References

154 entries « ‹ 1 of 4 › »

2017

Grabowski, P; Wilson, J; Walker, A; Enz, D; Wang, S

Multimodal impairment-based physical therapy for the treatment of patients with post-concussion syndrome: A retrospective analysis on safety and feasibility Journal Article

In: Physical Therapy in Sport, vol. 23, pp. 22–30, 2017.

Abstract | Links | BibTeX | Tags: Cardiovascular exercise, Concussion, mild traumatic brain injury, Physical therapy

@article{Grabowski2017,

title = {Multimodal impairment-based physical therapy for the treatment of patients with post-concussion syndrome: A retrospective analysis on safety and feasibility},

author = {Grabowski, P and Wilson, J and Walker, A and Enz, D and Wang, S},

doi = {10.1016/j.ptsp.2016.06.001},

year  = {2017},

date = {2017-01-01},

journal = {Physical Therapy in Sport},

volume = {23},

pages = {22--30},

abstract = {Objective Demonstrate implementation, safety and feasibility of multimodal, impairment-based physical therapy (PT) combining vestibular/oculomotor and cervical rehabilitation with sub-symptom threshold exercise for the treatment of patients with post-concussion syndrome (PCS). Setting University hospital outpatient sports medicine facility. Participants Twenty-five patients (12\textendash20 years old) meeting World Health Organization criteria for PCS following sport-related concussion referred for supervised PT consisting of sub-symptom cardiovascular exercise, vestibular/oculomotor and cervical spine rehabilitation. Design Retrospective cohort. Main measures Post-Concussion Symptom Scale (PCSS) total score, maximum symptom-free heart rate (SFHR) during graded exercise testing (GXT), GXT duration, balance error scoring system (BESS) score, and number of adverse events. Results Patients demonstrated a statistically significant decreasing trend (p \< 0.01) for total PCSS scores (pre-PT M = 18.2 (SD = 14.2), post-PT M = 9.1 (SD = 10.8), n = 25). Maximum SFHR achieved on GXT increased 23% (p \< 0.01, n = 14), and BESS errors decreased 52% (p \< 0.01, n = 13). Two patients reported mild symptom exacerbation with aerobic exercise at home, attenuated by adjustment of the home exercise program. Conclusions Multimodal, impairment-based PT is safe and associated with diminishing PCS symptoms. This establishes feasibility for future clinical trials to determine viable treatment approaches to reduce symptoms and improve function while avoiding negative repercussions of physical inactivity and premature return to full activity. © 2016 Elsevier Ltd},

keywords = {Cardiovascular exercise, Concussion, mild traumatic brain injury, Physical therapy},

pubstate = {published},

tppubtype = {article}

}

Léveillé, E; Guay, S; Blais, C; Scherzer, P; De Beaumont, L

In: Journal of the International Neuropsychological Society, vol. 23, no. 1, pp. 65–77, 2017.

Abstract | Links | BibTeX | Tags: Anxiety, Concussion, depression, Emotional facial expression, Gender Differences, Sport

@article{Leveille2017,

title = {Sex-Related Differences in Emotion Recognition in Multi-concussed Athletes},

author = {L\'{e}veill\'{e}, E and Guay, S and Blais, C and Scherzer, P and {De Beaumont}, L},

doi = {10.1017/S1355617716001004},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the International Neuropsychological Society},

volume = {23},

number = {1},

pages = {65--77},

abstract = {Objectives: Concussion is defined as a complex pathophysiological process affecting the brain. Although the cumulative and long-term effects of multiple concussions are now well documented on cognitive and motor function, little is known about their effects on emotion recognition. Recent studies have suggested that concussion can result in emotional sequelae, particularly in females and multi-concussed athletes. The objective of this study was to investigate sex-related differences in emotion recognition in asymptomatic male and female multi-concussed athletes. Methods: We tested 28 control athletes (15 males) and 22 multi-concussed athletes (10 males) more than a year since the last concussion. Participants completed the Post-Concussion Symptom Scale, the Beck Depression Inventory-II, the Beck Anxiety Inventory, a neuropsychological test battery and a morphed emotion recognition task. Pictures of a male face expressing basic emotions (anger, disgust, fear, happiness, sadness, surprise) morphed with another emotion were randomly presented. After each face presentation, participants were asked to indicate the emotion expressed by the face. Results: Results revealed significant sex by group interactions in accuracy and intensity threshold for negative emotions, together with significant main effects of emotion and group. Conclusions: Male concussed athletes were significantly impaired in recognizing negative emotions and needed more emotional intensity to correctly identify these emotions, compared to same-sex controls. In contrast, female concussed athletes performed similarly to same-sex controls. These findings suggest that sex significantly modulates concussion effects on emotional facial expression recognition. © 2016 The International Neuropsychological Society.},

keywords = {Anxiety, Concussion, depression, Emotional facial expression, Gender Differences, Sport},

pubstate = {published},

tppubtype = {article}

}

Reider, Bruce

Activating the Omega 13 Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 275–277, 2017, ISBN: 03635465.

Links | BibTeX | Tags: ACL tear, Concussion, female athlete triad, football, Injury prevention, rugby, Soccer

Patterson, J N; Murphy, A M; Honaker, J A

Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes Journal Article

In: Journal of the American Academy of Audiology, vol. 28, no. 1, pp. 36–45, 2017.

Abstract | Links | BibTeX | Tags: Athletes, Concussion, DVAT, Dynamic visual acuity, Physical Exertion, Sport-related head injury, Vestibular function, Vestibulo-ocular reflex, Visual-vestibular, Vor

@article{Patterson2017,

title = {Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes},

author = {Patterson, J N and Murphy, A M and Honaker, J A},

doi = {10.3766/jaaa.15110},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the American Academy of Audiology},

volume = {28},

number = {1},

pages = {36--45},

abstract = {Background: Acute symptoms of dizziness and/or imbalance commonly experienced in athletes postconcussion are speculated to arise from dysfunction at multiple levels (i.e., inner ear or central vestibular system) to appropriately integrate afferent sensory information. Disruption along any pathway of the balance system can result in symptoms of dizziness, decreased postural control function (vestibulospinal reflex), and reduced vestibulo-ocular reflex function. This may also lead to decreased gaze stability with movements of the head and may account for symptoms of blurred vision or diplopia reported in almost half of athletes sustaining a concussion. Current concussion position statements include measures of postural control to examine changes to the balance system postconcussion. The Balance Error Scoring System (BESS) is a commonly used lowcost postural control measure for concussion assessment. Although this is a widely used measure for documenting balance function on both immediate (sideline) and recovery monitoring, the BESS has been shown to be affected by physical exertion. Therefore, the BESS may not be the most efficient means of examining functional changes to the balance system immediately after head injury. Dynamic Visual Acuity Test (DVAT) has been found to effectively evaluate and monitor changes to the gaze stability system postinjury. Thus, DVAT may be an additional measure in the concussion assessment battery, as well as an alternative for more immediate sideline assessment to help make objective return-To-play decisions. Purpose: The aim of the study was to determine the effects of physical exertion on a clinical vestibular assessment, the DVAT, in collegiate athletes, as a first step in defining the role of this measure in the concussion assessment battery. Research Design: Cross-sectional, repeated-measures design. Study Sample: Twenty-eight healthy collegiate athletes (20 males, 8 females; age = 20.25 ± 1.46 yr},

keywords = {Athletes, Concussion, DVAT, Dynamic visual acuity, Physical Exertion, Sport-related head injury, Vestibular function, Vestibulo-ocular reflex, Visual-vestibular, Vor},

pubstate = {published},

tppubtype = {article}

}

Krolikowski, Maciej P; Black, Amanda M; Palacios-Derflingher, Luz; Blake, Tracy A; Schneider, Kathryn J; Emery, Carolyn A

The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions in Youth Ice Hockey Players Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 468–473, 2017, ISBN: 03635465.

Abstract | Links | BibTeX | Tags: child and adolescent, Concussion, ice hockey, Injury prevention

@article{Krolikowski2017,

title = {The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions in Youth Ice Hockey Players},

author = {Krolikowski, Maciej P and Black, Amanda M and Palacios-Derflingher, Luz and Blake, Tracy A and Schneider, Kathryn J and Emery, Carolyn A},

doi = {10.1177/0363546516669701},

isbn = {03635465},

year  = {2017},

date = {2017-01-01},

journal = {American Journal of Sports Medicine},

volume = {45},

number = {2},

pages = {468--473},

abstract = {Background: Ice hockey is a popular winter sport in Canada. Concussions account for the greatest proportion of all injuries in youth ice hockey. In 2011, a policy change enforcing "zero tolerance for head contact" was implemented in all leagues in Canada. Purpose: To determine if the risk of game-related concussions and more severe concussions (ie, resulting in \>10 days of time loss) and the mechanisms of a concussion differed for Pee Wee class (ages 11-12 years) and Bantam class (ages 13-14 years) players after the 2011 "zero tolerance for head contact" policy change compared with players in similar divisions before the policy change. Study Design: Cohort study; Level of evidence, 3. Methods: The retrospective cohort included Pee Wee (most elite 70%, 2007-2008; n = 891) and Bantam (most elite 30%, 2008-2009; n = 378) players before the rule change and Pee Wee (2011-2012; n = 588) and Bantam (2011-2012; n = 242) players in the same levels of play after the policy change. Suspected concussions were identified by a team designate and referred to a sport medicine physician for diagnosis. Incidence rate ratios (IRRs) were estimated based on multiple Poisson regression analysis, controlling for clustering by team and other important covariates and offset by game-exposure hours. Incidence rates based on the mechanisms of a concussion were estimated based on univariate Poisson regression analysis. Results: The risk of game-related concussions increased after the head contact rule in Pee Wee (IRR, 1.85; 95% CI, 1.20-2.86) and Bantam (IRR, 2.48; 95% CI, 1.17-5.24) players. The risk of more severe concussions increased after the head contact rule in Pee Wee (IRR, 4.12; 95% CI, 2.00-8.50) and Bantam (IRR, 7.91; 95% CI, 3.13-19.94) players. The rates of concussions due to body checking and direct head contact increased after the rule change. Conclusion: The "zero tolerance for head contact" policy change did not reduce the risk of game-related concussions in Pee Wee or Bantam class ice hockey players. Increased concussion awareness and education after the policy change may have contributed to the increased risk of concussions found after the policy change. [ABSTRACT FROM AUTHOR]},

keywords = {child and adolescent, Concussion, ice hockey, Injury prevention},

pubstate = {published},

tppubtype = {article}

}

Background: Ice hockey is a popular winter sport in Canada. Concussions account for the greatest proportion of all injuries in youth ice hockey. In 2011, a policy change enforcing "zero tolerance for head contact" was implemented in all leagues in Canada. Purpose: To determine if the risk of game-related concussions and more severe concussions (ie, resulting in >10 days of time loss) and the mechanisms of a concussion differed for Pee Wee class (ages 11-12 years) and Bantam class (ages 13-14 years) players after the 2011 "zero tolerance for head contact" policy change compared with players in similar divisions before the policy change. Study Design: Cohort study; Level of evidence, 3. Methods: The retrospective cohort included Pee Wee (most elite 70%, 2007-2008; n = 891) and Bantam (most elite 30%, 2008-2009; n = 378) players before the rule change and Pee Wee (2011-2012; n = 588) and Bantam (2011-2012; n = 242) players in the same levels of play after the policy change. Suspected concussions were identified by a team designate and referred to a sport medicine physician for diagnosis. Incidence rate ratios (IRRs) were estimated based on multiple Poisson regression analysis, controlling for clustering by team and other important covariates and offset by game-exposure hours. Incidence rates based on the mechanisms of a concussion were estimated based on univariate Poisson regression analysis. Results: The risk of game-related concussions increased after the head contact rule in Pee Wee (IRR, 1.85; 95% CI, 1.20-2.86) and Bantam (IRR, 2.48; 95% CI, 1.17-5.24) players. The risk of more severe concussions increased after the head contact rule in Pee Wee (IRR, 4.12; 95% CI, 2.00-8.50) and Bantam (IRR, 7.91; 95% CI, 3.13-19.94) players. The rates of concussions due to body checking and direct head contact increased after the rule change. Conclusion: The "zero tolerance for head contact" policy change did not reduce the risk of game-related concussions in Pee Wee or Bantam class ice hockey players. Increased concussion awareness and education after the policy change may have contributed to the increased risk of concussions found after the policy change. [ABSTRACT FROM AUTHOR]

Stone, S; Lee, B; Garrison, J C; Blueitt, D; Creed, K

Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion Journal Article

In: Sports Health, vol. 9, no. 1, pp. 41–44, 2017.

Abstract | Links | BibTeX | Tags: Concussion, return-to-play progression, sex

@article{Stone2017,

title = {Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion},

author = {Stone, S and Lee, B and Garrison, J C and Blueitt, D and Creed, K},

doi = {10.1177/1941738116672184},

year  = {2017},

date = {2017-01-01},

journal = {Sports Health},

volume = {9},

number = {1},

pages = {41--44},

abstract = {Background: Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC. Hypothesis: After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non\textendashsport-related activity were excluded. Results: Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002). Conclusion: On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, aged 11 to 20 years, with regard to initiation of an RTP progression after SRC. Clinical Relevance: Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population. © 2016, © 2016 The Author(s).},

keywords = {Concussion, return-to-play progression, sex},

pubstate = {published},

tppubtype = {article}

}

Loosemore, Michael P; Butler, Charles F; Khadri, Abdelhamid; McDonagh, David; Patel, Vimal A; Bailes, Julian E

Use of Head Guards in AIBA Boxing Tournaments--A Cross-Sectional Observational Study Journal Article

In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 86–88, 2017, ISBN: 1050642X.

Abstract | BibTeX | Tags: acute brain injuries, Boxing, BOXING injuries, Concussion, CONFIDENCE intervals, CROSS-sectional method, DISEASE incidence, Head Protective Devices, LONGITUDINAL method, Poisson distribution, PREVENTION, PROBABILITY theory, Relative risk (Medicine), SAFETY hats, SPORTS events, STATISTICAL hypothesis testing, traumatic brain injury, WOUNDS & injuries

@article{Loosemore2017,

title = {Use of Head Guards in AIBA Boxing Tournaments--A Cross-Sectional Observational Study},

author = {Loosemore, Michael P and Butler, Charles F and Khadri, Abdelhamid and McDonagh, David and Patel, Vimal A and Bailes, Julian E},

isbn = {1050642X},

year  = {2017},

date = {2017-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {27},

number = {1},

pages = {86--88},

abstract = {Objective: This study looks at the changes in injuries after the implementation of a new rule by the International Boxing Association (AIBA) to remove head guards from its competitions. Design: A cross-sectional observational study performed prospectively. This brief report examines the removal of head guards in 2 different ways. The first was to examine the stoppages due to blows to the head by comparing World Series Boxing (WSB), without head guards, to other AIBA competitions with head guards. Secondly, we examined the last 3 world championships: 2009 and 2011 (with head guards) and 2013 (without head guards). Setting: World Series Boxing and AIBA world championship boxing. Participants: Boxers from WSB and AIBA world championships. Interventions: The information was recorded by ringside medical physicians. Main Outcome Measures: Stoppages per 10 000 rounds; stoppages per 1000 hours. Results: Both studies show that the number of stoppages due to head blows was significantly decreased without head guards. The studies also showed that there was a notable increase in cuts. Conclusions: Removing head guards may reduce the already small risk of acute brain injury in amateur boxing. [ABSTRACT FROM AUTHOR]},

keywords = {acute brain injuries, Boxing, BOXING injuries, Concussion, CONFIDENCE intervals, CROSS-sectional method, DISEASE incidence, Head Protective Devices, LONGITUDINAL method, Poisson distribution, PREVENTION, PROBABILITY theory, Relative risk (Medicine), SAFETY hats, SPORTS events, STATISTICAL hypothesis testing, traumatic brain injury, WOUNDS \&amp; injuries},

pubstate = {published},

tppubtype = {article}

}

Collins, M W; Womble, M N

American pediatric surgical association journal of pediatric surgery lecture Journal Article

In: Journal of Pediatric Surgery, vol. 52, no. 1, pp. 16–21, 2017.

Abstract | Links | BibTeX | Tags: Concussion, head injury, migraine, Ocular, Risk Factors, vestibular

Zusman, E E; Zopfi, P; Kuluva, J; Zuckerman, S

Can Ideas From United States Youth Sports Reduce Judo-Related Head Injuries in Japan? Journal Article

In: World Neurosurgery, vol. 97, pp. 725–727, 2017.

Links | BibTeX | Tags: Concussion, head injury, judo, Secondary impact syndrome, Soccer, traumatic brain injury, Youth sports

Gerrard, Paul B; Iverson, Grant L; Atkins, Joseph E; Maxwell, Bruce A; Zafonte, Ross; Schatz, Philip; Berkner, Paul D

Factor Structure of ImPACT® in Adolescent Student Athletes Journal Article

In: Archives of Clinical Neuropsychology, vol. 32, no. 1, pp. 117–122, 2017, ISBN: 08876177.

Abstract | Links | BibTeX | Tags: Athletes -- Psychology, ATTENTION-deficit hyperactivity disorder, Cognitive, COGNITIVE testing, Concussion, FACTOR analysis, Headache -- Treatment, Memory, Neuropsychological Tests, Sports

Strain, J F; Didehbani, N; Spence, J; Conover, H; Bartz, E K; Mansinghani, S; Jeroudi, M K; Rao, N K; Fields, L M; Kraut, M A; Cullum, C M; Hart, J; Womack, K B

White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes Journal Article

In: Journal of Neurotrauma, vol. 34, no. 2, pp. 372–379, 2017.

Abstract | Links | BibTeX | Tags: Concussion, DTI, naming, NATIONAL Football League, TBSS, white matter

Kroshus, E; Baugh, C M; Stein, C J; Austin, S B; Calzo, J P

Concussion reporting, sex, and conformity to traditional gender norms in young adults Journal Article

In: Journal of Adolescence, vol. 54, pp. 110–119, 2017.

Abstract | Links | BibTeX | Tags: college, Concussion, gender, Help-seeking, Sport

Montenigro, P H; Alosco, M L; Martin, B M; Daneshvar, D H; Mez, J; Chaisson, C E; Nowinski, C J; Au, R; McKee, A C; Cantu, R C; McClean, M D; Stern, R A; Tripodis, Y

Cumulative Head Impact Exposure Predicts Later-Life Depression, Apathy, Executive Dysfunction, and Cognitive Impairment in Former High School and College Football Players Journal Article

In: Journal of Neurotrauma, vol. 34, no. 2, pp. 328–340, 2017.

Abstract | Links | BibTeX | Tags: behavior, cognition, Concussion, football, long-term impairment, subconcussive impacts

@article{Montenigro2017,

title = {Cumulative Head Impact Exposure Predicts Later-Life Depression, Apathy, Executive Dysfunction, and Cognitive Impairment in Former High School and College Football Players},

author = {Montenigro, P H and Alosco, M L and Martin, B M and Daneshvar, D H and Mez, J and Chaisson, C E and Nowinski, C J and Au, R and McKee, A C and Cantu, R C and McClean, M D and Stern, R A and Tripodis, Y},

doi = {10.1089/neu.2016.4413},

year  = {2017},

date = {2017-01-01},

journal = {Journal of Neurotrauma},

volume = {34},

number = {2},

pages = {328--340},

abstract = {The term "repetitive head impacts" (RHI) refers to the cumulative exposure to concussive and subconcussive events. Although RHI are believed to increase risk for later-life neurological consequences (including chronic traumatic encephalopathy), quantitative analysis of this relationship has not yet been examined because of the lack of validated tools to quantify lifetime RHI exposure. The objectives of this study were: 1) to develop a metric to quantify cumulative RHI exposure from football, which we term the "cumulative head impact index" (CHII); 2) to use the CHII to examine the association between RHI exposure and long-term clinical outcomes; and 3) to evaluate its predictive properties relative to other exposure metrics (i.e., duration of play, age of first exposure, concussion history). Participants included 93 former high school and collegiate football players who completed objective cognitive and self-reported behavioral/mood tests as part of a larger ongoing longitudinal study. Using established cutoff scores, we transformed continuous outcomes into dichotomous variables (normal vs. impaired). The CHII was computed for each participant and derived from a combination of self-reported athletic history (i.e., number of seasons, position[s], levels played), and impact frequencies reported in helmet accelerometer studies. A bivariate probit, instrumental variable model revealed a threshold dose-response relationship between the CHII and risk for later-life cognitive impairment (p \< 0.0001), self-reported executive dysfunction (p \< 0.0001), depression (p \< 0.0001), apathy (p = 0.0161), and behavioral dysregulation (p \< 0.0001). Ultimately, the CHII demonstrated greater predictive validity than other individual exposure metrics. Copyright © 2017, Mary Ann Liebert, Inc. 2017.},

keywords = {behavior, cognition, Concussion, football, long-term impairment, subconcussive impacts},

pubstate = {published},

tppubtype = {article}

}

Cobbs, L; Hasanaj, L; Amorapanth, P; Rizzo, J R; Nolan, R; Serrano, L; Raynowska, J; Rucker, J C; Jordan, B D; Galetta, S L; Balcer, L J

Mobile Universal Lexicon Evaluation System (MULES) test: A new measure of rapid picture naming for concussion Journal Article

In: Journal of the Neurological Sciences, vol. 372, pp. 393–398, 2017.

