References

2017

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

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

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

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

@article{Krolikowski2017,

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

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

doi = {10.1177/0363546516669701},

isbn = {03635465},

year  = {2017},

date = {2017-01-01},

journal = {American Journal of Sports Medicine},

volume = {45},

number = {2},

pages = {468--473},

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

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

pubstate = {published},

tppubtype = {article}

}

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

2016

Daley, M; Dekaban, G; Bartha, R; Brown, A; Stewart, T C; Doherty, T; Fischer, L; Holmes, J; Menon, R S; Rupar, C A; Shoemaker, J K; Fraser, D D

Metabolomics profiling of concussion in adolescent male hockey players: a novel diagnostic method Journal Article

In: Metabolomics, vol. 12, no. 12, 2016.

Abstract | Links | BibTeX | Tags: adolescents, Biomarker, Concussion, DIAGNOSIS, ice hockey, Metabolomics

@article{Daley2016,

title = {Metabolomics profiling of concussion in adolescent male hockey players: a novel diagnostic method},

author = {Daley, M and Dekaban, G and Bartha, R and Brown, A and Stewart, T C and Doherty, T and Fischer, L and Holmes, J and Menon, R S and Rupar, C A and Shoemaker, J K and Fraser, D D},

doi = {10.1007/s11306-016-1131-5},

year  = {2016},

date = {2016-01-01},

journal = {Metabolomics},

volume = {12},

number = {12},

abstract = {Introduction: Concussions are a major health concern as they cause significant acute symptoms and in some athletes, long-term neurologic dysfunction. Diagnosis of concussion can be difficult, as are the decisions to stop play. Objective: To determine if concussions in adolescent male hockey players could be diagnosed using plasma metabolomics profiling. Methods: Plasma was obtained from 12 concussed and 17 non-concussed athletes, and assayed for 174 metabolites with proton nuclear magnetic resonance and direct injection liquid chromatography tandem mass spectrometry. Data were analysed with multivariate statistical analysis and machine learning. Results: The estimated time from concussion occurrence to blood draw at the first clinic visit was 2.3 ± 0.7 days. Using principal component analysis, the leading 10 components, each containing 9 metabolites, were shown to account for 82 % of the variance between cohorts, and relied heavily on changes in glycerophospholipids. Cross-validation of the classifier using a leave-one out approach demonstrated a 92 % accuracy rate in diagnosing a concussion (P \< 0.0001). The number of metabolites required to achieve the 92 % diagnostic accuracy was minimized from 174 to as few as 17 metabolites. Receiver operating characteristic analyses generated an area under the curve of 0.91, indicating excellent concussion diagnostic potential. Conclusion: Metabolomics profiling, together with multivariate statistical analysis and machine learning, identified concussed athletes with \>90 % certainty. Metabolomics profiling represents a novel diagnostic method for concussion, and may be amenable to point-of-care testing. © 2016, Springer Science+Business Media New York.},

keywords = {adolescents, Biomarker, Concussion, DIAGNOSIS, ice hockey, Metabolomics},

pubstate = {published},

tppubtype = {article}

}

Reider, B

Like a pro Journal Article

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

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

2015

Alworth, M; Bond, M C; Brady, W J

The sports medicine literature 2013 Journal Article

In: American Journal of Emergency Medicine, vol. 33, no. 9, pp. 1283–1287, 2015.

Links | BibTeX | Tags: achilles tendon rupture, athlete, Athletic Injuries, catecholaminergic polymorphic ventricular tachycar, cause of death, cervical spine injury, clinical assessment, cognitive defect, commotio cordis, Concussion, electrocardiogram, Emergency Medicine, emergency physician, emergency ward, endotracheal intubation, football, head injury, health care quality, heart ventricle tachycardia, human, Humans, hypertrophic cardiomyopathy, ice hockey, injury severity, long QT syndrome, memory assessment, myocarditis, neurologic examination, practice guideline, priority journal, resuscitation, retrograde amnesia, Review, sleep disorder, SPORTS medicine, sudden cardiac death, sudden death, traumatic brain injury, UNITED States

Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R

Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article

In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.

