.
Abstract | Links | BibTeX | Tags: adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War
@article{Haran2016,
title = {Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment},
author = {Haran, F J and Slaboda, J C and King, L A and Wright, W G and Houlihan, D and Norris, J N},
doi = {10.1089/neu.2015.4060},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {7},
pages = {705--711},
abstract = {This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT. SMs with mTBI performed significantly worse on the BESS and SOT when compared with comparative samples. When the SOT data were further examined using sensory ratios, the results indicated that postural instability was primarily a result of vestibular and visual integration dysfunction (r \> 0.62). The main finding of this study was that the sensitivity of the SOT composite score (50-58%) during the acute phase was higher than previous sensitivities found in the sports medicine literature for impact-related trauma. Copyright © 2016 Mary Ann Liebert, Inc.},
keywords = {adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War},
pubstate = {published},
tppubtype = {article}
}
Collins, M W; Kontos, A P; Okonkwo, D O; Almquist, J; Bailes, J; Barisa, M; Bazarian, J; Bloom, O J; Brody, D L; Cantu, R; Cardenas, J; Clugston, J; Cohen, R; Echemendia, R; Elbin, R J; Ellenbogen, R; Fonseca, J; Gioia, G; Guskiewicz, K; Heyer, R; Hotz, G; Iverson, G L; Jordan, B; Manley, G; Maroon, J; McAllister, T; McCrea, M; Mucha, A; Pieroth, E; Podell, K; Pombo, M; Shetty, T; Sills, A; Solomon, G; Thomas, D G; Valovich McLeod, T C; Yates, T; Zafonte, R
In: Neurosurgery, vol. 79, no. 6, pp. 912–929, 2016.
Abstract | Links | BibTeX | Tags: Concussion, mTBI, Rehabilitation, Treatment
@article{Collins2016,
title = {Statements of Agreement from the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015},
author = {Collins, M W and Kontos, A P and Okonkwo, D O and Almquist, J and Bailes, J and Barisa, M and Bazarian, J and Bloom, O J and Brody, D L and Cantu, R and Cardenas, J and Clugston, J and Cohen, R and Echemendia, R and Elbin, R J and Ellenbogen, R and Fonseca, J and Gioia, G and Guskiewicz, K and Heyer, R and Hotz, G and Iverson, G L and Jordan, B and Manley, G and Maroon, J and McAllister, T and McCrea, M and Mucha, A and Pieroth, E and Podell, K and Pombo, M and Shetty, T and Sills, A and Solomon, G and Thomas, D G and {Valovich McLeod}, T C and Yates, T and Zafonte, R},
doi = {10.1227/NEU.0000000000001447},
year = {2016},
date = {2016-01-01},
journal = {Neurosurgery},
volume = {79},
number = {6},
pages = {912--929},
abstract = {BACKGROUND: Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. OBJECTIVE: To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion. METHODS: On October 14 to 16, 2015, the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion meeting was convened in Pittsburgh, Pennsylvania. Thirty-seven concussion experts from neuropsychology, neurology, neurosurgery, sports medicine, physical medicine and rehabilitation, physical therapy, athletic training, and research and 12 individuals representing sport, military, and public health organizations attended the meeting. The 37 experts indicated their agreement on a series of statements using an audience response system clicker device. RESULTS: A total of 16 statements of agreement were supported covering (1) Summary of the Current Approach to Treating Concussion, (2) Heterogeneity and Evolving Clinical Profiles of Concussion, (3) TEAM Approach to Concussion Treatment: Specific Strategies, and (4) Future Directions: A Call to Research. Support (ie, response of agree or somewhat agree) for the statements ranged from to 97% to 100%. CONCLUSION: Concussions are characterized by diverse symptoms and impairments and evolving clinical profiles; recovery varies on the basis of modifying factors, injury severity, and treatments. Active and targeted treatments may enhance recovery after concussion. Research is needed on concussion clinical profiles, biomarkers, and the effectiveness and timing of treatments. Copyright © 2016 by the Congress of Neurological Surgeons.},
keywords = {Concussion, mTBI, Rehabilitation, Treatment},
pubstate = {published},
tppubtype = {article}
}
Muise, D P; MacKenzie, S J; Sutherland, T M
Frequency and magnitude of head accelerations in a Canadian interuniversity sport football team’s training camp and season Journal Article
In: International Journal of Athletic Therapy & Training, vol. 21, no. 5, pp. 36–41, 2016.
Abstract | Links | BibTeX | Tags: Biomechanics, Concussion, mTBI, Sport
@article{Muise2016,
title = {Frequency and magnitude of head accelerations in a Canadian interuniversity sport football team’s training camp and season},
author = {Muise, D P and MacKenzie, S J and Sutherland, T M},
doi = {10.1123/ijatt.2016-0005},
year = {2016},
date = {2016-01-01},
journal = {International Journal of Athletic Therapy \& Training},
volume = {21},
number = {5},
pages = {36--41},
abstract = {The increased awareness of concussion in sport has led to an examination of head impacts and the associated biomechanics that occur during these sporting events. The high rate of concussions in football makes it particularly relevant.1 The purpose of this study was to examine how frequently, and to what magnitude, Canadian University football players get hit in training camp and how this compares to practices and games in regular season. An ANOVA with repeated measures indicated that, on average, players were hit significantly more in games (45.2 hits) than training camp sessions (17.7 hits) and practices (8.0 hits), while training camp was associated with significantly more hits than practices (p \<. 001, $eta$2 =.392). Multiple positional differences were found. In particular, significantly more hits were experienced by offensive linemen (36.7 hits) and defensive linemen (31.6 hits) compared with all other positions (p \<.001, $eta$2 =.247). Study outcomes determined players/positions most at risk for concussion due to head impacts, which is beneficial in forming concussion prevention and assessment strategies. © 2016 Human Kinetics \textendashIJATT.},
keywords = {Biomechanics, Concussion, mTBI, Sport},
pubstate = {published},
tppubtype = {article}
}
Holtkamp, M D; Grimes, J; Ling, G
Concussion in the Military: an Evidence-Base Review of mTBI in US Military Personnel Focused on Posttraumatic Headache Journal Article
In: Current Pain & Headache Reports, vol. 20, no. 6, 2016.