Abstract | Links | BibTeX | Tags: Concussion, King-Devick test, Mobile Universal Lexicon Evaluation System, saccades, Sports, Vision

@article{Cobbs2017,

title = {Mobile Universal Lexicon Evaluation System (MULES) test: A new measure of rapid picture naming for concussion},

author = {Cobbs, L and Hasanaj, L and Amorapanth, P and Rizzo, J R and Nolan, R and Serrano, L and Raynowska, J and Rucker, J C and Jordan, B D and Galetta, S L and Balcer, L J},

doi = {10.1016/j.jns.2016.10.044},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the Neurological Sciences},

volume = {372},

pages = {393--398},

abstract = {Objective This study introduces a rapid picture naming test, the Mobile Universal Lexicon Evaluation System (MULES), as a novel, vision-based performance measure for concussion screening. The MULES is a visual-verbal task that includes 54 original photographs of fruits, objects and animals. We piloted MULES in a cohort of volunteers to determine feasibility, ranges of picture naming responses, and the relation of MULES time scores to those of King-Devick (K-D), a rapid number naming test. Methods A convenience sample (n = 20, age 34 ± 10) underwent MULES and K-D (spiral bound, iPad versions). Administration order was randomized; MULES tests were audio-recorded to provide objective data on temporal variability and ranges of picture naming responses. Results Scores for the best of two trials for all tests were 40\textendash50 s; average times required to name each MULES picture (0.72 ± 0.14 s) was greater than those needed for each K-D number ((spiral: 0.33 ± 0.05 s, iPad: 0.36 ± 0.06 s, 120 numbers), p \< 0.0001, paired t-test). MULES scores showed the greatest degree of improvement between trials (9.4 ± 4.8 s, p \< 0.0001 for trials 1 vs. 2), compared to K-D (spiral 1.5 ± 3.3 s, iPad 1.8 ± 3.4 s). Shorter MULES times demonstrated moderate and significant correlations with shorter iPad but not spiral K-D times (r = 0.49, p = 0.03). Conclusion The MULES test is a rapid picture naming task that may engage more extensive neural systems than more commonly used rapid number naming tasks. Rapid picture naming may require additional processing devoted to color perception, object identification, and categorization. Both tests rely on initiation and sequencing of saccadic eye movements. © 2016 Elsevier B.V.},

keywords = {Concussion, King-Devick test, Mobile Universal Lexicon Evaluation System, saccades, Sports, Vision},

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}

}

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.

Gardner, A J; Kohler, R M N; Levi, C R; Iverson, G L

Usefulness of Video Review of Possible Concussions in National Youth Rugby League Journal Article

In: International Journal of Sports Medicine, vol. 38, no. 1, pp. 71–75, 2017.

Abstract | Links | BibTeX | Tags: Concussion, Injury management, Return to Play, Video analysis

Mihalik, J P; Lynall, R C; Wasserman, E B; Guskiewicz, K M; Marshall, S W

Evaluating the "threshold Theory": Can Head Impact Indicators Help? Journal Article

In: Medicine & Science in Sports & Exercise, vol. 49, no. 2, pp. 247–253, 2017.

Abstract | Links | BibTeX | Tags: Biomechanics, Brain Injury, Concussion, sport injury

Dickson, T J; Trathen, S; Terwiel, F A; Waddington, G; Adams, R

Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study Journal Article

In: Scandinavian Journal of Medicine & Science in Sports, vol. 27, no. 2, pp. 236–244, 2017, ISBN: 09057188.

Abstract | Links | BibTeX | Tags: CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries

@article{Dickson2017,

title = {Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study},

author = {Dickson, T J and Trathen, S and Terwiel, F A and Waddington, G and Adams, R},

doi = {10.1111/sms.12642},

isbn = {09057188},

year  = {2017},

date = {2017-01-01},

journal = {Scandinavian Journal of Medicine \& Science in Sports},

volume = {27},

number = {2},

pages = {236--244},

abstract = {This research explored associations between helmet use and head injuries in snowsports by investigating reported snowsport injuries in Western Canada from 2008-2009 to 2012-2013. The key finding was that increased helmet use (from 69% to 80%) was not associated with a reduction in reported head injuries. Over the study period, the average rate of reported head injuries was 0.2/1000 skier visits, with a statistically significant variation ( P \< 0.001). The line of best fit showed an non-significant upward trend ( P = 0.13). Lacerations were the only subcategory of head injuries that decreased significantly with helmet use. A higher proportion of people who reported a head injury were wearing a helmet than for injuries other than to the head. Skiers were more likely to report a head injury when wearing a helmet than snowboarders ( P \< 0.001 cf. P = 0.22). There were significant differences in characteristics of helmet and non-helmet wearers. Helmet wearers were more likely to be: young adults ( P \< 0.001); beginner/novices ( P = 0.004); and snowboarders ( P \< 0.001), but helmet wearing was not associated with gender ( P = 0.191). Further research is needed to explore the possible reasons for the failure of helmets to reduce head injuries, for example, increased reporting of head injuries and increased risk-taking combined with over-rating of the helmets' protection.},

keywords = {CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries},

pubstate = {published},

tppubtype = {article}

}

Churchill, N; Hutchison, M G; Leung, G; Graham, S; Schweizer, T A

Changes in functional connectivity of the brain associated with a history of sport concussion: A preliminary investigation Journal Article

In: Brain Injury, vol. 31, no. 1, pp. 39–48, 2017.

Abstract | Links | BibTeX | Tags: Concussion, Functional MRI, MRI scan, neuroimaging

@article{Churchill2017,

title = {Changes in functional connectivity of the brain associated with a history of sport concussion: A preliminary investigation},

author = {Churchill, N and Hutchison, M G and Leung, G and Graham, S and Schweizer, T A},

doi = {10.1080/02699052.2016.1221135},

year  = {2017},

date = {2017-01-01},

journal = {Brain Injury},

volume = {31},

number = {1},

pages = {39--48},

abstract = {Objective: There is evidence of long-term clinical consequences associated with a history of sport concussion. However, there remains limited information about the underlying changes in brain function. The goal of this study was to identify brain regions where abnormal resting-state function is associated with chronic concussion, for athletes without persistent symptoms. Methods: Functional Magnetic Resonance Imaging (fMRI) was performed on a group of athletes with prior concussion (n = 22) and a group without documented injury (n = 21). Multivariate predictive modelling was used to localize reliable changes in brain connectivity that are associated with a history of concussion and with clinical factors, including number of prior concussions and recovery time from last injury. Results: No significant differences were found between athletes with and without a history of concussion, but functional connectivity was significantly associated with clinical history. The number of prior concussions was associated with most extensive connectivity changes, particularly for elements of the visual attention network and cerebellum. Conclusion: The findings of this preliminary study indicate that functional brain abnormalities associated with chronic concussion may be significantly dependent on clinical history. In addition, elements of the visual and cerebellar systems may be most sensitive to the long-term effects of sport concussion. © 2017 Taylor \& Francis Group, LLC.},

keywords = {Concussion, Functional MRI, MRI scan, neuroimaging},

pubstate = {published},

tppubtype = {article}

}

Klein, T A; Graves, J M

A Comparison of Psychiatric and Nonpsychiatric Nurse Practitioner Knowledge and Management Recommendations Regarding Adolescent Mild Traumatic Brain Injury Journal Article

In: Journal of the American Psychiatric Nurses Association, vol. 23, no. 1, pp. 37–49, 2017.

Abstract | Links | BibTeX | Tags: adolescents/adolescence, Brain Injury, Concussion, nurse practitioner

@article{Klein2017,

title = {A Comparison of Psychiatric and Nonpsychiatric Nurse Practitioner Knowledge and Management Recommendations Regarding Adolescent Mild Traumatic Brain Injury},

author = {Klein, T A and Graves, J M},

doi = {10.1177/1078390316668992},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the American Psychiatric Nurses Association},

volume = {23},

number = {1},

pages = {37--49},

abstract = {BACKGROUND: Nurse practitioners (NPs) are statutorily authorized to provide assessment and cognitive recommendations for concussion in most states. Their scope of practice includes assessment and management of concussion sequalae including anxiety, insomnia, and depression, as well as return to school and activity guidance. OBJECTIVES: Analysis of symptom-based diagnosis of mild traumatic brain injury (TBI) in adolescents, including return to school and school workload recommendations comparing psychiatric and nonpsychiatric NPs. DESIGN: Cross-sectional Web-based survey with embedded videos using standardized actors and scripts randomized for patient sex and sport. A total of 4,849 NPs licensed in Oregon or Washington were invited by e-mail to view and respond to this study, with a response rate of 23%. RESULTS: Psychiatric mental health nurse practitioners (PMHNPs) were 44% less likely than family NPs to report using standardized concussion tools. 17% had completed continuing education on mild TBI compared to 54.5% of family NPs. Seven PMHNPs provided additional feedback related to discomfort in completing the survey due to lack of comfort or experience. Return to school recommendations and reduced workload advice did not significantly differ by NP type. CONCLUSION: PMHNPs may support individualized assessment through concussion evaluation, use of standardized tools, and differential consideration of TBI for mental health symptoms. More research is required related to the role and contribution of cognitive rest to full recovery. © 2016, © The Author(s) 2016.},

keywords = {adolescents/adolescence, Brain Injury, Concussion, nurse practitioner},

pubstate = {published},

tppubtype = {article}

}

Roberts, Simon P; Trewartha, Grant; England, Michael; Goodison, William; Stokes, Keith A

Concussions and Head Injuries in English Community Rugby Union Match Play Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 480–487, 2017, ISBN: 03635465.

Abstract | Links | BibTeX | Tags: Concussion, EPIDEMIOLOGY, injury, Rugby Union

@article{Roberts2017,

title = {Concussions and Head Injuries in English Community Rugby Union Match Play},

author = {Roberts, Simon P and Trewartha, Grant and England, Michael and Goodison, William and Stokes, Keith A},

doi = {10.1177/0363546516668296},

isbn = {03635465},

year  = {2017},

date = {2017-01-01},

journal = {American Journal of Sports Medicine},

volume = {45},

number = {2},

pages = {480--487},

abstract = {Background: Previous research has described general injury patterns in community-level rugby union, but specific information on time-loss head injuries has not been reported. Purpose: To establish the incidence and nature of significant time-loss head injuries in English community rugby match play, and to identify the injury risk for specific contact events. Study Design: Descriptive epidemiology study. Methods: Over 6 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), 76 (2011-2012), 50 (2012-2013), 67 (2013-2014), and 58 (2014-2015) English community rugby clubs (Rugby Football Union levels 3-9) over a total of 175,940 hours of player match exposure. Club injury management staff reported information for all head injuries sustained during match play whereby the player was absent for 8 days or greater. Clubs were subdivided into semiprofessional (mean player age, 24.6 ± 4.7 years), amateur (24.9 ± 5.1 years), and recreational (25.6 ± 6.1 years) playing levels. Contact events from a sample of 30 matches filmed over seasons 2009-2010, 2010-2011, and 2011-2012 provided mean values for the frequency of contact events. Results: The overall incidence for time-loss head injuries was 2.43 injuries per 1000 player match hours, with a higher incidence for the amateur (2.78; 95% CI, 2.37-3.20) compared with recreational (2.20; 95% CI, 1.86-2.53) (P = .032) playing level but not different to the semiprofessional (2.31; 95% CI, 1.83-2.79) playing level. Concussion was the most common time-loss head injury, with 1.46 per 1000 player match hours. The tackle event was associated with 64% of all head injuries and 74% of all concussions. There was also a higher risk of injuries per tackle (0.33 per 1000 events; 95% CI, 0.30-0.37) compared with all other contact events. Conclusion: Concussion was the most common head injury diagnosis, although it is likely that this injury was underreported. Continuing education programs for medical staff and players are essential for the improved identification and management of these injuries. With the majority of head injuries occurring during a tackle, an improved technique in this contact event through coach and player education may be effective in reducing these injuries. [ABSTRACT FROM AUTHOR].},

keywords = {Concussion, EPIDEMIOLOGY, injury, Rugby Union},

pubstate = {published},

tppubtype = {article}

}

Background: Previous research has described general injury patterns in community-level rugby union, but specific information on time-loss head injuries has not been reported. Purpose: To establish the incidence and nature of significant time-loss head injuries in English community rugby match play, and to identify the injury risk for specific contact events. Study Design: Descriptive epidemiology study. Methods: Over 6 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), 76 (2011-2012), 50 (2012-2013), 67 (2013-2014), and 58 (2014-2015) English community rugby clubs (Rugby Football Union levels 3-9) over a total of 175,940 hours of player match exposure. Club injury management staff reported information for all head injuries sustained during match play whereby the player was absent for 8 days or greater. Clubs were subdivided into semiprofessional (mean player age, 24.6 ± 4.7 years), amateur (24.9 ± 5.1 years), and recreational (25.6 ± 6.1 years) playing levels. Contact events from a sample of 30 matches filmed over seasons 2009-2010, 2010-2011, and 2011-2012 provided mean values for the frequency of contact events. Results: The overall incidence for time-loss head injuries was 2.43 injuries per 1000 player match hours, with a higher incidence for the amateur (2.78; 95% CI, 2.37-3.20) compared with recreational (2.20; 95% CI, 1.86-2.53) (P = .032) playing level but not different to the semiprofessional (2.31; 95% CI, 1.83-2.79) playing level. Concussion was the most common time-loss head injury, with 1.46 per 1000 player match hours. The tackle event was associated with 64% of all head injuries and 74% of all concussions. There was also a higher risk of injuries per tackle (0.33 per 1000 events; 95% CI, 0.30-0.37) compared with all other contact events. Conclusion: Concussion was the most common head injury diagnosis, although it is likely that this injury was underreported. Continuing education programs for medical staff and players are essential for the improved identification and management of these injuries. With the majority of head injuries occurring during a tackle, an improved technique in this contact event through coach and player education may be effective in reducing these injuries. [ABSTRACT FROM AUTHOR].

Anzalone, Anthony J; Blueitt, Damond; Case, Tami; McGuffin, Tiffany; Pollard, Kalyssa; Garrison, J Craig; Jones, Margaret T; Pavur, Robert; Turner, Stephanie; Oliver, Jonathan M

A Positive Vestibular/Ocular Motor Screening (VOMS) Is Associated With Increased Recovery Time After Sports-Related Concussion in Youth and Adolescent Athletes Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 474–479, 2017, ISBN: 03635465.

Abstract | Links | BibTeX | Tags: Concussion, Ocular motor, Symptoms, vestibular

Moore, R D; Lepine, J; Ellemberg, D

The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function Journal Article

In: International Journal of Psychophysiology, vol. 112, pp. 22–30, 2017.

Abstract | Links | BibTeX | Tags: Concussion, ERPs, Neurophysiology, neuropsychology, Sub-concussion

@article{Moore2017,

title = {The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function},

author = {Moore, R D and Lepine, J and Ellemberg, D},

doi = {10.1016/j.ijpsycho.2016.11.011},

year  = {2017},

date = {2017-01-01},

journal = {International Journal of Psychophysiology},

volume = {112},

pages = {22--30},

abstract = {Accumulating research demonstrates that repetitive sub-concussive impacts can alter the structure, function and connectivity of the brain. However, the functional significance of these alterations as well as the independent contribution of concussive and sub-concussive impacts to neurophysiological and neuropsychological health are unclear. Accordingly, we compared the neurophysiological and neuropsychological function of contact athletes with (concussion group) and without (sub-concussion group) a history of concussion, to non-contact athletes. We evaluated event-related brain potentials (ERPs) elicited during an oddball task and performance on a targeted battery of neuropsychological tasks. Athletes in the sub-concussion and concussion groups exhibited similar amplitude reductions in the ERP indices of attentional resource allocation (P3b) and attentional orienting (P3a) relative to non-contact athletes. However, only athletes in the concussion group exhibited reduced amplitude in the ERP index of perceptual attention (N1). Athletes in the sub-concussion and concussion groups also exhibited deficits in memory recall relative to non-contact athletes, but athletes in the concussion group also exhibited significantly more recall errors than athletes in the sub-concussion group. Additionally, only athletes in the concussion group exhibited response delays during the oddball task. The current findings suggest that sub-concussive impacts are associated with alterations in the neurophysiological and neuropsychological indices of essential cognitive functions, albeit to a lesser degree than the combination of sub-concussive and concussive impacts. © 2016 Elsevier B.V.},

keywords = {Concussion, ERPs, Neurophysiology, neuropsychology, Sub-concussion},

pubstate = {published},

tppubtype = {article}

}

Tanaka, Yuto; Tsugawa, Tsuyoshi; Maeda, Yoshinobu

Effect of mouthguards on impact to the craniomandibular complex Journal Article

In: Dental Traumatology, vol. 33, no. 1, pp. 51–56, 2017, ISBN: 16004469.

Abstract | Links | BibTeX | Tags: Concussion, craniomandibular complex, Face -- Wounds & injuries, Impact loads (Engineering), Jaws, MOUTH protectors, Mouthguard, Pendulums, teeth-clenching, Temporomandibular joint

Bailly, N; Afquir, S; Laporte, J D; Melot, A; Savary, D; Seigneuret, E; Delay, J B; Donnadieu, T; Masson, C; Arnoux, P J

Analysis of Injury Mechanisms in Head Injuries in Skiers and Snowboarders Journal Article

In: Medicine & Science in Sports & Exercise, vol. 49, no. 1, pp. 1–10, 2017.

Abstract | Links | BibTeX | Tags: Concussion, head injury, Helmet, SKI, snowboard

@article{Bailly2017,

title = {Analysis of Injury Mechanisms in Head Injuries in Skiers and Snowboarders},

author = {Bailly, N and Afquir, S and Laporte, J D and Melot, A and Savary, D and Seigneuret, E and Delay, J B and Donnadieu, T and Masson, C and Arnoux, P J},

doi = {10.1249/MSS.0000000000001078},

year  = {2017},

date = {2017-01-01},

journal = {Medicine \& Science in Sports \& Exercise},

volume = {49},

number = {1},

pages = {1--10},

abstract = {Purpose Mechanisms of injury and description of head impacts leading to traumatic brain injury (TBI) in skiers and snowboarders have not been extensively documented. We investigate snow sport crashes leading to TBI 1) to identify typical mechanisms leading to TBI to better target prevention measures and 2) to identify the injury mechanisms and the head impact conditions. Methods The subjects were skiers and snowboarders diagnosed of TBI and admitted between 2013 and 2015 to one of the 15 medical offices and three hospital centers involved in the study. The survey includes the description of the patients (age, sex, practice, skill level, and helmet use), the crash (type, location, estimated speed, causes, and fall description), and the injuries sustained (symptoms, head trauma scores, and other injuries). Sketches were used to describe the crash and impact locations. Clustering methods were used to distinguish profiles of injured participants. Results A total of 295 skiers and 71 snowboarders were interviewed. The most frequent type of mechanism was falls (54%), followed by collision between users (18%) and jumps (15%). Collision with obstacle (13%) caused the most serious TBI. Three categories of patients were identified. First, men age 16-25 yr are more involved in crash at high speed or in connection with a jump. Second, women, children (\<16 yr), and beginners are particularly injured in collisions between users. Third, those older than 50 yr, usually nonhelmeted, are frequently involved in falls. Ten crash scenarios were identified. Falling head first is the most frequent of skiers' falls (28%). Conclusion Crash scenarios leading to TBI were identified and associated with profiles of injured participants. Those results should help to better target TBI prevention and protection campaigns. © 2016 by the American College of Sports Medicine.},

keywords = {Concussion, head injury, Helmet, SKI, snowboard},

pubstate = {published},

tppubtype = {article}

}

2016

Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D

Association of football subconcussive head impacts with ocular near point of convergence Journal Article

In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.

Abstract | Links | BibTeX | Tags: Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult

@article{Kawata2016,

title = {Association of football subconcussive head impacts with ocular near point of convergence},

author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},

doi = {10.1001/jamaophthalmol.2016.1085},

year  = {2016},

date = {2016-01-01},

journal = {JAMA Ophthalmology},

volume = {134},

number = {7},

pages = {763--769},

abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},

keywords = {Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Kim, S; Spengler, J O; Connaughton, D P

An exploratory study of concussion management policies in municipal park and recreation departments Journal Article

In: Journal of Policy Research in Tourism, Leisure and Events, vol. 8, no. 3, pp. 274–288, 2016.

Abstract | Links | BibTeX | Tags: Concussion, Injury prevention, policy, recreation, risk management, Youth sports

Howell, D R; Meehan III, W P

Normative values for a video-force plate assessment of postural control in athletic children Journal Article

In: Journal of Pediatric Orthopaedics Part B, vol. 25, no. 4, pp. 310–314, 2016.

Abstract | Links | BibTeX | Tags: Athletes, Balance, Balance Error Scoring System, Concussion, postural stability, Sports

Carter-Allison, S N; Potter, S; Rimes, K

Diagnosis Threat and Injury Beliefs after Mild Traumatic Brain Injury Journal Article

In: Archives of Clinical Neuropsychology, vol. 31, no. 7, pp. 727–737, 2016.

Abstract | Links | BibTeX | Tags: attention, Concussion, Illness perceptions, Memory, Stereotype threat, Suggestibility

@article{Carter-Allison2016,

title = {Diagnosis Threat and Injury Beliefs after Mild Traumatic Brain Injury},

author = {Carter-Allison, S N and Potter, S and Rimes, K},

doi = {10.1093/arclin/acw062},

year  = {2016},

date = {2016-01-01},

journal = {Archives of Clinical Neuropsychology},

volume = {31},

number = {7},

pages = {727--737},

abstract = {Background Diagnosis threat is a psychosocial factor proposed to contribute to poor cognitive outcomes following mild traumatic brain injury (mTBI). The current research explored diagnosis threat impact on objective and subjective cognitive performance in a "high risk" population of athletes. Two possible moderators of diagnosis threat - injury beliefs and suggestibility - were also investigated. Method Seventy-six participants with a history of mTBI were recruited through sports clubs and randomized to a months threat group (instructions drew attention to mTBI history) or a control group (no mention of mTBI). They completed a battery of neuropsychological tests and questionnaires regarding day-to-day cognitive abilities. Measures of depression, anxiety, illness beliefs and suggestibility were also collected. Results No significant group differences were found on any neuropsychological tasks, nor on self-report of cognitive difficulties. Illness beliefs were not found to play a moderating role in general, although the majority of the study sample did not report negative mTBI beliefs and expectations: concern about the consequences of injury was associated with weaker performance on one test, WAIS-III Digit Span performance. Suggestibility was also found to have a significant affect on this test. Conclusions Diagnosis threat did not appear to have a marked affect on objective or subjective cognitive performance after mTBI in athletes. Differing injury beliefs between the study's athlete population and the general population is a possible explanation for different findings in the area. This and other sources of potential variation in the affect of diagnosis threat are discussed. © 2016 Crown copyright 2016.},

keywords = {attention, Concussion, Illness perceptions, Memory, Stereotype threat, Suggestibility},

pubstate = {published},

tppubtype = {article}

}

Chermann, J F; Savigny, A; Radafy, A; Blandin, N; Bohu, Y

In: Journal de Traumatologie du Sport, vol. 33, no. 2, pp. 88–96, 2016.

