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Hutchison, M G; Comper, P; Meeuwisse, W H; Echemendia, R J
A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what? Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 547–551, 2015.
@article{Hutchison2015,
title = {A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what?},
author = {Hutchison, M G and Comper, P and Meeuwisse, W H and Echemendia, R J},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {547--551},
abstract = {BACKGROUND: Although there is a growing understanding of the consequences of concussions in hockey, very little is known about the precipitating factors associated with this type of injury. AIM: To describe player characteristics and situational factors associated with concussions in the National Hockey League (NHL). METHODS: Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006-2010 seasons using an inclusive cohort of professional hockey players. Digital video records were coded and analysed using the Heads Up Checklist. RESULTS: Of 197 medically diagnosed concussions, 88% involved contact with an opponent. Forwards accounted for more concussions than expected compared with on-ice proportional representation (95% CI 60 to 73; p=0.04). Significantly more concussions occurred in the first period (47%) compared with the second and third periods (p=0.047), with the majority of concussions occurring in the defensive zone (45%). Approximately 47% of the concussions occurred in open ice, 53% occurred in the perimeter. Finally, 37% of the concussions involved injured players' heads contacting the boards or glass. CONCLUSIONS: This study describes several specific factors associated with concussions in the NHL, including period of the game, player position, body size, and specific locations on the ice and particular situations based on a player's position.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 = {},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
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.
@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 = {},
pubstate = {published},
tppubtype = {article}
}
Gardner, A J; Tan, C O; Ainslie, P N; Van Donkelaar, P; Stanwell, P; Levi, C R; Iverson, G L
Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 16, pp. 1050–1055, 2015.
@article{Gardner2015bb,
title = {Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review},
author = {Gardner, A J and Tan, C O and Ainslie, P N and {Van Donkelaar}, P and Stanwell, P and Levi, C R and Iverson, G L},
doi = {10.1136/bjsports-2014-093901},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {16},
pages = {1050--1055},
abstract = {Background: Traumatic brain injury influences regulation of cerebral blood flow in animal models and in human studies. We reviewed the use of transcranial Doppler ultrasound (US) to monitor cerebrovascular reactivity following sport-related concussion. Review method: A narrative and systematic review of articles published in the English language, from December 1982 to October 2013. Data sources: Articles were retrieved via numerous databases using relevant key terms. Observational, cohort, correlational, cross-sectional and longitudinal studies were included. Results: Three publications met the criteria for inclusion; these provided data from 42 athletes and 33 controls. All three studies reported reductions in cerebrovascular reactivity via transcranial Doppler US. Conclusions: These initial results support the use of cerebrovascular reactivity as a research tool for identifying altered neurophysiology and monitoring recovery in adult athletes. Larger cross-sectional, prospective and longitudinal studies are required to understand the sensitivity and prognostic value of cerebrovascular reactivity in sport-related concussion. © 2015, BMJ Publishing Group. All rights reserved.},
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}
}
Olivera, A; Lejbman, N; Jeromin, A; French, L M; Kim, H S; Cashion, A; Mysliwiec, V; Diaz-Arrastia, R; Gill, J
Peripheral Total Tau in Military Personnel Who Sustain Traumatic Brain Injuries During Deployment Journal Article
In: JAMA Neurology, vol. 72, no. 10, pp. 1109–1116, 2015.
