Dillard, C; Ditchman, N; Nersessova, K; Foster, N; Wehman, P; West, M; Riedlinger, B; Monasterio, E; Shaw, B; Neblett, J
Post-concussion symptoms in mild traumatic brain injury: findings from a paediatric outpatient clinic Journal Article
In: Disability & Rehabilitation, vol. 39, no. 6, pp. 544–550, 2017.
Abstract | Links | BibTeX | Tags: Adolescent, brain concussion, Brain Injuries, Child, paediatric hospitals, Post-Concussion Syndrome
@article{Dillard2017,
title = {Post-concussion symptoms in mild traumatic brain injury: findings from a paediatric outpatient clinic},
author = {Dillard, C and Ditchman, N and Nersessova, K and Foster, N and Wehman, P and West, M and Riedlinger, B and Monasterio, E and Shaw, B and Neblett, J},
doi = {10.3109/09638288.2016.1152602},
year = {2017},
date = {2017-01-01},
journal = {Disability \& Rehabilitation},
volume = {39},
number = {6},
pages = {544--550},
abstract = {Purpose Mild traumatic brain injury (mTBI) is common among children and is associated with a range of symptomatology and clinical presentations. This study uses data from a paediatric outpatient TBI clinic to (1) investigate characteristics associated with more severe post-concussive symptoms and (2) examine differences in the proportion of individuals endorsing specific post-concussion symptoms based on group (e.g., sex, type of injury, and psychiatric history). Methods Data from the Children’s Hospital of Richmond’s TBI outpatient programme were analysed (N = 157). Results Gender and sports injury were associated with severity of symptoms. In addition, females endorsed a greater number of overall symptoms than males. A number of specific symptoms were found to be endorsed to a greater extent based on psychiatric history and type of injury; however, overall total number of symptoms endorsed did not differ based on these characteristics. Conclusions Findings from this study provide further evidence that mTBI affects a wide range of youth and that associated symptomatology can indeed be varied. Moreover, results revealed differences in endorsement of specific symptoms and symptom severity based on patient and injury characteristics which have implications for concussion assessment and treatment. Implications for Rehabilitation Symptoms following mild traumatic brain injury (mTBI) in children and adolescents can have varied presentation, ranging from minimal to severe. Females and those with non-sports-related injuries are more likely to endorse greater symptoms following concussion. Symptom evaluation is an essential component of the concussion assessment and treatment of paediatric patients following mTBI, and clinicians should be aware of patient characteristics associated with increased symptoms, especially when baseline symptom data are not available. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {Adolescent, brain concussion, Brain Injuries, Child, paediatric hospitals, Post-Concussion Syndrome},
pubstate = {published},
tppubtype = {article}
}
Hansen, C; Cushman, D; Chen, W; Bounsanga, J; Hung, M
Reliability testing of the balance error scoring system in children between the ages of 5 and 14 Journal Article
In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 64–68, 2017.
Abstract | Links | BibTeX | Tags: brain concussion, Child, pediatrics, Reproducibility of Results, Sports
@article{Hansen2017,
title = {Reliability testing of the balance error scoring system in children between the ages of 5 and 14},
author = {Hansen, C and Cushman, D and Chen, W and Bounsanga, J and Hung, M},
doi = {10.1097/JSM.0000000000000293},
year = {2017},
date = {2017-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {27},
number = {1},
pages = {64--68},
abstract = {Objective: Pediatric concussion is an extensive public health concern with a complex clinical presentation. Balance assessment has been well-studied in the adult population, but has been limited in children. We aimed to assess the reliability and minimum detectable change (MDC) of the Balance Error Scoring System (BESS) in healthy children. Design: This prospective observational study included 373 healthy children aged 5 to 14. Interrater reliability was assessed by having 4 assessors review videos of 50 random subjects distributed evenly by age and sex across the entire cohort. Intrarater reliability was performed by having assessors review videos of other assessors' live evaluations. Test-retest reliability was obtained by comparing BESS scores as recorded live at the 2 separate time points by the same rater. Setting: Local elementary and junior high schools. Participants: Three hundred and seventy three healthy children between the ages of 5 and 14. Interventions: The BESS was performed on all children. Main Outcome Measures: Intraclass Correlation Coefficients (ICCs) and MDC Scores. Results: The overall interrater ICC was determined to be 0.93 [95% confidence interval (CI), 0.79-0.97] and intrarater ICC was 0.96 (95% CI, 0.95-0.97) with individual intrarater ICCs ranging between 0.69 and 0.99. The test-retest reliability was 0.90 (95% CI, 0.88- 0.92). The MDCs were 9.6, 4.6, and 7.3 points at the 95% CIs for interrater, intrarater, and test-retest comparisons, respectively. No learning effect was seen. Conclusions: The BESS demonstrates excellent reliability in the pediatric population without evidence of a learning effect. © 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {brain concussion, Child, pediatrics, Reproducibility of Results, Sports},
pubstate = {published},
tppubtype = {article}
}
Bachynski, K E
Tolerable Risks? Physicians and Youth Tackle Football Journal Article
In: New England Journal of Medicine, vol. 374, no. 5, pp. 405–407, 2016.
BibTeX | Tags: *Athletic Injuries/pc [Prevention & Control], *Brain Concussion/pc [Prevention & Control], *Football/in [Injuries], *Guidelines as Topic, *Physician's Role, *SPORTS medicine, Adolescent, Brain Concussion/et [Etiology], Child, Craniocerebral Trauma/et [Etiology], Craniocerebral Trauma/pc [Prevention & Control], Head Protective Devices, Humans, Medical, pediatrics, Societies, UNITED States
@article{Bachynski2016,
title = {Tolerable Risks? Physicians and Youth Tackle Football},
author = {Bachynski, K E},
year = {2016},
date = {2016-01-01},
journal = {New England Journal of Medicine},
volume = {374},
number = {5},
pages = {405--407},
keywords = {*Athletic Injuries/pc [Prevention \& Control], *Brain Concussion/pc [Prevention \& Control], *Football/in [Injuries], *Guidelines as Topic, *Physician's Role, *SPORTS medicine, Adolescent, Brain Concussion/et [Etiology], Child, Craniocerebral Trauma/et [Etiology], Craniocerebral Trauma/pc [Prevention \& Control], Head Protective Devices, Humans, Medical, pediatrics, Societies, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Hansen, C; Cushman, D; Anderson, N; Chen, W; Cheng, C; Hon, S D; Hung, M
A Normative Dataset of the Balance Error Scoring System in Children Aged between 5 and 14 Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 6, pp. 497–501, 2016.
Abstract | Links | BibTeX | Tags: brain concussion, Child, pediatrics, Reference Values, Sports
@article{Hansen2016,
title = {A Normative Dataset of the Balance Error Scoring System in Children Aged between 5 and 14},
author = {Hansen, C and Cushman, D and Anderson, N and Chen, W and Cheng, C and Hon, S D and Hung, M},
doi = {10.1097/JSM.0000000000000285},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {6},
pages = {497--501},
abstract = {Objective: Pediatric head injuries occur commonly and are being reported in increasing numbers. Balance testing is a key component in the evaluation of suspected concussion, and the balance error scoring system (BESS) is likely the most well-known and widely used measure. To date, normative BESS scores for adults have been reported but not for children. Design: Normative data for BESS scores and modified BESS scores were created in a cohort of healthy children. Potential variables were analyzed as predictors of BESS performance. Setting: Local elementary and junior high schools. Participants: A total of 373 healthy children between the ages of 5 and 14. Interventions: The BESS was performed on all children. Assessment of Risk Factors: Gender, body mass index percentile, previous concussions, athletic participation, age, and the parental opinion of child's balance ability were examined as factors associated with the BESS score. Main Outcome Measures: BESS scores. Results: Normative data are reported, stratified by age groups of 5 to 7 years, 8 to 10 years, and 11 to 14 years of age, for both BESS and modified BESS. Median BESS scores are 23 for children aged 5 to 7, 18 for children aged 8 to 10, and 16 for children aged 11 to 14. Median modified BESS scores are 8 for children age 5 to 7, 5 for children age 8 to 10, and 4 for children age 11 to 14. Increasing age and positive parental opinion regarding their child's balance ability were independently correlated with decreasing BESS scores (P \< 0.01). Conclusions: The normative data on BESS scores for healthy children reported here provide age-stratified reference values for suspected balance alterations. © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {brain concussion, Child, pediatrics, Reference Values, Sports},
pubstate = {published},
tppubtype = {article}
}
Halstead, M E
Pharmacologic Therapies for Pediatric Concussions Journal Article
In: Sports & Health, vol. 8, no. 1, pp. 50–52, 2016.
Abstract | BibTeX | Tags: *Acetaminophen/tu [Therapeutic Use], *Analgesics, *Anti-Inflammatory Agents, *Athletic Injuries/co [Complications], *Brain Concussion/co [Complications], *Post-Traumatic Headache/et [Etiology], 0 (Analgesics, 0 (Anti-Inflammatory Agents, 362O9ITL9D (Acetaminophen), Athletic Injuries/dt [Drug Therapy], Brain Concussion/dt [Drug Therapy], Child, Consensus, Humans, Non-Narcotic), Non-Narcotic/tu [Therapeutic Use], Non-Steroidal), Non-Steroidal/tu [Thera, Physicians'/sn [Statistics & Nu, Post-Traumatic Headache/dt [Drug Therapy], Practice Guidelines as Topic, Practice Patterns, Recovery of Function, Retrospective Studies
@article{Halstead2016,
title = {Pharmacologic Therapies for Pediatric Concussions},
author = {Halstead, M E},
year = {2016},
date = {2016-01-01},
journal = {Sports \& Health},
volume = {8},
number = {1},
pages = {50--52},
abstract = {CONTEXT: Pediatric concussions are common, and emphasis on correct diagnosis and management is stressed in consensus guidelines. Medications may have a role in management of concussion, but no consensus exists regarding appropriate pharmacologic therapy. EVIDENCE ACQUISITION: Nonsystematic review. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: There is limited evidence for hypertonic saline to improve posttraumatic headache in the emergency department setting. There is essentially no evidence for the use of any other medication in management of pediatric sport-related concussion. CONCLUSION: Further research is necessary to determine whether there is benefit to the use of any pharmacotherapy in the management of pediatric-aged athletes with concussions.},
keywords = {*Acetaminophen/tu [Therapeutic Use], *Analgesics, *Anti-Inflammatory Agents, *Athletic Injuries/co [Complications], *Brain Concussion/co [Complications], *Post-Traumatic Headache/et [Etiology], 0 (Analgesics, 0 (Anti-Inflammatory Agents, 362O9ITL9D (Acetaminophen), Athletic Injuries/dt [Drug Therapy], Brain Concussion/dt [Drug Therapy], Child, Consensus, Humans, Non-Narcotic), Non-Narcotic/tu [Therapeutic Use], Non-Steroidal), Non-Steroidal/tu [Thera, Physicians'/sn [Statistics \& Nu, Post-Traumatic Headache/dt [Drug Therapy], Practice Guidelines as Topic, Practice Patterns, Recovery of Function, Retrospective Studies},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Selzer, B J; Geh, N; Srinivasan, D; Strahle, M; Martinez-Sosa, M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with arachnoid cysts Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 410–417, 2016.
Abstract | BibTeX | Tags: *Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male
@article{Strahle2016b,
title = {Sports participation with arachnoid cysts},
author = {Strahle, J and Selzer, B J and Geh, N and Srinivasan, D and Strahle, M and Martinez-Sosa, M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {410--417},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 +/- 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.},
keywords = {*Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
Abstract | BibTeX | Tags: *Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {*Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Geh, N; Selzer, B J; Bower, R; Himedan, M; Strahle, M; Wetjen, N M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with Chiari I malformation Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 403–409, 2016.
Abstract | BibTeX | Tags: *Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool
@article{Strahle2016,
title = {Sports participation with Chiari I malformation},
author = {Strahle, J and Geh, N and Selzer, B J and Bower, R and Himedan, M and Strahle, M and Wetjen, N M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {403--409},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with Chiari I malformation (CM-I). The authors' goal was to define the risk of sports participation for children with the imaging finding of CM-I. METHODS A prospective survey was administered to 503 CM-I patients at 2 sites over a 46-month period. Data were gathered on imaging characteristics, treatment, sports participation, and any sport-related injuries. Additionally, 81 patients completed at least 1 subsequent survey following their initial entry into the registry and were included in a prospective group, with a mean prospective follow-up period of 11 months. RESULTS Of the 503 CM-I patients, 328 participated in sports for a cumulative duration of 4641 seasons; 205 of these patients participated in contact sports. There were no serious or catastrophic neurological injuries. One patient had temporary extremity paresthesias that resolved within hours, and this was not definitely considered to be related to the CM-I. In the prospective cohort, there were no permanent neurological injuries. CONCLUSIONS No permanent or catastrophic neurological injuries were observed in CM-I patients participating in athletic activities. The authors believe that the risk of such injuries is low and that, in most cases, sports participation by children with CM-I is safe.},
keywords = {*Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool},
pubstate = {published},
tppubtype = {article}
}
Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L
Point of health care entry for youth with concussion within a large pediatric care network Journal Article
In: JAMA Pediatr, vol. 170, no. 7, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race
@article{Arbogast2016,
title = {Point of health care entry for youth with concussion within a large pediatric care network},
author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},
doi = {10.1001/jamapediatrics.2016.0294},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {7},
abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},
keywords = {Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race},
pubstate = {published},
tppubtype = {article}
}
O'Kane, J W
Is Heading in Youth Soccer Dangerous Play? Journal Article
In: Physician & Sportsmedicine, vol. 44, no. 2, pp. 190–194, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/et [Etiology], *Brain Injury, *Soccer/in [Injuries], Adolescent, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention & Control], Brain Injuries/pc [Prevention & Control], Brain Injury, Child, Chronic/et [Etiology], Chronic/pc [Prevention & Control], Humans, Risk Factors, UNITED States
@article{OKane2016,
title = {Is Heading in Youth Soccer Dangerous Play?},
author = {O'Kane, J W},
year = {2016},
date = {2016-01-01},
journal = {Physician \& Sportsmedicine},
volume = {44},
number = {2},
pages = {190--194},
abstract = {BACKGROUND: Soccer is among the most popular youth sports with over 3 million youth players registered in the U.S. Soccer is unique in that players intentionally use their head to strike the ball, leading to concerns that heading could cause acute or chronic brain injury, especially in the immature brains of children. METHODS: Pub Med search without date restriction was conducted in November 2014 and August 2015 using the terms soccer and concussion, heading and concussion, and youth soccer and concussion. 310 articles were identified and reviewed for applicable content specifically relating to youth athletes, heading, and/or acute or chronic brain injury from soccer. RESULTS: Soccer is a low-risk sport for catastrophic head injury, but concussions are relatively common and heading often plays a role. At all levels of play, concussions are more likely to occur in the act of heading than with other facets of the game. While concussion from heading the ball without other contact to the head appears rare in adult players, some data suggests children are more susceptible to concussion from heading primarily in game situations. Contributing factors include biomechanical forces, less developed technique, and the immature brain's susceptibility to injury. CONCLUSIONS: There is no evidence that heading in youth soccer causes any permanent brain injury and there is limited evidence that heading in youth soccer can cause concussion. A reasonable approach based on U.S. Youth Soccer recommendations is to teach heading after age 10 in controlled settings, and heading in games should be delayed until skill acquisition and physical maturity allow the youth player to head correctly with confidence.},
keywords = {*Brain Injuries/et [Etiology], *Brain Injury, *Soccer/in [Injuries], Adolescent, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention \& Control], Brain Injuries/pc [Prevention \& Control], Brain Injury, Child, Chronic/et [Etiology], Chronic/pc [Prevention \& Control], Humans, Risk Factors, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Puvenna, V; Engeler, M; Banjara, M; Brennan, C; Schreiber, P; Dadas, A; Bahrami, A; Solanki, J; Bandyopadhyay, A; Morris, J K; Bernick, C; Ghosh, C; Rapp, E; Bazarian, J J; Janigro, D
Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy Journal Article
In: Brain Research, vol. 1630, pp. 225–240, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult
@article{Puvenna2016,
title = {Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy},
author = {Puvenna, V and Engeler, M and Banjara, M and Brennan, C and Schreiber, P and Dadas, A and Bahrami, A and Solanki, J and Bandyopadhyay, A and Morris, J K and Bernick, C and Ghosh, C and Rapp, E and Bazarian, J J and Janigro, D},
year = {2016},
date = {2016-01-01},
journal = {Brain Research},
volume = {1630},
pages = {225--240},
abstract = {Repetitive traumatic brain injury (rTBI) is one of the major risk factors for the abnormal deposition of phosphorylated tau (PT) in the brain and chronic traumatic encephalopathy (CTE). CTE and temporal lobe epilepsy (TLE) affect the limbic system, but no comparative studies on PT distribution in TLE and CTE are available. It is also unclear whether PT pathology results from repeated head hits (rTBI). These gaps prevent a thorough understanding of the pathogenesis and clinical significance of PT, limiting our ability to develop preventative and therapeutic interventions. We quantified PT in TLE and CTE to unveil whether a history of rTBI is a prerequisite for PT accumulation in the brain. Six postmortem CTE (mean 73.3 years) and age matched control samples were compared to 19 surgically resected TLE brain specimens (4 months-58 years; mean 27.6 years). No history of TBI was present in TLE or control; all CTE patients had a history of rTBI. TLE and CTE brain displayed increased levels of PT as revealed by immunohistochemistry. No age-dependent changes were noted, as PT was present as early as 4 months after birth. In TLE and CTE, cortical neurons, perivascular regions around penetrating pial vessels and meninges were immunopositive for PT; white matter tracts also displayed robust expression of extracellular PT organized in bundles parallel to venules. Microscopically, there were extensive tau-immunoreactive neuronal, astrocytic and degenerating neurites throughout the brain. In CTE perivascular tangles were most prominent. Overall, significant differences in staining intensities were found between CTE and control (P\<0.01) but not between CTE and TLE (P=0.08). pS199 tau analysis showed that CTE had the most high molecular weight tangle-associated tau, whereas epileptic brain contained low molecular weight tau. Tau deposition may not be specific to rTBI since TLE recapitulated most of the pathological features of CTE. Copyright © 2015 Elsevier B.V. All rights reserved.},
keywords = {*Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Bressan, S; Babl, F E
Diagnosis and management of paediatric concussion Journal Article
In: Journal of Paediatrics & Child Health, vol. 52, no. 2, pp. 151–157, 2016.
Abstract | Links | BibTeX | Tags: Article, brain concussion, brain injury assessment, Child, child care, childhood injury, chronic brain disease, clinical feature, Concussion, conservative treatment, Glasgow Coma Scale, glial fibrillary acidic protein, human, neuroimaging, neuron specific enolase, patient care, Post Concussive Symptom Scale, post-concussive syndrome, priority journal, protein S100B, Second impact syndrome, Sport Concussion Assessment Tool 3, traumatic brain injury
@article{Bressan2016,
title = {Diagnosis and management of paediatric concussion},
author = {Bressan, S and Babl, F E},
doi = {10.1111/jpc.12967},
year = {2016},
date = {2016-01-01},
journal = {Journal of Paediatrics \& Child Health},
volume = {52},
number = {2},
pages = {151--157},
abstract = {Heightened recognition of concussions and concerns about their sequelae in children has become an increasing community and public health concern. Biomarkers and clinical tests are being explored, but the diagnosis of concussion in the emergency department continues to be based on clinical signs and symptoms. While the majority of children go on to recover from post-concussive symptoms within 2 weeks, it is unclear which patients with concussion will go on to develop short- or long-term sequelae. A number of more or less evidence-based guidelines have become available which seek to guide clinicians on how to manage children post-concussion. In general, care after the emergency department is focused on reducing the risk of re-injury and rest until cerebral recovery with a graduated return to school and then play. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).},
keywords = {Article, brain concussion, brain injury assessment, Child, child care, childhood injury, chronic brain disease, clinical feature, Concussion, conservative treatment, Glasgow Coma Scale, glial fibrillary acidic protein, human, neuroimaging, neuron specific enolase, patient care, Post Concussive Symptom Scale, post-concussive syndrome, priority journal, protein S100B, Second impact syndrome, Sport Concussion Assessment Tool 3, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Bharadwaj, S; Rocker, J
Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management Journal Article
In: Current Opinion in Pediatrics, vol. 28, no. 1, pp. 121–131, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention & Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]
@article{Bharadwaj2016,
title = {Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management},
author = {Bharadwaj, S and Rocker, J},
year = {2016},
date = {2016-01-01},
journal = {Current Opinion in Pediatrics},
volume = {28},
number = {1},
pages = {121--131},
abstract = {PURPOSE OF REVIEW: We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions. RECENT FINDINGS: Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging. New evidence has demonstrated the significant harmful effects of ionizing radiation. Recent studies have risk-stratified patients to identify those at risk of clinically important traumatic brain injury, to minimize the exposure to ionizing radiation for those who are at a low risk of any significant disorder. SUMMARY: Pediatric minor head injury is a common complaint, but the vast majority of those injured will suffer no significant consequences. The Pediatric Emergency Care Applied Research Network has created an algorithm to identify minor head trauma patients who require emergent head CTs versus those at low risk who do not require neuroimaging. Additionally, in recent years there has been an increase in the occurrence of concussions. We describe the characteristics of concussions, appropriate management, and the return-to-play guidelines.},
keywords = {*Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention \& Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]},
pubstate = {published},
tppubtype = {article}
}
Keays, G; Friedman, D; Gagnon, I
A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study Journal Article
In: Clinical Pediatrics, vol. 55, no. 7, pp. 603–613, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States
@article{Keays2016,
title = {A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study},
author = {Keays, G and Friedman, D and Gagnon, I},
doi = {10.1177/0009922815602631},
year = {2016},
date = {2016-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {7},
pages = {603--613},
abstract = {Introduction. Little is known about Canadian youth football injuries. The objectives of this study were (a) to contrast the injuries in Canadian and American football players aged 6 to 17 years and (b) compare the injuries sustained during organized football with those in nonorganized football. Methods. Using a retrospective cohort design based on data from the Canadian Hospitals Injury Reporting and Prevention Program and the National Electronic Injury Surveillance System a comparison of injuries was made. Results. Trends in injuries were comparable. Proportions and odds of injuries were similar, except for a few exceptions. In Canada, more girls were injured and fractures were more prevalent. Compared with nonorganized football, organized football players were older, involved more males, and suffered more traumatic brain injuries and injuries to their lower extremities. Conclusion. Canadian and American youth football injuries were similar. The type of football, be it organized or nonorganized, has an impact on injuries. © 2016 The Author(s).},
keywords = {Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Rogers, L A
Let the Kids Play Football! Journal Article
In: North Carolina Medical Journal, vol. 76, no. 4, pp. 272, 2015.
