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}
}
Reider, Bruce
Activating the Omega 13 Journal Article
In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 275–277, 2017, ISBN: 03635465.
Links | BibTeX | Tags: ACL tear, Concussion, female athlete triad, football, Injury prevention, rugby, Soccer
@article{Reider2017,
title = {Activating the Omega 13},
author = {Reider, Bruce},
doi = {10.1177/0363546517690145},
isbn = {03635465},
year = {2017},
date = {2017-01-01},
journal = {American Journal of Sports Medicine},
volume = {45},
number = {2},
pages = {275--277},
keywords = {ACL tear, Concussion, female athlete triad, football, Injury prevention, rugby, Soccer},
pubstate = {published},
tppubtype = {article}
}
Dickson, T J; Trathen, S; Terwiel, F A; Waddington, G; Adams, R
Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study Journal Article
In: Scandinavian Journal of Medicine & Science in Sports, vol. 27, no. 2, pp. 236–244, 2017, ISBN: 09057188.
Abstract | Links | BibTeX | Tags: CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries
@article{Dickson2017,
title = {Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study},
author = {Dickson, T J and Trathen, S and Terwiel, F A and Waddington, G and Adams, R},
doi = {10.1111/sms.12642},
isbn = {09057188},
year = {2017},
date = {2017-01-01},
journal = {Scandinavian Journal of Medicine \& Science in Sports},
volume = {27},
number = {2},
pages = {236--244},
abstract = {This research explored associations between helmet use and head injuries in snowsports by investigating reported snowsport injuries in Western Canada from 2008-2009 to 2012-2013. The key finding was that increased helmet use (from 69% to 80%) was not associated with a reduction in reported head injuries. Over the study period, the average rate of reported head injuries was 0.2/1000 skier visits, with a statistically significant variation ( P \< 0.001). The line of best fit showed an non-significant upward trend ( P = 0.13). Lacerations were the only subcategory of head injuries that decreased significantly with helmet use. A higher proportion of people who reported a head injury were wearing a helmet than for injuries other than to the head. Skiers were more likely to report a head injury when wearing a helmet than snowboarders ( P \< 0.001 cf. P = 0.22). There were significant differences in characteristics of helmet and non-helmet wearers. Helmet wearers were more likely to be: young adults ( P \< 0.001); beginner/novices ( P = 0.004); and snowboarders ( P \< 0.001), but helmet wearing was not associated with gender ( P = 0.191). Further research is needed to explore the possible reasons for the failure of helmets to reduce head injuries, for example, increased reporting of head injuries and increased risk-taking combined with over-rating of the helmets' protection.},
keywords = {CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries},
pubstate = {published},
tppubtype = {article}
}
Baldwin, G; Breiding, M; Sleet, D
Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC) Journal Article
In: NeuroRehabilitation, vol. 39, no. 3, pp. 345–349, 2016.
Abstract | Links | BibTeX | Tags: injury causes, Injury prevention, traumatic brain injury, unintentional injury
@article{Baldwin2016,
title = {Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC)},
author = {Baldwin, G and Breiding, M and Sleet, D},
doi = {10.3233/NRE-161366},
year = {2016},
date = {2016-01-01},
journal = {NeuroRehabilitation},
volume = {39},
number = {3},
pages = {345--349},
abstract = {Traumatic brain injury (TBI) can have long term effects on mental and physical health, and can disrupt vocational, educational, and social functioning. TBIs can range from mild to severe and their effects can last many years after the initial injury. CDC seeks to reduce the burden of TBI from unintentional injuries through a focus on primary prevention, improved recognition and management, and intervening to improve health outcomes after TBI. CDC uses a 4-stage public health model to guide TBI prevention, moving from 1) surveillance of TBI, 2) identification of risk and protective factors for TBI, 3) development and testing of evidence-based interventions, to 4) bringing effective intervention to scale through widespread adoption. CDC's unintentional injury prevention activities focus on the prevention of sports-related concussions, motor vehicle crashes, and older adult falls. For concussion prevention, CDC developed Heads Up - an awareness initiative focusing on ways to prevent a concussion in sports, and identifying how to recognize and manage potential concussions. In motor vehicle injury prevention, CDC has developed a tool (MV PICCS) to calculate the expected number of injuries prevented and lives saved using various evidence-based motor vehicle crash prevention strategies. To help prevent TBI related to older adult falls, CDC has developed STEADI, an initiative to help primary care providers identify their patients' falls risk and provide effective interventions. In the future, CDC is focused on advancing our understanding of the public health burden of TBI through improved surveillance in order to produce more comprehensive estimates of the public health burden of TBI. © 2016 - IOS Press and the authors. All rights reserved.},
keywords = {injury causes, Injury prevention, traumatic brain injury, unintentional injury},
pubstate = {published},
tppubtype = {article}
}
Kim, S; Spengler, J O; Connaughton, D P
An exploratory study of concussion management policies in municipal park and recreation departments Journal Article
In: Journal of Policy Research in Tourism, Leisure and Events, vol. 8, no. 3, pp. 274–288, 2016.