Abstract | Links | BibTeX | Tags: Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult

@article{Meehan2015,

title = {Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low},

author = {Meehan, W P and Jordaan, M and Prabhu, S P and Carew, L and Mannix, R C and Proctor, M R},

doi = {10.1097/JSM.0000000000000107},

year  = {2015},

date = {2015-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {25},

number = {2},

pages = {133--137},

abstract = {Objective: To estimate the risk of athletes with Chiari malformations sustaining a catastrophic injury. Design: Retrospective, descriptive cohort study. Participants: All patients diagnosed with Chiari malformation at our institution between June 2008 and November 2011. Assessment of Risk Factors: Participants were mailed a questionnaire regarding the number of seasons they participated in organized athletics. Magnetic resonance images were reviewed to describe the characteristics of respondent's Chiari malformations. Main Outcome Measures: Whether or not the patient had sustained an injury resulting in death, coma, or paralysis. Results: We had a 53% (N = 147) response rate. Respondents were of a mean age of 15 years (SD, 2 years) at the time of diagnosis. The mean length of protrusion of the cerebellar tonsils below the foramen magnum was 11.2 mm (SD, 5.7 mm). Most of the respondents had pointed cerebellar tonsils and some degree of crowding within the foramen magnum. During a total of 1627 athletic seasons played by patients with Chiari malformation, 0 respondents [95% confidence interval (CI), 0.0000-0.0023] sustained an injury resulting in death, coma, or paralysis. Likewise, during 191 collision sport athletic seasons, 0 (95% CI, 0.0000-0.0191) respondents sustained an injury resulting in death, coma, or paralysis. Conclusions: The risk of athletes with Chiari malformations suffering catastrophic injuries during sports participation is low. This estimate of risk should be considered when making return-toplay decisions. Given the variability of anatomical consideration for patients with Chiari malformations, however, each return-to-play decision must continue to be made on a case-by-case basis, considering all of the available information. Clinical Relevance: The low risk of athletes with Chiari malformations suffering catastrophic injuries in sports should be considered when making return-to-play decisions. © 2014 Wolters Kluwer Health, Inc. All rights reserved.},

keywords = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},

pubstate = {published},

tppubtype = {article}

}

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.

2014

Montenigro, P H; Baugh, C M; Daneshvar, D H; Mez, J; Budson, A E; Au, R; Katz, D I; Cantu, R C; Stern, R A

Clinical subtypes of chronic traumatic encephalopathy: Literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome Journal Article

In: Alzheimer's Research and Therapy, vol. 6, no. 5-8, 2014.

Abstract | Links | BibTeX | Tags: Anxiety, apathy, ataxia, ataxic gait, attention, attention disturbance, behavior disorder, blunted affect, Boxing, chronic brain disease, Chronic traumatic encephalopathy, Chronic Traumatic Encephalopathy aggression, clinical feature, clonus, cognitive defect, contact sport, delusion, Dementia, depression, depth perception, differential diagnosis, disease classification, dysarthria, dysgraphia, euphoria, executive function, fatigue, football, hopelessness, human, ice hockey, impulsiveness, insomnia, intelligence, irritability, language disability, mania, medical literature, memory disorder, mental concentration, mental instability, mood disorder, muscle weakness, neurologic gait disorder, paranoia, Parkinsonism, personality disorder, physical violence, preventive medicine, psychosis, Research Diagnostic Criteria, Review, risk factor, shuffling gait, social disability, social isolation, spastic gait, spasticity, speech disorder, sport injury, suicidal ideation, traumatic brain injury, traumatic encephalopathy syndrome, tremor, unsteady gait, violence, wrestling