@article{Olivera2015,
title = {Peripheral Total Tau in Military Personnel Who Sustain Traumatic Brain Injuries During Deployment},
author = {Olivera, A and Lejbman, N and Jeromin, A and French, L M and Kim, H S and Cashion, A and Mysliwiec, V and Diaz-Arrastia, R and Gill, J},
year = {2015},
date = {2015-01-01},
journal = {JAMA Neurology},
volume = {72},
number = {10},
pages = {1109--1116},
abstract = {IMPORTANCE: Approximately one-third of military personnel who deploy for combat operations sustain 1 or more traumatic brain injuries (TBIs), which increases the risk for chronic symptoms of postconcussive disorder, posttraumatic stress disorder, and depression and for the development of chronic traumatic encephalopathy. Elevated concentrations of tau are observed in blood shortly following a TBI, but, to our knowledge, the role of tau elevations in blood in the onset and maintenance of chronic symptoms after TBI has not been investigated. OBJECTIVES: To assess peripheral tau levels in military personnel exposed to TBI and to examine the relationship between chronic neurological symptoms and tau elevations. DESIGN, SETTING, AND PARTICIPANTS: Observational assessment from September 2012 to August 2014 of US military personnel at the Madigan Army Medical Center who had been deployed within the previous 18 months. Plasma total tau concentrations were measured using a novel ultrasensitive single-molecule enzyme-linked immunosorbent assay. Classification of participants with and without self-reported TBI was made using the Warrior Administered Retrospective Casualty Assessment Tool. Self-reported symptoms of postconcussive disorder, posttraumatic stress disorder, and depression were determined by the Neurobehavioral Symptom Inventory, the Posttraumatic Stress Disorder Checklist Military Version, and the Quick Inventory of Depressive Symptomatology, respectively. Group differences in tau concentrations were determined through analysis of variance models, and area under the receiver operating characteristic curve determined the sensitivity and specificity of tau concentrations in predicting TBI and chronic symptoms. Seventy participants with self-reported TBI on the Warrior Administered Retrospective Casualty Assessment Tool and 28 control participants with no TBI exposure were included. MAIN OUTCOMES AND MEASURES: Concentration of total tau in peripheral blood. RESULTS: Concentrations of plasma tau were significantly elevated in the 70 participants with self-reported TBI compared with the 28 controls (mean [SD], 1.13 [0.78] vs 0.63 [0.48] pg/mL, respectively; F1},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Waldron-Perrine, B; Tree, H A; Spencer, R J; Suhr, J; Bieliauskas, L
Informational literature influences symptom expression following mild head injury: An analog study Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1051–1055, 2015.
@article{Waldron-Perrine2015,
title = {Informational literature influences symptom expression following mild head injury: An analog study},
author = {Waldron-Perrine, B and Tree, H A and Spencer, R J and Suhr, J and Bieliauskas, L},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1051--1055},
abstract = {PRIMARY OBJECTIVE: Many Veterans involved in recent OEF/OIF conflicts return with reports of having experienced an mTBI. The Veteran's Affairs (VA) and Department of Defense (DoD) have gone to great lengths to provide information to Veterans regarding possible effects of TBI. Although well intended, this information may possibly have an iatrogenic effect. Conversely, setting positive expectations for recovery from mTBI has been shown to result in decreased symptomatology. RESEARCH DESIGN: One-way ANOVA and Tukey post-hoc analyses were used to determine whether there were significant differences on reported severity and number of PCS symptoms (NSI) among the three experimental groups (recovery focused information; expectation for persistent symptoms; and no information given). METHODS AND PROCEDURES: Undergraduate students, who were told to imagine they had experienced a military-related TBI, reported varying levels of expected symptoms when given either positive or negative information about symptom expectation. MAIN OUTCOMES AND RESULTS: The results indicate that presenting recovery-oriented literature resulted in the lowest report of expected symptoms, whereas presenting no information resulted in the highest report of expected symptoms. CONCLUSIONS: Providing Veterans with information regarding a likely positive trajectory of recovery may result in less symptom persistence during rehabilitation.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lefebvre, G; Tremblay, S; Théoret, H
Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1032–1043, 2015.