Abstract | Links | BibTeX | Tags: brain, Concussion, Sports

@article{Chermann2016,

title = {Sports-related concussion in elite athletes: Prospective study of 211 cases seen in a specialized outpatient clinic},

author = {Chermann, J F and Savigny, A and Radafy, A and Blandin, N and Bohu, Y},

doi = {10.1016/j.jts.2015.12.008},

year  = {2016},

date = {2016-01-01},

journal = {Journal de Traumatologie du Sport},

volume = {33},

number = {2},

pages = {88--96},

abstract = {Sports-related brain concussion is not well known despite its frequency. Few cases are reported. Brain concussion leads to an immediate transient alteration of the neurological functions followed by a post-concussion syndrome of variable duration. Due to the risk of neurodegenerative disease related to repeated concussion, we created a specialized outpatient clinic devoted to sports-related brain concussions in order to better apprehend the phenomenon, to search for factors predictive of unfavorable outcome, and most importantly to elaborate a protocol and a set of criteria for determining the moment the incriminated activity can be resumed under good conditions. The cohort included 211 athletes who attended the specialized outpatient clinic, 168 men and 43 women. The largest number of patients were rugby players (n = 166, 78.7%). Among the 211 athletes, 126 (59.7%) had already had one concussion and 132 attended the clinic twice, at most four days after the concussion. The diagnosis was considered on the playing field, generally because of the presence of amnesia or loss of consciousness. Among the 211 athletes, 106 (50.2%) left the field immediately after the concussion. For the post-concussion syndrome, headache was the most common functional sign (170/211, 80.6%). Age (\< 20 years), female gender, and recent history of a brain concussion were factors predictive of poor outcome as measured by the duration of the post-concussion syndrome and delay before returning to the sports activity. Loss of consciousness, anterograde or retrograde amnesia, and the number of episodes of prior brain concussion did not have any impact on the duration of the post-concussion syndrome and delay before returning to the sports activity. In our opinion, a specialized outpatient clinic visit less than four days after the concussion can help reduce the length of the post-concussion syndrome, mainly resulting from good patient education and better therapeutic management. © 2016},

keywords = {brain, Concussion, Sports},

pubstate = {published},

tppubtype = {article}

}

Sports-related brain concussion is not well known despite its frequency. Few cases are reported. Brain concussion leads to an immediate transient alteration of the neurological functions followed by a post-concussion syndrome of variable duration. Due to the risk of neurodegenerative disease related to repeated concussion, we created a specialized outpatient clinic devoted to sports-related brain concussions in order to better apprehend the phenomenon, to search for factors predictive of unfavorable outcome, and most importantly to elaborate a protocol and a set of criteria for determining the moment the incriminated activity can be resumed under good conditions. The cohort included 211 athletes who attended the specialized outpatient clinic, 168 men and 43 women. The largest number of patients were rugby players (n = 166, 78.7%). Among the 211 athletes, 126 (59.7%) had already had one concussion and 132 attended the clinic twice, at most four days after the concussion. The diagnosis was considered on the playing field, generally because of the presence of amnesia or loss of consciousness. Among the 211 athletes, 106 (50.2%) left the field immediately after the concussion. For the post-concussion syndrome, headache was the most common functional sign (170/211, 80.6%). Age (< 20 years), female gender, and recent history of a brain concussion were factors predictive of poor outcome as measured by the duration of the post-concussion syndrome and delay before returning to the sports activity. Loss of consciousness, anterograde or retrograde amnesia, and the number of episodes of prior brain concussion did not have any impact on the duration of the post-concussion syndrome and delay before returning to the sports activity. In our opinion, a specialized outpatient clinic visit less than four days after the concussion can help reduce the length of the post-concussion syndrome, mainly resulting from good patient education and better therapeutic management. © 2016

Bunworth, R

Egg-shell skulls or institutional negligence? The liability of World Rugby for incidents of concussion suffered by professional players in England and Ireland Journal Article

In: International Sports Law Journal, vol. 16, no. 1-2, pp. 82–98, 2016.

Abstract | Links | BibTeX | Tags: Concussion, Duty of care, Governing body, Liability, Negligence, rugby

@article{Bunworth2016,

title = {Egg-shell skulls or institutional negligence? The liability of World Rugby for incidents of concussion suffered by professional players in England and Ireland},

author = {Bunworth, R},

doi = {10.1007/s40318-016-0095-y},

year  = {2016},

date = {2016-01-01},

journal = {International Sports Law Journal},

volume = {16},

number = {1-2},

pages = {82--98},

abstract = {The number of incidents of concussion in professional rugby union is increasing steadily. In the English Rugby Premiership, concussion was the most frequent injury suffered by professional players in each of the last 3 seasons. Further, there is developing evidence of a link between suffering repeated concussions and chronic traumatic encephalopathy, a degenerative brain disease. World Rugby’s principal response to the growing problem of concussion in rugby has been through the introduction of the Pitch Side Concussion Assessment and the Return to Play protocols. Few amendments have been made to the playing rules of the sport with the express intention of reducing the frequency with which concussions occur. The article explores whether World Rugby could be found to owe professional rugby players a duty of care under the laws of negligence in England and Ireland. The article then goes on to examine if World Rugby could be found to have acted negligently in its response to the issue of concussion, through the adoption of its concussion management rules and its failure to amend the playing rules of the sport in an attempt to prevent concussions from occurring. Following this, the article analyses the difficulty which a potential plaintiff would face in establishing causation in a negligence action against World Rugby. The article concludes with suggested changes which World Rugby could implement to lessen the possibility of a finding that it has acted negligently in relation to players’ safety. © 2016, T.M.C. Asser Instituut.},

keywords = {Concussion, Duty of care, Governing body, Liability, Negligence, rugby},

pubstate = {published},

tppubtype = {article}

}

Reider, B

Like a pro Journal Article

In: American Journal of Sports Medicine, vol. 44, no. 9, pp. 2199–2201, 2016.

Links | BibTeX | Tags: Baseball, BASKETBALL, Concussion, femoroacetabular impingement, football, ice hockey, ulnar collateral ligament

Kontos, A P; Sufrinko, A; Womble, M; Kegel, N

Neuropsychological Assessment Following Concussion: an Evidence‐Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion Journal Article

In: Current Pain & Headache Reports, vol. 20, no. 6, 2016.

Abstract | Links | BibTeX | Tags: Baseline, brain function, Computerized assessment battery, computerized neuropsychological test, Concussion, evidence based practice, human, MEDICAL research, Neurocognitive tests, Neuropsychological evaluation, neuropsychological test, paper and pencil neuropsychological test, psychologic assessment, reliability, Review, Sport, TASK performance

@article{Kontos2016b,

title = {Neuropsychological Assessment Following Concussion: an Evidence‐Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion},

author = {Kontos, A P and Sufrinko, A and Womble, M and Kegel, N},

doi = {10.1007/s11916-016-0571-y},

year  = {2016},

date = {2016-01-01},

journal = {Current Pain \& Headache Reports},

volume = {20},

number = {6},

abstract = {Neuropsychological evaluation is one component of a comprehensive and multifaceted assessment following concussion. Although some neuropsychologists use a “hybrid” assessment approach integrating computerized neurocognitive testing batteries with traditional paper and pencil tests, computerized neurocognitive test batteries are the predominant testing modality for assessment of athletes from the youth to professional level. This review summarizes the most recent research supporting the utility of neuropsychological evaluation and highlights the strengths and weaknesses of both computerized and traditional neuropsychological testing approaches. The most up to date research and guidelines on baseline neurocognitive testing is also discussed. This paper addresses concerns regarding reliability of neuropsychological testing while providing an overview of factors that influence test performance, both transient situational factors (e.g., pain level, anxiety) and characteristics of particular subgroups (e.g., age, preexisting learning disabilities), warranting the expertise of an experienced neuropsychologist for interpretation. Currently, research is moving forward by integrating neuropsychological evaluation with emerging assessment approaches for other domains of brain function (e.g., vestibular function) vulnerable to concussion. © 2016, Springer Science+Business Media New York.},

keywords = {Baseline, brain function, Computerized assessment battery, computerized neuropsychological test, Concussion, evidence based practice, human, MEDICAL research, Neurocognitive tests, Neuropsychological evaluation, neuropsychological test, paper and pencil neuropsychological test, psychologic assessment, reliability, Review, Sport, TASK performance},

pubstate = {published},

tppubtype = {article}

}

Hecimovicha, Mark; Kingb, Doug; Maraisc, Ida

Player and parent concussion knowledge and awareness in youth Australian Rules Football Journal Article

In: Sport Journal, pp. 1–19, 2016, ISBN: 15439518.

Abstract | BibTeX | Tags: *ACADEMIC achievement, *BRAIN -- Concussion, *FIRST aid in illness & injury, *FOOTBALL injuries, *SLEEP disorders, *SPORTS participation, *SYMPTOMS, ADOLESCENCE, Australia, Australian Rules football, AWARENESS, Concussion, DESCRIPTIVE statistics, HEALTH literacy, Parent, PARENTS -- Attitudes, PROBABILITY theory, Questionnaires, STATISTICAL significance, Treatment, Youth

@article{Hecimovicha2016,

title = {Player and parent concussion knowledge and awareness in youth Australian Rules Football},

author = {Hecimovicha, Mark and Kingb, Doug and Maraisc, Ida},

isbn = {15439518},

year  = {2016},

date = {2016-01-01},

journal = {Sport Journal},

pages = {1--19},

abstract = {Purpose: The purpose of this study was to measure concussion knowledge and awareness of youth Australian Rules Football players and parents. Secondary aims were examining if player's maturity in age, history of concussion and years played and parents who have undergone first aid and concussion training would increase knowledge. Methods: 1,441 parents and 284 youth ARF players completed a 23-item concussion knowledge survey consisting of three areas: concussion symptoms, management, and return-to-play criteria. Results: There was significant difference in knowledge of concussion management and return-to play criteria between players and parents (p= less than 0.01). Players age, years played and history of concussion did not increase knowledge, however, parents with concussion training had significantly higher scores than those without (p= less than 0.01). Some return-to-play criteria and signs and symptom not thought to be associated with concussion such as disturbed sleeping and difficulty studying were difficult for both groups to associate as related to concussion. Conclusions: Future concussion education opportunities for player and parents need to focus on return-to-play criteria and uncommon signs and symptoms such as sleep disturbances and problems studying. Applications in sport: The findings reflect certain areas that need to be incorporated into educational opportunities for players and parents, especially those who have limited access to qualified health care professionals such as ATC's. Although there is minimal evidence supporting concussion educational opportunities, awareness and knowledge of concussion is the greatest positive influence for symptom reporting among young athletes. However, the ideal delivery mode and educational content for interventions appropriate to each group has yet to be identified so steps such as defining the target group, measuring their level of awareness and knowledge, and monitoring of effectiveness. Overall, the goal should be to provide at least the basic information regarding concussion but as the results of this study demonstrate ensure lesser known aspects such as return-to-play criteria and signs and symptoms such as sleep disturbances and difficulty studying or concentrating are incorporated. ABSTRACT FROM AUTHOR},

keywords = {*ACADEMIC achievement, *BRAIN -- Concussion, *FIRST aid in illness \&amp; injury, *FOOTBALL injuries, *SLEEP disorders, *SPORTS participation, *SYMPTOMS, ADOLESCENCE, Australia, Australian Rules football, AWARENESS, Concussion, DESCRIPTIVE statistics, HEALTH literacy, Parent, PARENTS -- Attitudes, PROBABILITY theory, Questionnaires, STATISTICAL significance, Treatment, Youth},

pubstate = {published},

tppubtype = {article}

}

Purpose: The purpose of this study was to measure concussion knowledge and awareness of youth Australian Rules Football players and parents. Secondary aims were examining if player's maturity in age, history of concussion and years played and parents who have undergone first aid and concussion training would increase knowledge. Methods: 1,441 parents and 284 youth ARF players completed a 23-item concussion knowledge survey consisting of three areas: concussion symptoms, management, and return-to-play criteria. Results: There was significant difference in knowledge of concussion management and return-to play criteria between players and parents (p= less than 0.01). Players age, years played and history of concussion did not increase knowledge, however, parents with concussion training had significantly higher scores than those without (p= less than 0.01). Some return-to-play criteria and signs and symptom not thought to be associated with concussion such as disturbed sleeping and difficulty studying were difficult for both groups to associate as related to concussion. Conclusions: Future concussion education opportunities for player and parents need to focus on return-to-play criteria and uncommon signs and symptoms such as sleep disturbances and problems studying. Applications in sport: The findings reflect certain areas that need to be incorporated into educational opportunities for players and parents, especially those who have limited access to qualified health care professionals such as ATC's. Although there is minimal evidence supporting concussion educational opportunities, awareness and knowledge of concussion is the greatest positive influence for symptom reporting among young athletes. However, the ideal delivery mode and educational content for interventions appropriate to each group has yet to be identified so steps such as defining the target group, measuring their level of awareness and knowledge, and monitoring of effectiveness. Overall, the goal should be to provide at least the basic information regarding concussion but as the results of this study demonstrate ensure lesser known aspects such as return-to-play criteria and signs and symptoms such as sleep disturbances and difficulty studying or concentrating are incorporated. ABSTRACT FROM AUTHOR

Collins, M W; Kontos, A P; Okonkwo, D O; Almquist, J; Bailes, J; Barisa, M; Bazarian, J; Bloom, O J; Brody, D L; Cantu, R; Cardenas, J; Clugston, J; Cohen, R; Echemendia, R; Elbin, R J; Ellenbogen, R; Fonseca, J; Gioia, G; Guskiewicz, K; Heyer, R; Hotz, G; Iverson, G L; Jordan, B; Manley, G; Maroon, J; McAllister, T; McCrea, M; Mucha, A; Pieroth, E; Podell, K; Pombo, M; Shetty, T; Sills, A; Solomon, G; Thomas, D G; Valovich McLeod, T C; Yates, T; Zafonte, R

Statements of Agreement from the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015 Journal Article

In: Neurosurgery, vol. 79, no. 6, pp. 912–929, 2016.

Abstract | Links | BibTeX | Tags: Concussion, mTBI, Rehabilitation, Treatment

@article{Collins2016,

title = {Statements of Agreement from the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015},

author = {Collins, M W and Kontos, A P and Okonkwo, D O and Almquist, J and Bailes, J and Barisa, M and Bazarian, J and Bloom, O J and Brody, D L and Cantu, R and Cardenas, J and Clugston, J and Cohen, R and Echemendia, R and Elbin, R J and Ellenbogen, R and Fonseca, J and Gioia, G and Guskiewicz, K and Heyer, R and Hotz, G and Iverson, G L and Jordan, B and Manley, G and Maroon, J and McAllister, T and McCrea, M and Mucha, A and Pieroth, E and Podell, K and Pombo, M and Shetty, T and Sills, A and Solomon, G and Thomas, D G and {Valovich McLeod}, T C and Yates, T and Zafonte, R},

doi = {10.1227/NEU.0000000000001447},

year  = {2016},

date = {2016-01-01},

journal = {Neurosurgery},

volume = {79},

number = {6},

pages = {912--929},

abstract = {BACKGROUND: Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. OBJECTIVE: To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion. METHODS: On October 14 to 16, 2015, the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion meeting was convened in Pittsburgh, Pennsylvania. Thirty-seven concussion experts from neuropsychology, neurology, neurosurgery, sports medicine, physical medicine and rehabilitation, physical therapy, athletic training, and research and 12 individuals representing sport, military, and public health organizations attended the meeting. The 37 experts indicated their agreement on a series of statements using an audience response system clicker device. RESULTS: A total of 16 statements of agreement were supported covering (1) Summary of the Current Approach to Treating Concussion, (2) Heterogeneity and Evolving Clinical Profiles of Concussion, (3) TEAM Approach to Concussion Treatment: Specific Strategies, and (4) Future Directions: A Call to Research. Support (ie, response of agree or somewhat agree) for the statements ranged from to 97% to 100%. CONCLUSION: Concussions are characterized by diverse symptoms and impairments and evolving clinical profiles; recovery varies on the basis of modifying factors, injury severity, and treatments. Active and targeted treatments may enhance recovery after concussion. Research is needed on concussion clinical profiles, biomarkers, and the effectiveness and timing of treatments. Copyright © 2016 by the Congress of Neurological Surgeons.},

keywords = {Concussion, mTBI, Rehabilitation, Treatment},

pubstate = {published},

tppubtype = {article}

}

Kroshus, E; Gillard, D; Haarbauer‐Krupa, J; Goldman, R E; Bickham, D S

Talking with young children about concussions: An exploratory study Journal Article

In: Child: Care, Health and Development, 2016, ISBN: 0305-1862 1365-2214.

Abstract | Links | BibTeX | Tags: 2016, Brain Injury, children, Concussion, No terms assigned, Parents, Sport

@article{Kroshus2016b,

title = {Talking with young children about concussions: An exploratory study},

author = {Kroshus, E and Gillard, D and Haarbauer‐Krupa, J and Goldman, R E and Bickham, D S},

doi = {10.1111/cch.12433},

isbn = {0305-1862

1365-2214},

year  = {2016},

date = {2016-01-01},

journal = {Child: Care, Health and Development},

publisher = {Wiley-Blackwell Publishing Ltd.},

address = {United Kingdom},

abstract = {Background Concussion education for children early in their participation in organized sport may help shape lasting attitudes about concussion safety. However, existing programming and research focus on older ages. Methods Qualitative interviews about concussions were conducted with twenty children between the ages of six and eight. Structural, descriptive and pattern coding were used to organize the transcribed interviews and identify emergent themes. Results Eighteen of the participants indicated that they had heard of the word concussion, with 12 describing the injury as related to the brain or head. The most frequently described mechanisms of injury were impacts to the head or falls, and symptoms tended to be somatic, such as generalized pain. The most frequently endorsed strategy to avoid sustaining a concussion was to ‘follow the rules.’ Multiple participants referenced parents as an informal source of information about concussions. Conclusions While most participants demonstrated some awareness about concussions, there were clear knowledge gaps that can be addressed with developmentally appropriate concussion education programming. Consistent with their developmental stage, interventions targeted at children in this age range may be most successful if they use basic logic, concrete ideas, provide rules to be followed and engage parents in dissemination. (PsycINFO Database Record (c) 2016 APA, all rights reserved)},

keywords = {2016, Brain Injury, children, Concussion, No terms assigned, Parents, Sport},

pubstate = {published},

tppubtype = {article}

}

Gregory, A; Kerr, Z; Parsons, J

Selected issues in injury and illness prevention and the team physician: A consensus statement Journal Article

In: Current Sports Medicine Reports, vol. 15, no. 1, pp. 48–59, 2016.

Abstract | Links | BibTeX | Tags: Accident prevention, Article, athlete, cervical spine injury, commotio cordis, Concussion, consultation, coronary artery anomaly, documentation, elbow injury, head and neck injury, heart right ventricle dysplasia, heat injury, human, hypertrophic cardiomyopathy, knowledge, patellofemoral pain syndrome, physician, risk factor, shoulder injury, skin infection, sport injury, SPORTS medicine, total quality management

Sanghera, Navjit K; Baas, Eric A; Bakkum, Barclay W; Foreman, Katie; Beckerman, Stephen

Sports vision evaluation findings in an elite athlete population Journal Article

In: Optometry & Visual Performance, vol. 4, no. 3, pp. 137–146, 2016, ISBN: 2325-3479 2325-3487.

Abstract | BibTeX | Tags: 2016, Binocular Vision, binocular vision disorder, brain concussion, Concussion, Sports, sports vision, traumatic brain injury, Vision Disorders

@article{Sanghera2016,

title = {Sports vision evaluation findings in an elite athlete population},

author = {Sanghera, Navjit K and Baas, Eric A and Bakkum, Barclay W and Foreman, Katie and Beckerman, Stephen},

isbn = {2325-3479

2325-3487},

year  = {2016},

date = {2016-01-01},

journal = {Optometry \& Visual Performance},

volume = {4},

number = {3},

pages = {137--146},

publisher = {Optometric Extension Program Foundation, Inc.},

address = {US},

abstract = {Background: Epidemiological studies suggest that the athletic population has a significant need for vision care. Recently, there has been an increased awareness and discussion of sports-related concussion, which can have a negative impact on athletic performance. The goal of this investigation is to characterize baseline performance of a cohort of elite athletes on a battery of sports vision tests. This information can: 1) serve as a baseline for comparison after an athlete is concussed, 2) help evaluate the effects of concussion on the visual system as it relates to athletic performance, and 3) help establish vision-related criteria for determining if and when an athlete is ready to return to play and perform at pre-concussive levels. Methods: Twenty-one male Major League Soccer athletes ages 18-35 were tested on 20 sports vision-related tests. Results: Eighteen of 21 subjects (86%) demonstrated one or more clinically significant problems with visual acuity, ocular health, binocular vision, and/or exhibited visual symptoms. The screening results indicate that 17% failed visual acuity, 26% displayed abnormal ocular health findings, 6% exhibited binocular vision problems, and 29% complained of at least one visual symptom related to a previous incident involving head trauma or concussion. Conclusion: This visual performance testing characterized baseline findings for this population and may help determine how deficits may interfere with optimum athletic performance at the elite level. The baseline testing could also serve as an indicator of recovery in acute vs. chronic stages and help determine if and when a concussed athlete is ready to return to play. (PsycINFO Database Record (c) 2016 APA, all rights reserved)},

keywords = {2016, Binocular Vision, binocular vision disorder, brain concussion, Concussion, Sports, sports vision, traumatic brain injury, Vision Disorders},

pubstate = {published},

tppubtype = {article}

}

Stieg, P E; Perrine, K

Helmet Use and Traumatic Brain Injury in Snowboarding Journal Article

In: World Neurosurgery, vol. 86, pp. 65–68, 2016.

Links | BibTeX | Tags: brain hemorrhage, Concussion, disability, emergency ward, Female, head injury, Head Protective Devices, Helmet, human, Humans, Injuries, Male, Morbidity, MORTALITY, Neuroprotection, Review, skiing, skull fracture, Snowboarding, Traumatic, traumatic brain injury, UNITED States, winter sport

Kringler, W; Brand, B; Eidenmüller, A M

Concussion in team sports: Neuropsychological aspects Journal Article

In: Sports Orthopaedics and Traumatology, vol. 32, no. 4, pp. 364–367, 2016.

Abstract | Links | BibTeX | Tags: Concussion, mild traumatic brain injury, Return-to-play, Sport-neuropsychology, SPORTS medicine, Team sports

Reynolds, E; Fazio, V C; Sandel, N; Schatz, P; Henry, L C

Cognitive Development and the Immediate Postconcussion Assessment and Cognitive Testing: A Case for Separate Norms in Preadolescents Journal Article

In: Applied Neuropsychology: Child, vol. 5, no. 4, pp. 283–293, 2016.