Abstract | Links | BibTeX | Tags: Concussion, Injury prevention, policy, recreation, risk management, Youth sports
@article{Kim2016a,
title = {An exploratory study of concussion management policies in municipal park and recreation departments},
author = {Kim, S and Spengler, J O and Connaughton, D P},
doi = {10.1080/19407963.2016.1181077},
year = {2016},
date = {2016-01-01},
journal = {Journal of Policy Research in Tourism, Leisure and Events},
volume = {8},
number = {3},
pages = {274--288},
abstract = {Despite the burgeoning interest in reducing concussions among youth sport participants, research investigating concussion safety policies of municipal park and recreation departments has been sparse. A national survey of park and recreation professionals in 50 states (n = 739, response rate of 23%) was conducted in 2015 to assess concussion management policies and practices of municipal park and recreation departments. Only about one-third of respondents indicated that their departments required coaches to be trained in concussion safety. Among those who mandated concussion safety training, the CDC’s ‘Heads Up: Concussion in Youth Sports’ was the most commonly used concussion safety training material. Despite the low number of departments requiring concussion safety training for youth sport coaches using park/recreation facilities, nearly two-thirds encouraged concussion safety training for such coaches. The results suggest that, overall, municipal park and recreation department’s concussion safety policies are lagging behind those typically found in interscholastic and collegiate sport programs. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {Concussion, Injury prevention, policy, recreation, risk management, Youth sports},
pubstate = {published},
tppubtype = {article}
}
Herman, D C; Barth, J T
Drop-jump landing varies with baseline neurocognition: Implications for anterior cruciate ligament injury risk and prevention Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 9, pp. 2347–2353, 2016.
Abstract | Links | BibTeX | Tags: ACL, Biomechanics, Injury prevention, Motion analysis
@article{Herman2016,
title = {Drop-jump landing varies with baseline neurocognition: Implications for anterior cruciate ligament injury risk and prevention},
author = {Herman, D C and Barth, J T},
doi = {10.1177/0363546516657338},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {9},
pages = {2347--2353},
abstract = {Background: Neurocognitive status may be a risk factor for anterior cruciate ligament (ACL) injury. Neurocognitive domains such as visual attention, processing speed/reaction time, and dual-tasking may influence ACL injury risk via alterations to neuromuscular performance during athletic tasks. However, the relationship between neurocognition and performance during athletic tasks is not yet established. Hypothesis: Athletes with low baseline neurocognitive scores will demonstrate poorer jump landing performance compared with athletes with high baseline neurocognitive score. Study Design: Controlled laboratory study. Methods: Neurocognitive performance was measured using the Concussion Resolution Index (CRI). Three-dimensional kinematic and kinetic data of the dominant limb were collected for 37 recreational athletes while performing an unanticipated jump-landing task. Healthy, nonconcussed subjects were screened using a computer-based neurocognitive test into a high performers (HP; n = 20; average CRI percentile, 78th) and a low performers (LP; n = 17; average CRI percentile, 41st) group. The task consisted of a forward jump onto a force plate with an immediate rebound to a second target that was assigned 250 milliseconds before landing on the force plate. Kinematic and kinetic data were obtained during the first jump landing. Results: The LP group demonstrated significantly altered neuromuscular performance during the landing phase while completing the jump-landing task, including significantly increased peak vertical ground-reaction force (mean ± SD of LP vs HP: 1.81 ± 0.53 vs 1.38 ± 0.37 body weight [BW]; P \<.01), peak anterior tibial shear force (0.91 ± 0.17 vs 0.72 ± 0.22 BW; P \<.01), knee abduction moment (0.47 ± 0.56 vs 0.03 ± 0.64 BW × body height; P =.03), and knee abduction angle (6.1° ± 4.7° vs 1.3° ± 5.6°; P =.03), as well as decreased trunk flexion angle (9.6° ± 9.6° vs 16.4° ± 11.2°; P \<.01). Conclusion: Healthy athletes with lower baseline neurocognitive performance generate knee kinematic and kinetic patterns that are linked to ACL injury. Clinical Relevance: Neurocognitive testing using the CRI may be useful for identification of athletes at elevated risk for future ACL injury. © American Orthopaedic Society for Sports Medicine.},
keywords = {ACL, Biomechanics, Injury prevention, Motion analysis},
pubstate = {published},
tppubtype = {article}
}
Patton, D A; McIntosh, A S
Considerations for the performance requirements and technical specifications of soft-shell padded headgear Journal Article
In: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology, vol. 230, no. 1, pp. 29–42, 2016.
