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}
}
Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L
Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting
@article{Silverberg2016,
title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},
author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},
doi = {10.1097/JSM.0000000000000241},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {3},
pages = {226--231},
abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting},
pubstate = {published},
tppubtype = {article}
}
Gilchrist, I; Moglo, K; Storr, M; Pelland, L
Effects of head flexion posture on the multidirectional static force capacity of the neck Journal Article
In: Clinical Biomechanics, vol. 37, pp. 44–52, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal
@article{Gilchrist2016,
title = {Effects of head flexion posture on the multidirectional static force capacity of the neck},
author = {Gilchrist, I and Moglo, K and Storr, M and Pelland, L},
doi = {10.1016/j.clinbiomech.2016.05.016},
year = {2016},
date = {2016-01-01},
journal = {Clinical Biomechanics},
volume = {37},
pages = {44--52},
abstract = {Background Neck muscle force protects vertebral alignment and resists potentially injurious loading of osteoligamentous structures during head impacts. As the majority of neck muscles generate moments about all three planes of motion, it is not clear how the force capacity of the neck might be modulated by direction of force application and head posture. The aim of our study was to measure the multidirectional moment-generating capacity of the neck and to evaluate effects of 20° of head flexion, a common head position in contact sports, on the measured capacity. Methods We conducted a cross-sectional study, with 25 males, 20-30 years old, performing maximum voluntary contractions, with ballistic intent, along eight directions, set at 45° intervals in the horizontal plane of the head. Three-dimensional moments at C3 and T1 were calculated using equations of static equilibrium. The variable of interest was the impulse of force generated from 0-50 ms. Effects of direction of force application and head posture, neutral and 20° flexion, were evaluated by two-way analysis of variance and linear regression. Findings Impulse of force was lower along diagonal planes, at 45° from the mid-sagittal plane, compared to orthogonal planes (P \< 0.001). Compared to neutral posture, head flexion produced a 55.2% decrease in impulse capacity at C3 and 45.9% at T1. Interpretation The risk of injury with head impact would intrinsically be higher along diagonal planes and with a 20° head down position due to a lower moment generating capacity of the neck in the first 50 ms of force application. © 2015 Elsevier Ltd. All rights reserved.},
keywords = {adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal},
pubstate = {published},
tppubtype = {article}
}
Abaji, J P; Curnier, D; Moore, R D; Ellemberg, D
Persisting effects of concussion on heart rate variability during physical exertion Journal Article
In: Journal of Neurotrauma, vol. 33, no. 9, pp. 811–817, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY
@article{Abaji2016,
title = {Persisting effects of concussion on heart rate variability during physical exertion},
author = {Abaji, J P and Curnier, D and Moore, R D and Ellemberg, D},
doi = {10.1089/neu.2015.3989},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {9},
pages = {811--817},
abstract = {The purpose of this study was to evaluate cardiac autonomic modulation in university athletes during the post-acute to late phase (mean, 95 days ±63) of injury at rest and during physical exertion. We also sought to evaluate the effect of time since injury and number of injuries on heart rate variability (HRV). We hypothesized that physical exertion would reveal persisting modifications in HRV following a concussion. We included, in a cross-sectional design, athletes who sustained a concussion and matched controls. Concussions were identified by a medical doctor using established criteria. Twelve male concussed and 12 control athletes took part in the study. Control participants were teammates who were chosen to match the concussed athletes with regard to their height, weight, education, and age. The beat-to-beat electrocardiogram intervals of the participants were measured at rest and during physical exertion (isometric hand grip contraction; IHGC), which was sustained for 3 minutes at 30% of the participants' maximum. Linear and nonlinear parameters of HRV were calculated. The ratio between low and high frequency (LF/HF) bands was calculated to assess the sympathovagal balance. During the IHGC, but not at rest, concussed athletes presented significantly lower power in HF bands, leading to a significantly higher LF/HF ratio (p ≤ 0.05). Thus, asymptomatic athletes still may exhibit modifications in cardiac autonomic modulation weeks to months following injury. These modifications may only become apparent during physical exertion. Monitoring HRV may aid diagnosis and provide insight about safe return to play. © Mary Ann Liebert, Inc. 2016.},