Abstract | Links | BibTeX | Tags: apolipoprotein E4, assessment, biological marker, botulinum toxin, brain concussion, calcitonin gene related peptide receptor antagonis, comorbidity, Concussion, depression, DIAGNOSTIC imaging, disease course, genetic polymorphism, genetic predisposition, glial fibrillary acidic protein, headache, Headache disorder, human, MANAGEMENT, migraine, Military personnel, mTBI, neuroimaging, Pathophysiology, postconcussion syndrome, posttraumatic headache, posttraumatic stress disorder, Prognosis, Review, serotonin 1 agonist, serotonin 1F agonist, soldier, traumatic brain injury, Treatment, tricyclic antidepressant agent, triptan derivative, unclassified drug, UNITED States
@article{Holtkamp2016,
title = {Concussion in the Military: an Evidence-Base Review of mTBI in US Military Personnel Focused on Posttraumatic Headache},
author = {Holtkamp, M D and Grimes, J and Ling, G},
doi = {10.1007/s11916-016-0572-x},
year = {2016},
date = {2016-01-01},
journal = {Current Pain \& Headache Reports},
volume = {20},
number = {6},
abstract = {Traumatic brain injury (TBI) is defined as an alteration in brain function caused by an external force. Mild TBI or concussion is now well recognized to be a risk of military service as well as participation in athletic sports such as football. Posttraumatic headache (PTH) is the most common symptom after mTBI in US service members. PTH most commonly presents with migraine-like headache features. The following is an overview of the epidemiology, pathophysiology, clinical course, prognosis, complications, and treatment of mTBI and associated comorbidities with a focus on PTH. There is a particular emphasis on emerging evidence-based clinical practice. One important medical consequence of the recognition that mTBI is a highly prevalent among military service members is that the Department of Defense (DoD) is dedicating significant financial and intellectual resources to better understanding and developing treatments for TBI. The identification of the importance of TBI among the US military population has had the added benefit of increasing awareness of this condition among civilian populations, particularly those engaged in both professional and youth sports. The NIH and NSF are also supporting important TBI research. President Obama’s Brain Initiative is also providing additional impetus for these efforts. Unfortunately, the understanding of the acute and chronic effects of mTBI on the brain remains limited. Gratefully, there is hope that through innovative research, there will be advances in elucidating the underlying pathophysiology, which will lead to clinical and prognostic indicators, ultimately resulting in new treatment options for this very complicated set of disorders. © 2016, Springer Science+Business Media New York (outside the USA).},
keywords = {apolipoprotein E4, assessment, biological marker, botulinum toxin, brain concussion, calcitonin gene related peptide receptor antagonis, comorbidity, Concussion, depression, DIAGNOSTIC imaging, disease course, genetic polymorphism, genetic predisposition, glial fibrillary acidic protein, headache, Headache disorder, human, MANAGEMENT, migraine, Military personnel, mTBI, neuroimaging, Pathophysiology, postconcussion syndrome, posttraumatic headache, posttraumatic stress disorder, Prognosis, Review, serotonin 1 agonist, serotonin 1F agonist, soldier, traumatic brain injury, Treatment, tricyclic antidepressant agent, triptan derivative, unclassified drug, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Fineblit, S; Selci, E; Loewen, H; Ellis, M; Russell, K
Health-Related Quality of Life after Pediatric Mild Traumatic Brain Injury/Concussion: A Systematic Review Journal Article
In: Journal of Neurotrauma, vol. 33, no. 17, pp. 1561–1568, 2016.
Abstract | Links | BibTeX | Tags: Concussion, HRQOL, mTBI
@article{Fineblit2016,
title = {Health-Related Quality of Life after Pediatric Mild Traumatic Brain Injury/Concussion: A Systematic Review},
author = {Fineblit, S and Selci, E and Loewen, H and Ellis, M and Russell, K},
doi = {10.1089/neu.2015.4292},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {17},
pages = {1561--1568},
abstract = {Health-related quality of life (HRQOL) is an emerging method to quantify the consequences of pediatric mild traumatic brain injury (mTBI)/concussion in both clinical practice and research. However, to utilize HRQOL measurements to their full potential in the context of mTBI/concussion recovery, a better understanding of the typical course of HRQOL after these injuries is needed. The objective of this study was to summarize current knowledge on HRQOL after pediatric mTBI/concussion and identify areas in need of further research. The following databases from their earliest date of coverage through June 1, 2015 were used: MEDLINE®, PubMed, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), and Child Development and Adolescent Studies (CDAS). Studies must have examined and reported HRQOL in a pediatric population after mTBI/concussion, using a validated HRQOL measurement tool. Eight of 1660 records identified ultimately met inclusion criteria. Comprehensive data were extracted and checked by a second reviewer for accuracy and completeness. There appears to be a small but important subgroup of patients who experience poor HRQOL outcomes up to a year or longer post-injury. Potential predictors of poor HRQOL include older age, lower socioeconomic status, or a history of headaches or trouble sleeping. Differing definitions of mTBI precluded meta-analysis. HRQOL represents an important outcome measure in mTBI/concussion clinical practice and research. The evidence shows that a small but important proportion of patients have diminished HRQOL up to a year or longer post-injury. Further study on this topic is warranted to determine the typical longitudinal progression of HRQOL after pediatric concussion. © Copyright 2016, Mary Ann Liebert, Inc. 2016.},
keywords = {Concussion, HRQOL, mTBI},
pubstate = {published},
tppubtype = {article}
}
Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M
Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.
Abstract | Links | BibTeX | Tags: academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome
@article{Alexander2015,
title = {Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes},
author = {Alexander, D G and Shuttleworth-Edwards, A B and Kidd, M and Malcolm, C M},
doi = {10.3109/02699052.2015.1031699},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1113--1125},
abstract = {Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby. © 2015 Taylor \& Francis Group, LLC.},
keywords = {academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Phillips, S; Woessner, D
Sports-Related Traumatic Brain Injury Journal Article
In: Primary Care - Clinics in Office Practice, vol. 42, no. 2, pp. 243–248, 2015.
Abstract | Links | BibTeX | Tags: Anxiety, Athletic Injuries, attention deficit disorder, balance disorder, Balance Error Scoring System, benzodiazepine derivative, beta adrenergic receptor blocking agent, body equilibrium, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion, coordination disorder, depression, Dizziness, drowsiness, evaluation and follow up, headache, human, Humans, irritability, meclozine, memory disorder, mental concentration, Mild TBI guidelines, mild traumatic brain injury, mood change, mTBI, nausea, NFL Sideline Concussion Assessment Tool, nuclear magnetic resonance imaging, paracetamol, personal hygiene, postconcussion syndrome, Postconcussive syndrome, Primary Health Care, priority journal, procedures, recurrent disease, rest, Review, scoring system, Sideline Concussion Assessment Tool 3, Sideline concussion assessment tool 3 (SCAT3), sleep disorder, Sport, sport injury, Sports, Sports-related, Tomography, traumatic brain injury, tricyclic antidepressant agent, VERTIGO, visual disorder, vomiting, X-Ray Computed
@article{Phillips2015b,
title = {Sports-Related Traumatic Brain Injury},
author = {Phillips, S and Woessner, D},
doi = {10.1016/j.pop.2015.01.010},
year = {2015},
date = {2015-01-01},
journal = {Primary Care - Clinics in Office Practice},
volume = {42},
number = {2},
pages = {243--248},
abstract = {Concussions have garnered more attention in the medical literature, media, and social media. As such, in the nomenclature according to the Centers for Disease Control and Prevention, the term concussion has been supplanted by the term mild traumatic brain injury. Current numbers indicate that 1.7 million TBIs are documented annually, with estimates around 3 million annually (173,285 sports- and recreation-related TBIs among children and adolescents). The Sideline Concussion Assessment Tool 3 and the NFL Sideline Concussion Assessment Tool are commonly used sideline tools. © 2015 Elsevier Inc.},
keywords = {Anxiety, Athletic Injuries, attention deficit disorder, balance disorder, Balance Error Scoring System, benzodiazepine derivative, beta adrenergic receptor blocking agent, body equilibrium, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion, coordination disorder, depression, Dizziness, drowsiness, evaluation and follow up, headache, human, Humans, irritability, meclozine, memory disorder, mental concentration, Mild TBI guidelines, mild traumatic brain injury, mood change, mTBI, nausea, NFL Sideline Concussion Assessment Tool, nuclear magnetic resonance imaging, paracetamol, personal hygiene, postconcussion syndrome, Postconcussive syndrome, Primary Health Care, priority journal, procedures, recurrent disease, rest, Review, scoring system, Sideline Concussion Assessment Tool 3, Sideline concussion assessment tool 3 (SCAT3), sleep disorder, Sport, sport injury, Sports, Sports-related, Tomography, traumatic brain injury, tricyclic antidepressant agent, VERTIGO, visual disorder, vomiting, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
DiFazio, M; Silverberg, N D; Kirkwood, M W; Bernier, R; Iverson, G L
Prolonged Activity Restriction after Concussion: Are We Worsening Outcomes? Journal Article
In: Clinical Pediatrics, vol. 55, no. 5, pp. 443–451, 2015.