Abstract | Links | BibTeX | Tags: Australian football, Biomechanics, Concussion, Design, Head Injuries, head injury, headgear, Injury prevention, protective equipment, rugby, Sports
@article{Patton2016b,
title = {Considerations for the performance requirements and technical specifications of soft-shell padded headgear},
author = {Patton, D A and McIntosh, A S},
doi = {10.1177/1754337115615482},
year = {2016},
date = {2016-01-01},
journal = {Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology},
volume = {230},
number = {1},
pages = {29--42},
abstract = {Laboratory and epidemiological research in Australian football, rugby league and rugby union has demonstrated that commercially available soft-shell padded headgear is currently ineffective in reducing the risk of concussion. However, modified headgear studies have demonstrated that significant improvements in impact energy attenuation performance are possible with small design changes, such as increases in foam density and thickness. A literature review of the design, performance and use of headgear in Australian football, rugby league and rugby union was conducted. A total of 23 articles were identified using primary and secondary search strategies, which included epidemiological field studies, laboratory impact test studies and studies investigating the behaviours and attitudes of players. The results of the review were synthesised and used to identify injury reduction objectives and appropriate design criteria. The need for a headgear standard was identified and performance requirements were discussed, which drew upon human tolerance and sports-specific head impact exposure data. Usability and behavioural issues, which require consideration during the design process, were also assessed. © IMechE 2015.},
keywords = {Australian football, Biomechanics, Concussion, Design, Head Injuries, head injury, headgear, Injury prevention, protective equipment, rugby, Sports},
pubstate = {published},
tppubtype = {article}
}
Morimoto, K; Kasuyama, T; Sakurai, S; Nakazawa, R; Sakamoto, M
Head acceleration of trackles in high school rugby players Journal Article
In: Japanese Journal of Clinical Sports Medicine, vol. 20, no. 2, pp. 292–298, 2012, ISBN: 13464159.
Abstract | BibTeX | Tags: *HIGH schools, *RUGBY football players, *SCHOOL sports, *SPORTS medicine, Concussion, Contact sports, FIRST grade (Education), Injury prevention
@article{Morimoto2012,
title = {Head acceleration of trackles in high school rugby players},
author = {Morimoto, K and Kasuyama, T and Sakurai, S and Nakazawa, R and Sakamoto, M},
isbn = {13464159},
year = {2012},
date = {2012-01-01},
journal = {Japanese Journal of Clinical Sports Medicine},
volume = {20},
number = {2},
pages = {292--298},
abstract = {Head acceleration at the time of tackling was measured for forty-seven high school rugby players. The time to reach the peak values for the lateral non-tackle side and tackle side peaks after coming into contact with the tackle machine, as well as the gap between the two peaks (amplitude time) were analyzed. In comparing student grade, the amplitude time of a right Power Foot Tackle of third grade students was significantly shorter than that of first grade students. Regarding differences between left and right tackles, the amplitude time of a right Diving Tackle was significantly shorter than the left side tackle. Differences in the timing of head movements were thought to have been determined by the skill level and shoulder effectiveness of the tackles. Topics for the future study include measurement of head acceleration in a state approximating that of actual motion, point of contact, verification of training, etc. ABSTRACT FROM AUTHOR},
keywords = {*HIGH schools, *RUGBY football players, *SCHOOL sports, *SPORTS medicine, Concussion, Contact sports, FIRST grade (Education), Injury prevention},
pubstate = {published},
tppubtype = {article}
}
Krolikowski, Maciej P; Black, Amanda M; Palacios-Derflingher, Luz; Blake, Tracy A; Schneider, Kathryn J; Emery, Carolyn A
The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions in Youth Ice Hockey Players Journal Article
In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 468–473, 2017, ISBN: 03635465.
@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}
}
Reider, Bruce
Activating the Omega 13 Journal Article
In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 275–277, 2017, ISBN: 03635465.
@article{Reider2017,
title = {Activating the Omega 13},
author = {Reider, Bruce},
doi = {10.1177/0363546517690145},
isbn = {03635465},
year = {2017},
date = {2017-01-01},
journal = {American Journal of Sports Medicine},
volume = {45},
number = {2},
pages = {275--277},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Dickson, T J; Trathen, S; Terwiel, F A; Waddington, G; Adams, R
Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study Journal Article
In: Scandinavian Journal of Medicine & Science in Sports, vol. 27, no. 2, pp. 236–244, 2017, ISBN: 09057188.
@article{Dickson2017,
title = {Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study},
author = {Dickson, T J and Trathen, S and Terwiel, F A and Waddington, G and Adams, R},
doi = {10.1111/sms.12642},
isbn = {09057188},
year = {2017},
date = {2017-01-01},
journal = {Scandinavian Journal of Medicine \& Science in Sports},
volume = {27},
number = {2},
pages = {236--244},
abstract = {This research explored associations between helmet use and head injuries in snowsports by investigating reported snowsport injuries in Western Canada from 2008-2009 to 2012-2013. The key finding was that increased helmet use (from 69% to 80%) was not associated with a reduction in reported head injuries. Over the study period, the average rate of reported head injuries was 0.2/1000 skier visits, with a statistically significant variation ( P \< 0.001). The line of best fit showed an non-significant upward trend ( P = 0.13). Lacerations were the only subcategory of head injuries that decreased significantly with helmet use. A higher proportion of people who reported a head injury were wearing a helmet than for injuries other than to the head. Skiers were more likely to report a head injury when wearing a helmet than snowboarders ( P \< 0.001 cf. P = 0.22). There were significant differences in characteristics of helmet and non-helmet wearers. Helmet wearers were more likely to be: young adults ( P \< 0.001); beginner/novices ( P = 0.004); and snowboarders ( P \< 0.001), but helmet wearing was not associated with gender ( P = 0.191). Further research is needed to explore the possible reasons for the failure of helmets to reduce head injuries, for example, increased reporting of head injuries and increased risk-taking combined with over-rating of the helmets' protection.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Baldwin, G; Breiding, M; Sleet, D
Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC) Journal Article
In: NeuroRehabilitation, vol. 39, no. 3, pp. 345–349, 2016.