Abstract | Links | BibTeX | Tags: cognitive development, Concussion, neuropsychology, preadolescent

Poland, K M; McKay, M P; Zonfrillo, M R; Barth, T H; Kaminski, R

Changes in baseline concussion assessment scores following a school bus crash Journal Article

In: Traffic Injury Prevention, vol. 17, pp. 6–10, 2016.

Abstract | Links | BibTeX | Tags: athlete, COGNITIVE testing, Concussion, crash, school bus, transportation

@article{Poland2016,

title = {Changes in baseline concussion assessment scores following a school bus crash},

author = {Poland, K M and McKay, M P and Zonfrillo, M R and Barth, T H and Kaminski, R},

doi = {10.1080/15389588.2016.1194518},

year  = {2016},

date = {2016-01-01},

journal = {Traffic Injury Prevention},

volume = {17},

pages = {6--10},

abstract = {Objective: The objective of this article is to present concussion assessment data for 30 male athletes prior to and after being involved in a large school bus crash. The athletes on the bus, all male and aged 14\textendash18 years, were participants in their school's concussion management program that included baseline and postinjury testing using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Methods: This case study described changes in concussion assessment scores for 30 male athletes following a primarily frontal school bus crash. Data from the school's concussion management program, including baseline test data and postinjury assessment data, were reviewed. Athletes who required multiple postinjury assessments by the program were identified as having had significant cognitive changes as a result of the bus crash. Results: Twenty-nine of 30 athletes were injured. One had lumbar compression fractures; others had various lacerations, abrasions, contusions, sprains, and nasal fractures. ImPACT data (postcrash) were available for all 30 athletes and 28 had available precrash baseline data. A total of 16 athletes (53.3%) had significant cognitive changes indicated by changes in their concussion assessment scores, some of which took months to improve. Conclusion: This case study highlights a unique opportunity to evaluate concussion assessment data from 30 male athletes involved in a high-speed school bus crash. Further, these data provide additional insight into assessing the effectiveness of current school bus occupant protection systems. © 2016 Taylor \& Francis Group, LLC.},

keywords = {athlete, COGNITIVE testing, Concussion, crash, school bus, transportation},

pubstate = {published},

tppubtype = {article}

}

Sullivan, K A; Edmed, S L

New vignettes for the experimental manipulation of injury cause in prospective mild traumatic brain injury research Journal Article

In: Brain Injury, vol. 30, no. 13-14, pp. 1699–1707, 2016.

Abstract | Links | BibTeX | Tags: Concussion, mild brain, survey, traumatic brain injury, vignette

Patton, D A; McIntosh, A S

Considerations for the performance requirements and technical specifications of soft-shell padded headgear Journal Article

In: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology, vol. 230, no. 1, pp. 29–42, 2016.

Abstract | Links | BibTeX | Tags: Australian football, Biomechanics, Concussion, Design, Head Injuries, head injury, headgear, Injury prevention, protective equipment, rugby, Sports

Belanger, H G; Vanderploeg, R D; McAllister, T

Subconcussive blows to the head: A formative review of short-term clinical outcomes Journal Article

In: Journal of Head Trauma Rehabilitation, vol. 31, no. 3, pp. 159–166, 2016.

Abstract | Links | BibTeX | Tags: Balance, cognition, Concussion, mild TBI, neuropsychological, Outcomes, subconcussion

@article{Belanger2016b,

title = {Subconcussive blows to the head: A formative review of short-term clinical outcomes},

author = {Belanger, H G and Vanderploeg, R D and McAllister, T},

doi = {10.1097/HTR.0000000000000138},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Head Trauma Rehabilitation},

volume = {31},

number = {3},

pages = {159--166},

abstract = {Background: Given questions about "lower thresholds" for concussion, as well as possible effects of repetitive concussion and chronic traumatic encephalopathy (CTE), and associated controversy, there is increasing interest in "subconcussive" blows and their potential significance. Objective: A formative review with critical examination of the developing literature on subconcussive blows in athletes with an emphasis on clinical outcomes. Methods: Studies of biomechanical, performance and/or symptom-based, and neuroimaging data were identified via PubMed search and critically reviewed. Five studies of symptom reporting/performance and 4 studies of neuroimaging were included. Results: The relation between biomechanical parameters and diagnosed concussion is not straightforward (ie, it is not the case that greater and more force leads to more severe injury or cognitive/behavioral sequelae). Neuropsychological studies of subconcussive blows within a single athletic season have failed to demonstrate any strong and consistent relations between number and severity of subconcussive events and cognitive change. Recent studies using neuroimaging have demonstrated a potential cumulative effect of subconcussive blows, at least in a subset of individuals. Conclusion: Human studies of the neurological/neuropsychological impact of subconcussive blows are currently quite limited. Subconcussive blows, in the short-term, have not been shown to cause significant clinical effects. To date, findings suggest that any effect of subconcussive blows is likely to be small or nonexistent, perhaps evident in a subset of individuals on select measures, and maybe even beneficial in some cases. Longerterm prospective studies are needed to determine if there is a cumulative dose effect. © 2016 Wolters Kluwer Health, Inc.},

keywords = {Balance, cognition, Concussion, mild TBI, neuropsychological, Outcomes, subconcussion},

pubstate = {published},

tppubtype = {article}

}

Sullivan, K A; Kempe, C B; Edmed, S L; Bonanno, G A

Resilience and Other Possible Outcomes After Mild Traumatic Brain Injury: a Systematic Review Journal Article

In: Neuropsychology Review, vol. 26, no. 2, pp. 173–185, 2016.

Abstract | Links | BibTeX | Tags: Concussion, mild traumatic brain injury, Persistent postconcussion symptoms, Resilience

@article{Sullivan2016bb,

title = {Resilience and Other Possible Outcomes After Mild Traumatic Brain Injury: a Systematic Review},

author = {Sullivan, K A and Kempe, C B and Edmed, S L and Bonanno, G A},

doi = {10.1007/s11065-016-9317-1},

year  = {2016},

date = {2016-01-01},

journal = {Neuropsychology Review},

volume = {26},

number = {2},

pages = {173--185},

abstract = {The relation between resilience and mild traumatic brain injury (TBI) outcome has been theorized but empirical studies have been scarce. This systematic review aimed to describe the research in this area. Electronic databases (Medline, CINAHL, PsychINFO, SPORTdiscus, and PILOTS) were searched from inception to August 2015 for studies in which resilience was measured following TBI. The search terms included ‘TBI’ ‘concussion’ ‘postconcussion’ ‘resilience’ and ‘hardiness’. Inclusion criteria were peer reviewed original research reports published in English, human participants aged 18 years and over with brain injury, and an accepted definition of mild TBI. Hand searching of identified articles was also undertaken. Of the 71 studies identified, five studies were accepted for review. These studies were formally assessed for risk of bias by two independent reviewers. Each study carried a risk of bias, most commonly a detection bias, but none were excluded on this basis. A narrative interpretation of the findings was used because the studies reflected fundamental differences in the conceptualization of resilience. No studies employed a trajectory based approach to measure a resilient outcome. In most cases, the eligible studies assessed trait resilience with a scale and used it as a predictor of outcome (postconcussion symptoms). Three of these studies showed that greater trait resilience was associated with better mild TBI outcomes (fewer symptoms). Future research of the adult mild TBI response that predicts a resilient outcome is encouraged. These studies could yield empirical evidence for a resilient, and other possible mild TBI outcomes. © 2016, Springer Science+Business Media New York.},

keywords = {Concussion, mild traumatic brain injury, Persistent postconcussion symptoms, Resilience},

pubstate = {published},

tppubtype = {article}

}

Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G

Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals Journal Article

In: EPMA Journal, vol. 7, no. 1, 2016.

Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study

@article{Schulte2016b,

title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},

author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},

doi = {10.1186/s13167-016-0050-x},

year  = {2016},

date = {2016-01-01},

journal = {EPMA Journal},

volume = {7},

number = {1},

abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},

keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},

pubstate = {published},

tppubtype = {article}

}

Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.

Cobb, B R; Zadnik, A M; Rowson, S

Comparative analysis of helmeted impact response of Hybrid III and National Operating Committee on Standards for Athletic Equipment headforms Journal Article

In: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology, vol. 230, no. 1, pp. 50–60, 2016.

Abstract | Links | BibTeX | Tags: Acceleration, Accident prevention, Angular acceleration, Biomechanics, Brain Injury, Coefficient of variation values, Comparative analysis, Concussion, Equipment, Evaluation protocol, helmet testing, Linear acceleration, Linear accelerations, Rotational acceleration, Safety devices, Sporting goods, standards

@article{Cobb2016,

title = {Comparative analysis of helmeted impact response of Hybrid III and National Operating Committee on Standards for Athletic Equipment headforms},

author = {Cobb, B R and Zadnik, A M and Rowson, S},

doi = {10.1177/1754337115599133},

year  = {2016},

date = {2016-01-01},

journal = {Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology},

volume = {230},

number = {1},

pages = {50--60},

abstract = {As advanced helmet testing methodologies are developed, the effect headform selection may have on the biomechanical impact response must be considered. This study sought to assess response differences between two of the most commonly used headforms, the Hybrid III and National Operating Committee on Standards for Athletic Equipment headforms, through a series of helmeted impact tests. A total of 180 pendulum impact tests were conducted with three impactor velocities and six impact locations. Test condition-specific significant differences were found between the two headforms for peak linear and angular accelerations ($alpha$ = 0.05), although differences tended to be small. On average, the National Operating Committee on Standards for Athletic Equipment headform experienced higher peak linear (3.7 ± 7.8%) and angular (12.0 ± 21.6%) accelerations, with some of the largest differences associated with impacts to the facemask. Without the facemask impacts, the average differences in linear (1.8 ± 6.0%) and angular (9.6 ± 15.9%) acceleration would be lower. No significant differences were found in coefficient of variation values for linear (Hybrid III: 2.6 ± 2.3%, National Operating Committee on Standards for Athletic Equipment: 2.0 ± 1.4%) or angular (Hybrid III: 4.9 ± 4.0%; National Operating Committee on Standards for Athletic Equipment: 5.2 ± 5.8%) acceleration. These data have application toward development and validation of future helmet evaluation protocols and standards. © IMechE 2015.},

keywords = {Acceleration, Accident prevention, Angular acceleration, Biomechanics, Brain Injury, Coefficient of variation values, Comparative analysis, Concussion, Equipment, Evaluation protocol, helmet testing, Linear acceleration, Linear accelerations, Rotational acceleration, Safety devices, Sporting goods, standards},

pubstate = {published},

tppubtype = {article}

}

Fineblit, S; Selci, E; Loewen, H; Ellis, M; Russell, K

In: Journal of Neurotrauma, vol. 33, no. 17, pp. 1561–1568, 2016.

Abstract | Links | BibTeX | Tags: Concussion, HRQOL, mTBI

@article{Fineblit2016,

title = {Health-Related Quality of Life after Pediatric Mild Traumatic Brain Injury/Concussion: A Systematic Review},

author = {Fineblit, S and Selci, E and Loewen, H and Ellis, M and Russell, K},

doi = {10.1089/neu.2015.4292},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Neurotrauma},

volume = {33},

number = {17},

pages = {1561--1568},

abstract = {Health-related quality of life (HRQOL) is an emerging method to quantify the consequences of pediatric mild traumatic brain injury (mTBI)/concussion in both clinical practice and research. However, to utilize HRQOL measurements to their full potential in the context of mTBI/concussion recovery, a better understanding of the typical course of HRQOL after these injuries is needed. The objective of this study was to summarize current knowledge on HRQOL after pediatric mTBI/concussion and identify areas in need of further research. The following databases from their earliest date of coverage through June 1, 2015 were used: MEDLINE®, PubMed, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), and Child Development and Adolescent Studies (CDAS). Studies must have examined and reported HRQOL in a pediatric population after mTBI/concussion, using a validated HRQOL measurement tool. Eight of 1660 records identified ultimately met inclusion criteria. Comprehensive data were extracted and checked by a second reviewer for accuracy and completeness. There appears to be a small but important subgroup of patients who experience poor HRQOL outcomes up to a year or longer post-injury. Potential predictors of poor HRQOL include older age, lower socioeconomic status, or a history of headaches or trouble sleeping. Differing definitions of mTBI precluded meta-analysis. HRQOL represents an important outcome measure in mTBI/concussion clinical practice and research. The evidence shows that a small but important proportion of patients have diminished HRQOL up to a year or longer post-injury. Further study on this topic is warranted to determine the typical longitudinal progression of HRQOL after pediatric concussion. © Copyright 2016, Mary Ann Liebert, Inc. 2016.},

keywords = {Concussion, HRQOL, mTBI},

pubstate = {published},

tppubtype = {article}

}

Caccese, J B; Kaminski, T W

Comparing computer-derived and human-observed scores for the Balance Error Scoring System Journal Article

In: Journal of Sport Rehabilitation, vol. 25, no. 2, pp. 133–136, 2016.

Abstract | Links | BibTeX | Tags: Concussion, postural stability, reliability

@article{Caccese2016bb,

title = {Comparing computer-derived and human-observed scores for the Balance Error Scoring System},

author = {Caccese, J B and Kaminski, T W},

doi = {10.1123/jsr.2014-0281},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Sport Rehabilitation},

volume = {25},

number = {2},

pages = {133--136},

abstract = {Context: The Balance Error Scoring System (BESS) is the current standard for assessing postural stability in concussed athletes on the sideline. However, research has questioned the objectivity and validity of the BESS, suggesting that while certain subcategories of the BESS have sufficient reliability to be used in evaluation of postural stability, the total score is not reliable, demonstrating limited interrater and intrarater reliability. Recently, a computerized BESS test was developed to automate scoring. Objective: To compare computerderived BESS scores with those taken from 3 trained human scorers. Design: Interrater reliability study. Setting: Athletic training room. Patients: NCAA Division I student athletes (53 male, 58 female; 19 ± 2 y, 168 ± 41 cm, 69 ± 4 kg). Interventions: Subjects were asked to perform the BESS while standing on the Tekscan (Boston, MA) MobileMat® BESS. The MobileMat BESS software displayed an error score at the end of each trial. Simultaneously, errors were recorded by 3 separate examiners. Errors were counted using the standard BESS scoring criteria. Main Outcome Measures: The number of BESS errors was computed for the 6 stances from the software and each of the 3 human scorers. Interclass correlation coefficients (ICCs) were used to compare errors for each stance scored by the MobileMat BESS software with each of 3 raters individually. The ICC values were converted to Fisher Z scores, averaged, and converted back into ICC values. Results: The double-leg, single-leg, and tandem-firm stances resulted in good agreement with human scorers (ICC = .999, .731, and .648). All foam stances resulted in fair agreement. Conclusions: Our results suggest that the MobileMat BESS is suitable for identifying BESS errors involving each of the 6 stances of the BESS protocol. Because the MobileMat BESS scores consistently and reliably, this system can be used with confidence by clinicians as an effective alternative to scoring the BESS. © 2016 Human Kinetics, Inc.},

keywords = {Concussion, postural stability, reliability},

pubstate = {published},

tppubtype = {article}

}

Context: The Balance Error Scoring System (BESS) is the current standard for assessing postural stability in concussed athletes on the sideline. However, research has questioned the objectivity and validity of the BESS, suggesting that while certain subcategories of the BESS have sufficient reliability to be used in evaluation of postural stability, the total score is not reliable, demonstrating limited interrater and intrarater reliability. Recently, a computerized BESS test was developed to automate scoring. Objective: To compare computerderived BESS scores with those taken from 3 trained human scorers. Design: Interrater reliability study. Setting: Athletic training room. Patients: NCAA Division I student athletes (53 male, 58 female; 19 ± 2 y, 168 ± 41 cm, 69 ± 4 kg). Interventions: Subjects were asked to perform the BESS while standing on the Tekscan (Boston, MA) MobileMat® BESS. The MobileMat BESS software displayed an error score at the end of each trial. Simultaneously, errors were recorded by 3 separate examiners. Errors were counted using the standard BESS scoring criteria. Main Outcome Measures: The number of BESS errors was computed for the 6 stances from the software and each of the 3 human scorers. Interclass correlation coefficients (ICCs) were used to compare errors for each stance scored by the MobileMat BESS software with each of 3 raters individually. The ICC values were converted to Fisher Z scores, averaged, and converted back into ICC values. Results: The double-leg, single-leg, and tandem-firm stances resulted in good agreement with human scorers (ICC = .999, .731, and .648). All foam stances resulted in fair agreement. Conclusions: Our results suggest that the MobileMat BESS is suitable for identifying BESS errors involving each of the 6 stances of the BESS protocol. Because the MobileMat BESS scores consistently and reliably, this system can be used with confidence by clinicians as an effective alternative to scoring the BESS. © 2016 Human Kinetics, Inc.

154 entries « ‹ 1 of 4 › »

Reference Search

154 entries « ‹ 1 of 8 › »

Roberts, Simon P; Trewartha, Grant; England, Michael; Goodison, William; Stokes, Keith A

Concussions and Head Injuries in English Community Rugby Union Match Play Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 480–487, 2017, ISBN: 03635465.

Abstract | Links | BibTeX

@article{Roberts2017,

title = {Concussions and Head Injuries in English Community Rugby Union Match Play},

author = {Roberts, Simon P and Trewartha, Grant and England, Michael and Goodison, William and Stokes, Keith A},

doi = {10.1177/0363546516668296},

isbn = {03635465},

year  = {2017},

date = {2017-01-01},

journal = {American Journal of Sports Medicine},

volume = {45},

number = {2},

pages = {480--487},

abstract = {Background: Previous research has described general injury patterns in community-level rugby union, but specific information on time-loss head injuries has not been reported. Purpose: To establish the incidence and nature of significant time-loss head injuries in English community rugby match play, and to identify the injury risk for specific contact events. Study Design: Descriptive epidemiology study. Methods: Over 6 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), 76 (2011-2012), 50 (2012-2013), 67 (2013-2014), and 58 (2014-2015) English community rugby clubs (Rugby Football Union levels 3-9) over a total of 175,940 hours of player match exposure. Club injury management staff reported information for all head injuries sustained during match play whereby the player was absent for 8 days or greater. Clubs were subdivided into semiprofessional (mean player age, 24.6 ± 4.7 years), amateur (24.9 ± 5.1 years), and recreational (25.6 ± 6.1 years) playing levels. Contact events from a sample of 30 matches filmed over seasons 2009-2010, 2010-2011, and 2011-2012 provided mean values for the frequency of contact events. Results: The overall incidence for time-loss head injuries was 2.43 injuries per 1000 player match hours, with a higher incidence for the amateur (2.78; 95% CI, 2.37-3.20) compared with recreational (2.20; 95% CI, 1.86-2.53) (P = .032) playing level but not different to the semiprofessional (2.31; 95% CI, 1.83-2.79) playing level. Concussion was the most common time-loss head injury, with 1.46 per 1000 player match hours. The tackle event was associated with 64% of all head injuries and 74% of all concussions. There was also a higher risk of injuries per tackle (0.33 per 1000 events; 95% CI, 0.30-0.37) compared with all other contact events. Conclusion: Concussion was the most common head injury diagnosis, although it is likely that this injury was underreported. Continuing education programs for medical staff and players are essential for the improved identification and management of these injuries. With the majority of head injuries occurring during a tackle, an improved technique in this contact event through coach and player education may be effective in reducing these injuries. [ABSTRACT FROM AUTHOR].},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Mihalik, J P; Lynall, R C; Wasserman, E B; Guskiewicz, K M; Marshall, S W

Evaluating the "threshold Theory": Can Head Impact Indicators Help? Journal Article

In: Medicine & Science in Sports & Exercise, vol. 49, no. 2, pp. 247–253, 2017.

Abstract | Links | BibTeX

Gardner, A J; Kohler, R M N; Levi, C R; Iverson, G L

Usefulness of Video Review of Possible Concussions in National Youth Rugby League Journal Article

In: International Journal of Sports Medicine, vol. 38, no. 1, pp. 71–75, 2017.

Abstract | Links | BibTeX

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

@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}

}

Cobbs, L; Hasanaj, L; Amorapanth, P; Rizzo, J R; Nolan, R; Serrano, L; Raynowska, J; Rucker, J C; Jordan, B D; Galetta, S L; Balcer, L J

Mobile Universal Lexicon Evaluation System (MULES) test: A new measure of rapid picture naming for concussion Journal Article

In: Journal of the Neurological Sciences, vol. 372, pp. 393–398, 2017.

Abstract | Links | BibTeX

@article{Cobbs2017,

title = {Mobile Universal Lexicon Evaluation System (MULES) test: A new measure of rapid picture naming for concussion},

author = {Cobbs, L and Hasanaj, L and Amorapanth, P and Rizzo, J R and Nolan, R and Serrano, L and Raynowska, J and Rucker, J C and Jordan, B D and Galetta, S L and Balcer, L J},

doi = {10.1016/j.jns.2016.10.044},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the Neurological Sciences},

volume = {372},

pages = {393--398},

abstract = {Objective This study introduces a rapid picture naming test, the Mobile Universal Lexicon Evaluation System (MULES), as a novel, vision-based performance measure for concussion screening. The MULES is a visual-verbal task that includes 54 original photographs of fruits, objects and animals. We piloted MULES in a cohort of volunteers to determine feasibility, ranges of picture naming responses, and the relation of MULES time scores to those of King-Devick (K-D), a rapid number naming test. Methods A convenience sample (n = 20, age 34 ± 10) underwent MULES and K-D (spiral bound, iPad versions). Administration order was randomized; MULES tests were audio-recorded to provide objective data on temporal variability and ranges of picture naming responses. Results Scores for the best of two trials for all tests were 40\textendash50 s; average times required to name each MULES picture (0.72 ± 0.14 s) was greater than those needed for each K-D number ((spiral: 0.33 ± 0.05 s, iPad: 0.36 ± 0.06 s, 120 numbers), p \< 0.0001, paired t-test). MULES scores showed the greatest degree of improvement between trials (9.4 ± 4.8 s, p \< 0.0001 for trials 1 vs. 2), compared to K-D (spiral 1.5 ± 3.3 s, iPad 1.8 ± 3.4 s). Shorter MULES times demonstrated moderate and significant correlations with shorter iPad but not spiral K-D times (r = 0.49, p = 0.03). Conclusion The MULES test is a rapid picture naming task that may engage more extensive neural systems than more commonly used rapid number naming tasks. Rapid picture naming may require additional processing devoted to color perception, object identification, and categorization. Both tests rely on initiation and sequencing of saccadic eye movements. © 2016 Elsevier B.V.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Montenigro, P H; Alosco, M L; Martin, B M; Daneshvar, D H; Mez, J; Chaisson, C E; Nowinski, C J; Au, R; McKee, A C; Cantu, R C; McClean, M D; Stern, R A; Tripodis, Y

Cumulative Head Impact Exposure Predicts Later-Life Depression, Apathy, Executive Dysfunction, and Cognitive Impairment in Former High School and College Football Players Journal Article

In: Journal of Neurotrauma, vol. 34, no. 2, pp. 328–340, 2017.