Abstract | Links | BibTeX | Tags: activity restriction, Anxiety, Article, athletic trainer, brain concussion, case report, Concussion, daily life activity, depression, Dizziness, evolution, exercise, expectation, headache, human, Male, mood disorder, mTBI, nocebo effect, patient harm, PHYSICAL ACTIVITY, practice guideline, prolonged activity restriction, psychological aspect, Rehabilitation, rest, school, traumatic brain injury, Treatment, treatment outcome, wrestling
@article{DiFazio2015,
title = {Prolonged Activity Restriction after Concussion: Are We Worsening Outcomes?},
author = {DiFazio, M and Silverberg, N D and Kirkwood, M W and Bernier, R and Iverson, G L},
doi = {10.1177/0009922815589914},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {5},
pages = {443--451},
abstract = {The current treatment of concussion or mild traumatic brain injury (mTBI) is primarily based on expert consensus. Most clinical practice guidelines advise cognitive and physical rest after injury including withdrawal from normal life activities such as school attendance, sports participation, and technology use until symptoms resolve. Some individuals who sustain an mTBI experience persistent physical, cognitive, and mental health problems. Activity restriction itself may contribute to protracted recovery and other complications. Williamson's Activity Restriction Model of Depression, formulated more than 20 years ago, is central to this hypothesis. We review research evidence for potential harms of prolonged activity restriction and report an mTBI case as an example of how an "activity restriction cascade" can unfold. According to this model, psychological consequences of removal from validating life activities, combined with physical deconditioning, contribute to the development and persistence of postconcussive symptoms after mTBI in some youth. A modification to mTBI guidelines that emphasizes prompt reengagement in life activities as tolerated is encouraged. © SAGE Publications.},
keywords = {activity restriction, Anxiety, Article, athletic trainer, brain concussion, case report, Concussion, daily life activity, depression, Dizziness, evolution, exercise, expectation, headache, human, Male, mood disorder, mTBI, nocebo effect, patient harm, PHYSICAL ACTIVITY, practice guideline, prolonged activity restriction, psychological aspect, Rehabilitation, rest, school, traumatic brain injury, Treatment, treatment outcome, wrestling},
pubstate = {published},
tppubtype = {article}
}
LeBlanc, Jeanne M; McLachlan, Kaitlyn
Prevention of Post-Concussional Syndrome in North American Workers: The Importance of Early Intervention on Vocational Outcome Journal Article
In: Australian Journal of Rehabilitation Counselling, vol. 16, no. 1, pp. 36–44, 2010, ISBN: 13238922.
Abstract | BibTeX | Tags: *BRAIN -- Wounds & injuries, *OUTPATIENT medical care, *POSTCONCUSSION syndrome, *REHABILITATION, Concussion, employment, INDIVIDUALIZED education programs, INDUSTRIAL hygiene, mild traumatic brain injury, mTBI, outpatient, PCS, post-concussive syndrome, Rehabilitation, Treatment
@article{LeBlanc2010,
title = {Prevention of Post-Concussional Syndrome in North American Workers: The Importance of Early Intervention on Vocational Outcome},
author = {LeBlanc, Jeanne M and McLachlan, Kaitlyn},
isbn = {13238922},
year = {2010},
date = {2010-01-01},
journal = {Australian Journal of Rehabilitation Counselling},
volume = {16},
number = {1},
pages = {36--44},
abstract = {The purpose of this study was to: (1) Establish whether or not specific rehabilitation for mild brain injury is effective for return to work; and (2) compare the efficacy of an impairment-focused model of treatment versus an early education approach in respect to ability to return to work. Two different approaches to intervention and treatment for those with a suspected concussion from a work-related injury were utilised by an urban, interdisciplinary, outpatient rehabilitation facility. The first approach, Group Treatment (GT), provided minimal early education at time of initial intake, emphasising an extensive group-focused interdisciplinary assessment and treatment. The second approach, Individualized Education and Treatment, (IET) emphasised early education, instead coupled with specific individualised services. Both groups received employment services. Post-discharge, GT ( N = 26) resulted in 46% ( n = 12) of individuals returning to competitive employment, while IET ( N = 23) resulted in 78% ( n = 18) of individuals returning to competitive employment. An asset-oriented early individualised educational approach appears to be a more effective for employment re-engagement. ABSTRACT FROM AUTHOR},
keywords = {*BRAIN -- Wounds \& injuries, *OUTPATIENT medical care, *POSTCONCUSSION syndrome, *REHABILITATION, Concussion, employment, INDIVIDUALIZED education programs, INDUSTRIAL hygiene, mild traumatic brain injury, mTBI, outpatient, PCS, post-concussive syndrome, Rehabilitation, Treatment},
pubstate = {published},
tppubtype = {article}
}
Terwilliger, V K; Pratson, L; Vaughan, C G; Gioia, G A
Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 33, no. 8, pp. 761–765, 2016.
@article{Terwilliger2016,
title = {Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes},
author = {Terwilliger, V K and Pratson, L and Vaughan, C G and Gioia, G A},
doi = {10.1089/neu.2015.4082},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {8},
pages = {761--765},
abstract = {Repeat concussion has been associated with risk for prolonged and pronounced clinical recovery in athletes. In this study of adolescent athletes, we examined whether an additional head impact within 24 h of a sports-related concussion (SRC) is associated with higher symptom burden and prolonged clinical recovery compared with a single-injury group. Forty-two student-athletes (52% male, mean age = 14.9 years) diagnosed with an SRC in a concussion clinic were selected for this study: (1) 21 athletes who sustained an additional significant head impact within 24 h of the initial injury (additional-impact group); (2) 21 single-injury athletes, age and gender matched, who sustained only one discrete concussive blow to the head (single-injury group). Groups did not differ on initial injury characteristics or pre-injury risk factors. The effect of injury status (single-vs. additional-impact) was examined on athlete-and parent-reported symptom burden (at first clinic visit) and length of recovery (LOR). Higher symptom burden was reported by the athletes and parents in the additional-impact group at the time of first visit. The additional-impact group also had a significantly longer LOR compared with the single-injury group. These findings provide preliminary, hypothesis-generating evidence for the importance of immediate removal from play following an SRC to protect athletes from re-injury, which may worsen symptoms and prolong recovery. The retrospective study design from a specialized clinical sample points to the need for future prospective studies of the relationship between single-and additional-impact injuries on symptom burden and LOR. © 2016 Mary Ann Liebert, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Slaboda, J C; King, L A; Wright, W G; Houlihan, D; Norris, J N
Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment Journal Article
In: Journal of Neurotrauma, vol. 33, no. 7, pp. 705–711, 2016.