@article{Lefebvre2015,
title = {Probing the effects of mild traumatic brain injury with transcranial magnetic stimulation of the primary motor cortex},
author = {Lefebvre, G and Tremblay, S and Th\'{e}oret, H},
doi = {10.3109/02699052.2015.1028447},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1032--1043},
abstract = {Primary objective: The present paper systematically reviews studies using transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) to assess cortical excitability, intra-cortical inhibition/facilitation and synaptic plasticity following mild traumatic brain injury (mTBI).Methods: Articles using TMS over M1 in patients with mTBI or sport-related concussion indexed in PubMed and published between 1998 and September 2014 were included in the present review.Main outcomes and results: From the 17 articles that matched search criteria, results from various TMS paradigms were summarized and divided in three main areas of interest: motor cortical excitability/facilitation, motor cortical inhibition and cortical plasticity. Although studies suggest a trend of abnormal intra-cortical inhibition following mTBI, no clear and specific pattern emerges from the surveyed data.Conclusions: At this time and with the possible exception of intra-cortical inhibitory measures, TMS cannot reliably detect changes in M1 excitability in individuals with mTBI or a concussion at both the acute and chronic stages of injury. This may be explained by the small number of studies and large variety of stimulation parameters. Additional longitudinal and multimodal studies are needed to better understand the nature of the excitability changes that may occur within M1 following mTBI. © 2015 Taylor \& Francis Group, LLC.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hinton-Bayre, A D
Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion Journal Article
In: Brain Impairment, vol. 16, no. 2, pp. 80–89, 2015.
@article{Hinton-Bayre2015,
title = {Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion},
author = {Hinton-Bayre, A D},
doi = {10.1017/BrImp.2015.14},
year = {2015},
date = {2015-01-01},
journal = {Brain Impairment},
volume = {16},
number = {2},
pages = {80--89},
abstract = {Objective: Obtaining baseline neuropsychological (NP) data to assist management of sports-related concussion has been considered the standard of care. The validity of this approach has been questioned, with suggestions that post-concussion testing alone will suffice. The present study compared the sensitivity of baseline and normative paradigms in the setting of sports-related concussion. Method: Baseline NP data were collected for 194 Australian rugby league athletes on a brief battery of paper-and-pencil NP tests. During competition, 27 athletes sustaining concussion referred from a sports physician were retested within two days of injury. Twenty-six uninjured controls were assessed at similar intervals. The baseline paradigm was assessed using a reliable change index for pre- and post-concussion scores. The normative paradigm was assessed comparing the post-concussion score to a normative mean. Results: The baseline paradigm was consistently more sensitive to negative change following concussion than the normative paradigm when using continuous data, despite reasonable agreement. However, when data were categorised as 'impaired' or 'not-impaired', using either 68% or 90% confidence intervals, the difference between paradigms failed to reach significance. Comparison of ROC curves for both paradigms found superior overall classification for one test and the composite score using baseline comparison data. Conclusions: Despite being a time and resource intensive process, the baseline paradigm as a repeated-measures design may be more sensitive than the between-subjects design of the normative paradigm for detecting changes following concussion. Further work is required to determine the validity of normative assessment in sports-related concussion. Copyright © Australasian Society for the Study of Brain Impairment 2015.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
McDevitt, J; Tierney, R T; Phillips, J; Gaughan, J P; Torg, J S; Krynetskiy, E
Association between GRIN2A promoter polymorphism and recovery from concussion Journal Article
In: Brain Injury, vol. 29, no. 13-14, pp. 1674–1681, 2015.