@article{Baldwin2016,
title = {Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC)},
author = {Baldwin, G and Breiding, M and Sleet, D},
doi = {10.3233/NRE-161366},
year = {2016},
date = {2016-01-01},
journal = {NeuroRehabilitation},
volume = {39},
number = {3},
pages = {345--349},
abstract = {Traumatic brain injury (TBI) can have long term effects on mental and physical health, and can disrupt vocational, educational, and social functioning. TBIs can range from mild to severe and their effects can last many years after the initial injury. CDC seeks to reduce the burden of TBI from unintentional injuries through a focus on primary prevention, improved recognition and management, and intervening to improve health outcomes after TBI. CDC uses a 4-stage public health model to guide TBI prevention, moving from 1) surveillance of TBI, 2) identification of risk and protective factors for TBI, 3) development and testing of evidence-based interventions, to 4) bringing effective intervention to scale through widespread adoption. CDC's unintentional injury prevention activities focus on the prevention of sports-related concussions, motor vehicle crashes, and older adult falls. For concussion prevention, CDC developed Heads Up - an awareness initiative focusing on ways to prevent a concussion in sports, and identifying how to recognize and manage potential concussions. In motor vehicle injury prevention, CDC has developed a tool (MV PICCS) to calculate the expected number of injuries prevented and lives saved using various evidence-based motor vehicle crash prevention strategies. To help prevent TBI related to older adult falls, CDC has developed STEADI, an initiative to help primary care providers identify their patients' falls risk and provide effective interventions. In the future, CDC is focused on advancing our understanding of the public health burden of TBI through improved surveillance in order to produce more comprehensive estimates of the public health burden of TBI. © 2016 - IOS Press and the authors. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kim, S; Spengler, J O; Connaughton, D P
An exploratory study of concussion management policies in municipal park and recreation departments Journal Article
In: Journal of Policy Research in Tourism, Leisure and Events, vol. 8, no. 3, pp. 274–288, 2016.
@article{Kim2016a,
title = {An exploratory study of concussion management policies in municipal park and recreation departments},
author = {Kim, S and Spengler, J O and Connaughton, D P},
doi = {10.1080/19407963.2016.1181077},
year = {2016},
date = {2016-01-01},
journal = {Journal of Policy Research in Tourism, Leisure and Events},
volume = {8},
number = {3},
pages = {274--288},
abstract = {Despite the burgeoning interest in reducing concussions among youth sport participants, research investigating concussion safety policies of municipal park and recreation departments has been sparse. A national survey of park and recreation professionals in 50 states (n = 739, response rate of 23%) was conducted in 2015 to assess concussion management policies and practices of municipal park and recreation departments. Only about one-third of respondents indicated that their departments required coaches to be trained in concussion safety. Among those who mandated concussion safety training, the CDC’s ‘Heads Up: Concussion in Youth Sports’ was the most commonly used concussion safety training material. Despite the low number of departments requiring concussion safety training for youth sport coaches using park/recreation facilities, nearly two-thirds encouraged concussion safety training for such coaches. The results suggest that, overall, municipal park and recreation department’s concussion safety policies are lagging behind those typically found in interscholastic and collegiate sport programs. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Herman, D C; Barth, J T
Drop-jump landing varies with baseline neurocognition: Implications for anterior cruciate ligament injury risk and prevention Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 9, pp. 2347–2353, 2016.
@article{Herman2016,
title = {Drop-jump landing varies with baseline neurocognition: Implications for anterior cruciate ligament injury risk and prevention},
author = {Herman, D C and Barth, J T},
doi = {10.1177/0363546516657338},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {9},
pages = {2347--2353},
abstract = {Background: Neurocognitive status may be a risk factor for anterior cruciate ligament (ACL) injury. Neurocognitive domains such as visual attention, processing speed/reaction time, and dual-tasking may influence ACL injury risk via alterations to neuromuscular performance during athletic tasks. However, the relationship between neurocognition and performance during athletic tasks is not yet established. Hypothesis: Athletes with low baseline neurocognitive scores will demonstrate poorer jump landing performance compared with athletes with high baseline neurocognitive score. Study Design: Controlled laboratory study. Methods: Neurocognitive performance was measured using the Concussion Resolution Index (CRI). Three-dimensional kinematic and kinetic data of the dominant limb were collected for 37 recreational athletes while performing an unanticipated jump-landing task. Healthy, nonconcussed subjects were screened using a computer-based neurocognitive test into a high performers (HP; n = 20; average CRI percentile, 78th) and a low performers (LP; n = 17; average CRI percentile, 41st) group. The task consisted of a forward jump onto a force plate with an immediate rebound to a second target that was assigned 250 milliseconds before landing on the force plate. Kinematic and kinetic data were obtained during the first jump landing. Results: The LP group demonstrated significantly altered neuromuscular performance during the landing phase while completing the jump-landing task, including significantly increased peak vertical ground-reaction force (mean ± SD of LP vs HP: 1.81 ± 0.53 vs 1.38 ± 0.37 body weight [BW]; P \<.01), peak anterior tibial shear force (0.91 ± 0.17 vs 0.72 ± 0.22 BW; P \<.01), knee abduction moment (0.47 ± 0.56 vs 0.03 ± 0.64 BW × body height; P =.03), and knee abduction angle (6.1° ± 4.7° vs 1.3° ± 5.6°; P =.03), as well as decreased trunk flexion angle (9.6° ± 9.6° vs 16.4° ± 11.2°; P \<.01). Conclusion: Healthy athletes with lower baseline neurocognitive performance generate knee kinematic and kinetic patterns that are linked to ACL injury. Clinical Relevance: Neurocognitive testing using the CRI may be useful for identification of athletes at elevated risk for future ACL injury. © American Orthopaedic Society for Sports Medicine.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Patton, D A; McIntosh, A S
Considerations for the performance requirements and technical specifications of soft-shell padded headgear Journal Article
In: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology, vol. 230, no. 1, pp. 29–42, 2016.