@article{Haran2016,
title = {Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment},
author = {Haran, F J and Slaboda, J C and King, L A and Wright, W G and Houlihan, D and Norris, J N},
doi = {10.1089/neu.2015.4060},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {7},
pages = {705--711},
abstract = {This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT. SMs with mTBI performed significantly worse on the BESS and SOT when compared with comparative samples. When the SOT data were further examined using sensory ratios, the results indicated that postural instability was primarily a result of vestibular and visual integration dysfunction (r \> 0.62). The main finding of this study was that the sensitivity of the SOT composite score (50-58%) during the acute phase was higher than previous sensitivities found in the sports medicine literature for impact-related trauma. Copyright © 2016 Mary Ann Liebert, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Collins, M W; Kontos, A P; Okonkwo, D O; Almquist, J; Bailes, J; Barisa, M; Bazarian, J; Bloom, O J; Brody, D L; Cantu, R; Cardenas, J; Clugston, J; Cohen, R; Echemendia, R; Elbin, R J; Ellenbogen, R; Fonseca, J; Gioia, G; Guskiewicz, K; Heyer, R; Hotz, G; Iverson, G L; Jordan, B; Manley, G; Maroon, J; McAllister, T; McCrea, M; Mucha, A; Pieroth, E; Podell, K; Pombo, M; Shetty, T; Sills, A; Solomon, G; Thomas, D G; Valovich McLeod, T C; Yates, T; Zafonte, R
In: Neurosurgery, vol. 79, no. 6, pp. 912–929, 2016.
@article{Collins2016,
title = {Statements of Agreement from the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015},
author = {Collins, M W and Kontos, A P and Okonkwo, D O and Almquist, J and Bailes, J and Barisa, M and Bazarian, J and Bloom, O J and Brody, D L and Cantu, R and Cardenas, J and Clugston, J and Cohen, R and Echemendia, R and Elbin, R J and Ellenbogen, R and Fonseca, J and Gioia, G and Guskiewicz, K and Heyer, R and Hotz, G and Iverson, G L and Jordan, B and Manley, G and Maroon, J and McAllister, T and McCrea, M and Mucha, A and Pieroth, E and Podell, K and Pombo, M and Shetty, T and Sills, A and Solomon, G and Thomas, D G and {Valovich McLeod}, T C and Yates, T and Zafonte, R},
doi = {10.1227/NEU.0000000000001447},
year = {2016},
date = {2016-01-01},
journal = {Neurosurgery},
volume = {79},
number = {6},
pages = {912--929},
abstract = {BACKGROUND: Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. OBJECTIVE: To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion. METHODS: On October 14 to 16, 2015, the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion meeting was convened in Pittsburgh, Pennsylvania. Thirty-seven concussion experts from neuropsychology, neurology, neurosurgery, sports medicine, physical medicine and rehabilitation, physical therapy, athletic training, and research and 12 individuals representing sport, military, and public health organizations attended the meeting. The 37 experts indicated their agreement on a series of statements using an audience response system clicker device. RESULTS: A total of 16 statements of agreement were supported covering (1) Summary of the Current Approach to Treating Concussion, (2) Heterogeneity and Evolving Clinical Profiles of Concussion, (3) TEAM Approach to Concussion Treatment: Specific Strategies, and (4) Future Directions: A Call to Research. Support (ie, response of agree or somewhat agree) for the statements ranged from to 97% to 100%. CONCLUSION: Concussions are characterized by diverse symptoms and impairments and evolving clinical profiles; recovery varies on the basis of modifying factors, injury severity, and treatments. Active and targeted treatments may enhance recovery after concussion. Research is needed on concussion clinical profiles, biomarkers, and the effectiveness and timing of treatments. Copyright © 2016 by the Congress of Neurological Surgeons.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Muise, D P; MacKenzie, S J; Sutherland, T M
Frequency and magnitude of head accelerations in a Canadian interuniversity sport football team’s training camp and season Journal Article
In: International Journal of Athletic Therapy & Training, vol. 21, no. 5, pp. 36–41, 2016.
@article{Muise2016,
title = {Frequency and magnitude of head accelerations in a Canadian interuniversity sport football team’s training camp and season},
author = {Muise, D P and MacKenzie, S J and Sutherland, T M},
doi = {10.1123/ijatt.2016-0005},
year = {2016},
date = {2016-01-01},
journal = {International Journal of Athletic Therapy \& Training},
volume = {21},
number = {5},
pages = {36--41},
abstract = {The increased awareness of concussion in sport has led to an examination of head impacts and the associated biomechanics that occur during these sporting events. The high rate of concussions in football makes it particularly relevant.1 The purpose of this study was to examine how frequently, and to what magnitude, Canadian University football players get hit in training camp and how this compares to practices and games in regular season. An ANOVA with repeated measures indicated that, on average, players were hit significantly more in games (45.2 hits) than training camp sessions (17.7 hits) and practices (8.0 hits), while training camp was associated with significantly more hits than practices (p \<. 001, $eta$2 =.392). Multiple positional differences were found. In particular, significantly more hits were experienced by offensive linemen (36.7 hits) and defensive linemen (31.6 hits) compared with all other positions (p \<.001, $eta$2 =.247). Study outcomes determined players/positions most at risk for concussion due to head impacts, which is beneficial in forming concussion prevention and assessment strategies. © 2016 Human Kinetics \textendashIJATT.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Holtkamp, M D; Grimes, J; Ling, G
Concussion in the Military: an Evidence-Base Review of mTBI in US Military Personnel Focused on Posttraumatic Headache Journal Article
In: Current Pain & Headache Reports, vol. 20, no. 6, 2016.
@article{Holtkamp2016,
title = {Concussion in the Military: an Evidence-Base Review of mTBI in US Military Personnel Focused on Posttraumatic Headache},
author = {Holtkamp, M D and Grimes, J and Ling, G},
doi = {10.1007/s11916-016-0572-x},
year = {2016},
date = {2016-01-01},
journal = {Current Pain \& Headache Reports},
volume = {20},
number = {6},
abstract = {Traumatic brain injury (TBI) is defined as an alteration in brain function caused by an external force. Mild TBI or concussion is now well recognized to be a risk of military service as well as participation in athletic sports such as football. Posttraumatic headache (PTH) is the most common symptom after mTBI in US service members. PTH most commonly presents with migraine-like headache features. The following is an overview of the epidemiology, pathophysiology, clinical course, prognosis, complications, and treatment of mTBI and associated comorbidities with a focus on PTH. There is a particular emphasis on emerging evidence-based clinical practice. One important medical consequence of the recognition that mTBI is a highly prevalent among military service members is that the Department of Defense (DoD) is dedicating significant financial and intellectual resources to better understanding and developing treatments for TBI. The identification of the importance of TBI among the US military population has had the added benefit of increasing awareness of this condition among civilian populations, particularly those engaged in both professional and youth sports. The NIH and NSF are also supporting important TBI research. President Obama’s Brain Initiative is also providing additional impetus for these efforts. Unfortunately, the understanding of the acute and chronic effects of mTBI on the brain remains limited. Gratefully, there is hope that through innovative research, there will be advances in elucidating the underlying pathophysiology, which will lead to clinical and prognostic indicators, ultimately resulting in new treatment options for this very complicated set of disorders. © 2016, Springer Science+Business Media New York (outside the USA).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fineblit, S; Selci, E; Loewen, H; Ellis, M; Russell, K
Health-Related Quality of Life after Pediatric Mild Traumatic Brain Injury/Concussion: A Systematic Review Journal Article
In: Journal of Neurotrauma, vol. 33, no. 17, pp. 1561–1568, 2016.