Abstract | Links | BibTeX

@article{Montenigro2017,

title = {Cumulative Head Impact Exposure Predicts Later-Life Depression, Apathy, Executive Dysfunction, and Cognitive Impairment in Former High School and College Football Players},

author = {Montenigro, P H and Alosco, M L and Martin, B M and Daneshvar, D H and Mez, J and Chaisson, C E and Nowinski, C J and Au, R and McKee, A C and Cantu, R C and McClean, M D and Stern, R A and Tripodis, Y},

doi = {10.1089/neu.2016.4413},

year  = {2017},

date = {2017-01-01},

journal = {Journal of Neurotrauma},

volume = {34},

number = {2},

pages = {328--340},

abstract = {The term "repetitive head impacts" (RHI) refers to the cumulative exposure to concussive and subconcussive events. Although RHI are believed to increase risk for later-life neurological consequences (including chronic traumatic encephalopathy), quantitative analysis of this relationship has not yet been examined because of the lack of validated tools to quantify lifetime RHI exposure. The objectives of this study were: 1) to develop a metric to quantify cumulative RHI exposure from football, which we term the "cumulative head impact index" (CHII); 2) to use the CHII to examine the association between RHI exposure and long-term clinical outcomes; and 3) to evaluate its predictive properties relative to other exposure metrics (i.e., duration of play, age of first exposure, concussion history). Participants included 93 former high school and collegiate football players who completed objective cognitive and self-reported behavioral/mood tests as part of a larger ongoing longitudinal study. Using established cutoff scores, we transformed continuous outcomes into dichotomous variables (normal vs. impaired). The CHII was computed for each participant and derived from a combination of self-reported athletic history (i.e., number of seasons, position[s], levels played), and impact frequencies reported in helmet accelerometer studies. A bivariate probit, instrumental variable model revealed a threshold dose-response relationship between the CHII and risk for later-life cognitive impairment (p \< 0.0001), self-reported executive dysfunction (p \< 0.0001), depression (p \< 0.0001), apathy (p = 0.0161), and behavioral dysregulation (p \< 0.0001). Ultimately, the CHII demonstrated greater predictive validity than other individual exposure metrics. Copyright © 2017, Mary Ann Liebert, Inc. 2017.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Kroshus, E; Baugh, C M; Stein, C J; Austin, S B; Calzo, J P

Concussion reporting, sex, and conformity to traditional gender norms in young adults Journal Article

In: Journal of Adolescence, vol. 54, pp. 110–119, 2017.

Abstract | Links | BibTeX

Strain, J F; Didehbani, N; Spence, J; Conover, H; Bartz, E K; Mansinghani, S; Jeroudi, M K; Rao, N K; Fields, L M; Kraut, M A; Cullum, C M; Hart, J; Womack, K B

White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes Journal Article

In: Journal of Neurotrauma, vol. 34, no. 2, pp. 372–379, 2017.

Abstract | Links | BibTeX

Dickson, T J; Trathen, S; Terwiel, F A; Waddington, G; Adams, R

Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study Journal Article

In: Scandinavian Journal of Medicine & Science in Sports, vol. 27, no. 2, pp. 236–244, 2017, ISBN: 09057188.

Abstract | Links | BibTeX

10.

Churchill, N; Hutchison, M G; Leung, G; Graham, S; Schweizer, T A

Changes in functional connectivity of the brain associated with a history of sport concussion: A preliminary investigation Journal Article

In: Brain Injury, vol. 31, no. 1, pp. 39–48, 2017.

Abstract | Links | BibTeX

11.

Gerrard, Paul B; Iverson, Grant L; Atkins, Joseph E; Maxwell, Bruce A; Zafonte, Ross; Schatz, Philip; Berkner, Paul D

Factor Structure of ImPACT® in Adolescent Student Athletes Journal Article

In: Archives of Clinical Neuropsychology, vol. 32, no. 1, pp. 117–122, 2017, ISBN: 08876177.

Abstract | Links | BibTeX

12.

Zusman, E E; Zopfi, P; Kuluva, J; Zuckerman, S

Can Ideas From United States Youth Sports Reduce Judo-Related Head Injuries in Japan? Journal Article

In: World Neurosurgery, vol. 97, pp. 725–727, 2017.

Links | BibTeX

13.

Klein, T A; Graves, J M

A Comparison of Psychiatric and Nonpsychiatric Nurse Practitioner Knowledge and Management Recommendations Regarding Adolescent Mild Traumatic Brain Injury Journal Article

In: Journal of the American Psychiatric Nurses Association, vol. 23, no. 1, pp. 37–49, 2017.

Abstract | Links | BibTeX

@article{Klein2017,

title = {A Comparison of Psychiatric and Nonpsychiatric Nurse Practitioner Knowledge and Management Recommendations Regarding Adolescent Mild Traumatic Brain Injury},

author = {Klein, T A and Graves, J M},

doi = {10.1177/1078390316668992},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the American Psychiatric Nurses Association},

volume = {23},

number = {1},

pages = {37--49},

abstract = {BACKGROUND: Nurse practitioners (NPs) are statutorily authorized to provide assessment and cognitive recommendations for concussion in most states. Their scope of practice includes assessment and management of concussion sequalae including anxiety, insomnia, and depression, as well as return to school and activity guidance. OBJECTIVES: Analysis of symptom-based diagnosis of mild traumatic brain injury (TBI) in adolescents, including return to school and school workload recommendations comparing psychiatric and nonpsychiatric NPs. DESIGN: Cross-sectional Web-based survey with embedded videos using standardized actors and scripts randomized for patient sex and sport. A total of 4,849 NPs licensed in Oregon or Washington were invited by e-mail to view and respond to this study, with a response rate of 23%. RESULTS: Psychiatric mental health nurse practitioners (PMHNPs) were 44% less likely than family NPs to report using standardized concussion tools. 17% had completed continuing education on mild TBI compared to 54.5% of family NPs. Seven PMHNPs provided additional feedback related to discomfort in completing the survey due to lack of comfort or experience. Return to school recommendations and reduced workload advice did not significantly differ by NP type. CONCLUSION: PMHNPs may support individualized assessment through concussion evaluation, use of standardized tools, and differential consideration of TBI for mental health symptoms. More research is required related to the role and contribution of cognitive rest to full recovery. © 2016, © The Author(s) 2016.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

14.

Collins, M W; Womble, M N

American pediatric surgical association journal of pediatric surgery lecture Journal Article

In: Journal of Pediatric Surgery, vol. 52, no. 1, pp. 16–21, 2017.

Abstract | Links | BibTeX

15.

Moore, R D; Lepine, J; Ellemberg, D

The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function Journal Article

In: International Journal of Psychophysiology, vol. 112, pp. 22–30, 2017.

Abstract | Links | BibTeX

@article{Moore2017,

title = {The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function},

author = {Moore, R D and Lepine, J and Ellemberg, D},

doi = {10.1016/j.ijpsycho.2016.11.011},

year  = {2017},

date = {2017-01-01},

journal = {International Journal of Psychophysiology},

volume = {112},

pages = {22--30},

abstract = {Accumulating research demonstrates that repetitive sub-concussive impacts can alter the structure, function and connectivity of the brain. However, the functional significance of these alterations as well as the independent contribution of concussive and sub-concussive impacts to neurophysiological and neuropsychological health are unclear. Accordingly, we compared the neurophysiological and neuropsychological function of contact athletes with (concussion group) and without (sub-concussion group) a history of concussion, to non-contact athletes. We evaluated event-related brain potentials (ERPs) elicited during an oddball task and performance on a targeted battery of neuropsychological tasks. Athletes in the sub-concussion and concussion groups exhibited similar amplitude reductions in the ERP indices of attentional resource allocation (P3b) and attentional orienting (P3a) relative to non-contact athletes. However, only athletes in the concussion group exhibited reduced amplitude in the ERP index of perceptual attention (N1). Athletes in the sub-concussion and concussion groups also exhibited deficits in memory recall relative to non-contact athletes, but athletes in the concussion group also exhibited significantly more recall errors than athletes in the sub-concussion group. Additionally, only athletes in the concussion group exhibited response delays during the oddball task. The current findings suggest that sub-concussive impacts are associated with alterations in the neurophysiological and neuropsychological indices of essential cognitive functions, albeit to a lesser degree than the combination of sub-concussive and concussive impacts. © 2016 Elsevier B.V.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

16.

Krolikowski, Maciej P; Black, Amanda M; Palacios-Derflingher, Luz; Blake, Tracy A; Schneider, Kathryn J; Emery, Carolyn A

The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions in Youth Ice Hockey Players Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 468–473, 2017, ISBN: 03635465.

Abstract | Links | BibTeX

@article{Krolikowski2017,

title = {The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions in Youth Ice Hockey Players},

author = {Krolikowski, Maciej P and Black, Amanda M and Palacios-Derflingher, Luz and Blake, Tracy A and Schneider, Kathryn J and Emery, Carolyn A},

doi = {10.1177/0363546516669701},

isbn = {03635465},

year  = {2017},

date = {2017-01-01},

journal = {American Journal of Sports Medicine},

volume = {45},

number = {2},

pages = {468--473},

abstract = {Background: Ice hockey is a popular winter sport in Canada. Concussions account for the greatest proportion of all injuries in youth ice hockey. In 2011, a policy change enforcing "zero tolerance for head contact" was implemented in all leagues in Canada. Purpose: To determine if the risk of game-related concussions and more severe concussions (ie, resulting in \>10 days of time loss) and the mechanisms of a concussion differed for Pee Wee class (ages 11-12 years) and Bantam class (ages 13-14 years) players after the 2011 "zero tolerance for head contact" policy change compared with players in similar divisions before the policy change. Study Design: Cohort study; Level of evidence, 3. Methods: The retrospective cohort included Pee Wee (most elite 70%, 2007-2008; n = 891) and Bantam (most elite 30%, 2008-2009; n = 378) players before the rule change and Pee Wee (2011-2012; n = 588) and Bantam (2011-2012; n = 242) players in the same levels of play after the policy change. Suspected concussions were identified by a team designate and referred to a sport medicine physician for diagnosis. Incidence rate ratios (IRRs) were estimated based on multiple Poisson regression analysis, controlling for clustering by team and other important covariates and offset by game-exposure hours. Incidence rates based on the mechanisms of a concussion were estimated based on univariate Poisson regression analysis. Results: The risk of game-related concussions increased after the head contact rule in Pee Wee (IRR, 1.85; 95% CI, 1.20-2.86) and Bantam (IRR, 2.48; 95% CI, 1.17-5.24) players. The risk of more severe concussions increased after the head contact rule in Pee Wee (IRR, 4.12; 95% CI, 2.00-8.50) and Bantam (IRR, 7.91; 95% CI, 3.13-19.94) players. The rates of concussions due to body checking and direct head contact increased after the rule change. Conclusion: The "zero tolerance for head contact" policy change did not reduce the risk of game-related concussions in Pee Wee or Bantam class ice hockey players. Increased concussion awareness and education after the policy change may have contributed to the increased risk of concussions found after the policy change. [ABSTRACT FROM AUTHOR]},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

17.

Reider, Bruce

Activating the Omega 13 Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 275–277, 2017, ISBN: 03635465.

Links | BibTeX

18.

Stone, S; Lee, B; Garrison, J C; Blueitt, D; Creed, K

Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion Journal Article

In: Sports Health, vol. 9, no. 1, pp. 41–44, 2017.

Abstract | Links | BibTeX

@article{Stone2017,

title = {Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion},

author = {Stone, S and Lee, B and Garrison, J C and Blueitt, D and Creed, K},

doi = {10.1177/1941738116672184},

year  = {2017},

date = {2017-01-01},

journal = {Sports Health},

volume = {9},

number = {1},

pages = {41--44},

abstract = {Background: Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC. Hypothesis: After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non\textendashsport-related activity were excluded. Results: Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002). Conclusion: On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, aged 11 to 20 years, with regard to initiation of an RTP progression after SRC. Clinical Relevance: Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population. © 2016, © 2016 The Author(s).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

19.

Patterson, J N; Murphy, A M; Honaker, J A

Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes Journal Article

In: Journal of the American Academy of Audiology, vol. 28, no. 1, pp. 36–45, 2017.

Abstract | Links | BibTeX

@article{Patterson2017,

title = {Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes},

author = {Patterson, J N and Murphy, A M and Honaker, J A},

doi = {10.3766/jaaa.15110},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the American Academy of Audiology},

volume = {28},

number = {1},

pages = {36--45},

abstract = {Background: Acute symptoms of dizziness and/or imbalance commonly experienced in athletes postconcussion are speculated to arise from dysfunction at multiple levels (i.e., inner ear or central vestibular system) to appropriately integrate afferent sensory information. Disruption along any pathway of the balance system can result in symptoms of dizziness, decreased postural control function (vestibulospinal reflex), and reduced vestibulo-ocular reflex function. This may also lead to decreased gaze stability with movements of the head and may account for symptoms of blurred vision or diplopia reported in almost half of athletes sustaining a concussion. Current concussion position statements include measures of postural control to examine changes to the balance system postconcussion. The Balance Error Scoring System (BESS) is a commonly used lowcost postural control measure for concussion assessment. Although this is a widely used measure for documenting balance function on both immediate (sideline) and recovery monitoring, the BESS has been shown to be affected by physical exertion. Therefore, the BESS may not be the most efficient means of examining functional changes to the balance system immediately after head injury. Dynamic Visual Acuity Test (DVAT) has been found to effectively evaluate and monitor changes to the gaze stability system postinjury. Thus, DVAT may be an additional measure in the concussion assessment battery, as well as an alternative for more immediate sideline assessment to help make objective return-To-play decisions. Purpose: The aim of the study was to determine the effects of physical exertion on a clinical vestibular assessment, the DVAT, in collegiate athletes, as a first step in defining the role of this measure in the concussion assessment battery. Research Design: Cross-sectional, repeated-measures design. Study Sample: Twenty-eight healthy collegiate athletes (20 males, 8 females; age = 20.25 ± 1.46 yr},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

20.

Tanaka, Yuto; Tsugawa, Tsuyoshi; Maeda, Yoshinobu

Effect of mouthguards on impact to the craniomandibular complex Journal Article

In: Dental Traumatology, vol. 33, no. 1, pp. 51–56, 2017, ISBN: 16004469.

Abstract | Links | BibTeX

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2017

Grabowski, P; Wilson, J; Walker, A; Enz, D; Wang, S

Multimodal impairment-based physical therapy for the treatment of patients with post-concussion syndrome: A retrospective analysis on safety and feasibility Journal Article

In: Physical Therapy in Sport, vol. 23, pp. 22–30, 2017.

Abstract | Links | BibTeX | Tags: Cardiovascular exercise, Concussion, mild traumatic brain injury, Physical therapy

@article{Grabowski2017,

title = {Multimodal impairment-based physical therapy for the treatment of patients with post-concussion syndrome: A retrospective analysis on safety and feasibility},

author = {Grabowski, P and Wilson, J and Walker, A and Enz, D and Wang, S},

doi = {10.1016/j.ptsp.2016.06.001},

year  = {2017},

date = {2017-01-01},

journal = {Physical Therapy in Sport},

volume = {23},

pages = {22--30},

abstract = {Objective Demonstrate implementation, safety and feasibility of multimodal, impairment-based physical therapy (PT) combining vestibular/oculomotor and cervical rehabilitation with sub-symptom threshold exercise for the treatment of patients with post-concussion syndrome (PCS). Setting University hospital outpatient sports medicine facility. Participants Twenty-five patients (12\textendash20 years old) meeting World Health Organization criteria for PCS following sport-related concussion referred for supervised PT consisting of sub-symptom cardiovascular exercise, vestibular/oculomotor and cervical spine rehabilitation. Design Retrospective cohort. Main measures Post-Concussion Symptom Scale (PCSS) total score, maximum symptom-free heart rate (SFHR) during graded exercise testing (GXT), GXT duration, balance error scoring system (BESS) score, and number of adverse events. Results Patients demonstrated a statistically significant decreasing trend (p \< 0.01) for total PCSS scores (pre-PT M = 18.2 (SD = 14.2), post-PT M = 9.1 (SD = 10.8), n = 25). Maximum SFHR achieved on GXT increased 23% (p \< 0.01, n = 14), and BESS errors decreased 52% (p \< 0.01, n = 13). Two patients reported mild symptom exacerbation with aerobic exercise at home, attenuated by adjustment of the home exercise program. Conclusions Multimodal, impairment-based PT is safe and associated with diminishing PCS symptoms. This establishes feasibility for future clinical trials to determine viable treatment approaches to reduce symptoms and improve function while avoiding negative repercussions of physical inactivity and premature return to full activity. © 2016 Elsevier Ltd},

keywords = {Cardiovascular exercise, Concussion, mild traumatic brain injury, Physical therapy},

pubstate = {published},

tppubtype = {article}

}

Léveillé, E; Guay, S; Blais, C; Scherzer, P; De Beaumont, L

In: Journal of the International Neuropsychological Society, vol. 23, no. 1, pp. 65–77, 2017.

Abstract | Links | BibTeX | Tags: Anxiety, Concussion, depression, Emotional facial expression, Gender Differences, Sport

@article{Leveille2017,

title = {Sex-Related Differences in Emotion Recognition in Multi-concussed Athletes},

author = {L\'{e}veill\'{e}, E and Guay, S and Blais, C and Scherzer, P and {De Beaumont}, L},

doi = {10.1017/S1355617716001004},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the International Neuropsychological Society},

volume = {23},

number = {1},

pages = {65--77},

abstract = {Objectives: Concussion is defined as a complex pathophysiological process affecting the brain. Although the cumulative and long-term effects of multiple concussions are now well documented on cognitive and motor function, little is known about their effects on emotion recognition. Recent studies have suggested that concussion can result in emotional sequelae, particularly in females and multi-concussed athletes. The objective of this study was to investigate sex-related differences in emotion recognition in asymptomatic male and female multi-concussed athletes. Methods: We tested 28 control athletes (15 males) and 22 multi-concussed athletes (10 males) more than a year since the last concussion. Participants completed the Post-Concussion Symptom Scale, the Beck Depression Inventory-II, the Beck Anxiety Inventory, a neuropsychological test battery and a morphed emotion recognition task. Pictures of a male face expressing basic emotions (anger, disgust, fear, happiness, sadness, surprise) morphed with another emotion were randomly presented. After each face presentation, participants were asked to indicate the emotion expressed by the face. Results: Results revealed significant sex by group interactions in accuracy and intensity threshold for negative emotions, together with significant main effects of emotion and group. Conclusions: Male concussed athletes were significantly impaired in recognizing negative emotions and needed more emotional intensity to correctly identify these emotions, compared to same-sex controls. In contrast, female concussed athletes performed similarly to same-sex controls. These findings suggest that sex significantly modulates concussion effects on emotional facial expression recognition. © 2016 The International Neuropsychological Society.},

keywords = {Anxiety, Concussion, depression, Emotional facial expression, Gender Differences, Sport},

pubstate = {published},

tppubtype = {article}

}

Reider, Bruce

Activating the Omega 13 Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 275–277, 2017, ISBN: 03635465.

Links | BibTeX | Tags: ACL tear, Concussion, female athlete triad, football, Injury prevention, rugby, Soccer

Patterson, J N; Murphy, A M; Honaker, J A

Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes Journal Article

In: Journal of the American Academy of Audiology, vol. 28, no. 1, pp. 36–45, 2017.

Abstract | Links | BibTeX | Tags: Athletes, Concussion, DVAT, Dynamic visual acuity, Physical Exertion, Sport-related head injury, Vestibular function, Vestibulo-ocular reflex, Visual-vestibular, Vor

@article{Patterson2017,

title = {Examining effects of physical exertion on the dynamic visual acuity test in collegiate athletes},

author = {Patterson, J N and Murphy, A M and Honaker, J A},

doi = {10.3766/jaaa.15110},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the American Academy of Audiology},

volume = {28},

number = {1},

pages = {36--45},

abstract = {Background: Acute symptoms of dizziness and/or imbalance commonly experienced in athletes postconcussion are speculated to arise from dysfunction at multiple levels (i.e., inner ear or central vestibular system) to appropriately integrate afferent sensory information. Disruption along any pathway of the balance system can result in symptoms of dizziness, decreased postural control function (vestibulospinal reflex), and reduced vestibulo-ocular reflex function. This may also lead to decreased gaze stability with movements of the head and may account for symptoms of blurred vision or diplopia reported in almost half of athletes sustaining a concussion. Current concussion position statements include measures of postural control to examine changes to the balance system postconcussion. The Balance Error Scoring System (BESS) is a commonly used lowcost postural control measure for concussion assessment. Although this is a widely used measure for documenting balance function on both immediate (sideline) and recovery monitoring, the BESS has been shown to be affected by physical exertion. Therefore, the BESS may not be the most efficient means of examining functional changes to the balance system immediately after head injury. Dynamic Visual Acuity Test (DVAT) has been found to effectively evaluate and monitor changes to the gaze stability system postinjury. Thus, DVAT may be an additional measure in the concussion assessment battery, as well as an alternative for more immediate sideline assessment to help make objective return-To-play decisions. Purpose: The aim of the study was to determine the effects of physical exertion on a clinical vestibular assessment, the DVAT, in collegiate athletes, as a first step in defining the role of this measure in the concussion assessment battery. Research Design: Cross-sectional, repeated-measures design. Study Sample: Twenty-eight healthy collegiate athletes (20 males, 8 females; age = 20.25 ± 1.46 yr},

keywords = {Athletes, Concussion, DVAT, Dynamic visual acuity, Physical Exertion, Sport-related head injury, Vestibular function, Vestibulo-ocular reflex, Visual-vestibular, Vor},

pubstate = {published},

tppubtype = {article}

}

Krolikowski, Maciej P; Black, Amanda M; Palacios-Derflingher, Luz; Blake, Tracy A; Schneider, Kathryn J; Emery, Carolyn A

The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions in Youth Ice Hockey Players Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 468–473, 2017, ISBN: 03635465.

