Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Halstead, M E
Pharmacologic Therapies for Pediatric Concussions Journal Article
In: Sports & Health, vol. 8, no. 1, pp. 50–52, 2016.
Abstract | BibTeX | Tags: *Acetaminophen/tu [Therapeutic Use], *Analgesics, *Anti-Inflammatory Agents, *Athletic Injuries/co [Complications], *Brain Concussion/co [Complications], *Post-Traumatic Headache/et [Etiology], 0 (Analgesics, 0 (Anti-Inflammatory Agents, 362O9ITL9D (Acetaminophen), Athletic Injuries/dt [Drug Therapy], Brain Concussion/dt [Drug Therapy], Child, Consensus, Humans, Non-Narcotic), Non-Narcotic/tu [Therapeutic Use], Non-Steroidal), Non-Steroidal/tu [Thera, Physicians'/sn [Statistics & Nu, Post-Traumatic Headache/dt [Drug Therapy], Practice Guidelines as Topic, Practice Patterns, Recovery of Function, Retrospective Studies
@article{Halstead2016,
title = {Pharmacologic Therapies for Pediatric Concussions},
author = {Halstead, M E},
year = {2016},
date = {2016-01-01},
journal = {Sports \& Health},
volume = {8},
number = {1},
pages = {50--52},
abstract = {CONTEXT: Pediatric concussions are common, and emphasis on correct diagnosis and management is stressed in consensus guidelines. Medications may have a role in management of concussion, but no consensus exists regarding appropriate pharmacologic therapy. EVIDENCE ACQUISITION: Nonsystematic review. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: There is limited evidence for hypertonic saline to improve posttraumatic headache in the emergency department setting. There is essentially no evidence for the use of any other medication in management of pediatric sport-related concussion. CONCLUSION: Further research is necessary to determine whether there is benefit to the use of any pharmacotherapy in the management of pediatric-aged athletes with concussions.},
keywords = {*Acetaminophen/tu [Therapeutic Use], *Analgesics, *Anti-Inflammatory Agents, *Athletic Injuries/co [Complications], *Brain Concussion/co [Complications], *Post-Traumatic Headache/et [Etiology], 0 (Analgesics, 0 (Anti-Inflammatory Agents, 362O9ITL9D (Acetaminophen), Athletic Injuries/dt [Drug Therapy], Brain Concussion/dt [Drug Therapy], Child, Consensus, Humans, Non-Narcotic), Non-Narcotic/tu [Therapeutic Use], Non-Steroidal), Non-Steroidal/tu [Thera, Physicians'/sn [Statistics \& Nu, Post-Traumatic Headache/dt [Drug Therapy], Practice Guidelines as Topic, Practice Patterns, Recovery of Function, Retrospective Studies},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Guskiewicz, K M; Barr, W B; Hammeke, T A; Randolph, C; Ahn, K W; Wang, Y; McCrea, M A
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 142–152, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors
@article{Nelson2016b,
title = {Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes},
author = {Nelson, L D and Guskiewicz, K M and Barr, W B and Hammeke, T A and Randolph, C and Ahn, K W and Wang, Y and McCrea, M A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {142--152},
abstract = {CONTEXT: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. OBJECTIVE: To compare clinical recovery patterns for high school and collegiate athletes. DESIGN: Prospective cohort study. SETTING: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. SUBJECTS: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). RESULTS: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. CONCLUSIONS: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Pham, H; Zemek, R
A 15-year-old rugby player with a head injury Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 187, no. 3, pp. 200–202, 2015.
BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Football/in [Injuries], Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ra [Radiography], Brain Concussion/rh [Rehabilitation], Brain Concussion/th [Therapy], Female, Glasgow Coma Scale, Humans, Physical Examination, Recovery of Function, Tomography, X-Ray Computed
@article{Pham2015,
title = {A 15-year-old rugby player with a head injury},
author = {Pham, H and Zemek, R},
year = {2015},
date = {2015-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {187},
number = {3},
pages = {200--202},
keywords = {*Brain Concussion/di [Diagnosis], *Football/in [Injuries], Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ra [Radiography], Brain Concussion/rh [Rehabilitation], Brain Concussion/th [Therapy], Female, Glasgow Coma Scale, Humans, Physical Examination, Recovery of Function, Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
McGinley, A D; Master, C L; Zonfrillo, M R
Sports-Related Head Injuries in Adolescents: A Comprehensive Update Journal Article
In: Adolescent Medicine, vol. 26, no. 3, pp. 491–506, 2015.