@article{Fineblit2016,
title = {Health-Related Quality of Life after Pediatric Mild Traumatic Brain Injury/Concussion: A Systematic Review},
author = {Fineblit, S and Selci, E and Loewen, H and Ellis, M and Russell, K},
doi = {10.1089/neu.2015.4292},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {17},
pages = {1561--1568},
abstract = {Health-related quality of life (HRQOL) is an emerging method to quantify the consequences of pediatric mild traumatic brain injury (mTBI)/concussion in both clinical practice and research. However, to utilize HRQOL measurements to their full potential in the context of mTBI/concussion recovery, a better understanding of the typical course of HRQOL after these injuries is needed. The objective of this study was to summarize current knowledge on HRQOL after pediatric mTBI/concussion and identify areas in need of further research. The following databases from their earliest date of coverage through June 1, 2015 were used: MEDLINE®, PubMed, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), and Child Development and Adolescent Studies (CDAS). Studies must have examined and reported HRQOL in a pediatric population after mTBI/concussion, using a validated HRQOL measurement tool. Eight of 1660 records identified ultimately met inclusion criteria. Comprehensive data were extracted and checked by a second reviewer for accuracy and completeness. There appears to be a small but important subgroup of patients who experience poor HRQOL outcomes up to a year or longer post-injury. Potential predictors of poor HRQOL include older age, lower socioeconomic status, or a history of headaches or trouble sleeping. Differing definitions of mTBI precluded meta-analysis. HRQOL represents an important outcome measure in mTBI/concussion clinical practice and research. The evidence shows that a small but important proportion of patients have diminished HRQOL up to a year or longer post-injury. Further study on this topic is warranted to determine the typical longitudinal progression of HRQOL after pediatric concussion. © Copyright 2016, Mary Ann Liebert, Inc. 2016.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M
Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.
@article{Alexander2015,
title = {Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes},
author = {Alexander, D G and Shuttleworth-Edwards, A B and Kidd, M and Malcolm, C M},
doi = {10.3109/02699052.2015.1031699},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1113--1125},
abstract = {Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby. © 2015 Taylor \& Francis Group, LLC.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Phillips, S; Woessner, D
Sports-Related Traumatic Brain Injury Journal Article
In: Primary Care - Clinics in Office Practice, vol. 42, no. 2, pp. 243–248, 2015.
@article{Phillips2015b,
title = {Sports-Related Traumatic Brain Injury},
author = {Phillips, S and Woessner, D},
doi = {10.1016/j.pop.2015.01.010},
year = {2015},
date = {2015-01-01},
journal = {Primary Care - Clinics in Office Practice},
volume = {42},
number = {2},
pages = {243--248},
abstract = {Concussions have garnered more attention in the medical literature, media, and social media. As such, in the nomenclature according to the Centers for Disease Control and Prevention, the term concussion has been supplanted by the term mild traumatic brain injury. Current numbers indicate that 1.7 million TBIs are documented annually, with estimates around 3 million annually (173,285 sports- and recreation-related TBIs among children and adolescents). The Sideline Concussion Assessment Tool 3 and the NFL Sideline Concussion Assessment Tool are commonly used sideline tools. © 2015 Elsevier Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
DiFazio, M; Silverberg, N D; Kirkwood, M W; Bernier, R; Iverson, G L
Prolonged Activity Restriction after Concussion: Are We Worsening Outcomes? Journal Article
In: Clinical Pediatrics, vol. 55, no. 5, pp. 443–451, 2015.
@article{DiFazio2015,
title = {Prolonged Activity Restriction after Concussion: Are We Worsening Outcomes?},
author = {DiFazio, M and Silverberg, N D and Kirkwood, M W and Bernier, R and Iverson, G L},
doi = {10.1177/0009922815589914},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {5},
pages = {443--451},
abstract = {The current treatment of concussion or mild traumatic brain injury (mTBI) is primarily based on expert consensus. Most clinical practice guidelines advise cognitive and physical rest after injury including withdrawal from normal life activities such as school attendance, sports participation, and technology use until symptoms resolve. Some individuals who sustain an mTBI experience persistent physical, cognitive, and mental health problems. Activity restriction itself may contribute to protracted recovery and other complications. Williamson's Activity Restriction Model of Depression, formulated more than 20 years ago, is central to this hypothesis. We review research evidence for potential harms of prolonged activity restriction and report an mTBI case as an example of how an "activity restriction cascade" can unfold. According to this model, psychological consequences of removal from validating life activities, combined with physical deconditioning, contribute to the development and persistence of postconcussive symptoms after mTBI in some youth. A modification to mTBI guidelines that emphasizes prompt reengagement in life activities as tolerated is encouraged. © SAGE Publications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
LeBlanc, Jeanne M; McLachlan, Kaitlyn
Prevention of Post-Concussional Syndrome in North American Workers: The Importance of Early Intervention on Vocational Outcome Journal Article
In: Australian Journal of Rehabilitation Counselling, vol. 16, no. 1, pp. 36–44, 2010, ISBN: 13238922.
@article{LeBlanc2010,
title = {Prevention of Post-Concussional Syndrome in North American Workers: The Importance of Early Intervention on Vocational Outcome},
author = {LeBlanc, Jeanne M and McLachlan, Kaitlyn},
isbn = {13238922},
year = {2010},
date = {2010-01-01},
journal = {Australian Journal of Rehabilitation Counselling},
volume = {16},
number = {1},
pages = {36--44},
abstract = {The purpose of this study was to: (1) Establish whether or not specific rehabilitation for mild brain injury is effective for return to work; and (2) compare the efficacy of an impairment-focused model of treatment versus an early education approach in respect to ability to return to work. Two different approaches to intervention and treatment for those with a suspected concussion from a work-related injury were utilised by an urban, interdisciplinary, outpatient rehabilitation facility. The first approach, Group Treatment (GT), provided minimal early education at time of initial intake, emphasising an extensive group-focused interdisciplinary assessment and treatment. The second approach, Individualized Education and Treatment, (IET) emphasised early education, instead coupled with specific individualised services. Both groups received employment services. Post-discharge, GT ( N = 26) resulted in 46% ( n = 12) of individuals returning to competitive employment, while IET ( N = 23) resulted in 78% ( n = 18) of individuals returning to competitive employment. An asset-oriented early individualised educational approach appears to be a more effective for employment re-engagement. ABSTRACT FROM AUTHOR},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Terwilliger, V K; Pratson, L; Vaughan, C G; Gioia, G A
Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes Journal Article
In: Journal of Neurotrauma, vol. 33, no. 8, pp. 761–765, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury
@article{Terwilliger2016,
title = {Additional Post-Concussion Impact Exposure May Affect Recovery in Adolescent Athletes},
author = {Terwilliger, V K and Pratson, L and Vaughan, C G and Gioia, G A},
doi = {10.1089/neu.2015.4082},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {8},
pages = {761--765},
abstract = {Repeat concussion has been associated with risk for prolonged and pronounced clinical recovery in athletes. In this study of adolescent athletes, we examined whether an additional head impact within 24 h of a sports-related concussion (SRC) is associated with higher symptom burden and prolonged clinical recovery compared with a single-injury group. Forty-two student-athletes (52% male, mean age = 14.9 years) diagnosed with an SRC in a concussion clinic were selected for this study: (1) 21 athletes who sustained an additional significant head impact within 24 h of the initial injury (additional-impact group); (2) 21 single-injury athletes, age and gender matched, who sustained only one discrete concussive blow to the head (single-injury group). Groups did not differ on initial injury characteristics or pre-injury risk factors. The effect of injury status (single-vs. additional-impact) was examined on athlete-and parent-reported symptom burden (at first clinic visit) and length of recovery (LOR). Higher symptom burden was reported by the athletes and parents in the additional-impact group at the time of first visit. The additional-impact group also had a significantly longer LOR compared with the single-injury group. These findings provide preliminary, hypothesis-generating evidence for the importance of immediate removal from play following an SRC to protect athletes from re-injury, which may worsen symptoms and prolong recovery. The retrospective study design from a specialized clinical sample points to the need for future prospective studies of the relationship between single-and additional-impact injuries on symptom burden and LOR. © 2016 Mary Ann Liebert, Inc.},
keywords = {Adolescent, Article, athlete, Athletes, brain concussion, Brain Injury, clinical article, Concussion, controlled study, CONVALESCENCE, Female, human, Male, mTBI, Parent, postconcussion syndrome, retrospective study, risk factor, sport injury},
pubstate = {published},
tppubtype = {article}
}
Haran, F J; Slaboda, J C; King, L A; Wright, W G; Houlihan, D; Norris, J N
Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment Journal Article
In: Journal of Neurotrauma, vol. 33, no. 7, pp. 705–711, 2016.