keywords = {adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY},
pubstate = {published},
tppubtype = {article}
}
Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K
Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article
In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends
@article{Vassilyadi2015,
title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},
author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},
doi = {10.1159/000431232},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Neurosurgery},
volume = {50},
number = {4},
pages = {196--203},
abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},
keywords = {Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends},
pubstate = {published},
tppubtype = {article}
}
De Matteo, C; Volterman, K A; Breithaupt, P G; Claridge, E A; Adamich, J; Timmons, B W
Exertion testing in youth with mild traumatic brain injury/concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors
@article{DeMatteo2015,
title = {Exertion testing in youth with mild traumatic brain injury/concussion},
author = {{De Matteo}, C and Volterman, K A and Breithaupt, P G and Claridge, E A and Adamich, J and Timmons, B W},
doi = {10.1249/MSS.0000000000000682},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results Participants had a mean ± SD symptom duration of 6.3 ± 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. © 2015 by the American College of Sports Medicine.},
keywords = {Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
Abstract | BibTeX | Tags: Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness},
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.
@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 = {},
pubstate = {published},
tppubtype = {article}
}
Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L
Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.
@article{Silverberg2016,
title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},
author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},
doi = {10.1097/JSM.0000000000000241},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {3},
pages = {226--231},
abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gilchrist, I; Moglo, K; Storr, M; Pelland, L
Effects of head flexion posture on the multidirectional static force capacity of the neck Journal Article
In: Clinical Biomechanics, vol. 37, pp. 44–52, 2016.
@article{Gilchrist2016,
title = {Effects of head flexion posture on the multidirectional static force capacity of the neck},
author = {Gilchrist, I and Moglo, K and Storr, M and Pelland, L},
doi = {10.1016/j.clinbiomech.2016.05.016},
year = {2016},
date = {2016-01-01},
journal = {Clinical Biomechanics},
volume = {37},
pages = {44--52},
abstract = {Background Neck muscle force protects vertebral alignment and resists potentially injurious loading of osteoligamentous structures during head impacts. As the majority of neck muscles generate moments about all three planes of motion, it is not clear how the force capacity of the neck might be modulated by direction of force application and head posture. The aim of our study was to measure the multidirectional moment-generating capacity of the neck and to evaluate effects of 20° of head flexion, a common head position in contact sports, on the measured capacity. Methods We conducted a cross-sectional study, with 25 males, 20-30 years old, performing maximum voluntary contractions, with ballistic intent, along eight directions, set at 45° intervals in the horizontal plane of the head. Three-dimensional moments at C3 and T1 were calculated using equations of static equilibrium. The variable of interest was the impulse of force generated from 0-50 ms. Effects of direction of force application and head posture, neutral and 20° flexion, were evaluated by two-way analysis of variance and linear regression. Findings Impulse of force was lower along diagonal planes, at 45° from the mid-sagittal plane, compared to orthogonal planes (P \< 0.001). Compared to neutral posture, head flexion produced a 55.2% decrease in impulse capacity at C3 and 45.9% at T1. Interpretation The risk of injury with head impact would intrinsically be higher along diagonal planes and with a 20° head down position due to a lower moment generating capacity of the neck in the first 50 ms of force application. © 2015 Elsevier Ltd. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Abaji, J P; Curnier, D; Moore, R D; Ellemberg, D
Persisting effects of concussion on heart rate variability during physical exertion Journal Article
In: Journal of Neurotrauma, vol. 33, no. 9, pp. 811–817, 2016.