@article{Montenigro2014,

title = {Clinical subtypes of chronic traumatic encephalopathy: Literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome},

author = {Montenigro, P H and Baugh, C M and Daneshvar, D H and Mez, J and Budson, A E and Au, R and Katz, D I and Cantu, R C and Stern, R A},

url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84908410645\&partnerID=40\&md5=bab59baeecd5adb22d0f84a4ce99bd5c},

doi = {10.1186/s13195-014-0068-z},

year  = {2014},

date = {2014-01-01},

journal = {Alzheimer's Research and Therapy},

volume = {6},

number = {5-8},

abstract = {The long-term consequences of repetitive head impacts have been described since the early 20th century. Terms such as punch drunk and dementia pugilistica were first used to describe the clinical syndromes experienced by boxers. A more generic designation, chronic traumatic encephalopathy (CTE), has been employed since the mid-1900s and has been used in recent years to describe a neurodegenerative disease found not just in boxers but in American football players, other contact sport athletes, military veterans, and others with histories of repetitive brain trauma, including concussions and subconcussive trauma. This article reviews the literature of the clinical manifestations of CTE from 202 published cases. The clinical features include impairments in mood (for example, depression and hopelessness), behavior (for example, explosivity and violence), cognition (for example, impaired memory, executive functioning, attention, and dementia), and, less commonly, motor functioning (for example, parkinsonism, ataxia, and dysarthria). We present proposed research criteria for traumatic encephalopathy syndrome (TES) which consist of four variants or subtypes (TES behavioral/mood variant, TES cognitive variant, TES mixed variant, and TES dementia) as well as classifications of 'probable CTE' and 'possible CTE'. These proposed criteria are expected to be modified and updated as new research findings become available. They are not meant to be used for a clinical diagnosis. Rather, they should be viewed as research criteria that can be employed in studies of the underlying causes, risk factors, differential diagnosis, prevention, and treatment of CTE and related disorders. © 2014 Montenigro et al.; licensee BioMed Central Ltd.},

keywords = {Anxiety, apathy, ataxia, ataxic gait, attention, attention disturbance, behavior disorder, blunted affect, Boxing, chronic brain disease, Chronic traumatic encephalopathy, Chronic Traumatic Encephalopathy aggression, clinical feature, clonus, cognitive defect, contact sport, delusion, Dementia, depression, depth perception, differential diagnosis, disease classification, dysarthria, dysgraphia, euphoria, executive function, fatigue, football, hopelessness, human, ice hockey, impulsiveness, insomnia, intelligence, irritability, language disability, mania, medical literature, memory disorder, mental concentration, mental instability, mood disorder, muscle weakness, neurologic gait disorder, paranoia, Parkinsonism, personality disorder, physical violence, preventive medicine, psychosis, Research Diagnostic Criteria, Review, risk factor, shuffling gait, social disability, social isolation, spastic gait, spasticity, speech disorder, sport injury, suicidal ideation, traumatic brain injury, traumatic encephalopathy syndrome, tremor, unsteady gait, violence, wrestling},

pubstate = {published},

tppubtype = {article}

}

Reference Search

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

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

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

Abstract | Links | BibTeX

@article{Krolikowski2017,

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

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

doi = {10.1177/0363546516669701},

isbn = {03635465},

year  = {2017},

date = {2017-01-01},

journal = {American Journal of Sports Medicine},

volume = {45},

number = {2},

pages = {468--473},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Daley, M; Dekaban, G; Bartha, R; Brown, A; Stewart, T C; Doherty, T; Fischer, L; Holmes, J; Menon, R S; Rupar, C A; Shoemaker, J K; Fraser, D D

Metabolomics profiling of concussion in adolescent male hockey players: a novel diagnostic method Journal Article

In: Metabolomics, vol. 12, no. 12, 2016.