Abstract | Links | BibTeX | Tags: adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War
@article{Haran2016,
title = {Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment},
author = {Haran, F J and Slaboda, J C and King, L A and Wright, W G and Houlihan, D and Norris, J N},
doi = {10.1089/neu.2015.4060},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {7},
pages = {705--711},
abstract = {This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT. SMs with mTBI performed significantly worse on the BESS and SOT when compared with comparative samples. When the SOT data were further examined using sensory ratios, the results indicated that postural instability was primarily a result of vestibular and visual integration dysfunction (r \> 0.62). The main finding of this study was that the sensitivity of the SOT composite score (50-58%) during the acute phase was higher than previous sensitivities found in the sports medicine literature for impact-related trauma. Copyright © 2016 Mary Ann Liebert, Inc.},
keywords = {adult, Afghanistan, Article, Balance Error Scoring System, BESS, body posture, brain injury assessment, controlled study, CONVALESCENCE, human, integration, major clinical study, Male, Military, military deployment, mTBI, scoring system, Sensory Organization Test, SOT, traumatic brain injury, visual disorder, War},
pubstate = {published},
tppubtype = {article}
}
Collins, M W; Kontos, A P; Okonkwo, D O; Almquist, J; Bailes, J; Barisa, M; Bazarian, J; Bloom, O J; Brody, D L; Cantu, R; Cardenas, J; Clugston, J; Cohen, R; Echemendia, R; Elbin, R J; Ellenbogen, R; Fonseca, J; Gioia, G; Guskiewicz, K; Heyer, R; Hotz, G; Iverson, G L; Jordan, B; Manley, G; Maroon, J; McAllister, T; McCrea, M; Mucha, A; Pieroth, E; Podell, K; Pombo, M; Shetty, T; Sills, A; Solomon, G; Thomas, D G; Valovich McLeod, T C; Yates, T; Zafonte, R
In: Neurosurgery, vol. 79, no. 6, pp. 912–929, 2016.
Abstract | Links | BibTeX | Tags: Concussion, mTBI, Rehabilitation, Treatment
@article{Collins2016,
title = {Statements of Agreement from the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015},
author = {Collins, M W and Kontos, A P and Okonkwo, D O and Almquist, J and Bailes, J and Barisa, M and Bazarian, J and Bloom, O J and Brody, D L and Cantu, R and Cardenas, J and Clugston, J and Cohen, R and Echemendia, R and Elbin, R J and Ellenbogen, R and Fonseca, J and Gioia, G and Guskiewicz, K and Heyer, R and Hotz, G and Iverson, G L and Jordan, B and Manley, G and Maroon, J and McAllister, T and McCrea, M and Mucha, A and Pieroth, E and Podell, K and Pombo, M and Shetty, T and Sills, A and Solomon, G and Thomas, D G and {Valovich McLeod}, T C and Yates, T and Zafonte, R},
doi = {10.1227/NEU.0000000000001447},
year = {2016},
date = {2016-01-01},
journal = {Neurosurgery},
volume = {79},
number = {6},
pages = {912--929},
abstract = {BACKGROUND: Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. OBJECTIVE: To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion. METHODS: On October 14 to 16, 2015, the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion meeting was convened in Pittsburgh, Pennsylvania. Thirty-seven concussion experts from neuropsychology, neurology, neurosurgery, sports medicine, physical medicine and rehabilitation, physical therapy, athletic training, and research and 12 individuals representing sport, military, and public health organizations attended the meeting. The 37 experts indicated their agreement on a series of statements using an audience response system clicker device. RESULTS: A total of 16 statements of agreement were supported covering (1) Summary of the Current Approach to Treating Concussion, (2) Heterogeneity and Evolving Clinical Profiles of Concussion, (3) TEAM Approach to Concussion Treatment: Specific Strategies, and (4) Future Directions: A Call to Research. Support (ie, response of agree or somewhat agree) for the statements ranged from to 97% to 100%. CONCLUSION: Concussions are characterized by diverse symptoms and impairments and evolving clinical profiles; recovery varies on the basis of modifying factors, injury severity, and treatments. Active and targeted treatments may enhance recovery after concussion. Research is needed on concussion clinical profiles, biomarkers, and the effectiveness and timing of treatments. Copyright © 2016 by the Congress of Neurological Surgeons.},
keywords = {Concussion, mTBI, Rehabilitation, Treatment},
pubstate = {published},
tppubtype = {article}
}
Muise, D P; MacKenzie, S J; Sutherland, T M
Frequency and magnitude of head accelerations in a Canadian interuniversity sport football team’s training camp and season Journal Article
In: International Journal of Athletic Therapy & Training, vol. 21, no. 5, pp. 36–41, 2016.
Abstract | Links | BibTeX | Tags: Biomechanics, Concussion, mTBI, Sport
@article{Muise2016,
title = {Frequency and magnitude of head accelerations in a Canadian interuniversity sport football team’s training camp and season},
author = {Muise, D P and MacKenzie, S J and Sutherland, T M},
doi = {10.1123/ijatt.2016-0005},
year = {2016},
date = {2016-01-01},
journal = {International Journal of Athletic Therapy \& Training},
volume = {21},
number = {5},
pages = {36--41},
abstract = {The increased awareness of concussion in sport has led to an examination of head impacts and the associated biomechanics that occur during these sporting events. The high rate of concussions in football makes it particularly relevant.1 The purpose of this study was to examine how frequently, and to what magnitude, Canadian University football players get hit in training camp and how this compares to practices and games in regular season. An ANOVA with repeated measures indicated that, on average, players were hit significantly more in games (45.2 hits) than training camp sessions (17.7 hits) and practices (8.0 hits), while training camp was associated with significantly more hits than practices (p \<. 001, $eta$2 =.392). Multiple positional differences were found. In particular, significantly more hits were experienced by offensive linemen (36.7 hits) and defensive linemen (31.6 hits) compared with all other positions (p \<.001, $eta$2 =.247). Study outcomes determined players/positions most at risk for concussion due to head impacts, which is beneficial in forming concussion prevention and assessment strategies. © 2016 Human Kinetics \textendashIJATT.},
keywords = {Biomechanics, Concussion, mTBI, Sport},
pubstate = {published},
tppubtype = {article}
}
Holtkamp, M D; Grimes, J; Ling, G
Concussion in the Military: an Evidence-Base Review of mTBI in US Military Personnel Focused on Posttraumatic Headache Journal Article
In: Current Pain & Headache Reports, vol. 20, no. 6, 2016.