Abstract | Links | BibTeX | Tags: child and adolescent, Concussion, ice hockey, Injury prevention

@article{Krolikowski2017,

title = {The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions in Youth Ice Hockey Players},

author = {Krolikowski, Maciej P and Black, Amanda M and Palacios-Derflingher, Luz and Blake, Tracy A and Schneider, Kathryn J and Emery, Carolyn A},

doi = {10.1177/0363546516669701},

isbn = {03635465},

year  = {2017},

date = {2017-01-01},

journal = {American Journal of Sports Medicine},

volume = {45},

number = {2},

pages = {468--473},

abstract = {Background: Ice hockey is a popular winter sport in Canada. Concussions account for the greatest proportion of all injuries in youth ice hockey. In 2011, a policy change enforcing "zero tolerance for head contact" was implemented in all leagues in Canada. Purpose: To determine if the risk of game-related concussions and more severe concussions (ie, resulting in \>10 days of time loss) and the mechanisms of a concussion differed for Pee Wee class (ages 11-12 years) and Bantam class (ages 13-14 years) players after the 2011 "zero tolerance for head contact" policy change compared with players in similar divisions before the policy change. Study Design: Cohort study; Level of evidence, 3. Methods: The retrospective cohort included Pee Wee (most elite 70%, 2007-2008; n = 891) and Bantam (most elite 30%, 2008-2009; n = 378) players before the rule change and Pee Wee (2011-2012; n = 588) and Bantam (2011-2012; n = 242) players in the same levels of play after the policy change. Suspected concussions were identified by a team designate and referred to a sport medicine physician for diagnosis. Incidence rate ratios (IRRs) were estimated based on multiple Poisson regression analysis, controlling for clustering by team and other important covariates and offset by game-exposure hours. Incidence rates based on the mechanisms of a concussion were estimated based on univariate Poisson regression analysis. Results: The risk of game-related concussions increased after the head contact rule in Pee Wee (IRR, 1.85; 95% CI, 1.20-2.86) and Bantam (IRR, 2.48; 95% CI, 1.17-5.24) players. The risk of more severe concussions increased after the head contact rule in Pee Wee (IRR, 4.12; 95% CI, 2.00-8.50) and Bantam (IRR, 7.91; 95% CI, 3.13-19.94) players. The rates of concussions due to body checking and direct head contact increased after the rule change. Conclusion: The "zero tolerance for head contact" policy change did not reduce the risk of game-related concussions in Pee Wee or Bantam class ice hockey players. Increased concussion awareness and education after the policy change may have contributed to the increased risk of concussions found after the policy change. [ABSTRACT FROM AUTHOR]},

keywords = {child and adolescent, Concussion, ice hockey, Injury prevention},

pubstate = {published},

tppubtype = {article}

}

Stone, S; Lee, B; Garrison, J C; Blueitt, D; Creed, K

Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion Journal Article

In: Sports Health, vol. 9, no. 1, pp. 41–44, 2017.

Abstract | Links | BibTeX | Tags: Concussion, return-to-play progression, sex

@article{Stone2017,

title = {Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion},

author = {Stone, S and Lee, B and Garrison, J C and Blueitt, D and Creed, K},

doi = {10.1177/1941738116672184},

year  = {2017},

date = {2017-01-01},

journal = {Sports Health},

volume = {9},

number = {1},

pages = {41--44},

abstract = {Background: Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC. Hypothesis: After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non\textendashsport-related activity were excluded. Results: Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002). Conclusion: On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, aged 11 to 20 years, with regard to initiation of an RTP progression after SRC. Clinical Relevance: Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population. © 2016, © 2016 The Author(s).},

keywords = {Concussion, return-to-play progression, sex},

pubstate = {published},

tppubtype = {article}

}

Loosemore, Michael P; Butler, Charles F; Khadri, Abdelhamid; McDonagh, David; Patel, Vimal A; Bailes, Julian E

Use of Head Guards in AIBA Boxing Tournaments--A Cross-Sectional Observational Study Journal Article

In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 86–88, 2017, ISBN: 1050642X.

@article{Loosemore2017,

title = {Use of Head Guards in AIBA Boxing Tournaments--A Cross-Sectional Observational Study},

author = {Loosemore, Michael P and Butler, Charles F and Khadri, Abdelhamid and McDonagh, David and Patel, Vimal A and Bailes, Julian E},

isbn = {1050642X},

year  = {2017},

date = {2017-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {27},

number = {1},

pages = {86--88},

abstract = {Objective: This study looks at the changes in injuries after the implementation of a new rule by the International Boxing Association (AIBA) to remove head guards from its competitions. Design: A cross-sectional observational study performed prospectively. This brief report examines the removal of head guards in 2 different ways. The first was to examine the stoppages due to blows to the head by comparing World Series Boxing (WSB), without head guards, to other AIBA competitions with head guards. Secondly, we examined the last 3 world championships: 2009 and 2011 (with head guards) and 2013 (without head guards). Setting: World Series Boxing and AIBA world championship boxing. Participants: Boxers from WSB and AIBA world championships. Interventions: The information was recorded by ringside medical physicians. Main Outcome Measures: Stoppages per 10 000 rounds; stoppages per 1000 hours. Results: Both studies show that the number of stoppages due to head blows was significantly decreased without head guards. The studies also showed that there was a notable increase in cuts. Conclusions: Removing head guards may reduce the already small risk of acute brain injury in amateur boxing. [ABSTRACT FROM AUTHOR]},

keywords = {acute brain injuries, Boxing, BOXING injuries, Concussion, CONFIDENCE intervals, CROSS-sectional method, DISEASE incidence, Head Protective Devices, LONGITUDINAL method, Poisson distribution, PREVENTION, PROBABILITY theory, Relative risk (Medicine), SAFETY hats, SPORTS events, STATISTICAL hypothesis testing, traumatic brain injury, WOUNDS \&amp; injuries},

pubstate = {published},

tppubtype = {article}

}

Collins, M W; Womble, M N

American pediatric surgical association journal of pediatric surgery lecture Journal Article

In: Journal of Pediatric Surgery, vol. 52, no. 1, pp. 16–21, 2017.

Abstract | Links | BibTeX | Tags: Concussion, head injury, migraine, Ocular, Risk Factors, vestibular

Zusman, E E; Zopfi, P; Kuluva, J; Zuckerman, S

Can Ideas From United States Youth Sports Reduce Judo-Related Head Injuries in Japan? Journal Article

In: World Neurosurgery, vol. 97, pp. 725–727, 2017.

Links | BibTeX | Tags: Concussion, head injury, judo, Secondary impact syndrome, Soccer, traumatic brain injury, Youth sports

Gerrard, Paul B; Iverson, Grant L; Atkins, Joseph E; Maxwell, Bruce A; Zafonte, Ross; Schatz, Philip; Berkner, Paul D

Factor Structure of ImPACT® in Adolescent Student Athletes Journal Article

In: Archives of Clinical Neuropsychology, vol. 32, no. 1, pp. 117–122, 2017, ISBN: 08876177.

Strain, J F; Didehbani, N; Spence, J; Conover, H; Bartz, E K; Mansinghani, S; Jeroudi, M K; Rao, N K; Fields, L M; Kraut, M A; Cullum, C M; Hart, J; Womack, K B

White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes Journal Article

In: Journal of Neurotrauma, vol. 34, no. 2, pp. 372–379, 2017.

Abstract | Links | BibTeX | Tags: Concussion, DTI, naming, NATIONAL Football League, TBSS, white matter

Kroshus, E; Baugh, C M; Stein, C J; Austin, S B; Calzo, J P

Concussion reporting, sex, and conformity to traditional gender norms in young adults Journal Article

In: Journal of Adolescence, vol. 54, pp. 110–119, 2017.

Abstract | Links | BibTeX | Tags: college, Concussion, gender, Help-seeking, Sport

Montenigro, P H; Alosco, M L; Martin, B M; Daneshvar, D H; Mez, J; Chaisson, C E; Nowinski, C J; Au, R; McKee, A C; Cantu, R C; McClean, M D; Stern, R A; Tripodis, Y

Cumulative Head Impact Exposure Predicts Later-Life Depression, Apathy, Executive Dysfunction, and Cognitive Impairment in Former High School and College Football Players Journal Article

In: Journal of Neurotrauma, vol. 34, no. 2, pp. 328–340, 2017.

Abstract | Links | BibTeX | Tags: behavior, cognition, Concussion, football, long-term impairment, subconcussive impacts

@article{Montenigro2017,

title = {Cumulative Head Impact Exposure Predicts Later-Life Depression, Apathy, Executive Dysfunction, and Cognitive Impairment in Former High School and College Football Players},

author = {Montenigro, P H and Alosco, M L and Martin, B M and Daneshvar, D H and Mez, J and Chaisson, C E and Nowinski, C J and Au, R and McKee, A C and Cantu, R C and McClean, M D and Stern, R A and Tripodis, Y},

doi = {10.1089/neu.2016.4413},

year  = {2017},

date = {2017-01-01},

journal = {Journal of Neurotrauma},

volume = {34},

number = {2},

pages = {328--340},

abstract = {The term "repetitive head impacts" (RHI) refers to the cumulative exposure to concussive and subconcussive events. Although RHI are believed to increase risk for later-life neurological consequences (including chronic traumatic encephalopathy), quantitative analysis of this relationship has not yet been examined because of the lack of validated tools to quantify lifetime RHI exposure. The objectives of this study were: 1) to develop a metric to quantify cumulative RHI exposure from football, which we term the "cumulative head impact index" (CHII); 2) to use the CHII to examine the association between RHI exposure and long-term clinical outcomes; and 3) to evaluate its predictive properties relative to other exposure metrics (i.e., duration of play, age of first exposure, concussion history). Participants included 93 former high school and collegiate football players who completed objective cognitive and self-reported behavioral/mood tests as part of a larger ongoing longitudinal study. Using established cutoff scores, we transformed continuous outcomes into dichotomous variables (normal vs. impaired). The CHII was computed for each participant and derived from a combination of self-reported athletic history (i.e., number of seasons, position[s], levels played), and impact frequencies reported in helmet accelerometer studies. A bivariate probit, instrumental variable model revealed a threshold dose-response relationship between the CHII and risk for later-life cognitive impairment (p \< 0.0001), self-reported executive dysfunction (p \< 0.0001), depression (p \< 0.0001), apathy (p = 0.0161), and behavioral dysregulation (p \< 0.0001). Ultimately, the CHII demonstrated greater predictive validity than other individual exposure metrics. Copyright © 2017, Mary Ann Liebert, Inc. 2017.},

keywords = {behavior, cognition, Concussion, football, long-term impairment, subconcussive impacts},

pubstate = {published},

tppubtype = {article}

}

Cobbs, L; Hasanaj, L; Amorapanth, P; Rizzo, J R; Nolan, R; Serrano, L; Raynowska, J; Rucker, J C; Jordan, B D; Galetta, S L; Balcer, L J

Mobile Universal Lexicon Evaluation System (MULES) test: A new measure of rapid picture naming for concussion Journal Article

In: Journal of the Neurological Sciences, vol. 372, pp. 393–398, 2017.

Abstract | Links | BibTeX | Tags: Concussion, King-Devick test, Mobile Universal Lexicon Evaluation System, saccades, Sports, Vision

@article{Cobbs2017,

title = {Mobile Universal Lexicon Evaluation System (MULES) test: A new measure of rapid picture naming for concussion},

author = {Cobbs, L and Hasanaj, L and Amorapanth, P and Rizzo, J R and Nolan, R and Serrano, L and Raynowska, J and Rucker, J C and Jordan, B D and Galetta, S L and Balcer, L J},

doi = {10.1016/j.jns.2016.10.044},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the Neurological Sciences},

volume = {372},

pages = {393--398},

abstract = {Objective This study introduces a rapid picture naming test, the Mobile Universal Lexicon Evaluation System (MULES), as a novel, vision-based performance measure for concussion screening. The MULES is a visual-verbal task that includes 54 original photographs of fruits, objects and animals. We piloted MULES in a cohort of volunteers to determine feasibility, ranges of picture naming responses, and the relation of MULES time scores to those of King-Devick (K-D), a rapid number naming test. Methods A convenience sample (n = 20, age 34 ± 10) underwent MULES and K-D (spiral bound, iPad versions). Administration order was randomized; MULES tests were audio-recorded to provide objective data on temporal variability and ranges of picture naming responses. Results Scores for the best of two trials for all tests were 40\textendash50 s; average times required to name each MULES picture (0.72 ± 0.14 s) was greater than those needed for each K-D number ((spiral: 0.33 ± 0.05 s, iPad: 0.36 ± 0.06 s, 120 numbers), p \< 0.0001, paired t-test). MULES scores showed the greatest degree of improvement between trials (9.4 ± 4.8 s, p \< 0.0001 for trials 1 vs. 2), compared to K-D (spiral 1.5 ± 3.3 s, iPad 1.8 ± 3.4 s). Shorter MULES times demonstrated moderate and significant correlations with shorter iPad but not spiral K-D times (r = 0.49, p = 0.03). Conclusion The MULES test is a rapid picture naming task that may engage more extensive neural systems than more commonly used rapid number naming tasks. Rapid picture naming may require additional processing devoted to color perception, object identification, and categorization. Both tests rely on initiation and sequencing of saccadic eye movements. © 2016 Elsevier B.V.},

keywords = {Concussion, King-Devick test, Mobile Universal Lexicon Evaluation System, saccades, Sports, Vision},

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 = {Adolescent, Alignment, Concussion, Convergence, Correlation coefficient, cross-sectional study, King-Devick, Ophthalmology, Optometers, Pupil function, Pupillometer, Repeated Measures, Sport, Time-differences, Vision screening, visual acuity, Visual functions},

pubstate = {published},

tppubtype = {article}

}

Gardner, A J; Kohler, R M N; Levi, C R; Iverson, G L

Usefulness of Video Review of Possible Concussions in National Youth Rugby League Journal Article

In: International Journal of Sports Medicine, vol. 38, no. 1, pp. 71–75, 2017.

Abstract | Links | BibTeX | Tags: Concussion, Injury management, Return to Play, Video analysis

Mihalik, J P; Lynall, R C; Wasserman, E B; Guskiewicz, K M; Marshall, S W

Evaluating the "threshold Theory": Can Head Impact Indicators Help? Journal Article

In: Medicine & Science in Sports & Exercise, vol. 49, no. 2, pp. 247–253, 2017.

Abstract | Links | BibTeX | Tags: Biomechanics, Brain Injury, Concussion, sport injury

Dickson, T J; Trathen, S; Terwiel, F A; Waddington, G; Adams, R

Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study Journal Article

In: Scandinavian Journal of Medicine & Science in Sports, vol. 27, no. 2, pp. 236–244, 2017, ISBN: 09057188.

@article{Dickson2017,

title = {Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study},

author = {Dickson, T J and Trathen, S and Terwiel, F A and Waddington, G and Adams, R},

doi = {10.1111/sms.12642},

isbn = {09057188},

year  = {2017},

date = {2017-01-01},

journal = {Scandinavian Journal of Medicine \& Science in Sports},

volume = {27},

number = {2},

pages = {236--244},

abstract = {This research explored associations between helmet use and head injuries in snowsports by investigating reported snowsport injuries in Western Canada from 2008-2009 to 2012-2013. The key finding was that increased helmet use (from 69% to 80%) was not associated with a reduction in reported head injuries. Over the study period, the average rate of reported head injuries was 0.2/1000 skier visits, with a statistically significant variation ( P \< 0.001). The line of best fit showed an non-significant upward trend ( P = 0.13). Lacerations were the only subcategory of head injuries that decreased significantly with helmet use. A higher proportion of people who reported a head injury were wearing a helmet than for injuries other than to the head. Skiers were more likely to report a head injury when wearing a helmet than snowboarders ( P \< 0.001 cf. P = 0.22). There were significant differences in characteristics of helmet and non-helmet wearers. Helmet wearers were more likely to be: young adults ( P \< 0.001); beginner/novices ( P = 0.004); and snowboarders ( P \< 0.001), but helmet wearing was not associated with gender ( P = 0.191). Further research is needed to explore the possible reasons for the failure of helmets to reduce head injuries, for example, increased reporting of head injuries and increased risk-taking combined with over-rating of the helmets' protection.},

keywords = {CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries},

pubstate = {published},

tppubtype = {article}

}

Churchill, N; Hutchison, M G; Leung, G; Graham, S; Schweizer, T A

Changes in functional connectivity of the brain associated with a history of sport concussion: A preliminary investigation Journal Article

In: Brain Injury, vol. 31, no. 1, pp. 39–48, 2017.

Abstract | Links | BibTeX | Tags: Concussion, Functional MRI, MRI scan, neuroimaging

@article{Churchill2017,

title = {Changes in functional connectivity of the brain associated with a history of sport concussion: A preliminary investigation},

author = {Churchill, N and Hutchison, M G and Leung, G and Graham, S and Schweizer, T A},

doi = {10.1080/02699052.2016.1221135},

year  = {2017},

date = {2017-01-01},

journal = {Brain Injury},

volume = {31},

number = {1},

pages = {39--48},

abstract = {Objective: There is evidence of long-term clinical consequences associated with a history of sport concussion. However, there remains limited information about the underlying changes in brain function. The goal of this study was to identify brain regions where abnormal resting-state function is associated with chronic concussion, for athletes without persistent symptoms. Methods: Functional Magnetic Resonance Imaging (fMRI) was performed on a group of athletes with prior concussion (n = 22) and a group without documented injury (n = 21). Multivariate predictive modelling was used to localize reliable changes in brain connectivity that are associated with a history of concussion and with clinical factors, including number of prior concussions and recovery time from last injury. Results: No significant differences were found between athletes with and without a history of concussion, but functional connectivity was significantly associated with clinical history. The number of prior concussions was associated with most extensive connectivity changes, particularly for elements of the visual attention network and cerebellum. Conclusion: The findings of this preliminary study indicate that functional brain abnormalities associated with chronic concussion may be significantly dependent on clinical history. In addition, elements of the visual and cerebellar systems may be most sensitive to the long-term effects of sport concussion. © 2017 Taylor \& Francis Group, LLC.},

keywords = {Concussion, Functional MRI, MRI scan, neuroimaging},

pubstate = {published},

tppubtype = {article}

}

Klein, T A; Graves, J M

A Comparison of Psychiatric and Nonpsychiatric Nurse Practitioner Knowledge and Management Recommendations Regarding Adolescent Mild Traumatic Brain Injury Journal Article

In: Journal of the American Psychiatric Nurses Association, vol. 23, no. 1, pp. 37–49, 2017.

Abstract | Links | BibTeX | Tags: adolescents/adolescence, Brain Injury, Concussion, nurse practitioner

@article{Klein2017,

title = {A Comparison of Psychiatric and Nonpsychiatric Nurse Practitioner Knowledge and Management Recommendations Regarding Adolescent Mild Traumatic Brain Injury},

author = {Klein, T A and Graves, J M},

doi = {10.1177/1078390316668992},

year  = {2017},

date = {2017-01-01},

journal = {Journal of the American Psychiatric Nurses Association},

volume = {23},

number = {1},

pages = {37--49},

abstract = {BACKGROUND: Nurse practitioners (NPs) are statutorily authorized to provide assessment and cognitive recommendations for concussion in most states. Their scope of practice includes assessment and management of concussion sequalae including anxiety, insomnia, and depression, as well as return to school and activity guidance. OBJECTIVES: Analysis of symptom-based diagnosis of mild traumatic brain injury (TBI) in adolescents, including return to school and school workload recommendations comparing psychiatric and nonpsychiatric NPs. DESIGN: Cross-sectional Web-based survey with embedded videos using standardized actors and scripts randomized for patient sex and sport. A total of 4,849 NPs licensed in Oregon or Washington were invited by e-mail to view and respond to this study, with a response rate of 23%. RESULTS: Psychiatric mental health nurse practitioners (PMHNPs) were 44% less likely than family NPs to report using standardized concussion tools. 17% had completed continuing education on mild TBI compared to 54.5% of family NPs. Seven PMHNPs provided additional feedback related to discomfort in completing the survey due to lack of comfort or experience. Return to school recommendations and reduced workload advice did not significantly differ by NP type. CONCLUSION: PMHNPs may support individualized assessment through concussion evaluation, use of standardized tools, and differential consideration of TBI for mental health symptoms. More research is required related to the role and contribution of cognitive rest to full recovery. © 2016, © The Author(s) 2016.},

keywords = {adolescents/adolescence, Brain Injury, Concussion, nurse practitioner},

pubstate = {published},

tppubtype = {article}

}

Roberts, Simon P; Trewartha, Grant; England, Michael; Goodison, William; Stokes, Keith A

Concussions and Head Injuries in English Community Rugby Union Match Play Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 480–487, 2017, ISBN: 03635465.