@article{Abaji2016,
title = {Persisting effects of concussion on heart rate variability during physical exertion},
author = {Abaji, J P and Curnier, D and Moore, R D and Ellemberg, D},
doi = {10.1089/neu.2015.3989},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {9},
pages = {811--817},
abstract = {The purpose of this study was to evaluate cardiac autonomic modulation in university athletes during the post-acute to late phase (mean, 95 days ±63) of injury at rest and during physical exertion. We also sought to evaluate the effect of time since injury and number of injuries on heart rate variability (HRV). We hypothesized that physical exertion would reveal persisting modifications in HRV following a concussion. We included, in a cross-sectional design, athletes who sustained a concussion and matched controls. Concussions were identified by a medical doctor using established criteria. Twelve male concussed and 12 control athletes took part in the study. Control participants were teammates who were chosen to match the concussed athletes with regard to their height, weight, education, and age. The beat-to-beat electrocardiogram intervals of the participants were measured at rest and during physical exertion (isometric hand grip contraction; IHGC), which was sustained for 3 minutes at 30% of the participants' maximum. Linear and nonlinear parameters of HRV were calculated. The ratio between low and high frequency (LF/HF) bands was calculated to assess the sympathovagal balance. During the IHGC, but not at rest, concussed athletes presented significantly lower power in HF bands, leading to a significantly higher LF/HF ratio (p ≤ 0.05). Thus, asymptomatic athletes still may exhibit modifications in cardiac autonomic modulation weeks to months following injury. These modifications may only become apparent during physical exertion. Monitoring HRV may aid diagnosis and provide insight about safe return to play. © Mary Ann Liebert, Inc. 2016.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K
Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article
In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.
@article{Vassilyadi2015,
title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},
author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},
doi = {10.1159/000431232},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Neurosurgery},
volume = {50},
number = {4},
pages = {196--203},
abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
De Matteo, C; Volterman, K A; Breithaupt, P G; Claridge, E A; Adamich, J; Timmons, B W
Exertion testing in youth with mild traumatic brain injury/concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015.
@article{DeMatteo2015,
title = {Exertion testing in youth with mild traumatic brain injury/concussion},
author = {{De Matteo}, C and Volterman, K A and Breithaupt, P G and Claridge, E A and Adamich, J and Timmons, B W},
doi = {10.1249/MSS.0000000000000682},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results Participants had a mean ± SD symptom duration of 6.3 ± 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. © 2015 by the American College of Sports Medicine.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
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}
}
Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L
Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting
@article{Silverberg2016,
title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},
author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},
doi = {10.1097/JSM.0000000000000241},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {3},
pages = {226--231},
abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting},
pubstate = {published},
tppubtype = {article}
}
Gilchrist, I; Moglo, K; Storr, M; Pelland, L
Effects of head flexion posture on the multidirectional static force capacity of the neck Journal Article
In: Clinical Biomechanics, vol. 37, pp. 44–52, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal
@article{Gilchrist2016,
title = {Effects of head flexion posture on the multidirectional static force capacity of the neck},
author = {Gilchrist, I and Moglo, K and Storr, M and Pelland, L},
doi = {10.1016/j.clinbiomech.2016.05.016},
year = {2016},
date = {2016-01-01},
journal = {Clinical Biomechanics},
volume = {37},
pages = {44--52},
abstract = {Background Neck muscle force protects vertebral alignment and resists potentially injurious loading of osteoligamentous structures during head impacts. As the majority of neck muscles generate moments about all three planes of motion, it is not clear how the force capacity of the neck might be modulated by direction of force application and head posture. The aim of our study was to measure the multidirectional moment-generating capacity of the neck and to evaluate effects of 20° of head flexion, a common head position in contact sports, on the measured capacity. Methods We conducted a cross-sectional study, with 25 males, 20-30 years old, performing maximum voluntary contractions, with ballistic intent, along eight directions, set at 45° intervals in the horizontal plane of the head. Three-dimensional moments at C3 and T1 were calculated using equations of static equilibrium. The variable of interest was the impulse of force generated from 0-50 ms. Effects of direction of force application and head posture, neutral and 20° flexion, were evaluated by two-way analysis of variance and linear regression. Findings Impulse of force was lower along diagonal planes, at 45° from the mid-sagittal plane, compared to orthogonal planes (P \< 0.001). Compared to neutral posture, head flexion produced a 55.2% decrease in impulse capacity at C3 and 45.9% at T1. Interpretation The risk of injury with head impact would intrinsically be higher along diagonal planes and with a 20° head down position due to a lower moment generating capacity of the neck in the first 50 ms of force application. © 2015 Elsevier Ltd. All rights reserved.},