Abstract | Links | BibTeX

@article{Daley2016,

title = {Metabolomics profiling of concussion in adolescent male hockey players: a novel diagnostic method},

author = {Daley, M and Dekaban, G and Bartha, R and Brown, A and Stewart, T C and Doherty, T and Fischer, L and Holmes, J and Menon, R S and Rupar, C A and Shoemaker, J K and Fraser, D D},

doi = {10.1007/s11306-016-1131-5},

year  = {2016},

date = {2016-01-01},

journal = {Metabolomics},

volume = {12},

number = {12},

abstract = {Introduction: Concussions are a major health concern as they cause significant acute symptoms and in some athletes, long-term neurologic dysfunction. Diagnosis of concussion can be difficult, as are the decisions to stop play. Objective: To determine if concussions in adolescent male hockey players could be diagnosed using plasma metabolomics profiling. Methods: Plasma was obtained from 12 concussed and 17 non-concussed athletes, and assayed for 174 metabolites with proton nuclear magnetic resonance and direct injection liquid chromatography tandem mass spectrometry. Data were analysed with multivariate statistical analysis and machine learning. Results: The estimated time from concussion occurrence to blood draw at the first clinic visit was 2.3 ± 0.7 days. Using principal component analysis, the leading 10 components, each containing 9 metabolites, were shown to account for 82 % of the variance between cohorts, and relied heavily on changes in glycerophospholipids. Cross-validation of the classifier using a leave-one out approach demonstrated a 92 % accuracy rate in diagnosing a concussion (P \< 0.0001). The number of metabolites required to achieve the 92 % diagnostic accuracy was minimized from 174 to as few as 17 metabolites. Receiver operating characteristic analyses generated an area under the curve of 0.91, indicating excellent concussion diagnostic potential. Conclusion: Metabolomics profiling, together with multivariate statistical analysis and machine learning, identified concussed athletes with \>90 % certainty. Metabolomics profiling represents a novel diagnostic method for concussion, and may be amenable to point-of-care testing. © 2016, Springer Science+Business Media New York.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Reider, B

Like a pro Journal Article

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

Links | BibTeX

Alworth, M; Bond, M C; Brady, W J

The sports medicine literature 2013 Journal Article

In: American Journal of Emergency Medicine, vol. 33, no. 9, pp. 1283–1287, 2015.

Links | BibTeX

Meehan, W P; Jordaan, M; Prabhu, S P; Carew, L; Mannix, R C; Proctor, M R

Risk of athletes with chiari malformations suffering catastrophic injuries during sports participation is low Journal Article

In: Clinical Journal of Sport Medicine, vol. 25, no. 2, pp. 133–137, 2015.

Abstract | Links | BibTeX

@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}

}

Montenigro, P H; Baugh, C M; Daneshvar, D H; Mez, J; Budson, A E; Au, R; Katz, D I; Cantu, R C; Stern, R A

Clinical subtypes of chronic traumatic encephalopathy: Literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome Journal Article

In: Alzheimer's Research and Therapy, vol. 6, no. 5-8, 2014.

Abstract | Links | BibTeX

@article{Montenigro2014,

title = {Clinical subtypes of chronic traumatic encephalopathy: Literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome},

author = {Montenigro, P H and Baugh, C M and Daneshvar, D H and Mez, J and Budson, A E and Au, R and Katz, D I and Cantu, R C and Stern, R A},

url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84908410645\&partnerID=40\&md5=bab59baeecd5adb22d0f84a4ce99bd5c},

doi = {10.1186/s13195-014-0068-z},

year  = {2014},

date = {2014-01-01},

journal = {Alzheimer's Research and Therapy},

volume = {6},

number = {5-8},

abstract = {The long-term consequences of repetitive head impacts have been described since the early 20th century. Terms such as punch drunk and dementia pugilistica were first used to describe the clinical syndromes experienced by boxers. A more generic designation, chronic traumatic encephalopathy (CTE), has been employed since the mid-1900s and has been used in recent years to describe a neurodegenerative disease found not just in boxers but in American football players, other contact sport athletes, military veterans, and others with histories of repetitive brain trauma, including concussions and subconcussive trauma. This article reviews the literature of the clinical manifestations of CTE from 202 published cases. The clinical features include impairments in mood (for example, depression and hopelessness), behavior (for example, explosivity and violence), cognition (for example, impaired memory, executive functioning, attention, and dementia), and, less commonly, motor functioning (for example, parkinsonism, ataxia, and dysarthria). We present proposed research criteria for traumatic encephalopathy syndrome (TES) which consist of four variants or subtypes (TES behavioral/mood variant, TES cognitive variant, TES mixed variant, and TES dementia) as well as classifications of 'probable CTE' and 'possible CTE'. These proposed criteria are expected to be modified and updated as new research findings become available. They are not meant to be used for a clinical diagnosis. Rather, they should be viewed as research criteria that can be employed in studies of the underlying causes, risk factors, differential diagnosis, prevention, and treatment of CTE and related disorders. © 2014 Montenigro et al.; licensee BioMed Central Ltd.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Most Referenced Keywords