BibTeX | Tags: *Brain Concussion/et [Etiology], *Brain Concussion/pc [Prevention & Control], *Football/in [Injuries], Adolescent, Child, Humans, UNITED States
@article{Rogers2015b,
title = {Let the Kids Play Football!},
author = {Rogers, L A},
year = {2015},
date = {2015-01-01},
journal = {North Carolina Medical Journal},
volume = {76},
number = {4},
pages = {272},
keywords = {*Brain Concussion/et [Etiology], *Brain Concussion/pc [Prevention \& Control], *Football/in [Injuries], Adolescent, Child, Humans, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Brown, J C; Viljoen, W; Lambert, M I; Readhead, C; Fuller, C; Van Mechelen, W; Verhagen, E
The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments Journal Article
In: Journal of Science & Medicine in Sport, vol. 18, no. 4, pp. 394–399, 2015.
Abstract | Links | BibTeX | Tags: Absenteeism, Adolescent, adult, Article, Athletic Injuries, Back Injuries, biokinetics, bone, Child, competition, Concussion, contusion, Craniocerebral Trauma, economic evaluation, economics, follow up, football, Football/economics, Football/economics/cost analysis, Football/injuries (MeSH terms), fracture, Fractures, head injury, Health, health care cost, Health Care Costs, health insurance, human, Humans, Injuries, injury, injury scale, Insurance, laceration, legal guardian, Lower Extremity, lower limb, major clinical study, Male, MEDICAL care, muscle cramp, muscle strain, Neck Injuries, neck injury, Occupational Therapy, Parent, physical medicine, physiotherapy, radiodiagnosis, rugby, skin bruising, SOUTH Africa, sport injury, Trauma Severity Indices, Upper Extremity, upper limb, Wounds and Injuries
@article{Brown2015b,
title = {The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments},
author = {Brown, J C and Viljoen, W and Lambert, M I and Readhead, C and Fuller, C and {Van Mechelen}, W and Verhagen, E},
doi = {10.1016/j.jsams.2014.06.015},
year = {2015},
date = {2015-01-01},
journal = {Journal of Science \& Medicine in Sport},
volume = {18},
number = {4},
pages = {394--399},
abstract = {Objectives: Rugby Union ("rugby") is a popular sport with high injury risk. Burden of injury is described by the incidence and severity of injury. However reports have ignored the monetary cost of injuries. Therefore the aim of this study was to describe the monetary cost associated with youth rugby injuries. Design: This descriptive study quantified medical treatments of injured players at the South African Rugby Union Youth tournaments in 2011/2012 and the days of work parents missed as a result of the injuries. A health insurer used these data to calculate associated costs. Methods: Legal guardians of the 421 injured players were contacted telephonically on a weekly basis until they returned to play. Treatments costs were estimated in South African Rands based on 2013 insurance rates and converted to US$ using purchasing power parities. Results: Of the 3652 players, 2% (n=71) sought medical care after the tournament. For these players, average treatment costs were high (US$731 per player, 95% CI: US$425-US$1096), with fractures being the most expensive type of injury. Players with medical insurance had higher costs (US$937, 95% CI: US$486-US$1500) than those without (US$220, 95% CI: US$145-US$302). Conclusions: Although a minority of players sought follow-up treatment after the tournaments, the cost of these injuries was high. Players without medical insurance having lower costs may indicate that these players did not receive adequate treatment for their injuries. Injury prevention efforts should consider injuries with high costs and the treatment of players without medical insurance. © 2014 Sports Medicine Australia.},
keywords = {Absenteeism, Adolescent, adult, Article, Athletic Injuries, Back Injuries, biokinetics, bone, Child, competition, Concussion, contusion, Craniocerebral Trauma, economic evaluation, economics, follow up, football, Football/economics, Football/economics/cost analysis, Football/injuries (MeSH terms), fracture, Fractures, head injury, Health, health care cost, Health Care Costs, health insurance, human, Humans, Injuries, injury, injury scale, Insurance, laceration, legal guardian, Lower Extremity, lower limb, major clinical study, Male, MEDICAL care, muscle cramp, muscle strain, Neck Injuries, neck injury, Occupational Therapy, Parent, physical medicine, physiotherapy, radiodiagnosis, rugby, skin bruising, SOUTH Africa, sport injury, Trauma Severity Indices, Upper Extremity, upper limb, Wounds and Injuries},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Ritchie, L J; Koltek, M; Hosain, S; Cordingley, D; Chu, S; Selci, E; Leiter, J; Russell, K
Psychiatric outcomes after pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 6, pp. 709–718, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports
@article{Ellis2015ab,
title = {Psychiatric outcomes after pediatric sports-related concussion},
author = {Ellis, M J and Ritchie, L J and Koltek, M and Hosain, S and Cordingley, D and Chu, S and Selci, E and Leiter, J and Russell, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {6},
pages = {709--718},
abstract = {OBJECT: The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. METHODS: The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. RESULTS: One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes. Interventions for patients with postinjury psychiatric outcomes included pharmacological therapy alone in 2 patients (10%), cognitive behavioral therapy alone in 4 (20%), multimodal therapy in 9 (45%), and no treatment in 5 (25%). Overall, 5 (25%) of the patients with postinjury psychiatric disorders were medically cleared to return to full sports participation, whereas 5 (25%) were lost to follow-up and 9 (45%) remained in treatment by the multidisciplinary concussion program at the end of the study period. One patient who was asymptomatic at the time of initial consultation committed suicide. CONCLUSIONS: Emotional symptoms were commonly reported among pediatric patients with SRC referred to a multidisciplinary pediatric concussion program. In some cases, these symptoms contributed to the development of an NPD, isolated suicidal ideation, and worsening symptoms of a preexisting psychiatric disorder. Future research is needed to clarify the prevalence, pathophysiology, risk factors, and evidence-based management of postinjury psychiatric outcomes after pediatric SRC. Successful management of these patients requires prompt recognition and multidisciplinary care by experts with clinical training and experience in concussion and psychiatry.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports},
pubstate = {published},
tppubtype = {article}
}
Davis, G A; Thurairatnam, S; Feleggakis, P; Anderson, V; Bressan, S; Babl, F E
HeadCheck: A concussion app Journal Article
In: Journal of Paediatrics & Child Health, vol. 51, no. 8, pp. 830–831, 2015.
Links | BibTeX | Tags: Adolescent, algorithm, Athletic Injuries, Australia, brain concussion, checklist, Child, child health care, consensus development, human, Humans, mobile application, Mobile Applications, mobile phone, practice guideline, priority journal, Review, smartphone, sport injury, validation process
@article{Davis2015ab,
title = {HeadCheck: A concussion app},
author = {Davis, G A and Thurairatnam, S and Feleggakis, P and Anderson, V and Bressan, S and Babl, F E},
doi = {10.1111/jpc.12879},
year = {2015},
date = {2015-01-01},
journal = {Journal of Paediatrics \& Child Health},
volume = {51},
number = {8},
pages = {830--831},
keywords = {Adolescent, algorithm, Athletic Injuries, Australia, brain concussion, checklist, Child, child health care, consensus development, human, Humans, mobile application, Mobile Applications, mobile phone, practice guideline, priority journal, Review, smartphone, sport injury, validation process},
pubstate = {published},
tppubtype = {article}
}
Smith, A M; Stuart, M J; Dodick, D W; Roberts, W O; Alford, P W; Ashare, A B; Aubrey, M; Benson, B W; Burke, C J; Dick, R; Eickhoff, C; Emery, C A; Flashman, L A; Gaz, D; Giza, C C; Greenwald, R M; Herring, S; Hoshizaki, T B; Hudziak, J J; Huston 3rd, J; Krause, D; LaVoi, N; Leaf, M; Leddy, J J; MacPherson, A; McKee, A C; Mihalik, J P; Moessner, A M; Montelpare, W J; Putukian, M; Schneider, K J; Szalkowski, R; Tabrum, M; Whitehead, J; Wiese-Bjornstal, D M
Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379] Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 78–87, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/pc [Prevention & Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention & Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention & Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult
@article{Smith2015a,
title = {Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379]},
author = {Smith, A M and Stuart, M J and Dodick, D W and Roberts, W O and Alford, P W and Ashare, A B and Aubrey, M and Benson, B W and Burke, C J and Dick, R and Eickhoff, C and Emery, C A and Flashman, L A and Gaz, D and Giza, C C and Greenwald, R M and Herring, S and Hoshizaki, T B and Hudziak, J J and {Huston 3rd}, J and Krause, D and LaVoi, N and Leaf, M and Leddy, J J and MacPherson, A and McKee, A C and Mihalik, J P and Moessner, A M and Montelpare, W J and Putukian, M and Schneider, K J and Szalkowski, R and Tabrum, M and Whitehead, J and Wiese-Bjornstal, D M},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {78--87},
abstract = {OBJECTIVE: To present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building on the Ice Hockey Summit I action plan (2011) to reduce SRC. METHODS: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October 2013). Summit II focused on (1) Basic Science of Concussions in Ice Hockey: Taking Science Forward; (2) Acute and Chronic Concussion Care: Making a Difference; (3) Preventing Concussions via Behavior, Rules, Education and Measuring Effectiveness; (4) Updates in Equipment: their Relationship to Industry Standards; and (5) Policies and Plans at State, National and Federal Levels to reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were subsequently voted on for purposes of prioritization. The following proceedings include knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. RESULTS: The Summit II evidence-based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. CONCLUSIONS: The highest priority action items identified from the Summit includes the following: (1) eliminate head hits from all levels of ice hockey, (2) change body-checking policies, and (3) eliminate fighting in all amateur and professional hockey.},
keywords = {*Brain Concussion/pc [Prevention \& Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention \& Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention \& Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Tackling in youth football Journal Article
In: Pediatrics, vol. 136, no. 5, pp. e1419–e1430, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, ankle injury, athlete, Athletic Injuries, causal attribution, Child, Concussion, contusion, Craniocerebral Trauma, disease association, football, hand injury, head and neck injury, human, Humans, Injuries, injury severity, knee injury, muscle training, Neck Injuries, Neck muscle, nonhuman, Preschool, preschool child, priority journal, protective equipment, quadriplegia, Review, sport injury, standards, strategic planning
@article{Anonymous2015,
title = {Tackling in youth football},
author = {Anonymous},
doi = {10.1542/peds.2015-3282},
year = {2015},
date = {2015-01-01},
journal = {Pediatrics},
volume = {136},
number = {5},
pages = {e1419--e1430},
abstract = {American football remains one of the most popular sports for young athletes. The injuries sustained during football, especially those to the head and neck, have been a topic of intense interest recently in both the public media and medical literature. The recognition of these injuries and the potential for longterm sequelae have led some physicians to call for a reduction in the number of contact practices, a postponement of tackling until a certain age, and even a ban on high school football. This statement reviews the literature regarding injuries in football, particularly those of the head and neck, the relationship between tackling and football-related injuries, and the potential effects of limiting or delaying tackling on injury risk. © 2015 by the American Academy of Pediatrics.},
keywords = {Adolescent, ankle injury, athlete, Athletic Injuries, causal attribution, Child, Concussion, contusion, Craniocerebral Trauma, disease association, football, hand injury, head and neck injury, human, Humans, Injuries, injury severity, knee injury, muscle training, Neck Injuries, Neck muscle, nonhuman, Preschool, preschool child, priority journal, protective equipment, quadriplegia, Review, sport injury, standards, strategic planning},
pubstate = {published},
tppubtype = {article}
}
Strand, S; Lechuga, D; Zachariah, T; Beaulieu, K
Relative risk for concussions in young female soccer players Journal Article
In: Applied Neuropsychology. Child, vol. 4, no. 1, pp. 58–64, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/ep [Epidemiology], *Soccer/in [Injuries], Adolescent, Case-Control Studies, Child, Female, Humans, Incidence, Risk Factors, United States/ep [Epidemiology]
@article{Strand2015,
title = {Relative risk for concussions in young female soccer players},
author = {Strand, S and Lechuga, D and Zachariah, T and Beaulieu, K},
year = {2015},
date = {2015-01-01},
journal = {Applied Neuropsychology. Child},
volume = {4},
number = {1},
pages = {58--64},
abstract = {The objective of this study was to determine the relative risk and reported symptoms of concussions in 11- to 13-year-old, female soccer players. For this, a survey to compare the reported incidence of concussion in age-matched female soccer players to nonsoccer players was performed. The survey included 342 girls between the ages of 11 and 13: 195 were involved in an organized soccer team and 147 were not involved in organized soccer but were allowed to participate in any other sport or activity. A total of 94 of the 195 soccer players, or 48%, reported at least one symptom consistent with a concussion. The most prevalent symptom for these girls was headache (84%). A total of 34 of the 147 nonsoccer players, or 23%, reported at least one symptom consistent with a concussion in the previous six months. These results determined that the relative risk of probable concussions among 11- to 13-year-old, female soccer players is 2.09 (p \< .001},
keywords = {*Brain Concussion/ep [Epidemiology], *Soccer/in [Injuries], Adolescent, Case-Control Studies, Child, Female, Humans, Incidence, Risk Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K
Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport
@article{Ellis2015,
title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},
author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},
doi = {10.3171/2015.1.PEDS14524},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery: Pediatrics},
volume = {16},
number = {3},
pages = {248--255},
abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},
keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},
pubstate = {published},
tppubtype = {article}
}
Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A
Zipline-related injuries treated in US EDs, 1997-2012 Journal Article
In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.
Abstract | Links | BibTeX | Tags: Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury
@article{Billock2015,
title = {Zipline-related injuries treated in US EDs, 1997-2012},
author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},
doi = {10.1016/j.ajem.2015.08.022},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Emergency Medicine},
volume = {33},
number = {12},
pages = {1745--1749},
abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},
keywords = {Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury},
pubstate = {published},
tppubtype = {article}
}
Little, C E; Emery, C; Black, A; Scott, S H; Meeuwisse, W; Nettel-Aguirre, A; Benson, B; Dukelow, S
Test-retest reliability of KINARM robot sensorimotor and cognitive assessment: in pediatric ice hockey players Journal Article
In: Journal of Neuroengineering & Rehabilitation, vol. 12, pp. 78, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/px [Psychology], *COGNITION, *Hockey/in [Injuries], *Robotics, *Sensation, Adolescent, Biomechanical Phenomena, Brain Concussion/pp [Physiopathology], Child, Computer simulation, Humans, learning, Longitudinal studies, Male, Neuropsychological Tests, Practice (Psychology), Prognosis, Prospective Studies, Psychomotor Performance/ph [Physiology], Reproducibility of Results, treatment outcome
@article{Little2015,
title = {Test-retest reliability of KINARM robot sensorimotor and cognitive assessment: in pediatric ice hockey players},
author = {Little, C E and Emery, C and Black, A and Scott, S H and Meeuwisse, W and Nettel-Aguirre, A and Benson, B and Dukelow, S},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neuroengineering \& Rehabilitation},
volume = {12},
pages = {78},
abstract = {BACKGROUND: Better diagnostic and prognostic tools are needed to address issues related to early diagnosis and management of concussion across the continuum of aging but particularly in children and adolescents. The purpose of the current study was to evaluate the reliability of robotic technology (KINARM robot) assessments of reaching, position sense, bimanual motor function, visuospatial skills, attention and decision making in youth ice hockey players (ages 10-14). METHODS: Thirty-four male children attended two testing days, one week apart. On day one, each subject completed five tasks on the robot with two examiners (alternating examiner sequence); the 2(nd) examiner followed the same procedure as the 1(st) immediately afterwards. One consistent examiner tested subjects one week later. This is a test-retest reliability study. The robotic tasks characterize sensorimotor and/or cognitive performance; 63 parameters from 5 tasks are reported. Session 1 was the 1(st) time the subject performed the 5 tasks, session 2 the 2(nd) time on day 1, and session 3 one week following. RESULTS: Intra-class correlation coefficients ranged from 0.06 to 0.91 and 0.09 to 0.90 for session 1 to 2 and 2 to 3, respectively. Bland-Altman plots showed agreement in a majority of the parameters and a learning effect in 25 % and 24 % of parameters in session 1 vs 2 and 1 vs 3, respectively but none for session 2 vs 3. Of those that showed a learning effect, only 8 % of parameters in session 1 vs 2 and 10 % in session 1 vs 3 had a clinical relevance measure\>0.8. CONCLUSIONS: The relative homogeneity of the sample and the effect of learning seen in some of the task parameters appears to have negatively impacted the intra-class correlation coefficients from session 1 to 2, with less impact for 2 to 3. The Bland-Altman analysis supports good absolute reliability in healthy male children with no neurological impairment ranging in age from 10 to 14. The clinically relevant learning effect seen, in a small number of parameters could be addressed by creating a learning effect adjustment factor and/or implementing a practice session, which would eliminate the learning effect.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/px [Psychology], *COGNITION, *Hockey/in [Injuries], *Robotics, *Sensation, Adolescent, Biomechanical Phenomena, Brain Concussion/pp [Physiopathology], Child, Computer simulation, Humans, learning, Longitudinal studies, Male, Neuropsychological Tests, Practice (Psychology), Prognosis, Prospective Studies, Psychomotor Performance/ph [Physiology], Reproducibility of Results, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Quatman-Yates, C C; Bonnette, S; Hugentobler, J A; Médé, B; Kiefer, A W; Kurowski, B G; Riley, M A
Postconcussion Postural Sway Variability Changes in Youth: The Benefit of Structural Variability Analyses Journal Article
In: Pediatric Physical Therapy, vol. 27, no. 4, pp. 316–327, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, ANALYSIS of variance, brain concussion/diagnosis, brain concussion/physiopathology, Child, female humans, Male, mild traumatic brain injury, postural balance
@article{Quatman-Yates2015,
title = {Postconcussion Postural Sway Variability Changes in Youth: The Benefit of Structural Variability Analyses},
author = {Quatman-Yates, C C and Bonnette, S and Hugentobler, J A and M\'{e}d\'{e}, B and Kiefer, A W and Kurowski, B G and Riley, M A},
doi = {10.1097/PEP.0000000000000193},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Physical Therapy},
volume = {27},
number = {4},
pages = {316--327},
abstract = {Using metrics that permit detailed analysis of sway variability, the authors demonstrate the capacity to detect alterations in postural control among youth who sustained concussion. Purpose: The purpose of this study was to evaluate the utility of postural sway variability as a potential assessment to detect altered postural sway in youth with symptoms related to a concussion. Methods: Forty participants (20 who were healthy and 20 who were injured) aged 10 to 16 years were assessed using the Balance Error Scoring System (BESS) and postural sway variability analyses applied to center-of-pressure data captured using a force plate. Results: Significant differences were observed between the 2 groups for postural sway variability metrics but not for the BESS. Specifically, path length was shorter and Sample and Renyi Entropies were more regular for the participants who were injured compared with the participants who were healthy (P \<.05). Conclusion: The results of this study indicate that postural sway variability may be a more valid measure than the BESS to detect postconcussion alterations in postural control in young athletes. © 2015 Wolters Kluwer Health, Inc.},
keywords = {Adolescent, ANALYSIS of variance, brain concussion/diagnosis, brain concussion/physiopathology, Child, female humans, Male, mild traumatic brain injury, postural balance},
pubstate = {published},
tppubtype = {article}
}
Freitag, A; Kirkwood, G; Scharer, S; Ofori-Asenso, R; Pollock, A M
Systematic review of rugby injuries in children and adolescents under 21 years Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 511–519, 2015.