keywords = {adult, Article, Biomechanics, BIOPHYSICS, body equilibrium, body posture, Cervical spine, Concussions, contact sport, cross-sectional study, Dynamometry, force, head flexion, head movement, head position, human, human experiment, Male, Muscle, muscle contraction, muscle strength, neck injury, Neck muscle, neck strength, priority journal},
pubstate = {published},
tppubtype = {article}
}
Abaji, J P; Curnier, D; Moore, R D; Ellemberg, D
Persisting effects of concussion on heart rate variability during physical exertion Journal Article
In: Journal of Neurotrauma, vol. 33, no. 9, pp. 811–817, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY
@article{Abaji2016,
title = {Persisting effects of concussion on heart rate variability during physical exertion},
author = {Abaji, J P and Curnier, D and Moore, R D and Ellemberg, D},
doi = {10.1089/neu.2015.3989},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {9},
pages = {811--817},
abstract = {The purpose of this study was to evaluate cardiac autonomic modulation in university athletes during the post-acute to late phase (mean, 95 days ±63) of injury at rest and during physical exertion. We also sought to evaluate the effect of time since injury and number of injuries on heart rate variability (HRV). We hypothesized that physical exertion would reveal persisting modifications in HRV following a concussion. We included, in a cross-sectional design, athletes who sustained a concussion and matched controls. Concussions were identified by a medical doctor using established criteria. Twelve male concussed and 12 control athletes took part in the study. Control participants were teammates who were chosen to match the concussed athletes with regard to their height, weight, education, and age. The beat-to-beat electrocardiogram intervals of the participants were measured at rest and during physical exertion (isometric hand grip contraction; IHGC), which was sustained for 3 minutes at 30% of the participants' maximum. Linear and nonlinear parameters of HRV were calculated. The ratio between low and high frequency (LF/HF) bands was calculated to assess the sympathovagal balance. During the IHGC, but not at rest, concussed athletes presented significantly lower power in HF bands, leading to a significantly higher LF/HF ratio (p ≤ 0.05). Thus, asymptomatic athletes still may exhibit modifications in cardiac autonomic modulation weeks to months following injury. These modifications may only become apparent during physical exertion. Monitoring HRV may aid diagnosis and provide insight about safe return to play. © Mary Ann Liebert, Inc. 2016.},
keywords = {adult, Article, athlete, brain concussion, cardiac autonomic modulation, clinical article, Concussion, controlled study, cross-sectional study, electrocardiogram, exercise, hand grip, heart rate variability, human, isometric hand grip contraction, Male, muscle isometric contraction, PHYSICAL ACTIVITY},
pubstate = {published},
tppubtype = {article}
}
Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K
Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article
In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends
@article{Vassilyadi2015,
title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},
author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},
doi = {10.1159/000431232},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Neurosurgery},
volume = {50},
number = {4},
pages = {196--203},
abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},
keywords = {Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends},
pubstate = {published},
tppubtype = {article}
}
De Matteo, C; Volterman, K A; Breithaupt, P G; Claridge, E A; Adamich, J; Timmons, B W
Exertion testing in youth with mild traumatic brain injury/concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors
@article{DeMatteo2015,
title = {Exertion testing in youth with mild traumatic brain injury/concussion},
author = {{De Matteo}, C and Volterman, K A and Breithaupt, P G and Claridge, E A and Adamich, J and Timmons, B W},
doi = {10.1249/MSS.0000000000000682},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results Participants had a mean ± SD symptom duration of 6.3 ± 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. © 2015 by the American College of Sports Medicine.},
keywords = {Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
Abstract | BibTeX | Tags: Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness},
pubstate = {published},
tppubtype = {article}
}