@article{Patton2016b,
title = {Considerations for the performance requirements and technical specifications of soft-shell padded headgear},
author = {Patton, D A and McIntosh, A S},
doi = {10.1177/1754337115615482},
year = {2016},
date = {2016-01-01},
journal = {Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology},
volume = {230},
number = {1},
pages = {29--42},
abstract = {Laboratory and epidemiological research in Australian football, rugby league and rugby union has demonstrated that commercially available soft-shell padded headgear is currently ineffective in reducing the risk of concussion. However, modified headgear studies have demonstrated that significant improvements in impact energy attenuation performance are possible with small design changes, such as increases in foam density and thickness. A literature review of the design, performance and use of headgear in Australian football, rugby league and rugby union was conducted. A total of 23 articles were identified using primary and secondary search strategies, which included epidemiological field studies, laboratory impact test studies and studies investigating the behaviours and attitudes of players. The results of the review were synthesised and used to identify injury reduction objectives and appropriate design criteria. The need for a headgear standard was identified and performance requirements were discussed, which drew upon human tolerance and sports-specific head impact exposure data. Usability and behavioural issues, which require consideration during the design process, were also assessed. © IMechE 2015.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Morimoto, K; Kasuyama, T; Sakurai, S; Nakazawa, R; Sakamoto, M
Head acceleration of trackles in high school rugby players Journal Article
In: Japanese Journal of Clinical Sports Medicine, vol. 20, no. 2, pp. 292–298, 2012, ISBN: 13464159.
@article{Morimoto2012,
title = {Head acceleration of trackles in high school rugby players},
author = {Morimoto, K and Kasuyama, T and Sakurai, S and Nakazawa, R and Sakamoto, M},
isbn = {13464159},
year = {2012},
date = {2012-01-01},
journal = {Japanese Journal of Clinical Sports Medicine},
volume = {20},
number = {2},
pages = {292--298},
abstract = {Head acceleration at the time of tackling was measured for forty-seven high school rugby players. The time to reach the peak values for the lateral non-tackle side and tackle side peaks after coming into contact with the tackle machine, as well as the gap between the two peaks (amplitude time) were analyzed. In comparing student grade, the amplitude time of a right Power Foot Tackle of third grade students was significantly shorter than that of first grade students. Regarding differences between left and right tackles, the amplitude time of a right Diving Tackle was significantly shorter than the left side tackle. Differences in the timing of head movements were thought to have been determined by the skill level and shoulder effectiveness of the tackles. Topics for the future study include measurement of head acceleration in a state approximating that of actual motion, point of contact, verification of training, etc. ABSTRACT FROM AUTHOR},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Krolikowski, Maciej P; Black, Amanda M; Palacios-Derflingher, Luz; Blake, Tracy A; Schneider, Kathryn J; Emery, Carolyn A
The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions in Youth Ice Hockey Players Journal Article
In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 468–473, 2017, ISBN: 03635465.