Abstract | BibTeX | Tags: *Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult
@article{Freitag2015a,
title = {Systematic review of rugby injuries in children and adolescents under 21 years},
author = {Freitag, A and Kirkwood, G and Scharer, S and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {511--519},
abstract = {A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {*Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K
Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article
In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends
@article{Vassilyadi2015,
title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},
author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},
doi = {10.1159/000431232},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Neurosurgery},
volume = {50},
number = {4},
pages = {196--203},
abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},
keywords = {Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends},
pubstate = {published},
tppubtype = {article}
}
Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S
Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article
In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed
@article{Morgan2015,
title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},
author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},
doi = {10.1007/s00381-015-2916-y},
year = {2015},
date = {2015-01-01},
journal = {Child's Nervous System},
volume = {31},
number = {12},
pages = {2305--2309},
abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},
keywords = {Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M
Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.
Abstract | Links | BibTeX | Tags: academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome
@article{Alexander2015,
title = {Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes},
author = {Alexander, D G and Shuttleworth-Edwards, A B and Kidd, M and Malcolm, C M},
doi = {10.3109/02699052.2015.1031699},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1113--1125},
abstract = {Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby. © 2015 Taylor \& Francis Group, LLC.},
keywords = {academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Leiter, J; Hall, T; McDonald, P J; Sawyer, S; Silver, N; Bunge, M; Essig, M
Neuroimaging findings in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 3, pp. 241–247, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed
@article{Ellis2015b,
title = {Neuroimaging findings in pediatric sports-related concussion},
author = {Ellis, M J and Leiter, J and Hall, T and McDonald, P J and Sawyer, S and Silver, N and Bunge, M and Essig, M},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {3},
pages = {241--247},
abstract = {OBJECT: The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. METHODS: The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age \< 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. RESULTS: A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). CONCLUSIONS: Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide information that impacts decision making about return to play and retirement from the sport.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
De Matteo, C; Volterman, K A; Breithaupt, P G; Claridge, E A; Adamich, J; Timmons, B W
Exertion testing in youth with mild traumatic brain injury/concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors
@article{DeMatteo2015,
title = {Exertion testing in youth with mild traumatic brain injury/concussion},
author = {{De Matteo}, C and Volterman, K A and Breithaupt, P G and Claridge, E A and Adamich, J and Timmons, B W},
doi = {10.1249/MSS.0000000000000682},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results Participants had a mean ± SD symptom duration of 6.3 ± 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. © 2015 by the American College of Sports Medicine.},
keywords = {Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Biederman, J; Feinberg, L; Chan, J; Adeyemo, B O; Woodworth, K Y; Panis, W; McGrath, N; Bhatnagar, S; Spencer, T J; Uchida, M; Kenworthy, T; Grossman, R; Zafonte, R; Faraone, S V
Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes Journal Article
In: Journal of Nervous & Mental Disease, vol. 203, no. 11, pp. 813–819, 2015.
Abstract | BibTeX | Tags: *Athletes, *Athletic Injuries/ep [Epidemiology], *Attention Deficit Disorder with Hyperactivity/ep, *Brain Injuries/ep [Epidemiology], *Students, Adolescent, adult, Athletic Injuries/di [Diagnosis], Attention Deficit Disorder with Hyperactivity/di [, Brain Injuries/di [Diagnosis], Child, Female, Humans, Male, Risk Factors, Young Adult
@article{Biederman2015,
title = {Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes},
author = {Biederman, J and Feinberg, L and Chan, J and Adeyemo, B O and Woodworth, K Y and Panis, W and McGrath, N and Bhatnagar, S and Spencer, T J and Uchida, M and Kenworthy, T and Grossman, R and Zafonte, R and Faraone, S V},
year = {2015},
date = {2015-01-01},
journal = {Journal of Nervous \& Mental Disease},
volume = {203},
number = {11},
pages = {813--819},
abstract = {A recent meta-analysis documented a significant statistical association between mild traumatic brain injury (mTBI) and attention deficit hyperactivity disorder (ADHD) (Adeyemo et al., 2014), but the direction of this effect was unclear. In this study, we hypothesized that ADHD would be an antecedent risk factor for mTBI. Participants were student athletes ages 12 to 25 who had sustained a mTBI and Controls of similar age and sex selected from studies of youth with and without ADHD. Subjects were assessed for symptoms of ADHD, concussion severity, and cognitive function. mTBI subjects had a significantly higher rate of ADHD than Controls, and in all cases the age of onset of ADHD was before mTBI onset. mTBI+ADHD subjects also had more severe concussion symptoms (fatigue and poor concentration) than mTBI-ADHD subjects. These results support ADHD as an antecedent risk factor for mTBI in student athletes and that its presence complicates the course of mTBI.},
keywords = {*Athletes, *Athletic Injuries/ep [Epidemiology], *Attention Deficit Disorder with Hyperactivity/ep, *Brain Injuries/ep [Epidemiology], *Students, Adolescent, adult, Athletic Injuries/di [Diagnosis], Attention Deficit Disorder with Hyperactivity/di [, Brain Injuries/di [Diagnosis], Child, Female, Humans, Male, Risk Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Davis, J; Canty, G
Are Sports-Related Concussions Giving You a Headache? Journal Article
In: Missouri Medicine, vol. 112, no. 3, pp. 187–191, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/di [Diagnosis], *Brain Concussion/th [Therapy], Adolescent, Brain Concussion/et [Etiology], Child, DIAGNOSTIC imaging, Emergency Medicine, Humans, Neuropsychological Tests, Patient Education as Topic
@article{Davis2015,
title = {Are Sports-Related Concussions Giving You a Headache?},
author = {Davis, J and Canty, G},
year = {2015},
date = {2015-01-01},
journal = {Missouri Medicine},
volume = {112},
number = {3},
pages = {187--191},
abstract = {Acute care visits for sports-related concussion (SRC) are increasing dramatically in adolescents. This review summarizes current concepts in the evaluation and management of pediatric SRC by health care providers in the acute care setting.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/di [Diagnosis], *Brain Concussion/th [Therapy], Adolescent, Brain Concussion/et [Etiology], Child, DIAGNOSTIC imaging, Emergency Medicine, Humans, Neuropsychological Tests, Patient Education as Topic},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
Abstract | BibTeX | Tags: Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness},
pubstate = {published},
tppubtype = {article}
}
Buzas, David; Jacobson, Nathan A; Morawa, Lawrence G
Concussions From 9 Youth Organized Sports: Results From NEISS Hospitals Over an 11-Year Time Frame, 2002-2012 Journal Article
In: Orthopaedic Journal of Sports Medicine, pp. 1–8, 2014.
Links | BibTeX | Tags: ADOLESCENCE, Adolescent Health, Age Factors, Athletic Injuries -- Epidemiology -- In Infancy an, Baseball, BASKETBALL, Brain Concussion -- Epidemiology -- In Infancy and, Child, Child Health, Data Analysis Software, descriptive research, DESCRIPTIVE statistics, Disease Surveillance, emergency care, Epidemiological Research, Female, football, Gymnastics, Hockey, human, Male, MICHIGAN, Pearson's Correlation Coefficient, Preschool, Prospective Studies, Racquet Sports, Soccer, unconsciousness, UNITED States, wrestling
@article{Buzas2014,
title = {Concussions From 9 Youth Organized Sports: Results From NEISS Hospitals Over an 11-Year Time Frame, 2002-2012},
author = {Buzas, David and Jacobson, Nathan A and Morawa, Lawrence G},
doi = {10.1177/2325967114528460},
year = {2014},
date = {2014-01-01},
journal = {Orthopaedic Journal of Sports Medicine},
pages = {1--8},
publisher = {Sage Publications Inc.},
address = {Thousand Oaks, California},
keywords = {ADOLESCENCE, Adolescent Health, Age Factors, Athletic Injuries -- Epidemiology -- In Infancy an, Baseball, BASKETBALL, Brain Concussion -- Epidemiology -- In Infancy and, Child, Child Health, Data Analysis Software, descriptive research, DESCRIPTIVE statistics, Disease Surveillance, emergency care, Epidemiological Research, Female, football, Gymnastics, Hockey, human, Male, MICHIGAN, Pearson's Correlation Coefficient, Preschool, Prospective Studies, Racquet Sports, Soccer, unconsciousness, UNITED States, wrestling},
pubstate = {published},
tppubtype = {article}
}
Crowley, P J; Crowley, M J
Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme Journal Article
In: British Journal of Sports Medicine, vol. 48, no. 2, pp. 147–150, 2014.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], *Track and Field/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention & Control], Attitudes, Child, Craniocerebral Trauma/ep [Epidemiology], Data Collection, Equipment Design, Health Knowledge, Health Policy, Health Promotion/og [Organization & Administration, Humans, Ireland/ep [Epidemiology], Practice, Risk Reduction Behavior, Track and Field/lj [Legislation & Jurisprudence], Track and Field/sn [Statistics & Numerical Data], Young Adult
@article{Crowley2014,
title = {Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme},
author = {Crowley, P J and Crowley, M J},
year = {2014},
date = {2014-01-01},
journal = {British Journal of Sports Medicine},
volume = {48},
number = {2},
pages = {147--150},
abstract = {BACKGROUND: Major head injuries are not uncommon in the Irish national game of hurling. Historically, helmets were not worn. METHODS: We report a multistage campaign to facilitate and encourage the use of appropriate headgear among the estimated 100 000 hurling players in Ireland. This campaign lasted for 27 years between 1985 and 2012, and involved a number of different stages including: (1) facilitating the establishment of a business dedicated to developing head protection equipment suitable for hurling, (2) placing a particular emphasis on continual product enhancement to the highest industrial standards, (3) engaging continually with the game's controlling body, the Gaelic Athletic Association (GAA), with the ultimate objective of securing a mandatory usage policy for protective helmets and faceguards, (4) longitudinal research to monitor hurling injury, equipment usage and players' attitudes and (5) widely communicating key research findings to GAA leaders and members, as well as to 1000 clubs and schools. RESULTS: One of our three relevant studies included 798 patients and identified a dramatic association between the type of head protection used by a player, if any, and the site of the injury requiring treatment. While 51% of the injured players without head protection suffered head trauma, this rate was only 35% among the players wearing helmets and 5% among players who were wearing full head protection (both a helmet and faceguard). CONCLUSION: The GAA responded in three stages to the accumulating evidence: (1) they introduced a mandatory regulation for those aged less than 18 years in 2005; (2) this ruling was extended to all players under 21 years in 2007 and (3) finally extended to all players irrespective of age, gender or grade from January 2010. The latter ruling applied to both games and organised training sessions.},
keywords = {*Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], *Track and Field/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention \& Control], Attitudes, Child, Craniocerebral Trauma/ep [Epidemiology], Data Collection, Equipment Design, Health Knowledge, Health Policy, Health Promotion/og [Organization \& Administration, Humans, Ireland/ep [Epidemiology], Practice, Risk Reduction Behavior, Track and Field/lj [Legislation \& Jurisprudence], Track and Field/sn [Statistics \& Numerical Data], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Zuckerman, Scott L; Lee, Young M; Odom, Mitchell J; Solomon, Gary S; Sills, Allen K
Baseline neurocognitive scores in athletes with attention deficit-spectrum disorders and/or learning disability Journal Article
In: Journal of Neurosurgery: Pediatrics, vol. 12, no. 2, pp. 103–109, 2013, ISBN: 1933-0707.
Links | BibTeX | Tags: ADOLESCENCE, Athletes, Athletic Injuries -- Complications, attention, Attention Deficit Hyperactivity Disorder -- Compli, Brain Concussion -- Complications, Brain Concussion -- Diagnosis, Brain Concussion -- Psychosocial Factors, Child, cognition, Cognition Disorders -- Diagnosis, Cognition Disorders -- Etiology, Female, human, Learning Disorders -- Complications, Male, Memory, Neuropsychological Tests, reaction time, Severity of Illness Indices, Sports
@article{Zuckerman2013,
title = {Baseline neurocognitive scores in athletes with attention deficit-spectrum disorders and/or learning disability},
author = {Zuckerman, Scott L and Lee, Young M and Odom, Mitchell J and Solomon, Gary S and Sills, Allen K},
doi = {10.3171/2013.5.PEDS12524},
isbn = {1933-0707},
year = {2013},
date = {2013-01-01},
journal = {Journal of Neurosurgery: Pediatrics},
volume = {12},
number = {2},
pages = {103--109},
publisher = {American Association of Neurological Surgeons \& the Journal of Neurosurgical Publishing Group},
address = {Rolling Meadows, Illinois},
keywords = {ADOLESCENCE, Athletes, Athletic Injuries -- Complications, attention, Attention Deficit Hyperactivity Disorder -- Compli, Brain Concussion -- Complications, Brain Concussion -- Diagnosis, Brain Concussion -- Psychosocial Factors, Child, cognition, Cognition Disorders -- Diagnosis, Cognition Disorders -- Etiology, Female, human, Learning Disorders -- Complications, Male, Memory, Neuropsychological Tests, reaction time, Severity of Illness Indices, Sports},
pubstate = {published},
tppubtype = {article}
}
Gaslin, Tracey C
Information and updates on concussion evaluation and management Journal Article
In: CompassPoint, vol. 23, no. 2, pp. 6–7, 2013.
Abstract | BibTeX | Tags: American Academy of Nursing, Brain Concussion -- Diagnosis -- In Infancy and Ch, Brain Concussion -- Therapy -- In Infancy and Chil, Camp Nursing, Child, Practice Guidelines
@article{Gaslin2013,
title = {Information and updates on concussion evaluation and management},
author = {Gaslin, Tracey C},
year = {2013},
date = {2013-01-01},
journal = {CompassPoint},
volume = {23},
number = {2},
pages = {6--7},
publisher = {Association of Camp Nurses},
address = {Fisherville, Kentucky},
abstract = {The potential for concussions is a possibility for all camp professionals. Knowing what, when, and who are part of your concussion management plan are an important elements to consider. This article briefly outlines the updates to concussion care and reaffirms the need for a proactive and comprehensive approach to evaluation and management.},
keywords = {American Academy of Nursing, Brain Concussion -- Diagnosis -- In Infancy and Ch, Brain Concussion -- Therapy -- In Infancy and Chil, Camp Nursing, Child, Practice Guidelines},
pubstate = {published},
tppubtype = {article}
}
Schupp, Christian M; Bedgood, Alysia
Sideline management from head to toe of the skeletally immature athlete Journal Article
In: Current Sports Medicine Reports, vol. 12, no. 3, pp. 162–169, 2013, ISBN: 1537-890X.
Links | BibTeX | Tags: ADOLESCENCE, Athletic Injuries -- Diagnosis, Athletic Injuries -- Therapy, Bone Development, Brain Concussion -- Diagnosis, Brain Concussion -- Therapy, Child, Fractures -- Diagnosis, Fractures -- Therapy, Preschool, Sports Medicine -- Methods, Young Adult
@article{Schupp2013,
title = {Sideline management from head to toe of the skeletally immature athlete},
author = {Schupp, Christian M and Bedgood, Alysia},
doi = {10.1249/JSR.0b013e3182913cac},
isbn = {1537-890X},
year = {2013},
date = {2013-01-01},
journal = {Current Sports Medicine Reports},
volume = {12},
number = {3},
pages = {162--169},
keywords = {ADOLESCENCE, Athletic Injuries -- Diagnosis, Athletic Injuries -- Therapy, Bone Development, Brain Concussion -- Diagnosis, Brain Concussion -- Therapy, Child, Fractures -- Diagnosis, Fractures -- Therapy, Preschool, Sports Medicine -- Methods, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Concussion in sport: fair play for young people Journal Article
In: Lancet, vol. 382, no. 9904, pp. 1536, 2013.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Adolescent, Athletic Injuries/et [Etiology], Brain Concussion/et [Etiology], Child, Humans, Preschool, Risk Factors, Sports, Young Adult
@article{Anonymous2013,
title = {Concussion in sport: fair play for young people},
author = {Anonymous},
year = {2013},
date = {2013-01-01},
journal = {Lancet},
volume = {382},
number = {9904},
pages = {1536},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Adolescent, Athletic Injuries/et [Etiology], Brain Concussion/et [Etiology], Child, Humans, Preschool, Risk Factors, Sports, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Barlow, Michael; Schlabach, Drew; Peiffer, Jeffrey; Cook, Chad
Differences in change scores and the predictive validity of three commonly used measures following concussion in the middle school and high school aged population...[corrected] [published erratum appears in INT J SPORTS PHYS THER 2011; 6(4):1p] Journal Article
In: International Journal of Sports Physical Therapy, vol. 6, no. 3, pp. 150–157, 2011, ISBN: 2159-2896.
Abstract | BibTeX | Tags: ADOLESCENCE, adult, Brain Concussion -- Diagnosis, Child, Data Analysis Software, Disability Evaluation, Female, human, Instrument Validation, Male, Middle, Ohio, Postconcussion Syndrome -- Risk Factors, Predictive Value of Tests, Record Review, Recovery, Retrospective Design, ROC Curve, Scales, Schools, Secondary, validity
@article{Barlow2011,
title = {Differences in change scores and the predictive validity of three commonly used measures following concussion in the middle school and high school aged population...[corrected] [published erratum appears in INT J SPORTS PHYS THER 2011; 6(4):1p]},
author = {Barlow, Michael and Schlabach, Drew and Peiffer, Jeffrey and Cook, Chad},
isbn = {2159-2896},
year = {2011},
date = {2011-01-01},
journal = {International Journal of Sports Physical Therapy},
volume = {6},
number = {3},
pages = {150--157},
publisher = {North American Journal of Sports Physical Therapy},
address = {Indianapolis, Indiana},
abstract = {Background: A battery of tests is commonly used to measure disability with and recovery from concussion. A number of different concussion-oriented assessment tests exist and each is considered useful. To the authors' knowledge, no study has compared the scores of these tests during recovery in the middle school and high school aged population to see how each change over time. Purpose: The purposes of this study were to analyze clinical data of concussed middle school and high school aged athletes to determine the concurrent and predictive validity for post-concussion syndrome (PCS) of the Post-Concussion Symptom Scale (PCSS), Balance Error Scoring System (BESS), and the five subscales of the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Methods: The study was a retrospective chart review performed on middle school and high school aged individuals with a diagnosis of concussion from the years 2008-2010 within the Akron Children's Hospital Sports Medicine system. To be eligible for inclusion in the dataset, each subject required a baseline measurement for each of the three tests (and all five subscales of the ImPACT) and a post-test measure. The mean age of the population was 15.38 years (SD=1.7) and ranged from 11 to 19 years. Pearson product correlation tests (correlation matrix) were used to analyze the concurrent validity of the test items during recovery following a concussion. Receiver operating characteristics (ROC) curves were used to determine the predictive validity of initial scores for developing PCS. Results: The correlation matrix captured five statistically significant findings; however, these suggested only weak to mild correlations. Five test items yielded an area under the curve (AUC) greater than 0.50 but only one was statistically significant. After qualitative evaluation, only one of the three tests (including the five subscales of the ImPACT) was useful in predicting post-concussion syndrome. Conclusion: This study suggests that there is poor concurrent validity among three commonly used concussion tests and there is no baseline score that predicts whether post-concussion syndrome will occur.},
keywords = {ADOLESCENCE, adult, Brain Concussion -- Diagnosis, Child, Data Analysis Software, Disability Evaluation, Female, human, Instrument Validation, Male, Middle, Ohio, Postconcussion Syndrome -- Risk Factors, Predictive Value of Tests, Record Review, Recovery, Retrospective Design, ROC Curve, Scales, Schools, Secondary, validity},
pubstate = {published},
tppubtype = {article}
}
for Disease Control, Centers; Prevention,
Nonfatal traumatic brain injuries from sports and recreation activities--United States, 2001-2005 Journal Article
In: MMWR - Morbidity & Mortality Weekly Report, vol. 56, no. 29, pp. 733–737, 2007.
Abstract | BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Injuries/ep [Epidemiology], Adolescent, adult, Child, Chronic traumatic encephalopathy, Female, Humans, Incidence/Epidemiology, Infant, Male, middle aged, Population Surveillance, Preschool, recreation, United States/ep [Epidemiology]
@article{CentersforDiseaseControlandPrevention2007,
title = {Nonfatal traumatic brain injuries from sports and recreation activities--United States, 2001-2005},
author = {{Centers for Disease Control and Prevention}},
year = {2007},
date = {2007-01-01},
journal = {MMWR - Morbidity \& Mortality Weekly Report},
volume = {56},
number = {29},
pages = {733--737},
abstract = {Each year in the United States, an estimated 38 million children and adolescents participate in organized sports, and approximately 170 million adults participate in some type of physical activity not related to work. The health benefits of these activities are tempered by the risk for injury, including traumatic brain injury (TBI). CDC estimates that 1.1 million persons with TBIs are treated and released from U.S. hospital emergency departments (EDs) each year, and an additional 235,000 are hospitalized for these injuries. TBIs can result in long-term, negative health effects (e.g., memory loss and behavioral changes). To characterize sports- and recreation-related (SR-related) TBIs among patients treated in U.S. hospital EDs, CDC analyzed data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for the period 2001-2005. This report summarizes the results of that analysis, which indicated that an estimated 207,830 patients with nonfatal SR-related TBIs were treated in EDs each year during this period. The highest rates of SR-related TBI ED visits for both males and females occurred among those aged 10-14 years. Increased awareness of TBI risks, prevention strategies, and the importance of timely identification and management is essential for reducing the incidence, severity, and long-term negative health effects of this type of injury.},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Injuries/ep [Epidemiology], Adolescent, adult, Child, Chronic traumatic encephalopathy, Female, Humans, Incidence/Epidemiology, Infant, Male, middle aged, Population Surveillance, Preschool, recreation, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Kerr, J; Swann, I J; Pentland, B
A survey of information given to head-injured patients on direct discharge from emergency departments in Scotland Journal Article
In: Emergency Medicine Journal, vol. 24, no. 5, pp. 330–332, 2007, ISBN: 1472-0205.