@article{McDevitt2015,
title = {Association between GRIN2A promoter polymorphism and recovery from concussion},
author = {McDevitt, J and Tierney, R T and Phillips, J and Gaughan, J P and Torg, J S and Krynetskiy, E},
doi = {10.3109/02699052.2015.1075252},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {13-14},
pages = {1674--1681},
abstract = {Objective: To determine genetic variability within the N-methyl-D-aspartate receptor 2A sub-unit (GRIN2A) gene promoter and its association with concussion recovery time. The hypothesis tested was that there would be a difference in allele and/or genotype distribution between two groups of athletes with normal and prolonged recovery.Methods: DNA was extracted from saliva collected from a total of 87 athletes with a physician-diagnosed concussion. The (GT) variable number tandem repeats (VNTR) within the promoter region of GRIN2A was genotyped. The long (L) allele was an allele with ≥25 repeats and the short (S) allele was an allele with \<25 repeats in the GT tract. Participants recovery time was followed prospectively and was categorized as normal (≤60 days) or prolonged (\>60 days).Results: LL carriers were 6-times more likely to recover longer than 60 days following the concussive event (p = 0.0433) when compared to SS carriers. Additionally, L allele carriers were found more frequently in the prolonged recovery group (p = 0.048).Conclusion: Determining genetic influence on concussion recovery will aid in future development of genetic counselling. The clinical relevance of genotyping athletes could improve management of athletes who experience concussion injuries. © 2015 Taylor \& Francis Group, LLC.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Laksari, K; Wu, L C; Kurt, M; Kuo, C; Camarillo, D C
Resonance of human brain under head acceleration Journal Article
In: Journal of the Royal Society Interface, vol. 12, no. 108, pp. 20150331, 2015.
@article{Laksari2015,
title = {Resonance of human brain under head acceleration},
author = {Laksari, K and Wu, L C and Kurt, M and Kuo, C and Camarillo, D C},
year = {2015},
date = {2015-01-01},
journal = {Journal of the Royal Society Interface},
volume = {12},
number = {108},
pages = {20150331},
abstract = {Although safety standards have reduced fatal head trauma due to single severe head impacts, mild trauma from repeated head exposures may carry risks of long-term chronic changes in the brain's function and structure. To study the physical sensitivities of the brain to mild head impacts, we developed the first dynamic model of the skull-brain based on in vivo MRI data. We showed that the motion of the brain can be described by a rigid-body with constrained kinematics. We further demonstrated that skull-brain dynamics can be approximated by an under-damped system with a low-frequency resonance at around 15 Hz. Furthermore, from our previous field measurements, we found that head motions in a variety of activities, including contact sports, show a primary frequency of less than 20 Hz. This implies that typical head exposures may drive the brain dangerously close to its mechanical resonance and lead to amplified brain-skull relative motions. Our results suggest a possible cause for mild brain trauma, which could occur due to repetitive low-acceleration head oscillations in a variety of recreational and occupational activities. Copyright © 2015 The Author(s) Published by the Royal Society. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Baker, J G; Leddy, J J; Darling, S R; Rieger, B P; Mashtare, T L; Sharma, T; Willer, B S
Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion Journal Article
In: Clinical Pediatrics, vol. 54, no. 10, pp. 961–968, 2015.
@article{Baker2015,
title = {Factors Associated with Problems for Adolescents Returning to the Classroom after Sport-Related Concussion},
author = {Baker, J G and Leddy, J J and Darling, S R and Rieger, B P and Mashtare, T L and Sharma, T and Willer, B S},
doi = {10.1177/0009922815588820},
year = {2015},
date = {2015-01-01},
journal = {Clinical Pediatrics},
volume = {54},
number = {10},
pages = {961--968},
abstract = {The primary objective of this study was to determine factors in the clinic setting associated with concussion-related problems in the school setting. A total of 91 student athletes, 13 to 19 years old, completed the SCAT2 and computerized testing during their initial visit to the clinic. During a follow-up telephone interview, one-third reported problems with return to school. The presence of problems reported in school was associated with severity of concussion as represented by recovery time and the overall number of symptoms at the first clinic visit. Gender, age, and previous concussions were not associated with school problems. Athletes with computerized test scores below the ninth percentile were more likely to report school problems. The current study offers some descriptive information for clinicians and ideas for future research related to adolescent athletes with concussion and problems with return to the classroom. © SAGE Publications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fitch, T; Villanueva, G; Quadir, M M; Sagiraju, H K; Alamgir, H
The prevalence and risk factors of Post-Traumatic Stress Disorder among workers injured in Rana Plaza building collapse in Bangladesh Journal Article
In: American Journal of Industrial Medicine, vol. 58, no. 7, pp. 756–763, 2015.