Abstract | Links | BibTeX | Tags: apolipoprotein E4, assessment, biological marker, botulinum toxin, brain concussion, calcitonin gene related peptide receptor antagonis, comorbidity, Concussion, depression, DIAGNOSTIC imaging, disease course, genetic polymorphism, genetic predisposition, glial fibrillary acidic protein, headache, Headache disorder, human, MANAGEMENT, migraine, Military personnel, mTBI, neuroimaging, Pathophysiology, postconcussion syndrome, posttraumatic headache, posttraumatic stress disorder, Prognosis, Review, serotonin 1 agonist, serotonin 1F agonist, soldier, traumatic brain injury, Treatment, tricyclic antidepressant agent, triptan derivative, unclassified drug, UNITED States
@article{Holtkamp2016,
title = {Concussion in the Military: an Evidence-Base Review of mTBI in US Military Personnel Focused on Posttraumatic Headache},
author = {Holtkamp, M D and Grimes, J and Ling, G},
doi = {10.1007/s11916-016-0572-x},
year = {2016},
date = {2016-01-01},
journal = {Current Pain \& Headache Reports},
volume = {20},
number = {6},
abstract = {Traumatic brain injury (TBI) is defined as an alteration in brain function caused by an external force. Mild TBI or concussion is now well recognized to be a risk of military service as well as participation in athletic sports such as football. Posttraumatic headache (PTH) is the most common symptom after mTBI in US service members. PTH most commonly presents with migraine-like headache features. The following is an overview of the epidemiology, pathophysiology, clinical course, prognosis, complications, and treatment of mTBI and associated comorbidities with a focus on PTH. There is a particular emphasis on emerging evidence-based clinical practice. One important medical consequence of the recognition that mTBI is a highly prevalent among military service members is that the Department of Defense (DoD) is dedicating significant financial and intellectual resources to better understanding and developing treatments for TBI. The identification of the importance of TBI among the US military population has had the added benefit of increasing awareness of this condition among civilian populations, particularly those engaged in both professional and youth sports. The NIH and NSF are also supporting important TBI research. President Obama’s Brain Initiative is also providing additional impetus for these efforts. Unfortunately, the understanding of the acute and chronic effects of mTBI on the brain remains limited. Gratefully, there is hope that through innovative research, there will be advances in elucidating the underlying pathophysiology, which will lead to clinical and prognostic indicators, ultimately resulting in new treatment options for this very complicated set of disorders. © 2016, Springer Science+Business Media New York (outside the USA).},
keywords = {apolipoprotein E4, assessment, biological marker, botulinum toxin, brain concussion, calcitonin gene related peptide receptor antagonis, comorbidity, Concussion, depression, DIAGNOSTIC imaging, disease course, genetic polymorphism, genetic predisposition, glial fibrillary acidic protein, headache, Headache disorder, human, MANAGEMENT, migraine, Military personnel, mTBI, neuroimaging, Pathophysiology, postconcussion syndrome, posttraumatic headache, posttraumatic stress disorder, Prognosis, Review, serotonin 1 agonist, serotonin 1F agonist, soldier, traumatic brain injury, Treatment, tricyclic antidepressant agent, triptan derivative, unclassified drug, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Fineblit, S; Selci, E; Loewen, H; Ellis, M; Russell, K
Health-Related Quality of Life after Pediatric Mild Traumatic Brain Injury/Concussion: A Systematic Review Journal Article
In: Journal of Neurotrauma, vol. 33, no. 17, pp. 1561–1568, 2016.
Abstract | Links | BibTeX | Tags: Concussion, HRQOL, mTBI
@article{Fineblit2016,
title = {Health-Related Quality of Life after Pediatric Mild Traumatic Brain Injury/Concussion: A Systematic Review},
author = {Fineblit, S and Selci, E and Loewen, H and Ellis, M and Russell, K},
doi = {10.1089/neu.2015.4292},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {17},
pages = {1561--1568},
abstract = {Health-related quality of life (HRQOL) is an emerging method to quantify the consequences of pediatric mild traumatic brain injury (mTBI)/concussion in both clinical practice and research. However, to utilize HRQOL measurements to their full potential in the context of mTBI/concussion recovery, a better understanding of the typical course of HRQOL after these injuries is needed. The objective of this study was to summarize current knowledge on HRQOL after pediatric mTBI/concussion and identify areas in need of further research. The following databases from their earliest date of coverage through June 1, 2015 were used: MEDLINE®, PubMed, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), and Child Development and Adolescent Studies (CDAS). Studies must have examined and reported HRQOL in a pediatric population after mTBI/concussion, using a validated HRQOL measurement tool. Eight of 1660 records identified ultimately met inclusion criteria. Comprehensive data were extracted and checked by a second reviewer for accuracy and completeness. There appears to be a small but important subgroup of patients who experience poor HRQOL outcomes up to a year or longer post-injury. Potential predictors of poor HRQOL include older age, lower socioeconomic status, or a history of headaches or trouble sleeping. Differing definitions of mTBI precluded meta-analysis. HRQOL represents an important outcome measure in mTBI/concussion clinical practice and research. The evidence shows that a small but important proportion of patients have diminished HRQOL up to a year or longer post-injury. Further study on this topic is warranted to determine the typical longitudinal progression of HRQOL after pediatric concussion. © Copyright 2016, Mary Ann Liebert, Inc. 2016.},
keywords = {Concussion, HRQOL, mTBI},
pubstate = {published},
tppubtype = {article}
}
Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M
Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.
Abstract | Links | BibTeX | Tags: academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome
@article{Alexander2015,
title = {Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes},
author = {Alexander, D G and Shuttleworth-Edwards, A B and Kidd, M and Malcolm, C M},
doi = {10.3109/02699052.2015.1031699},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1113--1125},
abstract = {Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby. © 2015 Taylor \& Francis Group, LLC.},
keywords = {academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Phillips, S; Woessner, D
Sports-Related Traumatic Brain Injury Journal Article
In: Primary Care - Clinics in Office Practice, vol. 42, no. 2, pp. 243–248, 2015.