Abstract | Links | BibTeX | Tags: adult, Child, Emergency Service, Head Injuries, human, Pamphlets, Patient Discharge Education -- Evaluation, postconcussion syndrome, Scotland
@article{Kerr2007,
title = {A survey of information given to head-injured patients on direct discharge from emergency departments in Scotland},
author = {Kerr, J and Swann, I J and Pentland, B},
doi = {10.1136/emj.2006.044230},
isbn = {1472-0205},
year = {2007},
date = {2007-01-01},
journal = {Emergency Medicine Journal},
volume = {24},
number = {5},
pages = {330--332},
publisher = {BMJ Publishing Group},
abstract = {AIM: To survey the information provided to head-injured patients on discharge from emergency departments (EDs) in Scotland. METHODS: EDs throughout Scotland were asked to supply a copy of their head injury advice pamphlet for analysis. Each pamphlet was assessed against a template and an Excel spreadsheet was created. RESULTS: All 30 (100%) Scottish EDs responded. The frequency with which specific features appeared varied widely, with most pamphlets concentrating on emergency features, with less emphasis on postconcussion symptoms. CONCLUSIONS: Head injury discharge advice should be standardised throughout EDs, with more emphasis given to postconcussion features.},
keywords = {adult, Child, Emergency Service, Head Injuries, human, Pamphlets, Patient Discharge Education -- Evaluation, postconcussion syndrome, Scotland},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A K; To, T M; Macarthur, C; Chipman, M L; Wright, J G; Parkin, P C
Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study Journal Article
In: Pediatrics, vol. 110, no. 5, pp. e60, 2002.
Abstract | BibTeX | Tags: *Bicycling/in [Injuries], *Bicycling/lj [Legislation & Jurisprudence], *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics & Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics & Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics & Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics & Numerical Data, Trauma Severity Indices
@article{Macpherson2002,
title = {Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study},
author = {Macpherson, A K and To, T M and Macarthur, C and Chipman, M L and Wright, J G and Parkin, P C},
year = {2002},
date = {2002-01-01},
journal = {Pediatrics},
volume = {110},
number = {5},
pages = {e60},
abstract = {OBJECTIVE: Childhood bicycle-related head injuries can be prevented through the use of helmets. Although helmet legislation has proved to be a successful strategy for the adoption of helmets, its effect on the rates of head injury is uncertain. In Canada, 4 provinces have such legislation. The objective of this study was to measure the impact of helmet legislation on bicycle-related head injuries in Canadian children. METHODS: Routinely collected data from the Canadian Institute for Health Information identified all Canadian children (5-19 years) who were hospitalized for bicycling-related injuries from 1994-1998. Children were categorized as head or other injury on the basis of International Classification of Diseases, Ninth Revision, codes. Rates of head injuries and other injuries were compared over time in provinces that adopted legislation and those that did not. RESULTS: Of the 9650 children who were hospitalized because of a bicycle-related injury, 3426 sustained injuries to the head and face and the remaining 6224 had other injuries. The bicycle-related head injury rate declined significantly (45% reduction) in provinces where legislation had been adopted compared with provinces and territories that did not adopt legislation (27% reduction). CONCLUSION: This country-wide study compared rates of head injury in regions with and without mandatory helmet legislation. Comparing head injuries with other non-head-injured children controlled for potential differences in children's cycling habits. The strong protective association between helmet legislation and head injuries supports the adoption of helmet legislation as an effective tool in the prevention of childhood bicycle-related head injuries.},
keywords = {*Bicycling/in [Injuries], *Bicycling/lj [Legislation \& Jurisprudence], *Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics \& Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics \& Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics \& Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics \& Numerical Data, Trauma Severity Indices},
pubstate = {published},
tppubtype = {article}
}
Dillard, C; Ditchman, N; Nersessova, K; Foster, N; Wehman, P; West, M; Riedlinger, B; Monasterio, E; Shaw, B; Neblett, J
Post-concussion symptoms in mild traumatic brain injury: findings from a paediatric outpatient clinic Journal Article
In: Disability & Rehabilitation, vol. 39, no. 6, pp. 544–550, 2017.
@article{Dillard2017,
title = {Post-concussion symptoms in mild traumatic brain injury: findings from a paediatric outpatient clinic},
author = {Dillard, C and Ditchman, N and Nersessova, K and Foster, N and Wehman, P and West, M and Riedlinger, B and Monasterio, E and Shaw, B and Neblett, J},
doi = {10.3109/09638288.2016.1152602},
year = {2017},
date = {2017-01-01},
journal = {Disability \& Rehabilitation},
volume = {39},
number = {6},
pages = {544--550},
abstract = {Purpose Mild traumatic brain injury (mTBI) is common among children and is associated with a range of symptomatology and clinical presentations. This study uses data from a paediatric outpatient TBI clinic to (1) investigate characteristics associated with more severe post-concussive symptoms and (2) examine differences in the proportion of individuals endorsing specific post-concussion symptoms based on group (e.g., sex, type of injury, and psychiatric history). Methods Data from the Children’s Hospital of Richmond’s TBI outpatient programme were analysed (N = 157). Results Gender and sports injury were associated with severity of symptoms. In addition, females endorsed a greater number of overall symptoms than males. A number of specific symptoms were found to be endorsed to a greater extent based on psychiatric history and type of injury; however, overall total number of symptoms endorsed did not differ based on these characteristics. Conclusions Findings from this study provide further evidence that mTBI affects a wide range of youth and that associated symptomatology can indeed be varied. Moreover, results revealed differences in endorsement of specific symptoms and symptom severity based on patient and injury characteristics which have implications for concussion assessment and treatment. Implications for Rehabilitation Symptoms following mild traumatic brain injury (mTBI) in children and adolescents can have varied presentation, ranging from minimal to severe. Females and those with non-sports-related injuries are more likely to endorse greater symptoms following concussion. Symptom evaluation is an essential component of the concussion assessment and treatment of paediatric patients following mTBI, and clinicians should be aware of patient characteristics associated with increased symptoms, especially when baseline symptom data are not available. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hansen, C; Cushman, D; Chen, W; Bounsanga, J; Hung, M
Reliability testing of the balance error scoring system in children between the ages of 5 and 14 Journal Article
In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 64–68, 2017.
@article{Hansen2017,
title = {Reliability testing of the balance error scoring system in children between the ages of 5 and 14},
author = {Hansen, C and Cushman, D and Chen, W and Bounsanga, J and Hung, M},
doi = {10.1097/JSM.0000000000000293},
year = {2017},
date = {2017-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {27},
number = {1},
pages = {64--68},
abstract = {Objective: Pediatric concussion is an extensive public health concern with a complex clinical presentation. Balance assessment has been well-studied in the adult population, but has been limited in children. We aimed to assess the reliability and minimum detectable change (MDC) of the Balance Error Scoring System (BESS) in healthy children. Design: This prospective observational study included 373 healthy children aged 5 to 14. Interrater reliability was assessed by having 4 assessors review videos of 50 random subjects distributed evenly by age and sex across the entire cohort. Intrarater reliability was performed by having assessors review videos of other assessors' live evaluations. Test-retest reliability was obtained by comparing BESS scores as recorded live at the 2 separate time points by the same rater. Setting: Local elementary and junior high schools. Participants: Three hundred and seventy three healthy children between the ages of 5 and 14. Interventions: The BESS was performed on all children. Main Outcome Measures: Intraclass Correlation Coefficients (ICCs) and MDC Scores. Results: The overall interrater ICC was determined to be 0.93 [95% confidence interval (CI), 0.79-0.97] and intrarater ICC was 0.96 (95% CI, 0.95-0.97) with individual intrarater ICCs ranging between 0.69 and 0.99. The test-retest reliability was 0.90 (95% CI, 0.88- 0.92). The MDCs were 9.6, 4.6, and 7.3 points at the 95% CIs for interrater, intrarater, and test-retest comparisons, respectively. No learning effect was seen. Conclusions: The BESS demonstrates excellent reliability in the pediatric population without evidence of a learning effect. © 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bachynski, K E
Tolerable Risks? Physicians and Youth Tackle Football Journal Article
In: New England Journal of Medicine, vol. 374, no. 5, pp. 405–407, 2016.
@article{Bachynski2016,
title = {Tolerable Risks? Physicians and Youth Tackle Football},
author = {Bachynski, K E},
year = {2016},
date = {2016-01-01},
journal = {New England Journal of Medicine},
volume = {374},
number = {5},
pages = {405--407},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Halstead, M E
Pharmacologic Therapies for Pediatric Concussions Journal Article
In: Sports & Health, vol. 8, no. 1, pp. 50–52, 2016.
@article{Halstead2016,
title = {Pharmacologic Therapies for Pediatric Concussions},
author = {Halstead, M E},
year = {2016},
date = {2016-01-01},
journal = {Sports \& Health},
volume = {8},
number = {1},
pages = {50--52},
abstract = {CONTEXT: Pediatric concussions are common, and emphasis on correct diagnosis and management is stressed in consensus guidelines. Medications may have a role in management of concussion, but no consensus exists regarding appropriate pharmacologic therapy. EVIDENCE ACQUISITION: Nonsystematic review. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: There is limited evidence for hypertonic saline to improve posttraumatic headache in the emergency department setting. There is essentially no evidence for the use of any other medication in management of pediatric sport-related concussion. CONCLUSION: Further research is necessary to determine whether there is benefit to the use of any pharmacotherapy in the management of pediatric-aged athletes with concussions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Selzer, B J; Geh, N; Srinivasan, D; Strahle, M; Martinez-Sosa, M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with arachnoid cysts Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 410–417, 2016.
@article{Strahle2016b,
title = {Sports participation with arachnoid cysts},
author = {Strahle, J and Selzer, B J and Geh, N and Srinivasan, D and Strahle, M and Martinez-Sosa, M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {410--417},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 +/- 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Geh, N; Selzer, B J; Bower, R; Himedan, M; Strahle, M; Wetjen, N M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with Chiari I malformation Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 403–409, 2016.
@article{Strahle2016,
title = {Sports participation with Chiari I malformation},
author = {Strahle, J and Geh, N and Selzer, B J and Bower, R and Himedan, M and Strahle, M and Wetjen, N M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {403--409},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with Chiari I malformation (CM-I). The authors' goal was to define the risk of sports participation for children with the imaging finding of CM-I. METHODS A prospective survey was administered to 503 CM-I patients at 2 sites over a 46-month period. Data were gathered on imaging characteristics, treatment, sports participation, and any sport-related injuries. Additionally, 81 patients completed at least 1 subsequent survey following their initial entry into the registry and were included in a prospective group, with a mean prospective follow-up period of 11 months. RESULTS Of the 503 CM-I patients, 328 participated in sports for a cumulative duration of 4641 seasons; 205 of these patients participated in contact sports. There were no serious or catastrophic neurological injuries. One patient had temporary extremity paresthesias that resolved within hours, and this was not definitely considered to be related to the CM-I. In the prospective cohort, there were no permanent neurological injuries. CONCLUSIONS No permanent or catastrophic neurological injuries were observed in CM-I patients participating in athletic activities. The authors believe that the risk of such injuries is low and that, in most cases, sports participation by children with CM-I is safe.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hansen, C; Cushman, D; Anderson, N; Chen, W; Cheng, C; Hon, S D; Hung, M
A Normative Dataset of the Balance Error Scoring System in Children Aged between 5 and 14 Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 6, pp. 497–501, 2016.
@article{Hansen2016,
title = {A Normative Dataset of the Balance Error Scoring System in Children Aged between 5 and 14},
author = {Hansen, C and Cushman, D and Anderson, N and Chen, W and Cheng, C and Hon, S D and Hung, M},
doi = {10.1097/JSM.0000000000000285},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {6},
pages = {497--501},
abstract = {Objective: Pediatric head injuries occur commonly and are being reported in increasing numbers. Balance testing is a key component in the evaluation of suspected concussion, and the balance error scoring system (BESS) is likely the most well-known and widely used measure. To date, normative BESS scores for adults have been reported but not for children. Design: Normative data for BESS scores and modified BESS scores were created in a cohort of healthy children. Potential variables were analyzed as predictors of BESS performance. Setting: Local elementary and junior high schools. Participants: A total of 373 healthy children between the ages of 5 and 14. Interventions: The BESS was performed on all children. Assessment of Risk Factors: Gender, body mass index percentile, previous concussions, athletic participation, age, and the parental opinion of child's balance ability were examined as factors associated with the BESS score. Main Outcome Measures: BESS scores. Results: Normative data are reported, stratified by age groups of 5 to 7 years, 8 to 10 years, and 11 to 14 years of age, for both BESS and modified BESS. Median BESS scores are 23 for children aged 5 to 7, 18 for children aged 8 to 10, and 16 for children aged 11 to 14. Median modified BESS scores are 8 for children age 5 to 7, 5 for children age 8 to 10, and 4 for children age 11 to 14. Increasing age and positive parental opinion regarding their child's balance ability were independently correlated with decreasing BESS scores (P \< 0.01). Conclusions: The normative data on BESS scores for healthy children reported here provide age-stratified reference values for suspected balance alterations. © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L
Point of health care entry for youth with concussion within a large pediatric care network Journal Article
In: JAMA Pediatr, vol. 170, no. 7, 2016.
@article{Arbogast2016,
title = {Point of health care entry for youth with concussion within a large pediatric care network},
author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},
doi = {10.1001/jamapediatrics.2016.0294},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {7},
abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
O'Kane, J W
Is Heading in Youth Soccer Dangerous Play? Journal Article
In: Physician & Sportsmedicine, vol. 44, no. 2, pp. 190–194, 2016.
@article{OKane2016,
title = {Is Heading in Youth Soccer Dangerous Play?},
author = {O'Kane, J W},
year = {2016},
date = {2016-01-01},
journal = {Physician \& Sportsmedicine},
volume = {44},
number = {2},
pages = {190--194},
abstract = {BACKGROUND: Soccer is among the most popular youth sports with over 3 million youth players registered in the U.S. Soccer is unique in that players intentionally use their head to strike the ball, leading to concerns that heading could cause acute or chronic brain injury, especially in the immature brains of children. METHODS: Pub Med search without date restriction was conducted in November 2014 and August 2015 using the terms soccer and concussion, heading and concussion, and youth soccer and concussion. 310 articles were identified and reviewed for applicable content specifically relating to youth athletes, heading, and/or acute or chronic brain injury from soccer. RESULTS: Soccer is a low-risk sport for catastrophic head injury, but concussions are relatively common and heading often plays a role. At all levels of play, concussions are more likely to occur in the act of heading than with other facets of the game. While concussion from heading the ball without other contact to the head appears rare in adult players, some data suggests children are more susceptible to concussion from heading primarily in game situations. Contributing factors include biomechanical forces, less developed technique, and the immature brain's susceptibility to injury. CONCLUSIONS: There is no evidence that heading in youth soccer causes any permanent brain injury and there is limited evidence that heading in youth soccer can cause concussion. A reasonable approach based on U.S. Youth Soccer recommendations is to teach heading after age 10 in controlled settings, and heading in games should be delayed until skill acquisition and physical maturity allow the youth player to head correctly with confidence.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Puvenna, V; Engeler, M; Banjara, M; Brennan, C; Schreiber, P; Dadas, A; Bahrami, A; Solanki, J; Bandyopadhyay, A; Morris, J K; Bernick, C; Ghosh, C; Rapp, E; Bazarian, J J; Janigro, D
Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy Journal Article
In: Brain Research, vol. 1630, pp. 225–240, 2016.
@article{Puvenna2016,
title = {Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy},
author = {Puvenna, V and Engeler, M and Banjara, M and Brennan, C and Schreiber, P and Dadas, A and Bahrami, A and Solanki, J and Bandyopadhyay, A and Morris, J K and Bernick, C and Ghosh, C and Rapp, E and Bazarian, J J and Janigro, D},
year = {2016},
date = {2016-01-01},
journal = {Brain Research},
volume = {1630},
pages = {225--240},
abstract = {Repetitive traumatic brain injury (rTBI) is one of the major risk factors for the abnormal deposition of phosphorylated tau (PT) in the brain and chronic traumatic encephalopathy (CTE). CTE and temporal lobe epilepsy (TLE) affect the limbic system, but no comparative studies on PT distribution in TLE and CTE are available. It is also unclear whether PT pathology results from repeated head hits (rTBI). These gaps prevent a thorough understanding of the pathogenesis and clinical significance of PT, limiting our ability to develop preventative and therapeutic interventions. We quantified PT in TLE and CTE to unveil whether a history of rTBI is a prerequisite for PT accumulation in the brain. Six postmortem CTE (mean 73.3 years) and age matched control samples were compared to 19 surgically resected TLE brain specimens (4 months-58 years; mean 27.6 years). No history of TBI was present in TLE or control; all CTE patients had a history of rTBI. TLE and CTE brain displayed increased levels of PT as revealed by immunohistochemistry. No age-dependent changes were noted, as PT was present as early as 4 months after birth. In TLE and CTE, cortical neurons, perivascular regions around penetrating pial vessels and meninges were immunopositive for PT; white matter tracts also displayed robust expression of extracellular PT organized in bundles parallel to venules. Microscopically, there were extensive tau-immunoreactive neuronal, astrocytic and degenerating neurites throughout the brain. In CTE perivascular tangles were most prominent. Overall, significant differences in staining intensities were found between CTE and control (P\<0.01) but not between CTE and TLE (P=0.08). pS199 tau analysis showed that CTE had the most high molecular weight tangle-associated tau, whereas epileptic brain contained low molecular weight tau. Tau deposition may not be specific to rTBI since TLE recapitulated most of the pathological features of CTE. Copyright © 2015 Elsevier B.V. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bressan, S; Babl, F E
Diagnosis and management of paediatric concussion Journal Article
In: Journal of Paediatrics & Child Health, vol. 52, no. 2, pp. 151–157, 2016.
@article{Bressan2016,
title = {Diagnosis and management of paediatric concussion},
author = {Bressan, S and Babl, F E},
doi = {10.1111/jpc.12967},
year = {2016},
date = {2016-01-01},
journal = {Journal of Paediatrics \& Child Health},
volume = {52},
number = {2},
pages = {151--157},
abstract = {Heightened recognition of concussions and concerns about their sequelae in children has become an increasing community and public health concern. Biomarkers and clinical tests are being explored, but the diagnosis of concussion in the emergency department continues to be based on clinical signs and symptoms. While the majority of children go on to recover from post-concussive symptoms within 2 weeks, it is unclear which patients with concussion will go on to develop short- or long-term sequelae. A number of more or less evidence-based guidelines have become available which seek to guide clinicians on how to manage children post-concussion. In general, care after the emergency department is focused on reducing the risk of re-injury and rest until cerebral recovery with a graduated return to school and then play. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bharadwaj, S; Rocker, J
Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management Journal Article
In: Current Opinion in Pediatrics, vol. 28, no. 1, pp. 121–131, 2016.
@article{Bharadwaj2016,
title = {Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management},
author = {Bharadwaj, S and Rocker, J},
year = {2016},
date = {2016-01-01},
journal = {Current Opinion in Pediatrics},
volume = {28},
number = {1},
pages = {121--131},
abstract = {PURPOSE OF REVIEW: We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions. RECENT FINDINGS: Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging. New evidence has demonstrated the significant harmful effects of ionizing radiation. Recent studies have risk-stratified patients to identify those at risk of clinically important traumatic brain injury, to minimize the exposure to ionizing radiation for those who are at a low risk of any significant disorder. SUMMARY: Pediatric minor head injury is a common complaint, but the vast majority of those injured will suffer no significant consequences. The Pediatric Emergency Care Applied Research Network has created an algorithm to identify minor head trauma patients who require emergent head CTs versus those at low risk who do not require neuroimaging. Additionally, in recent years there has been an increase in the occurrence of concussions. We describe the characteristics of concussions, appropriate management, and the return-to-play guidelines.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Keays, G; Friedman, D; Gagnon, I
A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study Journal Article
In: Clinical Pediatrics, vol. 55, no. 7, pp. 603–613, 2016.