@article{Fitch2015,
title = {The prevalence and risk factors of Post-Traumatic Stress Disorder among workers injured in Rana Plaza building collapse in Bangladesh},
author = {Fitch, T and Villanueva, G and Quadir, M M and Sagiraju, H K and Alamgir, H},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Industrial Medicine},
volume = {58},
number = {7},
pages = {756--763},
abstract = {OBJECTIVES: Prevalence and risk factors of PTSD among injured garment workers who survived a major factory collapse. METHODS: Survivors receiving treatment or rehabilitation care at one year post event were surveyed, which included Post Traumatic Stress Disorder Checklist Specific version. RESULTS: The respondents consisted of 181 people with a mean age of 27.8 years and a majority had less than high school education (91.2%). Multivariable logistic regression found that the odds of having PTSD was higher among married (OR: 3.2 [95% CI: 1.3-8.0]), those who used to work more than 70hr/week (OR: 2.4 [1.1-5.3]), workers who used to hold higher job positions (OR: 2.6 [1.2-5.6]) or who had a concussion injury (OR: 3.7 [1.4-9.8]). Among the respondents, 83.4% remained unemployed, and only 57.3% (63 people) reported receiving a quarter or less of what they were promised as compensation. CONCLUSIONS: Probable PTSD was prevalent among surviving workers of the Rana Plaza building collapse in Bangladesh.Copyright © 2015 Wiley Periodicals, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M N; Silverberg, N D; Iverson, G L
Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers Journal Article
In: Journal of Neurotrauma, vol. 32, no. 17, pp. 1301–1306, 2015.
@article{Dretsch2015,
title = {Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers},
author = {Dretsch, M N and Silverberg, N D and Iverson, G L},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {17},
pages = {1301--1306},
abstract = {The extent to which multiple past concussions are associated with lingering symptoms or mental health problems in military service members is not well understood. The purpose of this study was to examine the association between lifetime concussion history, cognitive functioning, general health, and psychological health in a large sample of fit-for-duty U.S. Army soldiers preparing for deployment. Data on 458 active-duty soldiers were collected and analyzed. A computerized cognitive screening battery (CNS-Vital Signs()) was used to assess complex attention (CA), reaction time (RT), processing speed (PS), cognitive flexibility (CF), and memory. Health questionnaires included the Neurobehavioral Symptom Inventory (NSI), PTSD Checklist-Military Version (PCL-M), Zung Depression and Anxiety Scales (ZDS; ZAS), Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Alcohol Use and Dependency Identification Test (AUDIT). Soldiers with a history of multiple concussions (i.e., three or more concussions) had significantly greater post-concussive symptom scores compared with those with zero (d=1.83, large effect), one (d=0.64, medium effect), and two (d=0.64, medium effect) prior concussions. Although the group with three or more concussions also reported more traumatic stress symptoms, the results revealed that traumatic stress was a mediator between concussions and post-concussive symptom severity. There were no significant differences on neurocognitive testing between the number of concussions. These results add to the accumulating evidence suggesting that most individuals recover from one or two prior concussions, but there is a greater risk for ongoing symptoms if one exceeds this number of injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M
Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes Journal Article
In: Brain Injury, vol. 29, no. 9, pp. 1113–1125, 2015.
@article{Alexander2015,
title = {Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes},
author = {Alexander, D G and Shuttleworth-Edwards, A B and Kidd, M and Malcolm, C M},
doi = {10.3109/02699052.2015.1031699},
year = {2015},
date = {2015-01-01},
journal = {Brain Injury},
volume = {29},
number = {9},
pages = {1113--1125},
abstract = {Background: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents.Objective: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years.Method: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups.Results: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group.Conclusions: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby. © 2015 Taylor \& Francis Group, LLC.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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.