Abstract | Links | BibTeX | Tags: Concussion, EPIDEMIOLOGY, injury, Rugby Union

@article{Roberts2017,

title = {Concussions and Head Injuries in English Community Rugby Union Match Play},

author = {Roberts, Simon P and Trewartha, Grant and England, Michael and Goodison, William and Stokes, Keith A},

doi = {10.1177/0363546516668296},

isbn = {03635465},

year  = {2017},

date = {2017-01-01},

journal = {American Journal of Sports Medicine},

volume = {45},

number = {2},

pages = {480--487},

abstract = {Background: Previous research has described general injury patterns in community-level rugby union, but specific information on time-loss head injuries has not been reported. Purpose: To establish the incidence and nature of significant time-loss head injuries in English community rugby match play, and to identify the injury risk for specific contact events. Study Design: Descriptive epidemiology study. Methods: Over 6 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), 76 (2011-2012), 50 (2012-2013), 67 (2013-2014), and 58 (2014-2015) English community rugby clubs (Rugby Football Union levels 3-9) over a total of 175,940 hours of player match exposure. Club injury management staff reported information for all head injuries sustained during match play whereby the player was absent for 8 days or greater. Clubs were subdivided into semiprofessional (mean player age, 24.6 ± 4.7 years), amateur (24.9 ± 5.1 years), and recreational (25.6 ± 6.1 years) playing levels. Contact events from a sample of 30 matches filmed over seasons 2009-2010, 2010-2011, and 2011-2012 provided mean values for the frequency of contact events. Results: The overall incidence for time-loss head injuries was 2.43 injuries per 1000 player match hours, with a higher incidence for the amateur (2.78; 95% CI, 2.37-3.20) compared with recreational (2.20; 95% CI, 1.86-2.53) (P = .032) playing level but not different to the semiprofessional (2.31; 95% CI, 1.83-2.79) playing level. Concussion was the most common time-loss head injury, with 1.46 per 1000 player match hours. The tackle event was associated with 64% of all head injuries and 74% of all concussions. There was also a higher risk of injuries per tackle (0.33 per 1000 events; 95% CI, 0.30-0.37) compared with all other contact events. Conclusion: Concussion was the most common head injury diagnosis, although it is likely that this injury was underreported. Continuing education programs for medical staff and players are essential for the improved identification and management of these injuries. With the majority of head injuries occurring during a tackle, an improved technique in this contact event through coach and player education may be effective in reducing these injuries. [ABSTRACT FROM AUTHOR].},

keywords = {Concussion, EPIDEMIOLOGY, injury, Rugby Union},

pubstate = {published},

tppubtype = {article}

}

Anzalone, Anthony J; Blueitt, Damond; Case, Tami; McGuffin, Tiffany; Pollard, Kalyssa; Garrison, J Craig; Jones, Margaret T; Pavur, Robert; Turner, Stephanie; Oliver, Jonathan M

A Positive Vestibular/Ocular Motor Screening (VOMS) Is Associated With Increased Recovery Time After Sports-Related Concussion in Youth and Adolescent Athletes Journal Article

In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 474–479, 2017, ISBN: 03635465.

Abstract | Links | BibTeX | Tags: Concussion, Ocular motor, Symptoms, vestibular

Moore, R D; Lepine, J; Ellemberg, D

The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function Journal Article

In: International Journal of Psychophysiology, vol. 112, pp. 22–30, 2017.

Abstract | Links | BibTeX | Tags: Concussion, ERPs, Neurophysiology, neuropsychology, Sub-concussion

@article{Moore2017,

title = {The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function},

author = {Moore, R D and Lepine, J and Ellemberg, D},

doi = {10.1016/j.ijpsycho.2016.11.011},

year  = {2017},

date = {2017-01-01},

journal = {International Journal of Psychophysiology},

volume = {112},

pages = {22--30},

abstract = {Accumulating research demonstrates that repetitive sub-concussive impacts can alter the structure, function and connectivity of the brain. However, the functional significance of these alterations as well as the independent contribution of concussive and sub-concussive impacts to neurophysiological and neuropsychological health are unclear. Accordingly, we compared the neurophysiological and neuropsychological function of contact athletes with (concussion group) and without (sub-concussion group) a history of concussion, to non-contact athletes. We evaluated event-related brain potentials (ERPs) elicited during an oddball task and performance on a targeted battery of neuropsychological tasks. Athletes in the sub-concussion and concussion groups exhibited similar amplitude reductions in the ERP indices of attentional resource allocation (P3b) and attentional orienting (P3a) relative to non-contact athletes. However, only athletes in the concussion group exhibited reduced amplitude in the ERP index of perceptual attention (N1). Athletes in the sub-concussion and concussion groups also exhibited deficits in memory recall relative to non-contact athletes, but athletes in the concussion group also exhibited significantly more recall errors than athletes in the sub-concussion group. Additionally, only athletes in the concussion group exhibited response delays during the oddball task. The current findings suggest that sub-concussive impacts are associated with alterations in the neurophysiological and neuropsychological indices of essential cognitive functions, albeit to a lesser degree than the combination of sub-concussive and concussive impacts. © 2016 Elsevier B.V.},

keywords = {Concussion, ERPs, Neurophysiology, neuropsychology, Sub-concussion},

pubstate = {published},

tppubtype = {article}

}

Tanaka, Yuto; Tsugawa, Tsuyoshi; Maeda, Yoshinobu

Effect of mouthguards on impact to the craniomandibular complex Journal Article

In: Dental Traumatology, vol. 33, no. 1, pp. 51–56, 2017, ISBN: 16004469.

Bailly, N; Afquir, S; Laporte, J D; Melot, A; Savary, D; Seigneuret, E; Delay, J B; Donnadieu, T; Masson, C; Arnoux, P J

Analysis of Injury Mechanisms in Head Injuries in Skiers and Snowboarders Journal Article

In: Medicine & Science in Sports & Exercise, vol. 49, no. 1, pp. 1–10, 2017.

Abstract | Links | BibTeX | Tags: Concussion, head injury, Helmet, SKI, snowboard

@article{Bailly2017,

title = {Analysis of Injury Mechanisms in Head Injuries in Skiers and Snowboarders},

author = {Bailly, N and Afquir, S and Laporte, J D and Melot, A and Savary, D and Seigneuret, E and Delay, J B and Donnadieu, T and Masson, C and Arnoux, P J},

doi = {10.1249/MSS.0000000000001078},

year  = {2017},

date = {2017-01-01},

journal = {Medicine \& Science in Sports \& Exercise},

volume = {49},

number = {1},

pages = {1--10},

abstract = {Purpose Mechanisms of injury and description of head impacts leading to traumatic brain injury (TBI) in skiers and snowboarders have not been extensively documented. We investigate snow sport crashes leading to TBI 1) to identify typical mechanisms leading to TBI to better target prevention measures and 2) to identify the injury mechanisms and the head impact conditions. Methods The subjects were skiers and snowboarders diagnosed of TBI and admitted between 2013 and 2015 to one of the 15 medical offices and three hospital centers involved in the study. The survey includes the description of the patients (age, sex, practice, skill level, and helmet use), the crash (type, location, estimated speed, causes, and fall description), and the injuries sustained (symptoms, head trauma scores, and other injuries). Sketches were used to describe the crash and impact locations. Clustering methods were used to distinguish profiles of injured participants. Results A total of 295 skiers and 71 snowboarders were interviewed. The most frequent type of mechanism was falls (54%), followed by collision between users (18%) and jumps (15%). Collision with obstacle (13%) caused the most serious TBI. Three categories of patients were identified. First, men age 16-25 yr are more involved in crash at high speed or in connection with a jump. Second, women, children (\<16 yr), and beginners are particularly injured in collisions between users. Third, those older than 50 yr, usually nonhelmeted, are frequently involved in falls. Ten crash scenarios were identified. Falling head first is the most frequent of skiers' falls (28%). Conclusion Crash scenarios leading to TBI were identified and associated with profiles of injured participants. Those results should help to better target TBI prevention and protection campaigns. © 2016 by the American College of Sports Medicine.},

keywords = {Concussion, head injury, Helmet, SKI, snowboard},

pubstate = {published},

tppubtype = {article}

}

2016

Kawata, K; Rubin, L H; Lee, J H; Sim, T; Takahagi, M; Szwanki, V; Bellamy, A; Darvish, K; Assari, S; Henderer, J D; Tierney, R; Langford, D

Association of football subconcussive head impacts with ocular near point of convergence Journal Article

In: JAMA Ophthalmology, vol. 134, no. 7, pp. 763–769, 2016.

@article{Kawata2016,

title = {Association of football subconcussive head impacts with ocular near point of convergence},

author = {Kawata, K and Rubin, L H and Lee, J H and Sim, T and Takahagi, M and Szwanki, V and Bellamy, A and Darvish, K and Assari, S and Henderer, J D and Tierney, R and Langford, D},

doi = {10.1001/jamaophthalmol.2016.1085},

year  = {2016},

date = {2016-01-01},

journal = {JAMA Ophthalmology},

volume = {134},

number = {7},

pages = {763--769},

abstract = {IMPORTANCE An increased understanding of the relationship between subconcussive head impacts and near point of convergence (NPC) ocular-motor function may be useful in delineating traumatic brain injury. OBJECTIVE To investigate whether repetitive subconcussive head impacts during preseason football practice cause changes in NPC. DESIGN, SETTING, AND PARTICIPANTS This prospective, observational study of 29 National Collegiate Athletic Association Division I football players included baseline and preseason practices (1 noncontact and 4 contact), and postseason follow-up and outcome measures were obtained for each time. An accelerometer-embedded mouthguard measured head impact kinematics. Based on the sum of head impacts from all 5 practices, players were categorized into lower (n = 7) or higher (n = 22) impact groups. EXPOSURES Players participated in regular practices, and all head impacts greater than 10g from the 5 practices were recorded using the i1Biometerics Vector mouthguard (i1 Biometrics Inc). MAIN OUTCOMES AND MEASURES Near point of convergence measures and symptom scores. RESULTS A total of 1193 head impacts were recorded from 5 training camp practices in the 29 collegiate football players; 22 were categorized into the higher-impact group and 7 into the lower-impact group. Therewere significant differences in head impact kinematics between lower- and higher-impact groups (number of impacts, 6 vs 41 [lower impact minus higher impact = 35; 95%CI, 21-51; P \< .001]; linear acceleration, 99g vs 1112g [lower impact minus higher impact= 1013; 95%CI, 621 - 1578; P \< .001]; angular acceleration, 7589 radian/s2 vs 65016 radian/s2 [lower impact minus higher impact= 57 427; 95%CI , 31 123-80 498; P \< .001], respectively). The trajectory and cumulative burden of subconcussive impacts on NPC differed by group (F for group × linear trend1},

keywords = {Acceleration, accelerometer, adult, Article, binocular convergence, Concussion, eye movement, follow up, football, head movement, human, KINEMATICS, major clinical study, Male, mouth protector, observational study, priority journal, prospective study, traumatic brain injury, Young Adult},

pubstate = {published},

tppubtype = {article}

}

Kim, S; Spengler, J O; Connaughton, D P

An exploratory study of concussion management policies in municipal park and recreation departments Journal Article

In: Journal of Policy Research in Tourism, Leisure and Events, vol. 8, no. 3, pp. 274–288, 2016.

Abstract | Links | BibTeX | Tags: Concussion, Injury prevention, policy, recreation, risk management, Youth sports

Howell, D R; Meehan III, W P

Normative values for a video-force plate assessment of postural control in athletic children Journal Article

In: Journal of Pediatric Orthopaedics Part B, vol. 25, no. 4, pp. 310–314, 2016.

Abstract | Links | BibTeX | Tags: Athletes, Balance, Balance Error Scoring System, Concussion, postural stability, Sports

Carter-Allison, S N; Potter, S; Rimes, K

Diagnosis Threat and Injury Beliefs after Mild Traumatic Brain Injury Journal Article

In: Archives of Clinical Neuropsychology, vol. 31, no. 7, pp. 727–737, 2016.

Abstract | Links | BibTeX | Tags: attention, Concussion, Illness perceptions, Memory, Stereotype threat, Suggestibility

@article{Carter-Allison2016,

title = {Diagnosis Threat and Injury Beliefs after Mild Traumatic Brain Injury},

author = {Carter-Allison, S N and Potter, S and Rimes, K},

doi = {10.1093/arclin/acw062},

year  = {2016},

date = {2016-01-01},

journal = {Archives of Clinical Neuropsychology},

volume = {31},

number = {7},

pages = {727--737},

abstract = {Background Diagnosis threat is a psychosocial factor proposed to contribute to poor cognitive outcomes following mild traumatic brain injury (mTBI). The current research explored diagnosis threat impact on objective and subjective cognitive performance in a "high risk" population of athletes. Two possible moderators of diagnosis threat - injury beliefs and suggestibility - were also investigated. Method Seventy-six participants with a history of mTBI were recruited through sports clubs and randomized to a months threat group (instructions drew attention to mTBI history) or a control group (no mention of mTBI). They completed a battery of neuropsychological tests and questionnaires regarding day-to-day cognitive abilities. Measures of depression, anxiety, illness beliefs and suggestibility were also collected. Results No significant group differences were found on any neuropsychological tasks, nor on self-report of cognitive difficulties. Illness beliefs were not found to play a moderating role in general, although the majority of the study sample did not report negative mTBI beliefs and expectations: concern about the consequences of injury was associated with weaker performance on one test, WAIS-III Digit Span performance. Suggestibility was also found to have a significant affect on this test. Conclusions Diagnosis threat did not appear to have a marked affect on objective or subjective cognitive performance after mTBI in athletes. Differing injury beliefs between the study's athlete population and the general population is a possible explanation for different findings in the area. This and other sources of potential variation in the affect of diagnosis threat are discussed. © 2016 Crown copyright 2016.},

keywords = {attention, Concussion, Illness perceptions, Memory, Stereotype threat, Suggestibility},

pubstate = {published},

tppubtype = {article}

}

Chermann, J F; Savigny, A; Radafy, A; Blandin, N; Bohu, Y

In: Journal de Traumatologie du Sport, vol. 33, no. 2, pp. 88–96, 2016.

Abstract | Links | BibTeX | Tags: brain, Concussion, Sports

@article{Chermann2016,

title = {Sports-related concussion in elite athletes: Prospective study of 211 cases seen in a specialized outpatient clinic},

author = {Chermann, J F and Savigny, A and Radafy, A and Blandin, N and Bohu, Y},

doi = {10.1016/j.jts.2015.12.008},

year  = {2016},

date = {2016-01-01},

journal = {Journal de Traumatologie du Sport},

volume = {33},

number = {2},

pages = {88--96},

abstract = {Sports-related brain concussion is not well known despite its frequency. Few cases are reported. Brain concussion leads to an immediate transient alteration of the neurological functions followed by a post-concussion syndrome of variable duration. Due to the risk of neurodegenerative disease related to repeated concussion, we created a specialized outpatient clinic devoted to sports-related brain concussions in order to better apprehend the phenomenon, to search for factors predictive of unfavorable outcome, and most importantly to elaborate a protocol and a set of criteria for determining the moment the incriminated activity can be resumed under good conditions. The cohort included 211 athletes who attended the specialized outpatient clinic, 168 men and 43 women. The largest number of patients were rugby players (n = 166, 78.7%). Among the 211 athletes, 126 (59.7%) had already had one concussion and 132 attended the clinic twice, at most four days after the concussion. The diagnosis was considered on the playing field, generally because of the presence of amnesia or loss of consciousness. Among the 211 athletes, 106 (50.2%) left the field immediately after the concussion. For the post-concussion syndrome, headache was the most common functional sign (170/211, 80.6%). Age (\< 20 years), female gender, and recent history of a brain concussion were factors predictive of poor outcome as measured by the duration of the post-concussion syndrome and delay before returning to the sports activity. Loss of consciousness, anterograde or retrograde amnesia, and the number of episodes of prior brain concussion did not have any impact on the duration of the post-concussion syndrome and delay before returning to the sports activity. In our opinion, a specialized outpatient clinic visit less than four days after the concussion can help reduce the length of the post-concussion syndrome, mainly resulting from good patient education and better therapeutic management. © 2016},

keywords = {brain, Concussion, Sports},

pubstate = {published},

tppubtype = {article}

}

Bunworth, R

Egg-shell skulls or institutional negligence? The liability of World Rugby for incidents of concussion suffered by professional players in England and Ireland Journal Article

In: International Sports Law Journal, vol. 16, no. 1-2, pp. 82–98, 2016.

Abstract | Links | BibTeX | Tags: Concussion, Duty of care, Governing body, Liability, Negligence, rugby

@article{Bunworth2016,

title = {Egg-shell skulls or institutional negligence? The liability of World Rugby for incidents of concussion suffered by professional players in England and Ireland},

author = {Bunworth, R},

doi = {10.1007/s40318-016-0095-y},

year  = {2016},

date = {2016-01-01},

journal = {International Sports Law Journal},

volume = {16},

number = {1-2},

pages = {82--98},

abstract = {The number of incidents of concussion in professional rugby union is increasing steadily. In the English Rugby Premiership, concussion was the most frequent injury suffered by professional players in each of the last 3 seasons. Further, there is developing evidence of a link between suffering repeated concussions and chronic traumatic encephalopathy, a degenerative brain disease. World Rugby’s principal response to the growing problem of concussion in rugby has been through the introduction of the Pitch Side Concussion Assessment and the Return to Play protocols. Few amendments have been made to the playing rules of the sport with the express intention of reducing the frequency with which concussions occur. The article explores whether World Rugby could be found to owe professional rugby players a duty of care under the laws of negligence in England and Ireland. The article then goes on to examine if World Rugby could be found to have acted negligently in its response to the issue of concussion, through the adoption of its concussion management rules and its failure to amend the playing rules of the sport in an attempt to prevent concussions from occurring. Following this, the article analyses the difficulty which a potential plaintiff would face in establishing causation in a negligence action against World Rugby. The article concludes with suggested changes which World Rugby could implement to lessen the possibility of a finding that it has acted negligently in relation to players’ safety. © 2016, T.M.C. Asser Instituut.},

keywords = {Concussion, Duty of care, Governing body, Liability, Negligence, rugby},

pubstate = {published},

tppubtype = {article}

}

Reider, B

Like a pro Journal Article

In: American Journal of Sports Medicine, vol. 44, no. 9, pp. 2199–2201, 2016.

Links | BibTeX | Tags: Baseball, BASKETBALL, Concussion, femoroacetabular impingement, football, ice hockey, ulnar collateral ligament

Kontos, A P; Sufrinko, A; Womble, M; Kegel, N

Neuropsychological Assessment Following Concussion: an Evidence‐Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion Journal Article

In: Current Pain & Headache Reports, vol. 20, no. 6, 2016.

@article{Kontos2016b,

title = {Neuropsychological Assessment Following Concussion: an Evidence‐Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion},

author = {Kontos, A P and Sufrinko, A and Womble, M and Kegel, N},

doi = {10.1007/s11916-016-0571-y},

year  = {2016},

date = {2016-01-01},

journal = {Current Pain \& Headache Reports},

volume = {20},

number = {6},

abstract = {Neuropsychological evaluation is one component of a comprehensive and multifaceted assessment following concussion. Although some neuropsychologists use a “hybrid” assessment approach integrating computerized neurocognitive testing batteries with traditional paper and pencil tests, computerized neurocognitive test batteries are the predominant testing modality for assessment of athletes from the youth to professional level. This review summarizes the most recent research supporting the utility of neuropsychological evaluation and highlights the strengths and weaknesses of both computerized and traditional neuropsychological testing approaches. The most up to date research and guidelines on baseline neurocognitive testing is also discussed. This paper addresses concerns regarding reliability of neuropsychological testing while providing an overview of factors that influence test performance, both transient situational factors (e.g., pain level, anxiety) and characteristics of particular subgroups (e.g., age, preexisting learning disabilities), warranting the expertise of an experienced neuropsychologist for interpretation. Currently, research is moving forward by integrating neuropsychological evaluation with emerging assessment approaches for other domains of brain function (e.g., vestibular function) vulnerable to concussion. © 2016, Springer Science+Business Media New York.},

keywords = {Baseline, brain function, Computerized assessment battery, computerized neuropsychological test, Concussion, evidence based practice, human, MEDICAL research, Neurocognitive tests, Neuropsychological evaluation, neuropsychological test, paper and pencil neuropsychological test, psychologic assessment, reliability, Review, Sport, TASK performance},

pubstate = {published},

tppubtype = {article}

}

Hecimovicha, Mark; Kingb, Doug; Maraisc, Ida

Player and parent concussion knowledge and awareness in youth Australian Rules Football Journal Article

In: Sport Journal, pp. 1–19, 2016, ISBN: 15439518.

@article{Hecimovicha2016,

title = {Player and parent concussion knowledge and awareness in youth Australian Rules Football},

author = {Hecimovicha, Mark and Kingb, Doug and Maraisc, Ida},

isbn = {15439518},

year  = {2016},

date = {2016-01-01},

journal = {Sport Journal},

pages = {1--19},

abstract = {Purpose: The purpose of this study was to measure concussion knowledge and awareness of youth Australian Rules Football players and parents. Secondary aims were examining if player's maturity in age, history of concussion and years played and parents who have undergone first aid and concussion training would increase knowledge. Methods: 1,441 parents and 284 youth ARF players completed a 23-item concussion knowledge survey consisting of three areas: concussion symptoms, management, and return-to-play criteria. Results: There was significant difference in knowledge of concussion management and return-to play criteria between players and parents (p= less than 0.01). Players age, years played and history of concussion did not increase knowledge, however, parents with concussion training had significantly higher scores than those without (p= less than 0.01). Some return-to-play criteria and signs and symptom not thought to be associated with concussion such as disturbed sleeping and difficulty studying were difficult for both groups to associate as related to concussion. Conclusions: Future concussion education opportunities for player and parents need to focus on return-to-play criteria and uncommon signs and symptoms such as sleep disturbances and problems studying. Applications in sport: The findings reflect certain areas that need to be incorporated into educational opportunities for players and parents, especially those who have limited access to qualified health care professionals such as ATC's. Although there is minimal evidence supporting concussion educational opportunities, awareness and knowledge of concussion is the greatest positive influence for symptom reporting among young athletes. However, the ideal delivery mode and educational content for interventions appropriate to each group has yet to be identified so steps such as defining the target group, measuring their level of awareness and knowledge, and monitoring of effectiveness. Overall, the goal should be to provide at least the basic information regarding concussion but as the results of this study demonstrate ensure lesser known aspects such as return-to-play criteria and signs and symptoms such as sleep disturbances and difficulty studying or concentrating are incorporated. ABSTRACT FROM AUTHOR},

keywords = {*ACADEMIC achievement, *BRAIN -- Concussion, *FIRST aid in illness \&amp; injury, *FOOTBALL injuries, *SLEEP disorders, *SPORTS participation, *SYMPTOMS, ADOLESCENCE, Australia, Australian Rules football, AWARENESS, Concussion, DESCRIPTIVE statistics, HEALTH literacy, Parent, PARENTS -- Attitudes, PROBABILITY theory, Questionnaires, STATISTICAL significance, Treatment, Youth},

pubstate = {published},

tppubtype = {article}

}

Statements of Agreement from the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015 Journal Article

In: Neurosurgery, vol. 79, no. 6, pp. 912–929, 2016.