@article{Keays2016,
title = {A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study},
author = {Keays, G and Friedman, D and Gagnon, I},
doi = {10.1177/0009922815602631},
year = {2016},
date = {2016-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {7},
pages = {603--613},
abstract = {Introduction. Little is known about Canadian youth football injuries. The objectives of this study were (a) to contrast the injuries in Canadian and American football players aged 6 to 17 years and (b) compare the injuries sustained during organized football with those in nonorganized football. Methods. Using a retrospective cohort design based on data from the Canadian Hospitals Injury Reporting and Prevention Program and the National Electronic Injury Surveillance System a comparison of injuries was made. Results. Trends in injuries were comparable. Proportions and odds of injuries were similar, except for a few exceptions. In Canada, more girls were injured and fractures were more prevalent. Compared with nonorganized football, organized football players were older, involved more males, and suffered more traumatic brain injuries and injuries to their lower extremities. Conclusion. Canadian and American youth football injuries were similar. The type of football, be it organized or nonorganized, has an impact on injuries. © 2016 The Author(s).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Rogers, L A
Let the Kids Play Football! Journal Article
In: North Carolina Medical Journal, vol. 76, no. 4, pp. 272, 2015.
@article{Rogers2015b,
title = {Let the Kids Play Football!},
author = {Rogers, L A},
year = {2015},
date = {2015-01-01},
journal = {North Carolina Medical Journal},
volume = {76},
number = {4},
pages = {272},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Brown, J C; Viljoen, W; Lambert, M I; Readhead, C; Fuller, C; Van Mechelen, W; Verhagen, E
The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments Journal Article
In: Journal of Science & Medicine in Sport, vol. 18, no. 4, pp. 394–399, 2015.
@article{Brown2015b,
title = {The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments},
author = {Brown, J C and Viljoen, W and Lambert, M I and Readhead, C and Fuller, C and {Van Mechelen}, W and Verhagen, E},
doi = {10.1016/j.jsams.2014.06.015},
year = {2015},
date = {2015-01-01},
journal = {Journal of Science \& Medicine in Sport},
volume = {18},
number = {4},
pages = {394--399},
abstract = {Objectives: Rugby Union ("rugby") is a popular sport with high injury risk. Burden of injury is described by the incidence and severity of injury. However reports have ignored the monetary cost of injuries. Therefore the aim of this study was to describe the monetary cost associated with youth rugby injuries. Design: This descriptive study quantified medical treatments of injured players at the South African Rugby Union Youth tournaments in 2011/2012 and the days of work parents missed as a result of the injuries. A health insurer used these data to calculate associated costs. Methods: Legal guardians of the 421 injured players were contacted telephonically on a weekly basis until they returned to play. Treatments costs were estimated in South African Rands based on 2013 insurance rates and converted to US$ using purchasing power parities. Results: Of the 3652 players, 2% (n=71) sought medical care after the tournament. For these players, average treatment costs were high (US$731 per player, 95% CI: US$425-US$1096), with fractures being the most expensive type of injury. Players with medical insurance had higher costs (US$937, 95% CI: US$486-US$1500) than those without (US$220, 95% CI: US$145-US$302). Conclusions: Although a minority of players sought follow-up treatment after the tournaments, the cost of these injuries was high. Players without medical insurance having lower costs may indicate that these players did not receive adequate treatment for their injuries. Injury prevention efforts should consider injuries with high costs and the treatment of players without medical insurance. © 2014 Sports Medicine Australia.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Dillard, C; Ditchman, N; Nersessova, K; Foster, N; Wehman, P; West, M; Riedlinger, B; Monasterio, E; Shaw, B; Neblett, J
Post-concussion symptoms in mild traumatic brain injury: findings from a paediatric outpatient clinic Journal Article
In: Disability & Rehabilitation, vol. 39, no. 6, pp. 544–550, 2017.
Abstract | Links | BibTeX | Tags: Adolescent, brain concussion, Brain Injuries, Child, paediatric hospitals, Post-Concussion Syndrome
@article{Dillard2017,
title = {Post-concussion symptoms in mild traumatic brain injury: findings from a paediatric outpatient clinic},
author = {Dillard, C and Ditchman, N and Nersessova, K and Foster, N and Wehman, P and West, M and Riedlinger, B and Monasterio, E and Shaw, B and Neblett, J},
doi = {10.3109/09638288.2016.1152602},
year = {2017},
date = {2017-01-01},
journal = {Disability \& Rehabilitation},
volume = {39},
number = {6},
pages = {544--550},
abstract = {Purpose Mild traumatic brain injury (mTBI) is common among children and is associated with a range of symptomatology and clinical presentations. This study uses data from a paediatric outpatient TBI clinic to (1) investigate characteristics associated with more severe post-concussive symptoms and (2) examine differences in the proportion of individuals endorsing specific post-concussion symptoms based on group (e.g., sex, type of injury, and psychiatric history). Methods Data from the Children’s Hospital of Richmond’s TBI outpatient programme were analysed (N = 157). Results Gender and sports injury were associated with severity of symptoms. In addition, females endorsed a greater number of overall symptoms than males. A number of specific symptoms were found to be endorsed to a greater extent based on psychiatric history and type of injury; however, overall total number of symptoms endorsed did not differ based on these characteristics. Conclusions Findings from this study provide further evidence that mTBI affects a wide range of youth and that associated symptomatology can indeed be varied. Moreover, results revealed differences in endorsement of specific symptoms and symptom severity based on patient and injury characteristics which have implications for concussion assessment and treatment. Implications for Rehabilitation Symptoms following mild traumatic brain injury (mTBI) in children and adolescents can have varied presentation, ranging from minimal to severe. Females and those with non-sports-related injuries are more likely to endorse greater symptoms following concussion. Symptom evaluation is an essential component of the concussion assessment and treatment of paediatric patients following mTBI, and clinicians should be aware of patient characteristics associated with increased symptoms, especially when baseline symptom data are not available. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {Adolescent, brain concussion, Brain Injuries, Child, paediatric hospitals, Post-Concussion Syndrome},
pubstate = {published},
tppubtype = {article}
}
Hansen, C; Cushman, D; Chen, W; Bounsanga, J; Hung, M
Reliability testing of the balance error scoring system in children between the ages of 5 and 14 Journal Article
In: Clinical Journal of Sport Medicine, vol. 27, no. 1, pp. 64–68, 2017.
Abstract | Links | BibTeX | Tags: brain concussion, Child, pediatrics, Reproducibility of Results, Sports
@article{Hansen2017,
title = {Reliability testing of the balance error scoring system in children between the ages of 5 and 14},
author = {Hansen, C and Cushman, D and Chen, W and Bounsanga, J and Hung, M},
doi = {10.1097/JSM.0000000000000293},
year = {2017},
date = {2017-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {27},
number = {1},
pages = {64--68},
abstract = {Objective: Pediatric concussion is an extensive public health concern with a complex clinical presentation. Balance assessment has been well-studied in the adult population, but has been limited in children. We aimed to assess the reliability and minimum detectable change (MDC) of the Balance Error Scoring System (BESS) in healthy children. Design: This prospective observational study included 373 healthy children aged 5 to 14. Interrater reliability was assessed by having 4 assessors review videos of 50 random subjects distributed evenly by age and sex across the entire cohort. Intrarater reliability was performed by having assessors review videos of other assessors' live evaluations. Test-retest reliability was obtained by comparing BESS scores as recorded live at the 2 separate time points by the same rater. Setting: Local elementary and junior high schools. Participants: Three hundred and seventy three healthy children between the ages of 5 and 14. Interventions: The BESS was performed on all children. Main Outcome Measures: Intraclass Correlation Coefficients (ICCs) and MDC Scores. Results: The overall interrater ICC was determined to be 0.93 [95% confidence interval (CI), 0.79-0.97] and intrarater ICC was 0.96 (95% CI, 0.95-0.97) with individual intrarater ICCs ranging between 0.69 and 0.99. The test-retest reliability was 0.90 (95% CI, 0.88- 0.92). The MDCs were 9.6, 4.6, and 7.3 points at the 95% CIs for interrater, intrarater, and test-retest comparisons, respectively. No learning effect was seen. Conclusions: The BESS demonstrates excellent reliability in the pediatric population without evidence of a learning effect. © 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {brain concussion, Child, pediatrics, Reproducibility of Results, Sports},
pubstate = {published},
tppubtype = {article}
}
Bachynski, K E
Tolerable Risks? Physicians and Youth Tackle Football Journal Article
In: New England Journal of Medicine, vol. 374, no. 5, pp. 405–407, 2016.
BibTeX | Tags: *Athletic Injuries/pc [Prevention & Control], *Brain Concussion/pc [Prevention & Control], *Football/in [Injuries], *Guidelines as Topic, *Physician's Role, *SPORTS medicine, Adolescent, Brain Concussion/et [Etiology], Child, Craniocerebral Trauma/et [Etiology], Craniocerebral Trauma/pc [Prevention & Control], Head Protective Devices, Humans, Medical, pediatrics, Societies, UNITED States
@article{Bachynski2016,
title = {Tolerable Risks? Physicians and Youth Tackle Football},
author = {Bachynski, K E},
year = {2016},
date = {2016-01-01},
journal = {New England Journal of Medicine},
volume = {374},
number = {5},
pages = {405--407},
keywords = {*Athletic Injuries/pc [Prevention \& Control], *Brain Concussion/pc [Prevention \& Control], *Football/in [Injuries], *Guidelines as Topic, *Physician's Role, *SPORTS medicine, Adolescent, Brain Concussion/et [Etiology], Child, Craniocerebral Trauma/et [Etiology], Craniocerebral Trauma/pc [Prevention \& Control], Head Protective Devices, Humans, Medical, pediatrics, Societies, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Hansen, C; Cushman, D; Anderson, N; Chen, W; Cheng, C; Hon, S D; Hung, M
A Normative Dataset of the Balance Error Scoring System in Children Aged between 5 and 14 Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 6, pp. 497–501, 2016.
Abstract | Links | BibTeX | Tags: brain concussion, Child, pediatrics, Reference Values, Sports
@article{Hansen2016,
title = {A Normative Dataset of the Balance Error Scoring System in Children Aged between 5 and 14},
author = {Hansen, C and Cushman, D and Anderson, N and Chen, W and Cheng, C and Hon, S D and Hung, M},
doi = {10.1097/JSM.0000000000000285},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {6},
pages = {497--501},
abstract = {Objective: Pediatric head injuries occur commonly and are being reported in increasing numbers. Balance testing is a key component in the evaluation of suspected concussion, and the balance error scoring system (BESS) is likely the most well-known and widely used measure. To date, normative BESS scores for adults have been reported but not for children. Design: Normative data for BESS scores and modified BESS scores were created in a cohort of healthy children. Potential variables were analyzed as predictors of BESS performance. Setting: Local elementary and junior high schools. Participants: A total of 373 healthy children between the ages of 5 and 14. Interventions: The BESS was performed on all children. Assessment of Risk Factors: Gender, body mass index percentile, previous concussions, athletic participation, age, and the parental opinion of child's balance ability were examined as factors associated with the BESS score. Main Outcome Measures: BESS scores. Results: Normative data are reported, stratified by age groups of 5 to 7 years, 8 to 10 years, and 11 to 14 years of age, for both BESS and modified BESS. Median BESS scores are 23 for children aged 5 to 7, 18 for children aged 8 to 10, and 16 for children aged 11 to 14. Median modified BESS scores are 8 for children age 5 to 7, 5 for children age 8 to 10, and 4 for children age 11 to 14. Increasing age and positive parental opinion regarding their child's balance ability were independently correlated with decreasing BESS scores (P \< 0.01). Conclusions: The normative data on BESS scores for healthy children reported here provide age-stratified reference values for suspected balance alterations. © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {brain concussion, Child, pediatrics, Reference Values, Sports},
pubstate = {published},
tppubtype = {article}
}
Halstead, M E
Pharmacologic Therapies for Pediatric Concussions Journal Article
In: Sports & Health, vol. 8, no. 1, pp. 50–52, 2016.
Abstract | BibTeX | Tags: *Acetaminophen/tu [Therapeutic Use], *Analgesics, *Anti-Inflammatory Agents, *Athletic Injuries/co [Complications], *Brain Concussion/co [Complications], *Post-Traumatic Headache/et [Etiology], 0 (Analgesics, 0 (Anti-Inflammatory Agents, 362O9ITL9D (Acetaminophen), Athletic Injuries/dt [Drug Therapy], Brain Concussion/dt [Drug Therapy], Child, Consensus, Humans, Non-Narcotic), Non-Narcotic/tu [Therapeutic Use], Non-Steroidal), Non-Steroidal/tu [Thera, Physicians'/sn [Statistics & Nu, Post-Traumatic Headache/dt [Drug Therapy], Practice Guidelines as Topic, Practice Patterns, Recovery of Function, Retrospective Studies
@article{Halstead2016,
title = {Pharmacologic Therapies for Pediatric Concussions},
author = {Halstead, M E},
year = {2016},
date = {2016-01-01},
journal = {Sports \& Health},
volume = {8},
number = {1},
pages = {50--52},
abstract = {CONTEXT: Pediatric concussions are common, and emphasis on correct diagnosis and management is stressed in consensus guidelines. Medications may have a role in management of concussion, but no consensus exists regarding appropriate pharmacologic therapy. EVIDENCE ACQUISITION: Nonsystematic review. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: There is limited evidence for hypertonic saline to improve posttraumatic headache in the emergency department setting. There is essentially no evidence for the use of any other medication in management of pediatric sport-related concussion. CONCLUSION: Further research is necessary to determine whether there is benefit to the use of any pharmacotherapy in the management of pediatric-aged athletes with concussions.},
keywords = {*Acetaminophen/tu [Therapeutic Use], *Analgesics, *Anti-Inflammatory Agents, *Athletic Injuries/co [Complications], *Brain Concussion/co [Complications], *Post-Traumatic Headache/et [Etiology], 0 (Analgesics, 0 (Anti-Inflammatory Agents, 362O9ITL9D (Acetaminophen), Athletic Injuries/dt [Drug Therapy], Brain Concussion/dt [Drug Therapy], Child, Consensus, Humans, Non-Narcotic), Non-Narcotic/tu [Therapeutic Use], Non-Steroidal), Non-Steroidal/tu [Thera, Physicians'/sn [Statistics \& Nu, Post-Traumatic Headache/dt [Drug Therapy], Practice Guidelines as Topic, Practice Patterns, Recovery of Function, Retrospective Studies},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Selzer, B J; Geh, N; Srinivasan, D; Strahle, M; Martinez-Sosa, M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with arachnoid cysts Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 410–417, 2016.
Abstract | BibTeX | Tags: *Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male
@article{Strahle2016b,
title = {Sports participation with arachnoid cysts},
author = {Strahle, J and Selzer, B J and Geh, N and Srinivasan, D and Strahle, M and Martinez-Sosa, M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {410--417},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 +/- 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.},
keywords = {*Arachnoid Cysts/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Mannix, R C; Quinn, B; Taylor, J A; Tan, C O; Meehan 3rd, W P
Physical Activity Level and Symptom Duration Are Not Associated After Concussion Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 4, pp. 1040–1046, 2016.
Abstract | BibTeX | Tags: *Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult
@article{Howell2016,
title = {Physical Activity Level and Symptom Duration Are Not Associated After Concussion},
author = {Howell, D R and Mannix, R C and Quinn, B and Taylor, J A and Tan, C O and {Meehan 3rd}, W P},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {4},
pages = {1040--1046},
abstract = {BACKGROUND: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited. PURPOSE: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: This study included 364 patients who were diagnosed with a concussion, were seen by a physician within 3 weeks of injury, and completed a questionnaire at the initial clinic visit. The questionnaire assessed the postconcussion symptom scale (PCSS) score, previous number of concussions, presence of the loss of consciousness or amnesia at the time of injury, and prior treatment for headaches. During each follow-up clinic visit, physical activity level was self-reported. A Cox proportional hazard model was constructed to determine the association between symptom duration, initial clinic visit responses, and self-reported physical activity level after the injury. RESULTS: Study participants ranged in age from 8 to 27 years (mean age, 15.0 years) and had sustained a mean of 0.8 prior concussions; 222 patients (61%) were male. On initial examination, the mean PCSS score was 34.7. The mean symptom duration was 48.9 days after the injury. Among the variables included in the model, initial PCSS score and female sex were independently associated with symptom duration, while physical activity level after the injury was not. For participants aged between 13 and 18 years, however, higher levels of physical activity after the injury were associated with a shorter symptom duration. CONCLUSION: Results from this study indicate that physical activity after the injury may not be universally detrimental to the recovery of concussion symptoms.Copyright © 2016 The Author(s).},
keywords = {*Motor Activity, *Post-Concussion Syndrome/et [Etiology], Adolescent, adult, Athletic Injuries/co [Complications], Child, Cohort Studies, Female, Humans, Male, self report, Surveys and Questionnaires, Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Strahle, J; Geh, N; Selzer, B J; Bower, R; Himedan, M; Strahle, M; Wetjen, N M; Muraszko, K M; Garton, H J; Maher, C O
Sports participation with Chiari I malformation Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 403–409, 2016.
Abstract | BibTeX | Tags: *Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics & Numerical Data], *Sports/sn [Statistics & Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool
@article{Strahle2016,
title = {Sports participation with Chiari I malformation},
author = {Strahle, J and Geh, N and Selzer, B J and Bower, R and Himedan, M and Strahle, M and Wetjen, N M and Muraszko, K M and Garton, H J and Maher, C O},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {403--409},
abstract = {OBJECT There is currently no consensus on the safety of sports participation for patients with Chiari I malformation (CM-I). The authors' goal was to define the risk of sports participation for children with the imaging finding of CM-I. METHODS A prospective survey was administered to 503 CM-I patients at 2 sites over a 46-month period. Data were gathered on imaging characteristics, treatment, sports participation, and any sport-related injuries. Additionally, 81 patients completed at least 1 subsequent survey following their initial entry into the registry and were included in a prospective group, with a mean prospective follow-up period of 11 months. RESULTS Of the 503 CM-I patients, 328 participated in sports for a cumulative duration of 4641 seasons; 205 of these patients participated in contact sports. There were no serious or catastrophic neurological injuries. One patient had temporary extremity paresthesias that resolved within hours, and this was not definitely considered to be related to the CM-I. In the prospective cohort, there were no permanent neurological injuries. CONCLUSIONS No permanent or catastrophic neurological injuries were observed in CM-I patients participating in athletic activities. The authors believe that the risk of such injuries is low and that, in most cases, sports participation by children with CM-I is safe.},
keywords = {*Arnold-Chiari Malformation/ep [Epidemiology], *Athletic Injuries/ep [Epidemiology], *Registries/sn [Statistics \& Numerical Data], *Sports/sn [Statistics \& Numerical Data], Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Preschool},
pubstate = {published},
tppubtype = {article}
}
Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L
Point of health care entry for youth with concussion within a large pediatric care network Journal Article
In: JAMA Pediatr, vol. 170, no. 7, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race
@article{Arbogast2016,
title = {Point of health care entry for youth with concussion within a large pediatric care network},
author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},
doi = {10.1001/jamapediatrics.2016.0294},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {7},
abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},
keywords = {Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race},
pubstate = {published},
tppubtype = {article}
}
O'Kane, J W
Is Heading in Youth Soccer Dangerous Play? Journal Article
In: Physician & Sportsmedicine, vol. 44, no. 2, pp. 190–194, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/et [Etiology], *Brain Injury, *Soccer/in [Injuries], Adolescent, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention & Control], Brain Injuries/pc [Prevention & Control], Brain Injury, Child, Chronic/et [Etiology], Chronic/pc [Prevention & Control], Humans, Risk Factors, UNITED States
@article{OKane2016,
title = {Is Heading in Youth Soccer Dangerous Play?},
author = {O'Kane, J W},
year = {2016},
date = {2016-01-01},
journal = {Physician \& Sportsmedicine},
volume = {44},
number = {2},
pages = {190--194},
abstract = {BACKGROUND: Soccer is among the most popular youth sports with over 3 million youth players registered in the U.S. Soccer is unique in that players intentionally use their head to strike the ball, leading to concerns that heading could cause acute or chronic brain injury, especially in the immature brains of children. METHODS: Pub Med search without date restriction was conducted in November 2014 and August 2015 using the terms soccer and concussion, heading and concussion, and youth soccer and concussion. 310 articles were identified and reviewed for applicable content specifically relating to youth athletes, heading, and/or acute or chronic brain injury from soccer. RESULTS: Soccer is a low-risk sport for catastrophic head injury, but concussions are relatively common and heading often plays a role. At all levels of play, concussions are more likely to occur in the act of heading than with other facets of the game. While concussion from heading the ball without other contact to the head appears rare in adult players, some data suggests children are more susceptible to concussion from heading primarily in game situations. Contributing factors include biomechanical forces, less developed technique, and the immature brain's susceptibility to injury. CONCLUSIONS: There is no evidence that heading in youth soccer causes any permanent brain injury and there is limited evidence that heading in youth soccer can cause concussion. A reasonable approach based on U.S. Youth Soccer recommendations is to teach heading after age 10 in controlled settings, and heading in games should be delayed until skill acquisition and physical maturity allow the youth player to head correctly with confidence.},
keywords = {*Brain Injuries/et [Etiology], *Brain Injury, *Soccer/in [Injuries], Adolescent, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention \& Control], Brain Injuries/pc [Prevention \& Control], Brain Injury, Child, Chronic/et [Etiology], Chronic/pc [Prevention \& Control], Humans, Risk Factors, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Puvenna, V; Engeler, M; Banjara, M; Brennan, C; Schreiber, P; Dadas, A; Bahrami, A; Solanki, J; Bandyopadhyay, A; Morris, J K; Bernick, C; Ghosh, C; Rapp, E; Bazarian, J J; Janigro, D
Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy Journal Article
In: Brain Research, vol. 1630, pp. 225–240, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult
@article{Puvenna2016,
title = {Is phosphorylated tau unique to chronic traumatic encephalopathy? Phosphorylated tau in epileptic brain and chronic traumatic encephalopathy},
author = {Puvenna, V and Engeler, M and Banjara, M and Brennan, C and Schreiber, P and Dadas, A and Bahrami, A and Solanki, J and Bandyopadhyay, A and Morris, J K and Bernick, C and Ghosh, C and Rapp, E and Bazarian, J J and Janigro, D},
year = {2016},
date = {2016-01-01},
journal = {Brain Research},
volume = {1630},
pages = {225--240},
abstract = {Repetitive traumatic brain injury (rTBI) is one of the major risk factors for the abnormal deposition of phosphorylated tau (PT) in the brain and chronic traumatic encephalopathy (CTE). CTE and temporal lobe epilepsy (TLE) affect the limbic system, but no comparative studies on PT distribution in TLE and CTE are available. It is also unclear whether PT pathology results from repeated head hits (rTBI). These gaps prevent a thorough understanding of the pathogenesis and clinical significance of PT, limiting our ability to develop preventative and therapeutic interventions. We quantified PT in TLE and CTE to unveil whether a history of rTBI is a prerequisite for PT accumulation in the brain. Six postmortem CTE (mean 73.3 years) and age matched control samples were compared to 19 surgically resected TLE brain specimens (4 months-58 years; mean 27.6 years). No history of TBI was present in TLE or control; all CTE patients had a history of rTBI. TLE and CTE brain displayed increased levels of PT as revealed by immunohistochemistry. No age-dependent changes were noted, as PT was present as early as 4 months after birth. In TLE and CTE, cortical neurons, perivascular regions around penetrating pial vessels and meninges were immunopositive for PT; white matter tracts also displayed robust expression of extracellular PT organized in bundles parallel to venules. Microscopically, there were extensive tau-immunoreactive neuronal, astrocytic and degenerating neurites throughout the brain. In CTE perivascular tangles were most prominent. Overall, significant differences in staining intensities were found between CTE and control (P\<0.01) but not between CTE and TLE (P=0.08). pS199 tau analysis showed that CTE had the most high molecular weight tangle-associated tau, whereas epileptic brain contained low molecular weight tau. Tau deposition may not be specific to rTBI since TLE recapitulated most of the pathological features of CTE. Copyright © 2015 Elsevier B.V. All rights reserved.},
keywords = {*Brain Injury, *Brain/me [Metabolism], *Epilepsy/me [Metabolism], *tau Proteins/me [Metabolism], 0 (MAPT protein, 0 (tau Proteins), 80 and over, Adolescent, adult, aged, Brain Injury, Brain/pa [Pathology], Brain/su [Surgery], Child, Chronic/me [Metabolism], Chronic/pa [Pathology], ENZYME-linked immunosorbent assay, Epilepsy/pa [Pathology], Epilepsy/su [Surgery], Female, human), Humans, immunohistochemistry, Infant, Male, middle aged, Phosphorylation, Preschool, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Bressan, S; Babl, F E
Diagnosis and management of paediatric concussion Journal Article
In: Journal of Paediatrics & Child Health, vol. 52, no. 2, pp. 151–157, 2016.