@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 = {},
pubstate = {published},
tppubtype = {article}
}
Jackson, K; Rubin, R; Van Hoeck, N; Hauert, T; Lana, V; Wang, H
The effect of selective head-neck cooling on physiological and cognitive functions in healthy volunteers Journal Article
In: Translational Neuroscience, vol. 6, no. 1, pp. 131–138, 2015.
@article{Jackson2015,
title = {The effect of selective head-neck cooling on physiological and cognitive functions in healthy volunteers},
author = {Jackson, K and Rubin, R and {Van Hoeck}, N and Hauert, T and Lana, V and Wang, H},
doi = {10.1515/tnsci-2015-0012},
year = {2015},
date = {2015-01-01},
journal = {Translational Neuroscience},
volume = {6},
number = {1},
pages = {131--138},
abstract = {In general, brain temperatures are elevated during physical sporting activities; therefore, reducing brain temperature shortly after a sports-related concussion (SRC) could be a promising intervention technique. The main objective of this study was to examine the effects of head and neck cooling on physiological and cognitive function in normal healthy volunteers. Twelve healthy volunteers underwent two different sessions of combined head and neck cooling, one session with a cold pack and one session with a room temperature pack. Physiological measurements included: systolic/diastolic blood pressure, pulse oximetry, heart rate, and sublingual and tympanic temperature. Cognitive assessment included: processing speed, executive function, and working memory tasks. Physiological measurements were taken pre-, mid- and post-cooling, while cognitive assessments were done before and after cooling. The order of the sessions was randomized. There was a significant decrease in tympanic temperature across both sessions; however more cooling occurred when the cold pack was in the device. There was no significant decrease in sublingual temperature across either session. The observed heart rates, pulse oximetry, systolic and diastolic blood pressure during the sessions were all within range of a normal healthy adult. Cognitive assessment remained stable across each session for both pre- and post-cooling. We propose that optimizing brain temperature management after brain injury using head and neck cooling technology may represent a sensible, practical, and effective strategy to potentially enhance recovery and perhaps minimize the subsequent short and long term consequences from SRC. © 2015 Kevin Jackson et al.},
keywords = {},
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.
@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 = {},
pubstate = {published},
tppubtype = {article}
}
Kerr, Z Y; Mihalik, J P; Guskiewicz, K M; Rosamond, W D; Evenson, K R; Marshall, S W
Agreement between athlete-recalled and clinically documented concussion histories in former collegiate athletes Journal Article
In: American Journal of Sports Medicine, vol. 43, no. 3, pp. 606–613, 2015.
@article{Kerr2015,
title = {Agreement between athlete-recalled and clinically documented concussion histories in former collegiate athletes},
author = {Kerr, Z Y and Mihalik, J P and Guskiewicz, K M and Rosamond, W D and Evenson, K R and Marshall, S W},
doi = {10.1177/0363546514562180},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Sports Medicine},
volume = {43},
number = {3},
pages = {606--613},
abstract = {Background: Athlete-recalled and clinically documented concussion histories have been used in research on former athletes, but both have limitations. Comparisons of these 2 types of concussion histories are needed to improve the accuracy of estimates of concussion history for future research and clinical care. Purpose: To estimate the agreement between athlete-recalled and clinically documented concussion histories during college and to explore reasons for differences. Study: Cohort study (diagnosis); Level of evidence, 3. Methods: Athlete-recalled concussion histories were provided by a convenience sample of 130 former collegiate athletes using an online questionnaire, and they were individually linked to previously collected clinical data that tracked medically diagnosed concussions at the host institution from 1996 to 2012. The intraclass correlation coefficient (ICC2,1) was used to assess agreement between athlete-recalled and clinically documented concussion histories. Descriptive analyses were performed to assess reasons for disagreement. Results: Agreement between athlete-recalled and clinically documented concussion histories was low (ICC2},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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