Show all

2017

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

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

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

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

@article{Krolikowski2017,

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

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

doi = {10.1177/0363546516669701},

isbn = {03635465},

year  = {2017},

date = {2017-01-01},

journal = {American Journal of Sports Medicine},

volume = {45},

number = {2},

pages = {468--473},

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

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

pubstate = {published},

tppubtype = {article}

}

2016

Daley, M; Dekaban, G; Bartha, R; Brown, A; Stewart, T C; Doherty, T; Fischer, L; Holmes, J; Menon, R S; Rupar, C A; Shoemaker, J K; Fraser, D D

Metabolomics profiling of concussion in adolescent male hockey players: a novel diagnostic method Journal Article

In: Metabolomics, vol. 12, no. 12, 2016.

Abstract | Links | BibTeX | Tags: adolescents, Biomarker, Concussion, DIAGNOSIS, ice hockey, Metabolomics

@article{Daley2016,

title = {Metabolomics profiling of concussion in adolescent male hockey players: a novel diagnostic method},

author = {Daley, M and Dekaban, G and Bartha, R and Brown, A and Stewart, T C and Doherty, T and Fischer, L and Holmes, J and Menon, R S and Rupar, C A and Shoemaker, J K and Fraser, D D},

doi = {10.1007/s11306-016-1131-5},

year  = {2016},

date = {2016-01-01},

journal = {Metabolomics},

volume = {12},

number = {12},

abstract = {Introduction: Concussions are a major health concern as they cause significant acute symptoms and in some athletes, long-term neurologic dysfunction. Diagnosis of concussion can be difficult, as are the decisions to stop play. Objective: To determine if concussions in adolescent male hockey players could be diagnosed using plasma metabolomics profiling. Methods: Plasma was obtained from 12 concussed and 17 non-concussed athletes, and assayed for 174 metabolites with proton nuclear magnetic resonance and direct injection liquid chromatography tandem mass spectrometry. Data were analysed with multivariate statistical analysis and machine learning. Results: The estimated time from concussion occurrence to blood draw at the first clinic visit was 2.3 ± 0.7 days. Using principal component analysis, the leading 10 components, each containing 9 metabolites, were shown to account for 82 % of the variance between cohorts, and relied heavily on changes in glycerophospholipids. Cross-validation of the classifier using a leave-one out approach demonstrated a 92 % accuracy rate in diagnosing a concussion (P \< 0.0001). The number of metabolites required to achieve the 92 % diagnostic accuracy was minimized from 174 to as few as 17 metabolites. Receiver operating characteristic analyses generated an area under the curve of 0.91, indicating excellent concussion diagnostic potential. Conclusion: Metabolomics profiling, together with multivariate statistical analysis and machine learning, identified concussed athletes with \>90 % certainty. Metabolomics profiling represents a novel diagnostic method for concussion, and may be amenable to point-of-care testing. © 2016, Springer Science+Business Media New York.},

keywords = {adolescents, Biomarker, Concussion, DIAGNOSIS, ice hockey, Metabolomics},

pubstate = {published},

tppubtype = {article}

}

Reider, B

Like a pro Journal Article

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

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

2015

Alworth, M; Bond, M C; Brady, W J

The sports medicine literature 2013 Journal Article

In: American Journal of Emergency Medicine, vol. 33, no. 9, pp. 1283–1287, 2015.