Abstract | Links | BibTeX | Tags: Article, brain concussion, brain injury assessment, Child, child care, childhood injury, chronic brain disease, clinical feature, Concussion, conservative treatment, Glasgow Coma Scale, glial fibrillary acidic protein, human, neuroimaging, neuron specific enolase, patient care, Post Concussive Symptom Scale, post-concussive syndrome, priority journal, protein S100B, Second impact syndrome, Sport Concussion Assessment Tool 3, traumatic brain injury
@article{Bressan2016,
title = {Diagnosis and management of paediatric concussion},
author = {Bressan, S and Babl, F E},
doi = {10.1111/jpc.12967},
year = {2016},
date = {2016-01-01},
journal = {Journal of Paediatrics \& Child Health},
volume = {52},
number = {2},
pages = {151--157},
abstract = {Heightened recognition of concussions and concerns about their sequelae in children has become an increasing community and public health concern. Biomarkers and clinical tests are being explored, but the diagnosis of concussion in the emergency department continues to be based on clinical signs and symptoms. While the majority of children go on to recover from post-concussive symptoms within 2 weeks, it is unclear which patients with concussion will go on to develop short- or long-term sequelae. A number of more or less evidence-based guidelines have become available which seek to guide clinicians on how to manage children post-concussion. In general, care after the emergency department is focused on reducing the risk of re-injury and rest until cerebral recovery with a graduated return to school and then play. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).},
keywords = {Article, brain concussion, brain injury assessment, Child, child care, childhood injury, chronic brain disease, clinical feature, Concussion, conservative treatment, Glasgow Coma Scale, glial fibrillary acidic protein, human, neuroimaging, neuron specific enolase, patient care, Post Concussive Symptom Scale, post-concussive syndrome, priority journal, protein S100B, Second impact syndrome, Sport Concussion Assessment Tool 3, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Bharadwaj, S; Rocker, J
Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management Journal Article
In: Current Opinion in Pediatrics, vol. 28, no. 1, pp. 121–131, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention & Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]
@article{Bharadwaj2016,
title = {Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management},
author = {Bharadwaj, S and Rocker, J},
year = {2016},
date = {2016-01-01},
journal = {Current Opinion in Pediatrics},
volume = {28},
number = {1},
pages = {121--131},
abstract = {PURPOSE OF REVIEW: We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions. RECENT FINDINGS: Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging. New evidence has demonstrated the significant harmful effects of ionizing radiation. Recent studies have risk-stratified patients to identify those at risk of clinically important traumatic brain injury, to minimize the exposure to ionizing radiation for those who are at a low risk of any significant disorder. SUMMARY: Pediatric minor head injury is a common complaint, but the vast majority of those injured will suffer no significant consequences. The Pediatric Emergency Care Applied Research Network has created an algorithm to identify minor head trauma patients who require emergent head CTs versus those at low risk who do not require neuroimaging. Additionally, in recent years there has been an increase in the occurrence of concussions. We describe the characteristics of concussions, appropriate management, and the return-to-play guidelines.},
keywords = {*Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention \& Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]},
pubstate = {published},
tppubtype = {article}
}
Keays, G; Friedman, D; Gagnon, I
A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study Journal Article
In: Clinical Pediatrics, vol. 55, no. 7, pp. 603–613, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States
@article{Keays2016,
title = {A 20-Year Comparison of Football-Related Injuries in American and Canadian Youth Aged 6 to 17 Years: A replication study},
author = {Keays, G and Friedman, D and Gagnon, I},
doi = {10.1177/0009922815602631},
year = {2016},
date = {2016-01-01},
journal = {Clinical Pediatrics},
volume = {55},
number = {7},
pages = {603--613},
abstract = {Introduction. Little is known about Canadian youth football injuries. The objectives of this study were (a) to contrast the injuries in Canadian and American football players aged 6 to 17 years and (b) compare the injuries sustained during organized football with those in nonorganized football. Methods. Using a retrospective cohort design based on data from the Canadian Hospitals Injury Reporting and Prevention Program and the National Electronic Injury Surveillance System a comparison of injuries was made. Results. Trends in injuries were comparable. Proportions and odds of injuries were similar, except for a few exceptions. In Canada, more girls were injured and fractures were more prevalent. Compared with nonorganized football, organized football players were older, involved more males, and suffered more traumatic brain injuries and injuries to their lower extremities. Conclusion. Canadian and American youth football injuries were similar. The type of football, be it organized or nonorganized, has an impact on injuries. © 2016 The Author(s).},
keywords = {Adolescent, American, Article, CANADA, Canadian, Child, children, Concussion, dislocation, emergency care, Female, football, head injury, human, Injuries, major clinical study, Male, replication study, retrospective study, skull fracture, spine fracture, sport injury, Sports, sprain, traumatic brain injury, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Rogers, L A
Let the Kids Play Football! Journal Article
In: North Carolina Medical Journal, vol. 76, no. 4, pp. 272, 2015.
BibTeX | Tags: *Brain Concussion/et [Etiology], *Brain Concussion/pc [Prevention & Control], *Football/in [Injuries], Adolescent, Child, Humans, UNITED States
@article{Rogers2015b,
title = {Let the Kids Play Football!},
author = {Rogers, L A},
year = {2015},
date = {2015-01-01},
journal = {North Carolina Medical Journal},
volume = {76},
number = {4},
pages = {272},
keywords = {*Brain Concussion/et [Etiology], *Brain Concussion/pc [Prevention \& Control], *Football/in [Injuries], Adolescent, Child, Humans, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Brown, J C; Viljoen, W; Lambert, M I; Readhead, C; Fuller, C; Van Mechelen, W; Verhagen, E
The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments Journal Article
In: Journal of Science & Medicine in Sport, vol. 18, no. 4, pp. 394–399, 2015.
Abstract | Links | BibTeX | Tags: Absenteeism, Adolescent, adult, Article, Athletic Injuries, Back Injuries, biokinetics, bone, Child, competition, Concussion, contusion, Craniocerebral Trauma, economic evaluation, economics, follow up, football, Football/economics, Football/economics/cost analysis, Football/injuries (MeSH terms), fracture, Fractures, head injury, Health, health care cost, Health Care Costs, health insurance, human, Humans, Injuries, injury, injury scale, Insurance, laceration, legal guardian, Lower Extremity, lower limb, major clinical study, Male, MEDICAL care, muscle cramp, muscle strain, Neck Injuries, neck injury, Occupational Therapy, Parent, physical medicine, physiotherapy, radiodiagnosis, rugby, skin bruising, SOUTH Africa, sport injury, Trauma Severity Indices, Upper Extremity, upper limb, Wounds and Injuries
@article{Brown2015b,
title = {The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments},
author = {Brown, J C and Viljoen, W and Lambert, M I and Readhead, C and Fuller, C and {Van Mechelen}, W and Verhagen, E},
doi = {10.1016/j.jsams.2014.06.015},
year = {2015},
date = {2015-01-01},
journal = {Journal of Science \& Medicine in Sport},
volume = {18},
number = {4},
pages = {394--399},
abstract = {Objectives: Rugby Union ("rugby") is a popular sport with high injury risk. Burden of injury is described by the incidence and severity of injury. However reports have ignored the monetary cost of injuries. Therefore the aim of this study was to describe the monetary cost associated with youth rugby injuries. Design: This descriptive study quantified medical treatments of injured players at the South African Rugby Union Youth tournaments in 2011/2012 and the days of work parents missed as a result of the injuries. A health insurer used these data to calculate associated costs. Methods: Legal guardians of the 421 injured players were contacted telephonically on a weekly basis until they returned to play. Treatments costs were estimated in South African Rands based on 2013 insurance rates and converted to US$ using purchasing power parities. Results: Of the 3652 players, 2% (n=71) sought medical care after the tournament. For these players, average treatment costs were high (US$731 per player, 95% CI: US$425-US$1096), with fractures being the most expensive type of injury. Players with medical insurance had higher costs (US$937, 95% CI: US$486-US$1500) than those without (US$220, 95% CI: US$145-US$302). Conclusions: Although a minority of players sought follow-up treatment after the tournaments, the cost of these injuries was high. Players without medical insurance having lower costs may indicate that these players did not receive adequate treatment for their injuries. Injury prevention efforts should consider injuries with high costs and the treatment of players without medical insurance. © 2014 Sports Medicine Australia.},
keywords = {Absenteeism, Adolescent, adult, Article, Athletic Injuries, Back Injuries, biokinetics, bone, Child, competition, Concussion, contusion, Craniocerebral Trauma, economic evaluation, economics, follow up, football, Football/economics, Football/economics/cost analysis, Football/injuries (MeSH terms), fracture, Fractures, head injury, Health, health care cost, Health Care Costs, health insurance, human, Humans, Injuries, injury, injury scale, Insurance, laceration, legal guardian, Lower Extremity, lower limb, major clinical study, Male, MEDICAL care, muscle cramp, muscle strain, Neck Injuries, neck injury, Occupational Therapy, Parent, physical medicine, physiotherapy, radiodiagnosis, rugby, skin bruising, SOUTH Africa, sport injury, Trauma Severity Indices, Upper Extremity, upper limb, Wounds and Injuries},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Ritchie, L J; Koltek, M; Hosain, S; Cordingley, D; Chu, S; Selci, E; Leiter, J; Russell, K
Psychiatric outcomes after pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 6, pp. 709–718, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports
@article{Ellis2015ab,
title = {Psychiatric outcomes after pediatric sports-related concussion},
author = {Ellis, M J and Ritchie, L J and Koltek, M and Hosain, S and Cordingley, D and Chu, S and Selci, E and Leiter, J and Russell, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {6},
pages = {709--718},
abstract = {OBJECT: The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. METHODS: The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. RESULTS: One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes. Interventions for patients with postinjury psychiatric outcomes included pharmacological therapy alone in 2 patients (10%), cognitive behavioral therapy alone in 4 (20%), multimodal therapy in 9 (45%), and no treatment in 5 (25%). Overall, 5 (25%) of the patients with postinjury psychiatric disorders were medically cleared to return to full sports participation, whereas 5 (25%) were lost to follow-up and 9 (45%) remained in treatment by the multidisciplinary concussion program at the end of the study period. One patient who was asymptomatic at the time of initial consultation committed suicide. CONCLUSIONS: Emotional symptoms were commonly reported among pediatric patients with SRC referred to a multidisciplinary pediatric concussion program. In some cases, these symptoms contributed to the development of an NPD, isolated suicidal ideation, and worsening symptoms of a preexisting psychiatric disorder. Future research is needed to clarify the prevalence, pathophysiology, risk factors, and evidence-based management of postinjury psychiatric outcomes after pediatric SRC. Successful management of these patients requires prompt recognition and multidisciplinary care by experts with clinical training and experience in concussion and psychiatry.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports},
pubstate = {published},
tppubtype = {article}
}
Davis, G A; Thurairatnam, S; Feleggakis, P; Anderson, V; Bressan, S; Babl, F E
HeadCheck: A concussion app Journal Article
In: Journal of Paediatrics & Child Health, vol. 51, no. 8, pp. 830–831, 2015.
Links | BibTeX | Tags: Adolescent, algorithm, Athletic Injuries, Australia, brain concussion, checklist, Child, child health care, consensus development, human, Humans, mobile application, Mobile Applications, mobile phone, practice guideline, priority journal, Review, smartphone, sport injury, validation process
@article{Davis2015ab,
title = {HeadCheck: A concussion app},
author = {Davis, G A and Thurairatnam, S and Feleggakis, P and Anderson, V and Bressan, S and Babl, F E},
doi = {10.1111/jpc.12879},
year = {2015},
date = {2015-01-01},
journal = {Journal of Paediatrics \& Child Health},
volume = {51},
number = {8},
pages = {830--831},
keywords = {Adolescent, algorithm, Athletic Injuries, Australia, brain concussion, checklist, Child, child health care, consensus development, human, Humans, mobile application, Mobile Applications, mobile phone, practice guideline, priority journal, Review, smartphone, sport injury, validation process},
pubstate = {published},
tppubtype = {article}
}
Smith, A M; Stuart, M J; Dodick, D W; Roberts, W O; Alford, P W; Ashare, A B; Aubrey, M; Benson, B W; Burke, C J; Dick, R; Eickhoff, C; Emery, C A; Flashman, L A; Gaz, D; Giza, C C; Greenwald, R M; Herring, S; Hoshizaki, T B; Hudziak, J J; Huston 3rd, J; Krause, D; LaVoi, N; Leaf, M; Leddy, J J; MacPherson, A; McKee, A C; Mihalik, J P; Moessner, A M; Montelpare, W J; Putukian, M; Schneider, K J; Szalkowski, R; Tabrum, M; Whitehead, J; Wiese-Bjornstal, D M
Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379] Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 78–87, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/pc [Prevention & Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention & Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention & Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult
@article{Smith2015a,
title = {Ice Hockey Summit II: zero tolerance for head hits and fighting.[Erratum appears in Clin J Sport Med. 2015 Jul;25(4):379]},
author = {Smith, A M and Stuart, M J and Dodick, D W and Roberts, W O and Alford, P W and Ashare, A B and Aubrey, M and Benson, B W and Burke, C J and Dick, R and Eickhoff, C and Emery, C A and Flashman, L A and Gaz, D and Giza, C C and Greenwald, R M and Herring, S and Hoshizaki, T B and Hudziak, J J and {Huston 3rd}, J and Krause, D and LaVoi, N and Leaf, M and Leddy, J J and MacPherson, A and McKee, A C and Mihalik, J P and Moessner, A M and Montelpare, W J and Putukian, M and Schneider, K J and Szalkowski, R and Tabrum, M and Whitehead, J and Wiese-Bjornstal, D M},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {78--87},
abstract = {OBJECTIVE: To present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building on the Ice Hockey Summit I action plan (2011) to reduce SRC. METHODS: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October 2013). Summit II focused on (1) Basic Science of Concussions in Ice Hockey: Taking Science Forward; (2) Acute and Chronic Concussion Care: Making a Difference; (3) Preventing Concussions via Behavior, Rules, Education and Measuring Effectiveness; (4) Updates in Equipment: their Relationship to Industry Standards; and (5) Policies and Plans at State, National and Federal Levels to reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were subsequently voted on for purposes of prioritization. The following proceedings include knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. RESULTS: The Summit II evidence-based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. CONCLUSIONS: The highest priority action items identified from the Summit includes the following: (1) eliminate head hits from all levels of ice hockey, (2) change body-checking policies, and (3) eliminate fighting in all amateur and professional hockey.},
keywords = {*Brain Concussion/pc [Prevention \& Control], *Brain Injury, *Hockey/in [Injuries], *Violence/pc [Prevention \& Control], Adolescent, adult, Brain Concussion/th [Therapy], Brain Injury, Child, Chronic/pc [Prevention \& Control], Chronic/th [Therapy], Congresses as Topic, Evidence-Based Medicine, Head Protective Devices/st [Standards], Hockey/st [Standards], Humans, policy, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Tackling in youth football Journal Article
In: Pediatrics, vol. 136, no. 5, pp. e1419–e1430, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, ankle injury, athlete, Athletic Injuries, causal attribution, Child, Concussion, contusion, Craniocerebral Trauma, disease association, football, hand injury, head and neck injury, human, Humans, Injuries, injury severity, knee injury, muscle training, Neck Injuries, Neck muscle, nonhuman, Preschool, preschool child, priority journal, protective equipment, quadriplegia, Review, sport injury, standards, strategic planning
@article{Anonymous2015,
title = {Tackling in youth football},
author = {Anonymous},
doi = {10.1542/peds.2015-3282},
year = {2015},
date = {2015-01-01},
journal = {Pediatrics},
volume = {136},
number = {5},
pages = {e1419--e1430},
abstract = {American football remains one of the most popular sports for young athletes. The injuries sustained during football, especially those to the head and neck, have been a topic of intense interest recently in both the public media and medical literature. The recognition of these injuries and the potential for longterm sequelae have led some physicians to call for a reduction in the number of contact practices, a postponement of tackling until a certain age, and even a ban on high school football. This statement reviews the literature regarding injuries in football, particularly those of the head and neck, the relationship between tackling and football-related injuries, and the potential effects of limiting or delaying tackling on injury risk. © 2015 by the American Academy of Pediatrics.},
keywords = {Adolescent, ankle injury, athlete, Athletic Injuries, causal attribution, Child, Concussion, contusion, Craniocerebral Trauma, disease association, football, hand injury, head and neck injury, human, Humans, Injuries, injury severity, knee injury, muscle training, Neck Injuries, Neck muscle, nonhuman, Preschool, preschool child, priority journal, protective equipment, quadriplegia, Review, sport injury, standards, strategic planning},
pubstate = {published},
tppubtype = {article}
}
Strand, S; Lechuga, D; Zachariah, T; Beaulieu, K
Relative risk for concussions in young female soccer players Journal Article
In: Applied Neuropsychology. Child, vol. 4, no. 1, pp. 58–64, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/ep [Epidemiology], *Soccer/in [Injuries], Adolescent, Case-Control Studies, Child, Female, Humans, Incidence, Risk Factors, United States/ep [Epidemiology]
@article{Strand2015,
title = {Relative risk for concussions in young female soccer players},
author = {Strand, S and Lechuga, D and Zachariah, T and Beaulieu, K},
year = {2015},
date = {2015-01-01},
journal = {Applied Neuropsychology. Child},
volume = {4},
number = {1},
pages = {58--64},
abstract = {The objective of this study was to determine the relative risk and reported symptoms of concussions in 11- to 13-year-old, female soccer players. For this, a survey to compare the reported incidence of concussion in age-matched female soccer players to nonsoccer players was performed. The survey included 342 girls between the ages of 11 and 13: 195 were involved in an organized soccer team and 147 were not involved in organized soccer but were allowed to participate in any other sport or activity. A total of 94 of the 195 soccer players, or 48%, reported at least one symptom consistent with a concussion. The most prevalent symptom for these girls was headache (84%). A total of 34 of the 147 nonsoccer players, or 23%, reported at least one symptom consistent with a concussion in the previous six months. These results determined that the relative risk of probable concussions among 11- to 13-year-old, female soccer players is 2.09 (p \< .001},
keywords = {*Brain Concussion/ep [Epidemiology], *Soccer/in [Injuries], Adolescent, Case-Control Studies, Child, Female, Humans, Incidence, Risk Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R
Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult
@article{Meehan2015,
title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},
author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},
doi = {10.1097/JSM.0000000000000107},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {2},
pages = {133--137},
abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Cordingley, D; Vis, S; Reimer, K; Leiter, J; Russell, K
Vestibulo-ocular dysfunction in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery: Pediatrics, vol. 16, no. 3, pp. 248–255, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport
@article{Ellis2015,
title = {Vestibulo-ocular dysfunction in pediatric sports-related concussion},
author = {Ellis, M J and Cordingley, D and Vis, S and Reimer, K and Leiter, J and Russell, K},
doi = {10.3171/2015.1.PEDS14524},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery: Pediatrics},
volume = {16},
number = {3},
pages = {248--255},
abstract = {Object The objective of this study was 2-fold: 1) to examine the prevalence of vestibulo-ocular dysfunction (VOD) among children and adolescents with acute sports-related concussion (SRC) and postconcussion syndrome (PCS) who were referred to a multidisciplinary pediatric concussion program; and 2) to determine if VOD is associated with the development of PCS in this cohort. Methods The authors conducted a retrospective review of all patients with acute SRC (presenting 30 days or less postinjury) and PCS (3 or more symptoms for at least 1 month) referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Initial assessment included clinical history, physical examination, and Post-Concussion Symptom Scale assessment. Patients were also assessed for VOD, which was defined as more than one subjective vestibular and oculomotor complaint (dizziness, blurred vision, and so on) and more than one objective physical examination finding (abnormal smooth pursuits, saccades, vestibulo-ocular reflex, and so on). This study was approved by the local institutional ethics review board. Results A total of 101 patients (mean age 14.2 years, SD 2.3 years; 63 male and 38 female patients) participated, including 77 (76.2%) with acute SRC and 24 (23.8%) with PCS. Twenty-two of the 77 patients (28.6%) with acute SRC and 15 of the 24 (62.5%) with PCS met the clinical criteria for VOD. The median duration of symptoms was 40 days (interquartile range [IQR] 28.5-54 days) for patients with acute SRC who had VOD compared with 21 days (IQR 13-32 days) for those without VOD (p = 0.0001). There was a statistically significant increase in the adjusted odds of developing PCS among patients with acute SRC who had VOD compared with those without VOD (adjusted OR 4.10; 95% CI 1.04-16.16). Conclusions Evidence of VOD was detected in a significant proportion of children and adolescents with acute SRC and PCS who were referred to a multidisciplinary pediatric concussion program. This clinical feature was a significant risk factor for the subsequent development of PCS in this pediatric acute SRC cohort. © AANS, 2015.},
keywords = {Adolescent, amnesia, Article, Athletic Injuries, Baseball, BASKETBALL, blurred vision, brain concussion, CANADA, Child, childhood disease, cohort analysis, complication, Concussion, consultation, controlled study, disease duration, Dizziness, Female, follow up, football, Hockey, human, Humans, interdisciplinary communication, major clinical study, Male, Manitoba, migraine, neuroimaging, neuropsychological test, Neuropsychological Tests, ODDS ratio, Pathophysiology, Pediatric, Physical Examination, physiotherapy, Post-Concussion Syndrome, postconcussion syndrome, Prevalence, priority journal, Reflex, Retrospective Studies, retrospective study, return to sport, saccadic eye movement, skating, skiing, Soccer, sport injury, sport related concussion, Sports-related concussion, Trauma, vestibular physiotherapy, Vestibular therapy, vestibulo ocular dysfunction, Vestibulo-Ocular, Vestibulo-ocular dysfunction, vestibuloocular reflex, VOLLEYBALL, Young Adult, youth sport},
pubstate = {published},
tppubtype = {article}
}
Billock, R M; Anderegg, J J; Mehan, T J; Chounthirath, T; Smith, G A
Zipline-related injuries treated in US EDs, 1997-2012 Journal Article
In: American Journal of Emergency Medicine, vol. 33, no. 12, pp. 1745–1749, 2015.
