References

2016

Laker, S R; Meron, A; Greher, M R; Wilson, J

Retirement and Activity Restrictions Following Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 487–501, 2016.

Links | BibTeX | Tags: Activity restrictions, athlete, attention deficit disorder, brain concussion, Concussion, CONVALESCENCE, depression, human, learning disorder, migraine, neuropsychological test, nonhuman, PHYSICAL ACTIVITY, postconcussion syndrome, practice guideline, priority journal, Retirement, return to sport, Review, risk factor, sleep disorder, sport injury, Sport-related concussion, subarachnoid hemorrhage, symptom, traumatic brain injury, unconsciousness

Connery, A K; Peterson, R L; Baker, D A; Randolph, C; Kirkwood, M W

The Role of Neuropsychological Evaluation in the Clinical Management of Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 475–486, 2016.

Links | BibTeX | Tags: brain concussion, childhood injury, CONVALESCENCE, health care access, health care delivery, human, medical history, mild TBI, Neuropsychological assessment, neuropsychological test, postconcussion syndrome, priority journal, return to sport, Review, risk factor, traumatic brain injury, validity

Covassin, T; Moran, R; Elbin, R J

Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009 Journal Article

In: Journal of Athletic Training, vol. 51, no. 3, pp. 189–194, 2016.

Abstract | BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities

@article{Covassin2016,

title = {Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009},

author = {Covassin, T and Moran, R and Elbin, R J},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Athletic Training},

volume = {51},

number = {3},

pages = {189--194},

abstract = {CONTEXT: Epidemiologic studies have identified differences in concussion incidence between the sexes. However, few authors to date have updated injury rates (IRs) and time loss between male and female concussed athletes. OBJECTIVE: To examine sex differences in IRs and time loss in concussed National Collegiate Athletic Association (NCAA) athletes. DESIGN: Descriptive epidemiologic study. SETTING: National Collegiate Athletic Association athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 1702 concusssed NCAA athletes, consisting of 903 females and 779 males participating in soccer, basketball, ice hockey, lacrosse, softball, or baseball over a 5-year period from 2004-2005 through 2008-2009. MAIN OUTCOME MEASURE(S): Using the NCAA Injury Surveillance Program, athletic trainers reported concussions, athlete-exposures (AEs), and time loss across 10 NCAA sports. An IR is the number of injuries in a particular category divided by the number of AEs in that category. RESULTS: During the study period, 1702 concussions were reported during 4 170 427 AEs for an overall total of 5.47 per 10 000 AEs. In sex-comparable sports, females had a 1.4 times higher overall concussion IR than males (IRs = 4.84 and 3.46, respectively), with greater rates in women's baseball/softball, basketball, ice hockey, and soccer than men. Female soccer and basketball players also displayed more time loss after concussion compared with male basketball and soccer players. CONCLUSIONS: Female athletes sustained a higher rate of concussion and, in all sports except lacrosse, had greater time loss from concussion than male athletes. Additional research is needed on sex differences in time loss after concussions.},

keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities},

pubstate = {published},

tppubtype = {article}

}

2015

Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K

Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article

In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.

Abstract | Links | BibTeX | Tags: Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport

@article{Ellis2015,

title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},

author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},

doi = {10.3171/2015.1.PEDS14524},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery: Pediatrics},

volume = {16},

number = {3},

pages = {248--255},

abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},

keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},

pubstate = {published},

tppubtype = {article}

}

Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.

Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E

Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article

In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.

Abstract | Links | BibTeX | Tags: alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption

@article{Moran2015,

title = {Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians},

author = {Moran, B and Tadikonda, P and Sneed, K B and Hummel, M and Guiteau, S and Coris, E E},

doi = {10.14423/SMJ.0000000000000340},

year  = {2015},

date = {2015-01-01},

journal = {Southern Medical Journal},

volume = {108},

number = {9},

pages = {553--558},

abstract = {Postconcussive syndrome is an increasingly recognized outcome of sports-related concussion (SRC), characterized by a constellation of poorly defined symptoms. Treatment of PCS is significantly different from that of SRC alone. Primary care physicians often are the first to evaluate these patients, but some are unfamiliar with the available therapeutic approaches. This review provides an overview of the pathophysiology of SRC and descriptions of both pharmacologic and nonpharmacologic treatment options to allow primary care physicians to provide evidence-based care to patients experiencing postconcussive syndrome. © 2015 by The Southern Medical Association.},

keywords = {alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption},

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}

}

Reference Search

Laker, S R; Meron, A; Greher, M R; Wilson, J

Retirement and Activity Restrictions Following Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 487–501, 2016.

Links | BibTeX

Connery, A K; Peterson, R L; Baker, D A; Randolph, C; Kirkwood, M W

The Role of Neuropsychological Evaluation in the Clinical Management of Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 475–486, 2016.

Links | BibTeX

Covassin, T; Moran, R; Elbin, R J

In: Journal of Athletic Training, vol. 51, no. 3, pp. 189–194, 2016.

