Kasamatsu, T; Cleary, M; Bennett, J; Howard, K; McLeod, T V
Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 153–161, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires
@article{Kasamatsu2016a,
title = {Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer},
author = {Kasamatsu, T and Cleary, M and Bennett, J and Howard, K and McLeod, T V},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {153--161},
abstract = {CONTEXT: Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools. OBJECTIVE: To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]). MAIN OUTCOME MEASURE(S): School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables. RESULTS: Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles. CONCLUSIONS: Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.},
keywords = {*Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
King, J B; Lopez-Larson, M P; Yurgelun-Todd, D A
Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 11, pp. 81–89, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult
@article{King2016a,
title = {Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury},
author = {King, J B and Lopez-Larson, M P and Yurgelun-Todd, D A},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {81--89},
abstract = {In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR \< .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p \< .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, 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}
}
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}
}
Buckley, T A; Burdette, G; Kelly, K
Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives Journal Article
In: Journal of Athletic Training, vol. 50, no. 8, pp. 879–888, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires
@article{Buckley2015,
title = {Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives},
author = {Buckley, T A and Burdette, G and Kelly, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Athletic Training},
volume = {50},
number = {8},
pages = {879--888},
abstract = {CONTEXT: The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. OBJECTIVE: To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. MAIN OUTCOME MEASURE(S): The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. RESULTS: Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%},
keywords = {*Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires},
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}
}
Kasamatsu, T; Cleary, M; Bennett, J; Howard, K; McLeod, T V
Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 153–161, 2016.
@article{Kasamatsu2016a,
title = {Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer},
author = {Kasamatsu, T and Cleary, M and Bennett, J and Howard, K and McLeod, T V},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {153--161},
abstract = {CONTEXT: Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools. OBJECTIVE: To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]). MAIN OUTCOME MEASURE(S): School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables. RESULTS: Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles. CONCLUSIONS: Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
King, J B; Lopez-Larson, M P; Yurgelun-Todd, D A
Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 11, pp. 81–89, 2016.
@article{King2016a,
title = {Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury},
author = {King, J B and Lopez-Larson, M P and Yurgelun-Todd, D A},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {81--89},
abstract = {In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR \< .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p \< .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Vassilyadi, M; Macartney, G; Barrowman, N; Anderson, P; Dube, K
Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study Journal Article
In: Pediatric Neurosurgery, vol. 50, no. 4, pp. 196–203, 2015.
@article{Vassilyadi2015,
title = {Symptom experience and quality of life in children after sport-related head injuries: A cross-sectional study},
author = {Vassilyadi, M and Macartney, G and Barrowman, N and Anderson, P and Dube, K},
doi = {10.1159/000431232},
year = {2015},
date = {2015-01-01},
journal = {Pediatric Neurosurgery},
volume = {50},
number = {4},
pages = {196--203},
abstract = {Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p \< 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
De Matteo, C; Volterman, K A; Breithaupt, P G; Claridge, E A; Adamich, J; Timmons, B W
Exertion testing in youth with mild traumatic brain injury/concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015.
@article{DeMatteo2015,
title = {Exertion testing in youth with mild traumatic brain injury/concussion},
author = {{De Matteo}, C and Volterman, K A and Breithaupt, P G and Claridge, E A and Adamich, J and Timmons, B W},
doi = {10.1249/MSS.0000000000000682},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results Participants had a mean ± SD symptom duration of 6.3 ± 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. © 2015 by the American College of Sports Medicine.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Buckley, T A; Burdette, G; Kelly, K
Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives Journal Article
In: Journal of Athletic Training, vol. 50, no. 8, pp. 879–888, 2015.
@article{Buckley2015,
title = {Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives},
author = {Buckley, T A and Burdette, G and Kelly, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Athletic Training},
volume = {50},
number = {8},
pages = {879--888},
abstract = {CONTEXT: The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. OBJECTIVE: To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. MAIN OUTCOME MEASURE(S): The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. RESULTS: Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%},
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}
}
Kasamatsu, T; Cleary, M; Bennett, J; Howard, K; McLeod, T V
Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 153–161, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires
@article{Kasamatsu2016a,
title = {Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer},
author = {Kasamatsu, T and Cleary, M and Bennett, J and Howard, K and McLeod, T V},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {153--161},
abstract = {CONTEXT: Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools. OBJECTIVE: To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]). MAIN OUTCOME MEASURE(S): School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables. RESULTS: Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles. CONCLUSIONS: Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.},
keywords = {*Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
King, J B; Lopez-Larson, M P; Yurgelun-Todd, D A
Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 11, pp. 81–89, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, Young Adult
@article{King2016a,
title = {Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury},
author = {King, J B and Lopez-Larson, M P and Yurgelun-Todd, D A},
year = {2016},
date = {2016-01-01},
journal = {NeuroImage Clinical},
volume = {11},
pages = {81--89},
abstract = {In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR \< .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p \< .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature.},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/pa [Pathology], Adolescent, adult, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging/mt [Methods], Male, middle aged, Post-Traumatic/di [Diagnosis], Post-Traumatic/pa [Pathology], Stress Disorders, veterans, 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}
}
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}
}
Buckley, T A; Burdette, G; Kelly, K
Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives Journal Article
In: Journal of Athletic Training, vol. 50, no. 8, pp. 879–888, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires
@article{Buckley2015,
title = {Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives},
author = {Buckley, T A and Burdette, G and Kelly, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Athletic Training},
volume = {50},
number = {8},
pages = {879--888},
abstract = {CONTEXT: The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. OBJECTIVE: To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. MAIN OUTCOME MEASURE(S): The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. RESULTS: Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%},
keywords = {*Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires},
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}
}