Abstract | Links | BibTeX | Tags: child and adolescent, Concussion, ice hockey, Injury prevention
@article{Krolikowski2017,
title = {The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions in Youth Ice Hockey Players},
author = {Krolikowski, Maciej P and Black, Amanda M and Palacios-Derflingher, Luz and Blake, Tracy A and Schneider, Kathryn J and Emery, Carolyn A},
doi = {10.1177/0363546516669701},
isbn = {03635465},
year = {2017},
date = {2017-01-01},
journal = {American Journal of Sports Medicine},
volume = {45},
number = {2},
pages = {468--473},
abstract = {Background: Ice hockey is a popular winter sport in Canada. Concussions account for the greatest proportion of all injuries in youth ice hockey. In 2011, a policy change enforcing "zero tolerance for head contact" was implemented in all leagues in Canada. Purpose: To determine if the risk of game-related concussions and more severe concussions (ie, resulting in \>10 days of time loss) and the mechanisms of a concussion differed for Pee Wee class (ages 11-12 years) and Bantam class (ages 13-14 years) players after the 2011 "zero tolerance for head contact" policy change compared with players in similar divisions before the policy change. Study Design: Cohort study; Level of evidence, 3. Methods: The retrospective cohort included Pee Wee (most elite 70%, 2007-2008; n = 891) and Bantam (most elite 30%, 2008-2009; n = 378) players before the rule change and Pee Wee (2011-2012; n = 588) and Bantam (2011-2012; n = 242) players in the same levels of play after the policy change. Suspected concussions were identified by a team designate and referred to a sport medicine physician for diagnosis. Incidence rate ratios (IRRs) were estimated based on multiple Poisson regression analysis, controlling for clustering by team and other important covariates and offset by game-exposure hours. Incidence rates based on the mechanisms of a concussion were estimated based on univariate Poisson regression analysis. Results: The risk of game-related concussions increased after the head contact rule in Pee Wee (IRR, 1.85; 95% CI, 1.20-2.86) and Bantam (IRR, 2.48; 95% CI, 1.17-5.24) players. The risk of more severe concussions increased after the head contact rule in Pee Wee (IRR, 4.12; 95% CI, 2.00-8.50) and Bantam (IRR, 7.91; 95% CI, 3.13-19.94) players. The rates of concussions due to body checking and direct head contact increased after the rule change. Conclusion: The "zero tolerance for head contact" policy change did not reduce the risk of game-related concussions in Pee Wee or Bantam class ice hockey players. Increased concussion awareness and education after the policy change may have contributed to the increased risk of concussions found after the policy change. [ABSTRACT FROM AUTHOR]},
keywords = {child and adolescent, Concussion, ice hockey, Injury prevention},
pubstate = {published},
tppubtype = {article}
}
Reider, Bruce
Activating the Omega 13 Journal Article
In: American Journal of Sports Medicine, vol. 45, no. 2, pp. 275–277, 2017, ISBN: 03635465.
Links | BibTeX | Tags: ACL tear, Concussion, female athlete triad, football, Injury prevention, rugby, Soccer
@article{Reider2017,
title = {Activating the Omega 13},
author = {Reider, Bruce},
doi = {10.1177/0363546517690145},
isbn = {03635465},
year = {2017},
date = {2017-01-01},
journal = {American Journal of Sports Medicine},
volume = {45},
number = {2},
pages = {275--277},
keywords = {ACL tear, Concussion, female athlete triad, football, Injury prevention, rugby, Soccer},
pubstate = {published},
tppubtype = {article}
}
Dickson, T J; Trathen, S; Terwiel, F A; Waddington, G; Adams, R
Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study Journal Article
In: Scandinavian Journal of Medicine & Science in Sports, vol. 27, no. 2, pp. 236–244, 2017, ISBN: 09057188.
Abstract | Links | BibTeX | Tags: CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries
@article{Dickson2017,
title = {Head injury trends and helmet use in skiers and snowboarders in Western Canada, 2008-2009 to 2012-2013: an ecological study},
author = {Dickson, T J and Trathen, S and Terwiel, F A and Waddington, G and Adams, R},
doi = {10.1111/sms.12642},
isbn = {09057188},
year = {2017},
date = {2017-01-01},
journal = {Scandinavian Journal of Medicine \& Science in Sports},
volume = {27},
number = {2},
pages = {236--244},
abstract = {This research explored associations between helmet use and head injuries in snowsports by investigating reported snowsport injuries in Western Canada from 2008-2009 to 2012-2013. The key finding was that increased helmet use (from 69% to 80%) was not associated with a reduction in reported head injuries. Over the study period, the average rate of reported head injuries was 0.2/1000 skier visits, with a statistically significant variation ( P \< 0.001). The line of best fit showed an non-significant upward trend ( P = 0.13). Lacerations were the only subcategory of head injuries that decreased significantly with helmet use. A higher proportion of people who reported a head injury were wearing a helmet than for injuries other than to the head. Skiers were more likely to report a head injury when wearing a helmet than snowboarders ( P \< 0.001 cf. P = 0.22). There were significant differences in characteristics of helmet and non-helmet wearers. Helmet wearers were more likely to be: young adults ( P \< 0.001); beginner/novices ( P = 0.004); and snowboarders ( P \< 0.001), but helmet wearing was not associated with gender ( P = 0.191). Further research is needed to explore the possible reasons for the failure of helmets to reduce head injuries, for example, increased reporting of head injuries and increased risk-taking combined with over-rating of the helmets' protection.},
keywords = {CANADA, CHI-squared test, Concussion, CONTENT mining, DATA analysis -- Software, DESCRIPTIVE statistics, Ecological research, Head Injuries, Helmets, Injury prevention, LOGISTIC regression analysis, ODDS ratio, PROBABILITY theory, SAFETY hats, SEVERITY of illness index, skiing, Skiing injuries, Snowboarding, Snowboarding injuries},
pubstate = {published},
tppubtype = {article}
}
Baldwin, G; Breiding, M; Sleet, D
Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC) Journal Article
In: NeuroRehabilitation, vol. 39, no. 3, pp. 345–349, 2016.