Abstract | Links | BibTeX | Tags: Concussion, mTBI, Rehabilitation, Treatment

@article{Collins2016,

title = {Statements of Agreement from the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015},

author = {Collins, M W and Kontos, A P and Okonkwo, D O and Almquist, J and Bailes, J and Barisa, M and Bazarian, J and Bloom, O J and Brody, D L and Cantu, R and Cardenas, J and Clugston, J and Cohen, R and Echemendia, R and Elbin, R J and Ellenbogen, R and Fonseca, J and Gioia, G and Guskiewicz, K and Heyer, R and Hotz, G and Iverson, G L and Jordan, B and Manley, G and Maroon, J and McAllister, T and McCrea, M and Mucha, A and Pieroth, E and Podell, K and Pombo, M and Shetty, T and Sills, A and Solomon, G and Thomas, D G and {Valovich McLeod}, T C and Yates, T and Zafonte, R},

doi = {10.1227/NEU.0000000000001447},

year  = {2016},

date = {2016-01-01},

journal = {Neurosurgery},

volume = {79},

number = {6},

pages = {912--929},

abstract = {BACKGROUND: Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. OBJECTIVE: To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion. METHODS: On October 14 to 16, 2015, the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion meeting was convened in Pittsburgh, Pennsylvania. Thirty-seven concussion experts from neuropsychology, neurology, neurosurgery, sports medicine, physical medicine and rehabilitation, physical therapy, athletic training, and research and 12 individuals representing sport, military, and public health organizations attended the meeting. The 37 experts indicated their agreement on a series of statements using an audience response system clicker device. RESULTS: A total of 16 statements of agreement were supported covering (1) Summary of the Current Approach to Treating Concussion, (2) Heterogeneity and Evolving Clinical Profiles of Concussion, (3) TEAM Approach to Concussion Treatment: Specific Strategies, and (4) Future Directions: A Call to Research. Support (ie, response of agree or somewhat agree) for the statements ranged from to 97% to 100%. CONCLUSION: Concussions are characterized by diverse symptoms and impairments and evolving clinical profiles; recovery varies on the basis of modifying factors, injury severity, and treatments. Active and targeted treatments may enhance recovery after concussion. Research is needed on concussion clinical profiles, biomarkers, and the effectiveness and timing of treatments. Copyright © 2016 by the Congress of Neurological Surgeons.},

keywords = {Concussion, mTBI, Rehabilitation, Treatment},

pubstate = {published},

tppubtype = {article}

}

Kroshus, E; Gillard, D; Haarbauer‐Krupa, J; Goldman, R E; Bickham, D S

Talking with young children about concussions: An exploratory study Journal Article

In: Child: Care, Health and Development, 2016, ISBN: 0305-1862 1365-2214.

Abstract | Links | BibTeX | Tags: 2016, Brain Injury, children, Concussion, No terms assigned, Parents, Sport

@article{Kroshus2016b,

title = {Talking with young children about concussions: An exploratory study},

author = {Kroshus, E and Gillard, D and Haarbauer‐Krupa, J and Goldman, R E and Bickham, D S},

doi = {10.1111/cch.12433},

isbn = {0305-1862

1365-2214},

year  = {2016},

date = {2016-01-01},

journal = {Child: Care, Health and Development},

publisher = {Wiley-Blackwell Publishing Ltd.},

address = {United Kingdom},

abstract = {Background Concussion education for children early in their participation in organized sport may help shape lasting attitudes about concussion safety. However, existing programming and research focus on older ages. Methods Qualitative interviews about concussions were conducted with twenty children between the ages of six and eight. Structural, descriptive and pattern coding were used to organize the transcribed interviews and identify emergent themes. Results Eighteen of the participants indicated that they had heard of the word concussion, with 12 describing the injury as related to the brain or head. The most frequently described mechanisms of injury were impacts to the head or falls, and symptoms tended to be somatic, such as generalized pain. The most frequently endorsed strategy to avoid sustaining a concussion was to ‘follow the rules.’ Multiple participants referenced parents as an informal source of information about concussions. Conclusions While most participants demonstrated some awareness about concussions, there were clear knowledge gaps that can be addressed with developmentally appropriate concussion education programming. Consistent with their developmental stage, interventions targeted at children in this age range may be most successful if they use basic logic, concrete ideas, provide rules to be followed and engage parents in dissemination. (PsycINFO Database Record (c) 2016 APA, all rights reserved)},

keywords = {2016, Brain Injury, children, Concussion, No terms assigned, Parents, Sport},

pubstate = {published},

tppubtype = {article}

}

Gregory, A; Kerr, Z; Parsons, J

Selected issues in injury and illness prevention and the team physician: A consensus statement Journal Article

In: Current Sports Medicine Reports, vol. 15, no. 1, pp. 48–59, 2016.

Sanghera, Navjit K; Baas, Eric A; Bakkum, Barclay W; Foreman, Katie; Beckerman, Stephen

Sports vision evaluation findings in an elite athlete population Journal Article

In: Optometry & Visual Performance, vol. 4, no. 3, pp. 137–146, 2016, ISBN: 2325-3479 2325-3487.

Abstract | BibTeX | Tags: 2016, Binocular Vision, binocular vision disorder, brain concussion, Concussion, Sports, sports vision, traumatic brain injury, Vision Disorders

@article{Sanghera2016,

title = {Sports vision evaluation findings in an elite athlete population},

author = {Sanghera, Navjit K and Baas, Eric A and Bakkum, Barclay W and Foreman, Katie and Beckerman, Stephen},

isbn = {2325-3479

2325-3487},

year  = {2016},

date = {2016-01-01},

journal = {Optometry \& Visual Performance},

volume = {4},

number = {3},

pages = {137--146},

publisher = {Optometric Extension Program Foundation, Inc.},

address = {US},

abstract = {Background: Epidemiological studies suggest that the athletic population has a significant need for vision care. Recently, there has been an increased awareness and discussion of sports-related concussion, which can have a negative impact on athletic performance. The goal of this investigation is to characterize baseline performance of a cohort of elite athletes on a battery of sports vision tests. This information can: 1) serve as a baseline for comparison after an athlete is concussed, 2) help evaluate the effects of concussion on the visual system as it relates to athletic performance, and 3) help establish vision-related criteria for determining if and when an athlete is ready to return to play and perform at pre-concussive levels. Methods: Twenty-one male Major League Soccer athletes ages 18-35 were tested on 20 sports vision-related tests. Results: Eighteen of 21 subjects (86%) demonstrated one or more clinically significant problems with visual acuity, ocular health, binocular vision, and/or exhibited visual symptoms. The screening results indicate that 17% failed visual acuity, 26% displayed abnormal ocular health findings, 6% exhibited binocular vision problems, and 29% complained of at least one visual symptom related to a previous incident involving head trauma or concussion. Conclusion: This visual performance testing characterized baseline findings for this population and may help determine how deficits may interfere with optimum athletic performance at the elite level. The baseline testing could also serve as an indicator of recovery in acute vs. chronic stages and help determine if and when a concussed athlete is ready to return to play. (PsycINFO Database Record (c) 2016 APA, all rights reserved)},

keywords = {2016, Binocular Vision, binocular vision disorder, brain concussion, Concussion, Sports, sports vision, traumatic brain injury, Vision Disorders},

pubstate = {published},

tppubtype = {article}

}

Stieg, P E; Perrine, K

Helmet Use and Traumatic Brain Injury in Snowboarding Journal Article

In: World Neurosurgery, vol. 86, pp. 65–68, 2016.

Kringler, W; Brand, B; Eidenmüller, A M

Concussion in team sports: Neuropsychological aspects Journal Article

In: Sports Orthopaedics and Traumatology, vol. 32, no. 4, pp. 364–367, 2016.

Abstract | Links | BibTeX | Tags: Concussion, mild traumatic brain injury, Return-to-play, Sport-neuropsychology, SPORTS medicine, Team sports

Reynolds, E; Fazio, V C; Sandel, N; Schatz, P; Henry, L C

Cognitive Development and the Immediate Postconcussion Assessment and Cognitive Testing: A Case for Separate Norms in Preadolescents Journal Article

In: Applied Neuropsychology: Child, vol. 5, no. 4, pp. 283–293, 2016.

Abstract | Links | BibTeX | Tags: cognitive development, Concussion, neuropsychology, preadolescent

Poland, K M; McKay, M P; Zonfrillo, M R; Barth, T H; Kaminski, R

Changes in baseline concussion assessment scores following a school bus crash Journal Article

In: Traffic Injury Prevention, vol. 17, pp. 6–10, 2016.

Abstract | Links | BibTeX | Tags: athlete, COGNITIVE testing, Concussion, crash, school bus, transportation

@article{Poland2016,

title = {Changes in baseline concussion assessment scores following a school bus crash},

author = {Poland, K M and McKay, M P and Zonfrillo, M R and Barth, T H and Kaminski, R},

doi = {10.1080/15389588.2016.1194518},

year  = {2016},

date = {2016-01-01},

journal = {Traffic Injury Prevention},

volume = {17},

pages = {6--10},

abstract = {Objective: The objective of this article is to present concussion assessment data for 30 male athletes prior to and after being involved in a large school bus crash. The athletes on the bus, all male and aged 14\textendash18 years, were participants in their school's concussion management program that included baseline and postinjury testing using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Methods: This case study described changes in concussion assessment scores for 30 male athletes following a primarily frontal school bus crash. Data from the school's concussion management program, including baseline test data and postinjury assessment data, were reviewed. Athletes who required multiple postinjury assessments by the program were identified as having had significant cognitive changes as a result of the bus crash. Results: Twenty-nine of 30 athletes were injured. One had lumbar compression fractures; others had various lacerations, abrasions, contusions, sprains, and nasal fractures. ImPACT data (postcrash) were available for all 30 athletes and 28 had available precrash baseline data. A total of 16 athletes (53.3%) had significant cognitive changes indicated by changes in their concussion assessment scores, some of which took months to improve. Conclusion: This case study highlights a unique opportunity to evaluate concussion assessment data from 30 male athletes involved in a high-speed school bus crash. Further, these data provide additional insight into assessing the effectiveness of current school bus occupant protection systems. © 2016 Taylor \& Francis Group, LLC.},

keywords = {athlete, COGNITIVE testing, Concussion, crash, school bus, transportation},

pubstate = {published},

tppubtype = {article}

}

Sullivan, K A; Edmed, S L

New vignettes for the experimental manipulation of injury cause in prospective mild traumatic brain injury research Journal Article

In: Brain Injury, vol. 30, no. 13-14, pp. 1699–1707, 2016.

Abstract | Links | BibTeX | Tags: Concussion, mild brain, survey, traumatic brain injury, vignette

Patton, D A; McIntosh, A S

Considerations for the performance requirements and technical specifications of soft-shell padded headgear Journal Article

In: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology, vol. 230, no. 1, pp. 29–42, 2016.

Abstract | Links | BibTeX | Tags: Australian football, Biomechanics, Concussion, Design, Head Injuries, head injury, headgear, Injury prevention, protective equipment, rugby, Sports

Belanger, H G; Vanderploeg, R D; McAllister, T

Subconcussive blows to the head: A formative review of short-term clinical outcomes Journal Article

In: Journal of Head Trauma Rehabilitation, vol. 31, no. 3, pp. 159–166, 2016.

Abstract | Links | BibTeX | Tags: Balance, cognition, Concussion, mild TBI, neuropsychological, Outcomes, subconcussion

@article{Belanger2016b,

title = {Subconcussive blows to the head: A formative review of short-term clinical outcomes},

author = {Belanger, H G and Vanderploeg, R D and McAllister, T},

doi = {10.1097/HTR.0000000000000138},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Head Trauma Rehabilitation},

volume = {31},

number = {3},

pages = {159--166},

abstract = {Background: Given questions about "lower thresholds" for concussion, as well as possible effects of repetitive concussion and chronic traumatic encephalopathy (CTE), and associated controversy, there is increasing interest in "subconcussive" blows and their potential significance. Objective: A formative review with critical examination of the developing literature on subconcussive blows in athletes with an emphasis on clinical outcomes. Methods: Studies of biomechanical, performance and/or symptom-based, and neuroimaging data were identified via PubMed search and critically reviewed. Five studies of symptom reporting/performance and 4 studies of neuroimaging were included. Results: The relation between biomechanical parameters and diagnosed concussion is not straightforward (ie, it is not the case that greater and more force leads to more severe injury or cognitive/behavioral sequelae). Neuropsychological studies of subconcussive blows within a single athletic season have failed to demonstrate any strong and consistent relations between number and severity of subconcussive events and cognitive change. Recent studies using neuroimaging have demonstrated a potential cumulative effect of subconcussive blows, at least in a subset of individuals. Conclusion: Human studies of the neurological/neuropsychological impact of subconcussive blows are currently quite limited. Subconcussive blows, in the short-term, have not been shown to cause significant clinical effects. To date, findings suggest that any effect of subconcussive blows is likely to be small or nonexistent, perhaps evident in a subset of individuals on select measures, and maybe even beneficial in some cases. Longerterm prospective studies are needed to determine if there is a cumulative dose effect. © 2016 Wolters Kluwer Health, Inc.},

keywords = {Balance, cognition, Concussion, mild TBI, neuropsychological, Outcomes, subconcussion},

pubstate = {published},

tppubtype = {article}

}

Sullivan, K A; Kempe, C B; Edmed, S L; Bonanno, G A

Resilience and Other Possible Outcomes After Mild Traumatic Brain Injury: a Systematic Review Journal Article

In: Neuropsychology Review, vol. 26, no. 2, pp. 173–185, 2016.

Abstract | Links | BibTeX | Tags: Concussion, mild traumatic brain injury, Persistent postconcussion symptoms, Resilience

@article{Sullivan2016bb,

title = {Resilience and Other Possible Outcomes After Mild Traumatic Brain Injury: a Systematic Review},

author = {Sullivan, K A and Kempe, C B and Edmed, S L and Bonanno, G A},

doi = {10.1007/s11065-016-9317-1},

year  = {2016},

date = {2016-01-01},

journal = {Neuropsychology Review},

volume = {26},

number = {2},

pages = {173--185},

abstract = {The relation between resilience and mild traumatic brain injury (TBI) outcome has been theorized but empirical studies have been scarce. This systematic review aimed to describe the research in this area. Electronic databases (Medline, CINAHL, PsychINFO, SPORTdiscus, and PILOTS) were searched from inception to August 2015 for studies in which resilience was measured following TBI. The search terms included ‘TBI’ ‘concussion’ ‘postconcussion’ ‘resilience’ and ‘hardiness’. Inclusion criteria were peer reviewed original research reports published in English, human participants aged 18 years and over with brain injury, and an accepted definition of mild TBI. Hand searching of identified articles was also undertaken. Of the 71 studies identified, five studies were accepted for review. These studies were formally assessed for risk of bias by two independent reviewers. Each study carried a risk of bias, most commonly a detection bias, but none were excluded on this basis. A narrative interpretation of the findings was used because the studies reflected fundamental differences in the conceptualization of resilience. No studies employed a trajectory based approach to measure a resilient outcome. In most cases, the eligible studies assessed trait resilience with a scale and used it as a predictor of outcome (postconcussion symptoms). Three of these studies showed that greater trait resilience was associated with better mild TBI outcomes (fewer symptoms). Future research of the adult mild TBI response that predicts a resilient outcome is encouraged. These studies could yield empirical evidence for a resilient, and other possible mild TBI outcomes. © 2016, Springer Science+Business Media New York.},

keywords = {Concussion, mild traumatic brain injury, Persistent postconcussion symptoms, Resilience},

pubstate = {published},

tppubtype = {article}

}

Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G

In: EPMA Journal, vol. 7, no. 1, 2016.

@article{Schulte2016b,

title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},

author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},

doi = {10.1186/s13167-016-0050-x},

year  = {2016},

date = {2016-01-01},

journal = {EPMA Journal},

volume = {7},

number = {1},

abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},

keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},

pubstate = {published},

tppubtype = {article}

}

Cobb, B R; Zadnik, A M; Rowson, S

Comparative analysis of helmeted impact response of Hybrid III and National Operating Committee on Standards for Athletic Equipment headforms Journal Article

In: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology, vol. 230, no. 1, pp. 50–60, 2016.

@article{Cobb2016,

title = {Comparative analysis of helmeted impact response of Hybrid III and National Operating Committee on Standards for Athletic Equipment headforms},

author = {Cobb, B R and Zadnik, A M and Rowson, S},

doi = {10.1177/1754337115599133},

year  = {2016},

date = {2016-01-01},

journal = {Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology},

volume = {230},

number = {1},

pages = {50--60},

abstract = {As advanced helmet testing methodologies are developed, the effect headform selection may have on the biomechanical impact response must be considered. This study sought to assess response differences between two of the most commonly used headforms, the Hybrid III and National Operating Committee on Standards for Athletic Equipment headforms, through a series of helmeted impact tests. A total of 180 pendulum impact tests were conducted with three impactor velocities and six impact locations. Test condition-specific significant differences were found between the two headforms for peak linear and angular accelerations ($alpha$ = 0.05), although differences tended to be small. On average, the National Operating Committee on Standards for Athletic Equipment headform experienced higher peak linear (3.7 ± 7.8%) and angular (12.0 ± 21.6%) accelerations, with some of the largest differences associated with impacts to the facemask. Without the facemask impacts, the average differences in linear (1.8 ± 6.0%) and angular (9.6 ± 15.9%) acceleration would be lower. No significant differences were found in coefficient of variation values for linear (Hybrid III: 2.6 ± 2.3%, National Operating Committee on Standards for Athletic Equipment: 2.0 ± 1.4%) or angular (Hybrid III: 4.9 ± 4.0%; National Operating Committee on Standards for Athletic Equipment: 5.2 ± 5.8%) acceleration. These data have application toward development and validation of future helmet evaluation protocols and standards. © IMechE 2015.},

keywords = {Acceleration, Accident prevention, Angular acceleration, Biomechanics, Brain Injury, Coefficient of variation values, Comparative analysis, Concussion, Equipment, Evaluation protocol, helmet testing, Linear acceleration, Linear accelerations, Rotational acceleration, Safety devices, Sporting goods, standards},

pubstate = {published},

tppubtype = {article}

}

Fineblit, S; Selci, E; Loewen, H; Ellis, M; Russell, K

In: Journal of Neurotrauma, vol. 33, no. 17, pp. 1561–1568, 2016.

Abstract | Links | BibTeX | Tags: Concussion, HRQOL, mTBI

@article{Fineblit2016,

title = {Health-Related Quality of Life after Pediatric Mild Traumatic Brain Injury/Concussion: A Systematic Review},

author = {Fineblit, S and Selci, E and Loewen, H and Ellis, M and Russell, K},

doi = {10.1089/neu.2015.4292},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Neurotrauma},

volume = {33},

number = {17},

pages = {1561--1568},

abstract = {Health-related quality of life (HRQOL) is an emerging method to quantify the consequences of pediatric mild traumatic brain injury (mTBI)/concussion in both clinical practice and research. However, to utilize HRQOL measurements to their full potential in the context of mTBI/concussion recovery, a better understanding of the typical course of HRQOL after these injuries is needed. The objective of this study was to summarize current knowledge on HRQOL after pediatric mTBI/concussion and identify areas in need of further research. The following databases from their earliest date of coverage through June 1, 2015 were used: MEDLINE®, PubMed, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), and Child Development and Adolescent Studies (CDAS). Studies must have examined and reported HRQOL in a pediatric population after mTBI/concussion, using a validated HRQOL measurement tool. Eight of 1660 records identified ultimately met inclusion criteria. Comprehensive data were extracted and checked by a second reviewer for accuracy and completeness. There appears to be a small but important subgroup of patients who experience poor HRQOL outcomes up to a year or longer post-injury. Potential predictors of poor HRQOL include older age, lower socioeconomic status, or a history of headaches or trouble sleeping. Differing definitions of mTBI precluded meta-analysis. HRQOL represents an important outcome measure in mTBI/concussion clinical practice and research. The evidence shows that a small but important proportion of patients have diminished HRQOL up to a year or longer post-injury. Further study on this topic is warranted to determine the typical longitudinal progression of HRQOL after pediatric concussion. © Copyright 2016, Mary Ann Liebert, Inc. 2016.},

keywords = {Concussion, HRQOL, mTBI},

pubstate = {published},

tppubtype = {article}

}

Caccese, J B; Kaminski, T W

Comparing computer-derived and human-observed scores for the Balance Error Scoring System Journal Article

In: Journal of Sport Rehabilitation, vol. 25, no. 2, pp. 133–136, 2016.

Abstract | Links | BibTeX | Tags: Concussion, postural stability, reliability

@article{Caccese2016bb,

title = {Comparing computer-derived and human-observed scores for the Balance Error Scoring System},

author = {Caccese, J B and Kaminski, T W},

doi = {10.1123/jsr.2014-0281},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Sport Rehabilitation},

volume = {25},

number = {2},

pages = {133--136},

abstract = {Context: The Balance Error Scoring System (BESS) is the current standard for assessing postural stability in concussed athletes on the sideline. However, research has questioned the objectivity and validity of the BESS, suggesting that while certain subcategories of the BESS have sufficient reliability to be used in evaluation of postural stability, the total score is not reliable, demonstrating limited interrater and intrarater reliability. Recently, a computerized BESS test was developed to automate scoring. Objective: To compare computerderived BESS scores with those taken from 3 trained human scorers. Design: Interrater reliability study. Setting: Athletic training room. Patients: NCAA Division I student athletes (53 male, 58 female; 19 ± 2 y, 168 ± 41 cm, 69 ± 4 kg). Interventions: Subjects were asked to perform the BESS while standing on the Tekscan (Boston, MA) MobileMat® BESS. The MobileMat BESS software displayed an error score at the end of each trial. Simultaneously, errors were recorded by 3 separate examiners. Errors were counted using the standard BESS scoring criteria. Main Outcome Measures: The number of BESS errors was computed for the 6 stances from the software and each of the 3 human scorers. Interclass correlation coefficients (ICCs) were used to compare errors for each stance scored by the MobileMat BESS software with each of 3 raters individually. The ICC values were converted to Fisher Z scores, averaged, and converted back into ICC values. Results: The double-leg, single-leg, and tandem-firm stances resulted in good agreement with human scorers (ICC = .999, .731, and .648). All foam stances resulted in fair agreement. Conclusions: Our results suggest that the MobileMat BESS is suitable for identifying BESS errors involving each of the 6 stances of the BESS protocol. Because the MobileMat BESS scores consistently and reliably, this system can be used with confidence by clinicians as an effective alternative to scoring the BESS. © 2016 Human Kinetics, Inc.},

keywords = {Concussion, postural stability, reliability},

pubstate = {published},

tppubtype = {article}

}

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