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 = {Adolescent, adult, Arnold Chiari malformation, Arnold-Chiari Malformation, Article, athlete, Athletes, Athletic Injuries, BASKETBALL, Brain Injuries, cerebrospinal fluid, cerebrospinal fluid flow, Child, cohort analysis, Cohort Studies, coma, Concussion, Death, descriptive research, digestive tract parameters, Female, football, foramen magnum, human, Humans, ice hockey, Magnetic Resonance Imaging, major clinical study, Male, MORTALITY, nuclear magnetic resonance imaging, paralysis, paresthesia, pathology, patient participation, priority journal, questionnaire, Retrospective Studies, retrospective study, RISK assessment, risk factor, Soccer, sport injury, Surveys and Questionnaires, terminal disease, Young Adult},

pubstate = {published},

tppubtype = {article}

}

2014

Montenigro, P H; Baugh, C M; Daneshvar, D H; Mez, J; Budson, A E; Au, R; Katz, D I; Cantu, R C; Stern, R A

Clinical subtypes of chronic traumatic encephalopathy: Literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome Journal Article

In: Alzheimer's Research and Therapy, vol. 6, no. 5-8, 2014.

@article{Montenigro2014,

title = {Clinical subtypes of chronic traumatic encephalopathy: Literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome},

author = {Montenigro, P H and Baugh, C M and Daneshvar, D H and Mez, J and Budson, A E and Au, R and Katz, D I and Cantu, R C and Stern, R A},

url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84908410645\&partnerID=40\&md5=bab59baeecd5adb22d0f84a4ce99bd5c},

doi = {10.1186/s13195-014-0068-z},

year  = {2014},

date = {2014-01-01},

journal = {Alzheimer's Research and Therapy},

volume = {6},

number = {5-8},

abstract = {The long-term consequences of repetitive head impacts have been described since the early 20th century. Terms such as punch drunk and dementia pugilistica were first used to describe the clinical syndromes experienced by boxers. A more generic designation, chronic traumatic encephalopathy (CTE), has been employed since the mid-1900s and has been used in recent years to describe a neurodegenerative disease found not just in boxers but in American football players, other contact sport athletes, military veterans, and others with histories of repetitive brain trauma, including concussions and subconcussive trauma. This article reviews the literature of the clinical manifestations of CTE from 202 published cases. The clinical features include impairments in mood (for example, depression and hopelessness), behavior (for example, explosivity and violence), cognition (for example, impaired memory, executive functioning, attention, and dementia), and, less commonly, motor functioning (for example, parkinsonism, ataxia, and dysarthria). We present proposed research criteria for traumatic encephalopathy syndrome (TES) which consist of four variants or subtypes (TES behavioral/mood variant, TES cognitive variant, TES mixed variant, and TES dementia) as well as classifications of 'probable CTE' and 'possible CTE'. These proposed criteria are expected to be modified and updated as new research findings become available. They are not meant to be used for a clinical diagnosis. Rather, they should be viewed as research criteria that can be employed in studies of the underlying causes, risk factors, differential diagnosis, prevention, and treatment of CTE and related disorders. © 2014 Montenigro et al.; licensee BioMed Central Ltd.},

keywords = {Anxiety, apathy, ataxia, ataxic gait, attention, attention disturbance, behavior disorder, blunted affect, Boxing, chronic brain disease, Chronic traumatic encephalopathy, Chronic Traumatic Encephalopathy aggression, clinical feature, clonus, cognitive defect, contact sport, delusion, Dementia, depression, depth perception, differential diagnosis, disease classification, dysarthria, dysgraphia, euphoria, executive function, fatigue, football, hopelessness, human, ice hockey, impulsiveness, insomnia, intelligence, irritability, language disability, mania, medical literature, memory disorder, mental concentration, mental instability, mood disorder, muscle weakness, neurologic gait disorder, paranoia, Parkinsonism, personality disorder, physical violence, preventive medicine, psychosis, Research Diagnostic Criteria, Review, risk factor, shuffling gait, social disability, social isolation, spastic gait, spasticity, speech disorder, sport injury, suicidal ideation, traumatic brain injury, traumatic encephalopathy syndrome, tremor, unsteady gait, violence, wrestling},

pubstate = {published},

tppubtype = {article}

}

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