Abstract | Links | BibTeX | Tags: injury causes, Injury prevention, traumatic brain injury, unintentional injury
@article{Baldwin2016,
title = {Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC)},
author = {Baldwin, G and Breiding, M and Sleet, D},
doi = {10.3233/NRE-161366},
year = {2016},
date = {2016-01-01},
journal = {NeuroRehabilitation},
volume = {39},
number = {3},
pages = {345--349},
abstract = {Traumatic brain injury (TBI) can have long term effects on mental and physical health, and can disrupt vocational, educational, and social functioning. TBIs can range from mild to severe and their effects can last many years after the initial injury. CDC seeks to reduce the burden of TBI from unintentional injuries through a focus on primary prevention, improved recognition and management, and intervening to improve health outcomes after TBI. CDC uses a 4-stage public health model to guide TBI prevention, moving from 1) surveillance of TBI, 2) identification of risk and protective factors for TBI, 3) development and testing of evidence-based interventions, to 4) bringing effective intervention to scale through widespread adoption. CDC's unintentional injury prevention activities focus on the prevention of sports-related concussions, motor vehicle crashes, and older adult falls. For concussion prevention, CDC developed Heads Up - an awareness initiative focusing on ways to prevent a concussion in sports, and identifying how to recognize and manage potential concussions. In motor vehicle injury prevention, CDC has developed a tool (MV PICCS) to calculate the expected number of injuries prevented and lives saved using various evidence-based motor vehicle crash prevention strategies. To help prevent TBI related to older adult falls, CDC has developed STEADI, an initiative to help primary care providers identify their patients' falls risk and provide effective interventions. In the future, CDC is focused on advancing our understanding of the public health burden of TBI through improved surveillance in order to produce more comprehensive estimates of the public health burden of TBI. © 2016 - IOS Press and the authors. All rights reserved.},
keywords = {injury causes, Injury prevention, traumatic brain injury, unintentional injury},
pubstate = {published},
tppubtype = {article}
}
Kim, S; Spengler, J O; Connaughton, D P
An exploratory study of concussion management policies in municipal park and recreation departments Journal Article
In: Journal of Policy Research in Tourism, Leisure and Events, vol. 8, no. 3, pp. 274–288, 2016.
Abstract | Links | BibTeX | Tags: Concussion, Injury prevention, policy, recreation, risk management, Youth sports
@article{Kim2016a,
title = {An exploratory study of concussion management policies in municipal park and recreation departments},
author = {Kim, S and Spengler, J O and Connaughton, D P},
doi = {10.1080/19407963.2016.1181077},
year = {2016},
date = {2016-01-01},
journal = {Journal of Policy Research in Tourism, Leisure and Events},
volume = {8},
number = {3},
pages = {274--288},
abstract = {Despite the burgeoning interest in reducing concussions among youth sport participants, research investigating concussion safety policies of municipal park and recreation departments has been sparse. A national survey of park and recreation professionals in 50 states (n = 739, response rate of 23%) was conducted in 2015 to assess concussion management policies and practices of municipal park and recreation departments. Only about one-third of respondents indicated that their departments required coaches to be trained in concussion safety. Among those who mandated concussion safety training, the CDC’s ‘Heads Up: Concussion in Youth Sports’ was the most commonly used concussion safety training material. Despite the low number of departments requiring concussion safety training for youth sport coaches using park/recreation facilities, nearly two-thirds encouraged concussion safety training for such coaches. The results suggest that, overall, municipal park and recreation department’s concussion safety policies are lagging behind those typically found in interscholastic and collegiate sport programs. © 2016 Informa UK Limited, trading as Taylor \& Francis Group.},
keywords = {Concussion, Injury prevention, policy, recreation, risk management, Youth sports},
pubstate = {published},
tppubtype = {article}
}
Herman, D C; Barth, J T
Drop-jump landing varies with baseline neurocognition: Implications for anterior cruciate ligament injury risk and prevention Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 9, pp. 2347–2353, 2016.