Abstract | Links | BibTeX | Tags: Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury
@article{Billock2015,
title = {Zipline-related injuries treated in US EDs, 1997-2012},
author = {Billock, R M and Anderegg, J J and Mehan, T J and Chounthirath, T and Smith, G A},
doi = {10.1016/j.ajem.2015.08.022},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Emergency Medicine},
volume = {33},
number = {12},
pages = {1745--1749},
abstract = {Purpose To investigate the epidemiology of zipline-related injuries in the United States. Basic Procedures The National Electronic Injury Surveillance System database was used to examine non-fatal zipline-related injuries treated in US emergency departments (EDs) from 1997 through 2012. Sample weights were applied to calculate national estimates. Main Findings From 1997 through 2012, an estimated 16 850 (95% CI, 13 188-20 512) zipline-related injuries were treated in US EDs. The annual injury rate per 1 million population increased by 52.3% from 7.64 (95% CI, 4.86-10.42) injuries in 2009 (the first year with a stable annual estimate) to 11.64 (95% CI, 7.83-15.45) injuries in 2012. Patients aged 0-9 years accounted for 45.0% of injuries, females made up 53.1% of injuries, and 11.7% of patients required hospitalization. Fractures accounted for the largest proportion of injuries (46.7%), and the upper extremities were the most commonly injured body region (44.1%). Falls were the most common mechanism of injury, accounting for 77.3% of injuries. Among cases where the location of the injury event was known, 30.8% of injuries occurred in a residential setting and 69.2% occurred in a public place. Principal Conclusions This study is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database. The rapid increase in zipline-related injuries in recent years suggests the need for additional safety guidelines and regulations. Commercial ziplines and publicly accessible non-commercial ziplines should be subject to uniform safety standards in all states and jurisdictions across the US, and homemade ziplines should not be used. © 2015 Elsevier Inc.},
keywords = {Accidental Falls, Adolescent, adult, arm fracture, Article, body regions, Child, Concussion, emergency health service, Emergency Service, emergency ward, EPIDEMIOLOGY, falling, Female, head and neck injury, head injury, Hospital, hospitalization, human, Humans, Infant, leg injury, major clinical study, Male, Newborn, Preschool, preschool child, priority journal, recreation, residential area, SAFETY, soft tissue injury, sport injury, sprain, statistics and numerical data, trunk injury, UNITED States, Wounds and Injuries, Young Adult, zipline related injury},
pubstate = {published},
tppubtype = {article}
}
Little, C E; Emery, C; Black, A; Scott, S H; Meeuwisse, W; Nettel-Aguirre, A; Benson, B; Dukelow, S
Test-retest reliability of KINARM robot sensorimotor and cognitive assessment: in pediatric ice hockey players Journal Article
In: Journal of Neuroengineering & Rehabilitation, vol. 12, pp. 78, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/px [Psychology], *COGNITION, *Hockey/in [Injuries], *Robotics, *Sensation, Adolescent, Biomechanical Phenomena, Brain Concussion/pp [Physiopathology], Child, Computer simulation, Humans, learning, Longitudinal studies, Male, Neuropsychological Tests, Practice (Psychology), Prognosis, Prospective Studies, Psychomotor Performance/ph [Physiology], Reproducibility of Results, treatment outcome
@article{Little2015,
title = {Test-retest reliability of KINARM robot sensorimotor and cognitive assessment: in pediatric ice hockey players},
author = {Little, C E and Emery, C and Black, A and Scott, S H and Meeuwisse, W and Nettel-Aguirre, A and Benson, B and Dukelow, S},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neuroengineering \& Rehabilitation},
volume = {12},
pages = {78},
abstract = {BACKGROUND: Better diagnostic and prognostic tools are needed to address issues related to early diagnosis and management of concussion across the continuum of aging but particularly in children and adolescents. The purpose of the current study was to evaluate the reliability of robotic technology (KINARM robot) assessments of reaching, position sense, bimanual motor function, visuospatial skills, attention and decision making in youth ice hockey players (ages 10-14). METHODS: Thirty-four male children attended two testing days, one week apart. On day one, each subject completed five tasks on the robot with two examiners (alternating examiner sequence); the 2(nd) examiner followed the same procedure as the 1(st) immediately afterwards. One consistent examiner tested subjects one week later. This is a test-retest reliability study. The robotic tasks characterize sensorimotor and/or cognitive performance; 63 parameters from 5 tasks are reported. Session 1 was the 1(st) time the subject performed the 5 tasks, session 2 the 2(nd) time on day 1, and session 3 one week following. RESULTS: Intra-class correlation coefficients ranged from 0.06 to 0.91 and 0.09 to 0.90 for session 1 to 2 and 2 to 3, respectively. Bland-Altman plots showed agreement in a majority of the parameters and a learning effect in 25 % and 24 % of parameters in session 1 vs 2 and 1 vs 3, respectively but none for session 2 vs 3. Of those that showed a learning effect, only 8 % of parameters in session 1 vs 2 and 10 % in session 1 vs 3 had a clinical relevance measure\>0.8. CONCLUSIONS: The relative homogeneity of the sample and the effect of learning seen in some of the task parameters appears to have negatively impacted the intra-class correlation coefficients from session 1 to 2, with less impact for 2 to 3. The Bland-Altman analysis supports good absolute reliability in healthy male children with no neurological impairment ranging in age from 10 to 14. The clinically relevant learning effect seen, in a small number of parameters could be addressed by creating a learning effect adjustment factor and/or implementing a practice session, which would eliminate the learning effect.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/px [Psychology], *COGNITION, *Hockey/in [Injuries], *Robotics, *Sensation, Adolescent, Biomechanical Phenomena, Brain Concussion/pp [Physiopathology], Child, Computer simulation, Humans, learning, Longitudinal studies, Male, Neuropsychological Tests, Practice (Psychology), Prognosis, Prospective Studies, Psychomotor Performance/ph [Physiology], Reproducibility of Results, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Quatman-Yates, C C; Bonnette, S; Hugentobler, J A; Médé, B; Kiefer, A W; Kurowski, B G; Riley, M A
Postconcussion Postural Sway Variability Changes in Youth: The Benefit of Structural Variability Analyses Journal Article
In: Pediatric Physical Therapy, vol. 27, no. 4, pp. 316–327, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, ANALYSIS of variance, brain concussion/diagnosis, brain concussion/physiopathology, Child, female humans, Male, mild traumatic brain injury, postural balance
@article{Quatman-Yates2015,
title = {Postconcussion Postural Sway Variability Changes in Youth: The Benefit of Structural Variability Analyses},
author = {Quatman-Yates, C C and Bonnette, S and Hugentobler, J A and M\'{e}d\'{e}, B and Kiefer, A W and Kurowski, B G and Riley, M A},
doi = {10.1097/PEP.0000000000000193},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Physical Therapy},
volume = {27},
number = {4},
pages = {316--327},
abstract = {Using metrics that permit detailed analysis of sway variability, the authors demonstrate the capacity to detect alterations in postural control among youth who sustained concussion. Purpose: The purpose of this study was to evaluate the utility of postural sway variability as a potential assessment to detect altered postural sway in youth with symptoms related to a concussion. Methods: Forty participants (20 who were healthy and 20 who were injured) aged 10 to 16 years were assessed using the Balance Error Scoring System (BESS) and postural sway variability analyses applied to center-of-pressure data captured using a force plate. Results: Significant differences were observed between the 2 groups for postural sway variability metrics but not for the BESS. Specifically, path length was shorter and Sample and Renyi Entropies were more regular for the participants who were injured compared with the participants who were healthy (P \<.05). Conclusion: The results of this study indicate that postural sway variability may be a more valid measure than the BESS to detect postconcussion alterations in postural control in young athletes. © 2015 Wolters Kluwer Health, Inc.},
keywords = {Adolescent, ANALYSIS of variance, brain concussion/diagnosis, brain concussion/physiopathology, Child, female humans, Male, mild traumatic brain injury, postural balance},
pubstate = {published},
tppubtype = {article}
}
Freitag, A; Kirkwood, G; Scharer, S; Ofori-Asenso, R; Pollock, A M
Systematic review of rugby injuries in children and adolescents under 21 years Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 511–519, 2015.
Abstract | BibTeX | Tags: *Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult
@article{Freitag2015a,
title = {Systematic review of rugby injuries in children and adolescents under 21 years},
author = {Freitag, A and Kirkwood, G and Scharer, S and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {511--519},
abstract = {A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {*Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K
Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article
In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends
@article{Vassilyadi2015,
title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},
author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},
doi = {10.1159/000431232},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Neurosurgery},
volume = {50},
number = {4},
pages = {196--203},
abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},
keywords = {Adolescent, adult, affect, Article, Athletic Injuries, behavior disorder, brain concussion, Child, clinical article, clinical assessment, cognitive defect, Cognitive Efficiency Index, complication, Concussion, Concussion Symptom Scale, controlled study, Craniocerebral Trauma, Cross-Sectional Studies, cross-sectional study, fatigue, Female, head injury, headache, human, Humans, Immediate Postconcussion Assessment and Cognitive, Likert scale, Male, memory disorder, mild traumatic brain injury, neuropsychological test, noise, Paediatric patients, Pediatric Quality of Life Inventory, postconcussion syndrome, priority journal, psychology, quality of life, rating scale, scoring system, Sport, sport injury, Sports, symptom, time factor, Time Factors, traumatic brain injury, trends},
pubstate = {published},
tppubtype = {article}
}
Morgan, C D; Zuckerman, S L; King, L E; Beaird, S E; Sills, A K; Solomon, G S
Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging Journal Article
In: Child's Nervous System, vol. 31, no. 12, pp. 2305–2309, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed
@article{Morgan2015,
title = {Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging},
author = {Morgan, C D and Zuckerman, S L and King, L E and Beaird, S E and Sills, A K and Solomon, G S},
doi = {10.1007/s00381-015-2916-y},
year = {2015},
date = {2015-01-01},
journal = {Child's Nervous System},
volume = {31},
number = {12},
pages = {2305--2309},
abstract = {Purpose: Approximately 90% of concussions are transient, with symptoms resolving within 10\textendash14 days. However, a minority of patients remain symptomatic several months post-injury, a condition known as post-concussion syndrome (PCS). The treatment of these patients can be challenging. The goal of our study was to assess the utility and cost-effectiveness of neurologic imaging two or more weeks post-injury in a cohort of youth with PCS. Methods: We conducted a retrospective study of 52 pediatric patients with persistent post-concussion symptoms after 3 months. We collected demographics and neuroimaging results obtained greater than 2 weeks post-concussion. Neuroimaging ordered in the first 2 weeks post-concussion was excluded, except to determine the rate of re-imaging. Descriptive statistics and corresponding cost data were collected. Results: Of 52 patients with PCS, 23/52 (44 %) had neuroimaging at least 2 weeks after the initial injury, for a total of 32 diagnostic studies. In summary, 1/19 MRIs (5.3 %), 1/8 CTs (13 %), and 0/5 x-rays (0 %) yielded significant positive findings, none of which altered clinical management. Chronic phase neuroimaging estimated costs from these 52 pediatric patients totaled $129,025. We estimate the cost to identify a single positive finding was $21,000 for head CT and $104,500 for brain MRI. Conclusions: In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase. © 2015, Springer-Verlag Berlin Heidelberg.},
keywords = {Adolescent, arachnoid cyst, Article, brain, Brain Injury, Child, Computed tomography (CT) neuroimaging, computer assisted tomography, Computer-Assisted, Concussion, cost effectiveness analysis, cost utility analysis, DECISION making, diagnostic value, DSM-IV, Female, human, Humans, image processing, Magnetic Resonance Imaging, Magnetic resonance imaging (MRI), major clinical study, Male, mild traumatic brain injury, neuroimaging, neurosurgery, nuclear magnetic resonance, nuclear magnetic resonance imaging, pathology, Post-Concussion Syndrome, postconcussion syndrome, Preschool, preschool child, priority journal, Radiography, Retrospective Studies, retrospective study, Sports, STATISTICS, Tomography, traumatic brain injury, X ray, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M
Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.
Abstract | Links | BibTeX | Tags: academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome
@article{Alexander2015,
title = {Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes},
author = {Alexander, D G and Shuttleworth-Edwards, A B and Kidd, M and Malcolm, C M},
doi = {10.3109/02699052.2015.1031699},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1113--1125},
abstract = {Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby. © 2015 Taylor \& Francis Group, LLC.},
keywords = {academic achievement, Academic performance, ADOLESCENCE, Adolescent, adolescent disease, adult, Article, Athletic Injuries, brain concussion, Brain Injuries, Child, cognition, Concussion, controlled study, Educational Status, football, human, Humans, Injuries, intelligence test, Intelligence Tests, Longitudinal studies, longitudinal study, major clinical study, Male, mild traumatic brain injury, mTBI, neurocognitive, neuropsychological test, Neuropsychological Tests, Pathophysiology, Prospective Studies, prospective study, psychologic test, psychology, rugby, SOUTH Africa, sport injury, TASK performance, traumatic brain injury, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Leiter, J; Hall, T; McDonald, P J; Sawyer, S; Silver, N; Bunge, M; Essig, M
Neuroimaging findings in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 3, pp. 241–247, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed
@article{Ellis2015b,
title = {Neuroimaging findings in pediatric sports-related concussion},
author = {Ellis, M J and Leiter, J and Hall, T and McDonald, P J and Sawyer, S and Silver, N and Bunge, M and Essig, M},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {3},
pages = {241--247},
abstract = {OBJECT: The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. METHODS: The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age \< 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. RESULTS: A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). CONCLUSIONS: Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide information that impacts decision making about return to play and retirement from the sport.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
De Matteo, C; Volterman, K A; Breithaupt, P G; Claridge, E A; Adamich, J; Timmons, B W
Exertion testing in youth with mild traumatic brain injury/concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors
@article{DeMatteo2015,
title = {Exertion testing in youth with mild traumatic brain injury/concussion},
author = {{De Matteo}, C and Volterman, K A and Breithaupt, P G and Claridge, E A and Adamich, J and Timmons, B W},
doi = {10.1249/MSS.0000000000000682},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results Participants had a mean ± SD symptom duration of 6.3 ± 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. © 2015 by the American College of Sports Medicine.},
keywords = {Adolescent, adolescents, brain concussion, Child, children, Cross-Sectional Studies, cross-sectional study, exercise, exercise test, exercise tolerance, Female, head injury, human, Humans, Male, Pathophysiology, Physical Exertion, Post-Concussion Syndrome, postconcussion syndrome, Return to Play, return to sport, time factor, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Biederman, J; Feinberg, L; Chan, J; Adeyemo, B O; Woodworth, K Y; Panis, W; McGrath, N; Bhatnagar, S; Spencer, T J; Uchida, M; Kenworthy, T; Grossman, R; Zafonte, R; Faraone, S V
Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes Journal Article
In: Journal of Nervous & Mental Disease, vol. 203, no. 11, pp. 813–819, 2015.