Abstract | Links | BibTeX | Tags: Anxiety, Athletic Injuries, attention deficit disorder, balance disorder, Balance Error Scoring System, benzodiazepine derivative, beta adrenergic receptor blocking agent, body equilibrium, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion, coordination disorder, depression, Dizziness, drowsiness, evaluation and follow up, headache, human, Humans, irritability, meclozine, memory disorder, mental concentration, Mild TBI guidelines, mild traumatic brain injury, mood change, mTBI, nausea, NFL Sideline Concussion Assessment Tool, nuclear magnetic resonance imaging, paracetamol, personal hygiene, postconcussion syndrome, Postconcussive syndrome, Primary Health Care, priority journal, procedures, recurrent disease, rest, Review, scoring system, Sideline Concussion Assessment Tool 3, Sideline concussion assessment tool 3 (SCAT3), sleep disorder, Sport, sport injury, Sports, Sports-related, Tomography, traumatic brain injury, tricyclic antidepressant agent, VERTIGO, visual disorder, vomiting, X-Ray Computed
@article{Phillips2015b,
title = {Sports-Related Traumatic Brain Injury},
author = {Phillips, S and Woessner, D},
doi = {10.1016/j.pop.2015.01.010},
year = {2015},
date = {2015-01-01},
journal = {Primary Care - Clinics in Office Practice},
volume = {42},
number = {2},
pages = {243--248},
abstract = {Concussions have garnered more attention in the medical literature, media, and social media. As such, in the nomenclature according to the Centers for Disease Control and Prevention, the term concussion has been supplanted by the term mild traumatic brain injury. Current numbers indicate that 1.7 million TBIs are documented annually, with estimates around 3 million annually (173,285 sports- and recreation-related TBIs among children and adolescents). The Sideline Concussion Assessment Tool 3 and the NFL Sideline Concussion Assessment Tool are commonly used sideline tools. © 2015 Elsevier Inc.},
keywords = {Anxiety, Athletic Injuries, attention deficit disorder, balance disorder, Balance Error Scoring System, benzodiazepine derivative, beta adrenergic receptor blocking agent, body equilibrium, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion, coordination disorder, depression, Dizziness, drowsiness, evaluation and follow up, headache, human, Humans, irritability, meclozine, memory disorder, mental concentration, Mild TBI guidelines, mild traumatic brain injury, mood change, mTBI, nausea, NFL Sideline Concussion Assessment Tool, nuclear magnetic resonance imaging, paracetamol, personal hygiene, postconcussion syndrome, Postconcussive syndrome, Primary Health Care, priority journal, procedures, recurrent disease, rest, Review, scoring system, Sideline Concussion Assessment Tool 3, Sideline concussion assessment tool 3 (SCAT3), sleep disorder, Sport, sport injury, Sports, Sports-related, Tomography, traumatic brain injury, tricyclic antidepressant agent, VERTIGO, visual disorder, vomiting, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
DiFazio, M; Silverberg, N D; Kirkwood, M W; Bernier, R; Iverson, G L
Prolonged Activity Restriction after Concussion: Are We Worsening Outcomes? Journal Article
In: Clinical Pediatrics, vol. 55, no. 5, pp. 443–451, 2015.
Abstract | Links | BibTeX | Tags: activity restriction, Anxiety, Article, athletic trainer, brain concussion, case report, Concussion, daily life activity, depression, Dizziness, evolution, exercise, expectation, headache, human, Male, mood disorder, mTBI, nocebo effect, patient harm, PHYSICAL ACTIVITY, practice guideline, prolonged activity restriction, psychological aspect, Rehabilitation, rest, school, traumatic brain injury, Treatment, treatment outcome, wrestling
@article{DiFazio2015,
title = {Prolonged Activity Restriction after Concussion: Are We Worsening Outcomes?},
author = {DiFazio, M and Silverberg, N D and Kirkwood, M W and Bernier, R and Iverson, G L},
doi = {10.1177/0009922815589914},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {5},
pages = {443--451},
abstract = {The current treatment of concussion or mild traumatic brain injury (mTBI) is primarily based on expert consensus. Most clinical practice guidelines advise cognitive and physical rest after injury including withdrawal from normal life activities such as school attendance, sports participation, and technology use until symptoms resolve. Some individuals who sustain an mTBI experience persistent physical, cognitive, and mental health problems. Activity restriction itself may contribute to protracted recovery and other complications. Williamson's Activity Restriction Model of Depression, formulated more than 20 years ago, is central to this hypothesis. We review research evidence for potential harms of prolonged activity restriction and report an mTBI case as an example of how an "activity restriction cascade" can unfold. According to this model, psychological consequences of removal from validating life activities, combined with physical deconditioning, contribute to the development and persistence of postconcussive symptoms after mTBI in some youth. A modification to mTBI guidelines that emphasizes prompt reengagement in life activities as tolerated is encouraged. © SAGE Publications.},
keywords = {activity restriction, Anxiety, Article, athletic trainer, brain concussion, case report, Concussion, daily life activity, depression, Dizziness, evolution, exercise, expectation, headache, human, Male, mood disorder, mTBI, nocebo effect, patient harm, PHYSICAL ACTIVITY, practice guideline, prolonged activity restriction, psychological aspect, Rehabilitation, rest, school, traumatic brain injury, Treatment, treatment outcome, wrestling},
pubstate = {published},
tppubtype = {article}
}
LeBlanc, Jeanne M; McLachlan, Kaitlyn
Prevention of Post-Concussional Syndrome in North American Workers: The Importance of Early Intervention on Vocational Outcome Journal Article
In: Australian Journal of Rehabilitation Counselling, vol. 16, no. 1, pp. 36–44, 2010, ISBN: 13238922.
Abstract | BibTeX | Tags: *BRAIN -- Wounds & injuries, *OUTPATIENT medical care, *POSTCONCUSSION syndrome, *REHABILITATION, Concussion, employment, INDIVIDUALIZED education programs, INDUSTRIAL hygiene, mild traumatic brain injury, mTBI, outpatient, PCS, post-concussive syndrome, Rehabilitation, Treatment
@article{LeBlanc2010,
title = {Prevention of Post-Concussional Syndrome in North American Workers: The Importance of Early Intervention on Vocational Outcome},
author = {LeBlanc, Jeanne M and McLachlan, Kaitlyn},
isbn = {13238922},
year = {2010},
date = {2010-01-01},
journal = {Australian Journal of Rehabilitation Counselling},
volume = {16},
number = {1},
pages = {36--44},
abstract = {The purpose of this study was to: (1) Establish whether or not specific rehabilitation for mild brain injury is effective for return to work; and (2) compare the efficacy of an impairment-focused model of treatment versus an early education approach in respect to ability to return to work. Two different approaches to intervention and treatment for those with a suspected concussion from a work-related injury were utilised by an urban, interdisciplinary, outpatient rehabilitation facility. The first approach, Group Treatment (GT), provided minimal early education at time of initial intake, emphasising an extensive group-focused interdisciplinary assessment and treatment. The second approach, Individualized Education and Treatment, (IET) emphasised early education, instead coupled with specific individualised services. Both groups received employment services. Post-discharge, GT ( N = 26) resulted in 46% ( n = 12) of individuals returning to competitive employment, while IET ( N = 23) resulted in 78% ( n = 18) of individuals returning to competitive employment. An asset-oriented early individualised educational approach appears to be a more effective for employment re-engagement. ABSTRACT FROM AUTHOR},
keywords = {*BRAIN -- Wounds \& injuries, *OUTPATIENT medical care, *POSTCONCUSSION syndrome, *REHABILITATION, Concussion, employment, INDIVIDUALIZED education programs, INDUSTRIAL hygiene, mild traumatic brain injury, mTBI, outpatient, PCS, post-concussive syndrome, Rehabilitation, Treatment},
pubstate = {published},
tppubtype = {article}
}