Abstract | Links | BibTeX | Tags: ACL, Biomechanics, Injury prevention, Motion analysis
@article{Herman2016,
title = {Drop-jump landing varies with baseline neurocognition: Implications for anterior cruciate ligament injury risk and prevention},
author = {Herman, D C and Barth, J T},
doi = {10.1177/0363546516657338},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {9},
pages = {2347--2353},
abstract = {Background: Neurocognitive status may be a risk factor for anterior cruciate ligament (ACL) injury. Neurocognitive domains such as visual attention, processing speed/reaction time, and dual-tasking may influence ACL injury risk via alterations to neuromuscular performance during athletic tasks. However, the relationship between neurocognition and performance during athletic tasks is not yet established. Hypothesis: Athletes with low baseline neurocognitive scores will demonstrate poorer jump landing performance compared with athletes with high baseline neurocognitive score. Study Design: Controlled laboratory study. Methods: Neurocognitive performance was measured using the Concussion Resolution Index (CRI). Three-dimensional kinematic and kinetic data of the dominant limb were collected for 37 recreational athletes while performing an unanticipated jump-landing task. Healthy, nonconcussed subjects were screened using a computer-based neurocognitive test into a high performers (HP; n = 20; average CRI percentile, 78th) and a low performers (LP; n = 17; average CRI percentile, 41st) group. The task consisted of a forward jump onto a force plate with an immediate rebound to a second target that was assigned 250 milliseconds before landing on the force plate. Kinematic and kinetic data were obtained during the first jump landing. Results: The LP group demonstrated significantly altered neuromuscular performance during the landing phase while completing the jump-landing task, including significantly increased peak vertical ground-reaction force (mean ± SD of LP vs HP: 1.81 ± 0.53 vs 1.38 ± 0.37 body weight [BW]; P \<.01), peak anterior tibial shear force (0.91 ± 0.17 vs 0.72 ± 0.22 BW; P \<.01), knee abduction moment (0.47 ± 0.56 vs 0.03 ± 0.64 BW × body height; P =.03), and knee abduction angle (6.1° ± 4.7° vs 1.3° ± 5.6°; P =.03), as well as decreased trunk flexion angle (9.6° ± 9.6° vs 16.4° ± 11.2°; P \<.01). Conclusion: Healthy athletes with lower baseline neurocognitive performance generate knee kinematic and kinetic patterns that are linked to ACL injury. Clinical Relevance: Neurocognitive testing using the CRI may be useful for identification of athletes at elevated risk for future ACL injury. © American Orthopaedic Society for Sports Medicine.},
keywords = {ACL, Biomechanics, Injury prevention, Motion analysis},
pubstate = {published},
tppubtype = {article}
}
Patton, D A; McIntosh, A S
Considerations for the performance requirements and technical specifications of soft-shell padded headgear Journal Article
In: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology, vol. 230, no. 1, pp. 29–42, 2016.
Abstract | Links | BibTeX | Tags: Australian football, Biomechanics, Concussion, Design, Head Injuries, head injury, headgear, Injury prevention, protective equipment, rugby, Sports
@article{Patton2016b,
title = {Considerations for the performance requirements and technical specifications of soft-shell padded headgear},
author = {Patton, D A and McIntosh, A S},
doi = {10.1177/1754337115615482},
year = {2016},
date = {2016-01-01},
journal = {Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology},
volume = {230},
number = {1},
pages = {29--42},
abstract = {Laboratory and epidemiological research in Australian football, rugby league and rugby union has demonstrated that commercially available soft-shell padded headgear is currently ineffective in reducing the risk of concussion. However, modified headgear studies have demonstrated that significant improvements in impact energy attenuation performance are possible with small design changes, such as increases in foam density and thickness. A literature review of the design, performance and use of headgear in Australian football, rugby league and rugby union was conducted. A total of 23 articles were identified using primary and secondary search strategies, which included epidemiological field studies, laboratory impact test studies and studies investigating the behaviours and attitudes of players. The results of the review were synthesised and used to identify injury reduction objectives and appropriate design criteria. The need for a headgear standard was identified and performance requirements were discussed, which drew upon human tolerance and sports-specific head impact exposure data. Usability and behavioural issues, which require consideration during the design process, were also assessed. © IMechE 2015.},
keywords = {Australian football, Biomechanics, Concussion, Design, Head Injuries, head injury, headgear, Injury prevention, protective equipment, rugby, Sports},
pubstate = {published},
tppubtype = {article}
}
Morimoto, K; Kasuyama, T; Sakurai, S; Nakazawa, R; Sakamoto, M
Head acceleration of trackles in high school rugby players Journal Article
In: Japanese Journal of Clinical Sports Medicine, vol. 20, no. 2, pp. 292–298, 2012, ISBN: 13464159.
Abstract | BibTeX | Tags: *HIGH schools, *RUGBY football players, *SCHOOL sports, *SPORTS medicine, Concussion, Contact sports, FIRST grade (Education), Injury prevention
@article{Morimoto2012,
title = {Head acceleration of trackles in high school rugby players},
author = {Morimoto, K and Kasuyama, T and Sakurai, S and Nakazawa, R and Sakamoto, M},
isbn = {13464159},
year = {2012},
date = {2012-01-01},
journal = {Japanese Journal of Clinical Sports Medicine},
volume = {20},
number = {2},
pages = {292--298},
abstract = {Head acceleration at the time of tackling was measured for forty-seven high school rugby players. The time to reach the peak values for the lateral non-tackle side and tackle side peaks after coming into contact with the tackle machine, as well as the gap between the two peaks (amplitude time) were analyzed. In comparing student grade, the amplitude time of a right Power Foot Tackle of third grade students was significantly shorter than that of first grade students. Regarding differences between left and right tackles, the amplitude time of a right Diving Tackle was significantly shorter than the left side tackle. Differences in the timing of head movements were thought to have been determined by the skill level and shoulder effectiveness of the tackles. Topics for the future study include measurement of head acceleration in a state approximating that of actual motion, point of contact, verification of training, etc. ABSTRACT FROM AUTHOR},
keywords = {*HIGH schools, *RUGBY football players, *SCHOOL sports, *SPORTS medicine, Concussion, Contact sports, FIRST grade (Education), Injury prevention},
pubstate = {published},
tppubtype = {article}
}