Abstract | BibTeX

@article{Covassin2016,

title = {Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009},

author = {Covassin, T and Moran, R and Elbin, R J},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Athletic Training},

volume = {51},

number = {3},

pages = {189--194},

abstract = {CONTEXT: Epidemiologic studies have identified differences in concussion incidence between the sexes. However, few authors to date have updated injury rates (IRs) and time loss between male and female concussed athletes. OBJECTIVE: To examine sex differences in IRs and time loss in concussed National Collegiate Athletic Association (NCAA) athletes. DESIGN: Descriptive epidemiologic study. SETTING: National Collegiate Athletic Association athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 1702 concusssed NCAA athletes, consisting of 903 females and 779 males participating in soccer, basketball, ice hockey, lacrosse, softball, or baseball over a 5-year period from 2004-2005 through 2008-2009. MAIN OUTCOME MEASURE(S): Using the NCAA Injury Surveillance Program, athletic trainers reported concussions, athlete-exposures (AEs), and time loss across 10 NCAA sports. An IR is the number of injuries in a particular category divided by the number of AEs in that category. RESULTS: During the study period, 1702 concussions were reported during 4 170 427 AEs for an overall total of 5.47 per 10 000 AEs. In sex-comparable sports, females had a 1.4 times higher overall concussion IR than males (IRs = 4.84 and 3.46, respectively), with greater rates in women's baseball/softball, basketball, ice hockey, and soccer than men. Female soccer and basketball players also displayed more time loss after concussion compared with male basketball and soccer players. CONCLUSIONS: Female athletes sustained a higher rate of concussion and, in all sports except lacrosse, had greater time loss from concussion than male athletes. Additional research is needed on sex differences in time loss after concussions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K

Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article

In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.

Abstract | Links | BibTeX

@article{Ellis2015,

title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},

author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},

doi = {10.3171/2015.1.PEDS14524},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery: Pediatrics},

volume = {16},

number = {3},

pages = {248--255},

abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E

Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article

In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.

Abstract | Links | BibTeX

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

@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}

}

Most Referenced Keywords

Show all

2016

Laker, S R; Meron, A; Greher, M R; Wilson, J

Retirement and Activity Restrictions Following Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 487–501, 2016.

Connery, A K; Peterson, R L; Baker, D A; Randolph, C; Kirkwood, M W

The Role of Neuropsychological Evaluation in the Clinical Management of Concussion Journal Article

In: Physical Medicine & Rehabilitation Clinics of North America, vol. 27, no. 2, pp. 475–486, 2016.

Covassin, T; Moran, R; Elbin, R J

In: Journal of Athletic Training, vol. 51, no. 3, pp. 189–194, 2016.

@article{Covassin2016,

title = {Sex Differences in Reported Concussion Injury Rates and Time Loss From Participation: An Update of the National Collegiate Athletic Association Injury Surveillance Program From 2004-2005 Through 2008-2009},

author = {Covassin, T and Moran, R and Elbin, R J},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Athletic Training},

volume = {51},

number = {3},

pages = {189--194},

abstract = {CONTEXT: Epidemiologic studies have identified differences in concussion incidence between the sexes. However, few authors to date have updated injury rates (IRs) and time loss between male and female concussed athletes. OBJECTIVE: To examine sex differences in IRs and time loss in concussed National Collegiate Athletic Association (NCAA) athletes. DESIGN: Descriptive epidemiologic study. SETTING: National Collegiate Athletic Association athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 1702 concusssed NCAA athletes, consisting of 903 females and 779 males participating in soccer, basketball, ice hockey, lacrosse, softball, or baseball over a 5-year period from 2004-2005 through 2008-2009. MAIN OUTCOME MEASURE(S): Using the NCAA Injury Surveillance Program, athletic trainers reported concussions, athlete-exposures (AEs), and time loss across 10 NCAA sports. An IR is the number of injuries in a particular category divided by the number of AEs in that category. RESULTS: During the study period, 1702 concussions were reported during 4 170 427 AEs for an overall total of 5.47 per 10 000 AEs. In sex-comparable sports, females had a 1.4 times higher overall concussion IR than males (IRs = 4.84 and 3.46, respectively), with greater rates in women's baseball/softball, basketball, ice hockey, and soccer than men. Female soccer and basketball players also displayed more time loss after concussion compared with male basketball and soccer players. CONCLUSIONS: Female athletes sustained a higher rate of concussion and, in all sports except lacrosse, had greater time loss from concussion than male athletes. Additional research is needed on sex differences in time loss after concussions.},

keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Baseball/in [Injuries], Basketball/in [Injuries], Female, Hockey/in [Injuries], Humans, Incidence, Male, Racquet Sports/in [Injuries], return to sport, Sex Distribution, Sex Factors, Soccer/in [Injuries], United States/ep [Epidemiology], Universities},

pubstate = {published},

tppubtype = {article}

}

2015

Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K

Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article

In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.

@article{Ellis2015,

title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},

author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},

doi = {10.3171/2015.1.PEDS14524},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Neurosurgery: Pediatrics},

volume = {16},

number = {3},

pages = {248--255},

abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},

keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},

pubstate = {published},

tppubtype = {article}

}

Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E

Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article

In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.

@article{Moran2015,

title = {Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians},

author = {Moran, B and Tadikonda, P and Sneed, K B and Hummel, M and Guiteau, S and Coris, E E},

doi = {10.14423/SMJ.0000000000000340},

year  = {2015},

date = {2015-01-01},

journal = {Southern Medical Journal},

volume = {108},

number = {9},

pages = {553--558},

abstract = {Postconcussive syndrome is an increasingly recognized outcome of sports-related concussion (SRC), characterized by a constellation of poorly defined symptoms. Treatment of PCS is significantly different from that of SRC alone. Primary care physicians often are the first to evaluate these patients, but some are unfamiliar with the available therapeutic approaches. This review provides an overview of the pathophysiology of SRC and descriptions of both pharmacologic and nonpharmacologic treatment options to allow primary care physicians to provide evidence-based care to patients experiencing postconcussive syndrome. © 2015 by The Southern Medical Association.},

keywords = {alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption},

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 = {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}

}

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