Abstract | BibTeX | Tags: *Athletes, *Athletic Injuries/ep [Epidemiology], *Attention Deficit Disorder with Hyperactivity/ep, *Brain Injuries/ep [Epidemiology], *Students, Adolescent, adult, Athletic Injuries/di [Diagnosis], Attention Deficit Disorder with Hyperactivity/di [, Brain Injuries/di [Diagnosis], Child, Female, Humans, Male, Risk Factors, Young Adult
@article{Biederman2015,
title = {Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes},
author = {Biederman, J and Feinberg, L and Chan, J and Adeyemo, B O and Woodworth, K Y and Panis, W and McGrath, N and Bhatnagar, S and Spencer, T J and Uchida, M and Kenworthy, T and Grossman, R and Zafonte, R and Faraone, S V},
year = {2015},
date = {2015-01-01},
journal = {Journal of Nervous \& Mental Disease},
volume = {203},
number = {11},
pages = {813--819},
abstract = {A recent meta-analysis documented a significant statistical association between mild traumatic brain injury (mTBI) and attention deficit hyperactivity disorder (ADHD) (Adeyemo et al., 2014), but the direction of this effect was unclear. In this study, we hypothesized that ADHD would be an antecedent risk factor for mTBI. Participants were student athletes ages 12 to 25 who had sustained a mTBI and Controls of similar age and sex selected from studies of youth with and without ADHD. Subjects were assessed for symptoms of ADHD, concussion severity, and cognitive function. mTBI subjects had a significantly higher rate of ADHD than Controls, and in all cases the age of onset of ADHD was before mTBI onset. mTBI+ADHD subjects also had more severe concussion symptoms (fatigue and poor concentration) than mTBI-ADHD subjects. These results support ADHD as an antecedent risk factor for mTBI in student athletes and that its presence complicates the course of mTBI.},
keywords = {*Athletes, *Athletic Injuries/ep [Epidemiology], *Attention Deficit Disorder with Hyperactivity/ep, *Brain Injuries/ep [Epidemiology], *Students, Adolescent, adult, Athletic Injuries/di [Diagnosis], Attention Deficit Disorder with Hyperactivity/di [, Brain Injuries/di [Diagnosis], Child, Female, Humans, Male, Risk Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Davis, J; Canty, G
Are Sports-Related Concussions Giving You a Headache? Journal Article
In: Missouri Medicine, vol. 112, no. 3, pp. 187–191, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/di [Diagnosis], *Brain Concussion/th [Therapy], Adolescent, Brain Concussion/et [Etiology], Child, DIAGNOSTIC imaging, Emergency Medicine, Humans, Neuropsychological Tests, Patient Education as Topic
@article{Davis2015,
title = {Are Sports-Related Concussions Giving You a Headache?},
author = {Davis, J and Canty, G},
year = {2015},
date = {2015-01-01},
journal = {Missouri Medicine},
volume = {112},
number = {3},
pages = {187--191},
abstract = {Acute care visits for sports-related concussion (SRC) are increasing dramatically in adolescents. This review summarizes current concepts in the evaluation and management of pediatric SRC by health care providers in the acute care setting.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/di [Diagnosis], *Brain Concussion/th [Therapy], Adolescent, Brain Concussion/et [Etiology], Child, DIAGNOSTIC imaging, Emergency Medicine, Humans, Neuropsychological Tests, Patient Education as Topic},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
Abstract | BibTeX | Tags: Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness},
pubstate = {published},
tppubtype = {article}
}
Buzas, David; Jacobson, Nathan A; Morawa, Lawrence G
Concussions From 9 Youth Organized Sports: Results From NEISS Hospitals Over an 11-Year Time Frame, 2002-2012 Journal Article
In: Orthopaedic Journal of Sports Medicine, pp. 1–8, 2014.
Links | BibTeX | Tags: ADOLESCENCE, Adolescent Health, Age Factors, Athletic Injuries -- Epidemiology -- In Infancy an, Baseball, BASKETBALL, Brain Concussion -- Epidemiology -- In Infancy and, Child, Child Health, Data Analysis Software, descriptive research, DESCRIPTIVE statistics, Disease Surveillance, emergency care, Epidemiological Research, Female, football, Gymnastics, Hockey, human, Male, MICHIGAN, Pearson's Correlation Coefficient, Preschool, Prospective Studies, Racquet Sports, Soccer, unconsciousness, UNITED States, wrestling
@article{Buzas2014,
title = {Concussions From 9 Youth Organized Sports: Results From NEISS Hospitals Over an 11-Year Time Frame, 2002-2012},
author = {Buzas, David and Jacobson, Nathan A and Morawa, Lawrence G},
doi = {10.1177/2325967114528460},
year = {2014},
date = {2014-01-01},
journal = {Orthopaedic Journal of Sports Medicine},
pages = {1--8},
publisher = {Sage Publications Inc.},
address = {Thousand Oaks, California},
keywords = {ADOLESCENCE, Adolescent Health, Age Factors, Athletic Injuries -- Epidemiology -- In Infancy an, Baseball, BASKETBALL, Brain Concussion -- Epidemiology -- In Infancy and, Child, Child Health, Data Analysis Software, descriptive research, DESCRIPTIVE statistics, Disease Surveillance, emergency care, Epidemiological Research, Female, football, Gymnastics, Hockey, human, Male, MICHIGAN, Pearson's Correlation Coefficient, Preschool, Prospective Studies, Racquet Sports, Soccer, unconsciousness, UNITED States, wrestling},
pubstate = {published},
tppubtype = {article}
}
Crowley, P J; Crowley, M J
Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme Journal Article
In: British Journal of Sports Medicine, vol. 48, no. 2, pp. 147–150, 2014.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], *Track and Field/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention & Control], Attitudes, Child, Craniocerebral Trauma/ep [Epidemiology], Data Collection, Equipment Design, Health Knowledge, Health Policy, Health Promotion/og [Organization & Administration, Humans, Ireland/ep [Epidemiology], Practice, Risk Reduction Behavior, Track and Field/lj [Legislation & Jurisprudence], Track and Field/sn [Statistics & Numerical Data], Young Adult
@article{Crowley2014,
title = {Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme},
author = {Crowley, P J and Crowley, M J},
year = {2014},
date = {2014-01-01},
journal = {British Journal of Sports Medicine},
volume = {48},
number = {2},
pages = {147--150},
abstract = {BACKGROUND: Major head injuries are not uncommon in the Irish national game of hurling. Historically, helmets were not worn. METHODS: We report a multistage campaign to facilitate and encourage the use of appropriate headgear among the estimated 100 000 hurling players in Ireland. This campaign lasted for 27 years between 1985 and 2012, and involved a number of different stages including: (1) facilitating the establishment of a business dedicated to developing head protection equipment suitable for hurling, (2) placing a particular emphasis on continual product enhancement to the highest industrial standards, (3) engaging continually with the game's controlling body, the Gaelic Athletic Association (GAA), with the ultimate objective of securing a mandatory usage policy for protective helmets and faceguards, (4) longitudinal research to monitor hurling injury, equipment usage and players' attitudes and (5) widely communicating key research findings to GAA leaders and members, as well as to 1000 clubs and schools. RESULTS: One of our three relevant studies included 798 patients and identified a dramatic association between the type of head protection used by a player, if any, and the site of the injury requiring treatment. While 51% of the injured players without head protection suffered head trauma, this rate was only 35% among the players wearing helmets and 5% among players who were wearing full head protection (both a helmet and faceguard). CONCLUSION: The GAA responded in three stages to the accumulating evidence: (1) they introduced a mandatory regulation for those aged less than 18 years in 2005; (2) this ruling was extended to all players under 21 years in 2007 and (3) finally extended to all players irrespective of age, gender or grade from January 2010. The latter ruling applied to both games and organised training sessions.},
keywords = {*Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], *Track and Field/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention \& Control], Attitudes, Child, Craniocerebral Trauma/ep [Epidemiology], Data Collection, Equipment Design, Health Knowledge, Health Policy, Health Promotion/og [Organization \& Administration, Humans, Ireland/ep [Epidemiology], Practice, Risk Reduction Behavior, Track and Field/lj [Legislation \& Jurisprudence], Track and Field/sn [Statistics \& Numerical Data], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Zuckerman, Scott L; Lee, Young M; Odom, Mitchell J; Solomon, Gary S; Sills, Allen K
Baseline neurocognitive scores in athletes with attention deficit-spectrum disorders and/or learning disability Journal Article
In: Journal of Neurosurgery: Pediatrics, vol. 12, no. 2, pp. 103–109, 2013, ISBN: 1933-0707.
Links | BibTeX | Tags: ADOLESCENCE, Athletes, Athletic Injuries -- Complications, attention, Attention Deficit Hyperactivity Disorder -- Compli, Brain Concussion -- Complications, Brain Concussion -- Diagnosis, Brain Concussion -- Psychosocial Factors, Child, cognition, Cognition Disorders -- Diagnosis, Cognition Disorders -- Etiology, Female, human, Learning Disorders -- Complications, Male, Memory, Neuropsychological Tests, reaction time, Severity of Illness Indices, Sports
@article{Zuckerman2013,
title = {Baseline neurocognitive scores in athletes with attention deficit-spectrum disorders and/or learning disability},
author = {Zuckerman, Scott L and Lee, Young M and Odom, Mitchell J and Solomon, Gary S and Sills, Allen K},
doi = {10.3171/2013.5.PEDS12524},
isbn = {1933-0707},
year = {2013},
date = {2013-01-01},
journal = {Journal of Neurosurgery: Pediatrics},
volume = {12},
number = {2},
pages = {103--109},
publisher = {American Association of Neurological Surgeons \& the Journal of Neurosurgical Publishing Group},
address = {Rolling Meadows, Illinois},
keywords = {ADOLESCENCE, Athletes, Athletic Injuries -- Complications, attention, Attention Deficit Hyperactivity Disorder -- Compli, Brain Concussion -- Complications, Brain Concussion -- Diagnosis, Brain Concussion -- Psychosocial Factors, Child, cognition, Cognition Disorders -- Diagnosis, Cognition Disorders -- Etiology, Female, human, Learning Disorders -- Complications, Male, Memory, Neuropsychological Tests, reaction time, Severity of Illness Indices, Sports},
pubstate = {published},
tppubtype = {article}
}
Gaslin, Tracey C
Information and updates on concussion evaluation and management Journal Article
In: CompassPoint, vol. 23, no. 2, pp. 6–7, 2013.
Abstract | BibTeX | Tags: American Academy of Nursing, Brain Concussion -- Diagnosis -- In Infancy and Ch, Brain Concussion -- Therapy -- In Infancy and Chil, Camp Nursing, Child, Practice Guidelines
@article{Gaslin2013,
title = {Information and updates on concussion evaluation and management},
author = {Gaslin, Tracey C},
year = {2013},
date = {2013-01-01},
journal = {CompassPoint},
volume = {23},
number = {2},
pages = {6--7},
publisher = {Association of Camp Nurses},
address = {Fisherville, Kentucky},
abstract = {The potential for concussions is a possibility for all camp professionals. Knowing what, when, and who are part of your concussion management plan are an important elements to consider. This article briefly outlines the updates to concussion care and reaffirms the need for a proactive and comprehensive approach to evaluation and management.},
keywords = {American Academy of Nursing, Brain Concussion -- Diagnosis -- In Infancy and Ch, Brain Concussion -- Therapy -- In Infancy and Chil, Camp Nursing, Child, Practice Guidelines},
pubstate = {published},
tppubtype = {article}
}
Schupp, Christian M; Bedgood, Alysia
Sideline management from head to toe of the skeletally immature athlete Journal Article
In: Current Sports Medicine Reports, vol. 12, no. 3, pp. 162–169, 2013, ISBN: 1537-890X.
Links | BibTeX | Tags: ADOLESCENCE, Athletic Injuries -- Diagnosis, Athletic Injuries -- Therapy, Bone Development, Brain Concussion -- Diagnosis, Brain Concussion -- Therapy, Child, Fractures -- Diagnosis, Fractures -- Therapy, Preschool, Sports Medicine -- Methods, Young Adult
@article{Schupp2013,
title = {Sideline management from head to toe of the skeletally immature athlete},
author = {Schupp, Christian M and Bedgood, Alysia},
doi = {10.1249/JSR.0b013e3182913cac},
isbn = {1537-890X},
year = {2013},
date = {2013-01-01},
journal = {Current Sports Medicine Reports},
volume = {12},
number = {3},
pages = {162--169},
keywords = {ADOLESCENCE, Athletic Injuries -- Diagnosis, Athletic Injuries -- Therapy, Bone Development, Brain Concussion -- Diagnosis, Brain Concussion -- Therapy, Child, Fractures -- Diagnosis, Fractures -- Therapy, Preschool, Sports Medicine -- Methods, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Concussion in sport: fair play for young people Journal Article
In: Lancet, vol. 382, no. 9904, pp. 1536, 2013.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Adolescent, Athletic Injuries/et [Etiology], Brain Concussion/et [Etiology], Child, Humans, Preschool, Risk Factors, Sports, Young Adult
@article{Anonymous2013,
title = {Concussion in sport: fair play for young people},
author = {Anonymous},
year = {2013},
date = {2013-01-01},
journal = {Lancet},
volume = {382},
number = {9904},
pages = {1536},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Adolescent, Athletic Injuries/et [Etiology], Brain Concussion/et [Etiology], Child, Humans, Preschool, Risk Factors, Sports, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Barlow, Michael; Schlabach, Drew; Peiffer, Jeffrey; Cook, Chad
Differences in change scores and the predictive validity of three commonly used measures following concussion in the middle school and high school aged population...[corrected] [published erratum appears in INT J SPORTS PHYS THER 2011; 6(4):1p] Journal Article
In: International Journal of Sports Physical Therapy, vol. 6, no. 3, pp. 150–157, 2011, ISBN: 2159-2896.
Abstract | BibTeX | Tags: ADOLESCENCE, adult, Brain Concussion -- Diagnosis, Child, Data Analysis Software, Disability Evaluation, Female, human, Instrument Validation, Male, Middle, Ohio, Postconcussion Syndrome -- Risk Factors, Predictive Value of Tests, Record Review, Recovery, Retrospective Design, ROC Curve, Scales, Schools, Secondary, validity
@article{Barlow2011,
title = {Differences in change scores and the predictive validity of three commonly used measures following concussion in the middle school and high school aged population...[corrected] [published erratum appears in INT J SPORTS PHYS THER 2011; 6(4):1p]},
author = {Barlow, Michael and Schlabach, Drew and Peiffer, Jeffrey and Cook, Chad},
isbn = {2159-2896},
year = {2011},
date = {2011-01-01},
journal = {International Journal of Sports Physical Therapy},
volume = {6},
number = {3},
pages = {150--157},
publisher = {North American Journal of Sports Physical Therapy},
address = {Indianapolis, Indiana},
abstract = {Background: A battery of tests is commonly used to measure disability with and recovery from concussion. A number of different concussion-oriented assessment tests exist and each is considered useful. To the authors' knowledge, no study has compared the scores of these tests during recovery in the middle school and high school aged population to see how each change over time. Purpose: The purposes of this study were to analyze clinical data of concussed middle school and high school aged athletes to determine the concurrent and predictive validity for post-concussion syndrome (PCS) of the Post-Concussion Symptom Scale (PCSS), Balance Error Scoring System (BESS), and the five subscales of the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Methods: The study was a retrospective chart review performed on middle school and high school aged individuals with a diagnosis of concussion from the years 2008-2010 within the Akron Children's Hospital Sports Medicine system. To be eligible for inclusion in the dataset, each subject required a baseline measurement for each of the three tests (and all five subscales of the ImPACT) and a post-test measure. The mean age of the population was 15.38 years (SD=1.7) and ranged from 11 to 19 years. Pearson product correlation tests (correlation matrix) were used to analyze the concurrent validity of the test items during recovery following a concussion. Receiver operating characteristics (ROC) curves were used to determine the predictive validity of initial scores for developing PCS. Results: The correlation matrix captured five statistically significant findings; however, these suggested only weak to mild correlations. Five test items yielded an area under the curve (AUC) greater than 0.50 but only one was statistically significant. After qualitative evaluation, only one of the three tests (including the five subscales of the ImPACT) was useful in predicting post-concussion syndrome. Conclusion: This study suggests that there is poor concurrent validity among three commonly used concussion tests and there is no baseline score that predicts whether post-concussion syndrome will occur.},
keywords = {ADOLESCENCE, adult, Brain Concussion -- Diagnosis, Child, Data Analysis Software, Disability Evaluation, Female, human, Instrument Validation, Male, Middle, Ohio, Postconcussion Syndrome -- Risk Factors, Predictive Value of Tests, Record Review, Recovery, Retrospective Design, ROC Curve, Scales, Schools, Secondary, validity},
pubstate = {published},
tppubtype = {article}
}
for Disease Control, Centers; Prevention,
Nonfatal traumatic brain injuries from sports and recreation activities--United States, 2001-2005 Journal Article
In: MMWR - Morbidity & Mortality Weekly Report, vol. 56, no. 29, pp. 733–737, 2007.
Abstract | BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Injuries/ep [Epidemiology], Adolescent, adult, Child, Chronic traumatic encephalopathy, Female, Humans, Incidence/Epidemiology, Infant, Male, middle aged, Population Surveillance, Preschool, recreation, United States/ep [Epidemiology]
@article{CentersforDiseaseControlandPrevention2007,
title = {Nonfatal traumatic brain injuries from sports and recreation activities--United States, 2001-2005},
author = {{Centers for Disease Control and Prevention}},
year = {2007},
date = {2007-01-01},
journal = {MMWR - Morbidity \& Mortality Weekly Report},
volume = {56},
number = {29},
pages = {733--737},
abstract = {Each year in the United States, an estimated 38 million children and adolescents participate in organized sports, and approximately 170 million adults participate in some type of physical activity not related to work. The health benefits of these activities are tempered by the risk for injury, including traumatic brain injury (TBI). CDC estimates that 1.1 million persons with TBIs are treated and released from U.S. hospital emergency departments (EDs) each year, and an additional 235,000 are hospitalized for these injuries. TBIs can result in long-term, negative health effects (e.g., memory loss and behavioral changes). To characterize sports- and recreation-related (SR-related) TBIs among patients treated in U.S. hospital EDs, CDC analyzed data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for the period 2001-2005. This report summarizes the results of that analysis, which indicated that an estimated 207,830 patients with nonfatal SR-related TBIs were treated in EDs each year during this period. The highest rates of SR-related TBI ED visits for both males and females occurred among those aged 10-14 years. Increased awareness of TBI risks, prevention strategies, and the importance of timely identification and management is essential for reducing the incidence, severity, and long-term negative health effects of this type of injury.},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Injuries/ep [Epidemiology], Adolescent, adult, Child, Chronic traumatic encephalopathy, Female, Humans, Incidence/Epidemiology, Infant, Male, middle aged, Population Surveillance, Preschool, recreation, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Kerr, J; Swann, I J; Pentland, B
A survey of information given to head-injured patients on direct discharge from emergency departments in Scotland Journal Article
In: Emergency Medicine Journal, vol. 24, no. 5, pp. 330–332, 2007, ISBN: 1472-0205.
Abstract | Links | BibTeX | Tags: adult, Child, Emergency Service, Head Injuries, human, Pamphlets, Patient Discharge Education -- Evaluation, postconcussion syndrome, Scotland
@article{Kerr2007,
title = {A survey of information given to head-injured patients on direct discharge from emergency departments in Scotland},
author = {Kerr, J and Swann, I J and Pentland, B},
doi = {10.1136/emj.2006.044230},
isbn = {1472-0205},
year = {2007},
date = {2007-01-01},
journal = {Emergency Medicine Journal},
volume = {24},
number = {5},
pages = {330--332},
publisher = {BMJ Publishing Group},
abstract = {AIM: To survey the information provided to head-injured patients on discharge from emergency departments (EDs) in Scotland. METHODS: EDs throughout Scotland were asked to supply a copy of their head injury advice pamphlet for analysis. Each pamphlet was assessed against a template and an Excel spreadsheet was created. RESULTS: All 30 (100%) Scottish EDs responded. The frequency with which specific features appeared varied widely, with most pamphlets concentrating on emergency features, with less emphasis on postconcussion symptoms. CONCLUSIONS: Head injury discharge advice should be standardised throughout EDs, with more emphasis given to postconcussion features.},
keywords = {adult, Child, Emergency Service, Head Injuries, human, Pamphlets, Patient Discharge Education -- Evaluation, postconcussion syndrome, Scotland},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A K; To, T M; Macarthur, C; Chipman, M L; Wright, J G; Parkin, P C
Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study Journal Article
In: Pediatrics, vol. 110, no. 5, pp. e60, 2002.
Abstract | BibTeX | Tags: *Bicycling/in [Injuries], *Bicycling/lj [Legislation & Jurisprudence], *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics & Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics & Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics & Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics & Numerical Data, Trauma Severity Indices
@article{Macpherson2002,
title = {Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study},
author = {Macpherson, A K and To, T M and Macarthur, C and Chipman, M L and Wright, J G and Parkin, P C},
year = {2002},
date = {2002-01-01},
journal = {Pediatrics},
volume = {110},
number = {5},
pages = {e60},
abstract = {OBJECTIVE: Childhood bicycle-related head injuries can be prevented through the use of helmets. Although helmet legislation has proved to be a successful strategy for the adoption of helmets, its effect on the rates of head injury is uncertain. In Canada, 4 provinces have such legislation. The objective of this study was to measure the impact of helmet legislation on bicycle-related head injuries in Canadian children. METHODS: Routinely collected data from the Canadian Institute for Health Information identified all Canadian children (5-19 years) who were hospitalized for bicycling-related injuries from 1994-1998. Children were categorized as head or other injury on the basis of International Classification of Diseases, Ninth Revision, codes. Rates of head injuries and other injuries were compared over time in provinces that adopted legislation and those that did not. RESULTS: Of the 9650 children who were hospitalized because of a bicycle-related injury, 3426 sustained injuries to the head and face and the remaining 6224 had other injuries. The bicycle-related head injury rate declined significantly (45% reduction) in provinces where legislation had been adopted compared with provinces and territories that did not adopt legislation (27% reduction). CONCLUSION: This country-wide study compared rates of head injury in regions with and without mandatory helmet legislation. Comparing head injuries with other non-head-injured children controlled for potential differences in children's cycling habits. The strong protective association between helmet legislation and head injuries supports the adoption of helmet legislation as an effective tool in the prevention of childhood bicycle-related head injuries.},
keywords = {*Bicycling/in [Injuries], *Bicycling/lj [Legislation \& Jurisprudence], *Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics \& Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics \& Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics \& Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics \& Numerical Data, Trauma Severity Indices},
pubstate = {published},
tppubtype = {article}
}