BibTeX | Tags: Adolescent, Athletic Injuries, brain concussion, Brain Injuries, Brain Injury, Chronic, CONVALESCENCE, human, Humans, injury scale, Recovery of Function, sport injury, Trauma Severity Indices
@article{McGinley2015,
title = {Sports-Related Head Injuries in Adolescents: A Comprehensive Update},
author = {McGinley, A D and Master, C L and Zonfrillo, M R},
year = {2015},
date = {2015-01-01},
journal = {Adolescent Medicine},
volume = {26},
number = {3},
pages = {491--506},
keywords = {Adolescent, Athletic Injuries, brain concussion, Brain Injuries, Brain Injury, Chronic, CONVALESCENCE, human, Humans, injury scale, Recovery of Function, sport injury, Trauma Severity Indices},
pubstate = {published},
tppubtype = {article}
}
Maerlender, A; Rieman, W; Lichtenstein, J; Condiracci, C
Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study Journal Article
In: Developmental Neuropsychology, vol. 40, no. 5, pp. 273–278, 2015.
Abstract | Links | BibTeX | Tags: adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome
@article{Maerlender2015a,
title = {Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study},
author = {Maerlender, A and Rieman, W and Lichtenstein, J and Condiracci, C},
doi = {10.1080/87565641.2015.1067706},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {5},
pages = {273--278},
abstract = {Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery. © 2015 Copyright © 2015 Taylor \& Francis Group, LLC.},
keywords = {adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Halstead, M E
Pharmacologic Therapies for Pediatric Concussions Journal Article
In: Sports & Health, vol. 8, no. 1, pp. 50–52, 2016.
@article{Halstead2016,
title = {Pharmacologic Therapies for Pediatric Concussions},
author = {Halstead, M E},
year = {2016},
date = {2016-01-01},
journal = {Sports \& Health},
volume = {8},
number = {1},
pages = {50--52},
abstract = {CONTEXT: Pediatric concussions are common, and emphasis on correct diagnosis and management is stressed in consensus guidelines. Medications may have a role in management of concussion, but no consensus exists regarding appropriate pharmacologic therapy. EVIDENCE ACQUISITION: Nonsystematic review. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: There is limited evidence for hypertonic saline to improve posttraumatic headache in the emergency department setting. There is essentially no evidence for the use of any other medication in management of pediatric sport-related concussion. CONCLUSION: Further research is necessary to determine whether there is benefit to the use of any pharmacotherapy in the management of pediatric-aged athletes with concussions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Guskiewicz, K M; Barr, W B; Hammeke, T A; Randolph, C; Ahn, K W; Wang, Y; McCrea, M A
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 142–152, 2016.
@article{Nelson2016b,
title = {Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes},
author = {Nelson, L D and Guskiewicz, K M and Barr, W B and Hammeke, T A and Randolph, C and Ahn, K W and Wang, Y and McCrea, M A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {142--152},
abstract = {CONTEXT: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. OBJECTIVE: To compare clinical recovery patterns for high school and collegiate athletes. DESIGN: Prospective cohort study. SETTING: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. SUBJECTS: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). RESULTS: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. CONCLUSIONS: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Pham, H; Zemek, R
A 15-year-old rugby player with a head injury Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 187, no. 3, pp. 200–202, 2015.
@article{Pham2015,
title = {A 15-year-old rugby player with a head injury},
author = {Pham, H and Zemek, R},
year = {2015},
date = {2015-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {187},
number = {3},
pages = {200--202},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
McGinley, A D; Master, C L; Zonfrillo, M R
Sports-Related Head Injuries in Adolescents: A Comprehensive Update Journal Article
In: Adolescent Medicine, vol. 26, no. 3, pp. 491–506, 2015.
@article{McGinley2015,
title = {Sports-Related Head Injuries in Adolescents: A Comprehensive Update},
author = {McGinley, A D and Master, C L and Zonfrillo, M R},
year = {2015},
date = {2015-01-01},
journal = {Adolescent Medicine},
volume = {26},
number = {3},
pages = {491--506},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Maerlender, A; Rieman, W; Lichtenstein, J; Condiracci, C
Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study Journal Article
In: Developmental Neuropsychology, vol. 40, no. 5, pp. 273–278, 2015.
@article{Maerlender2015a,
title = {Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study},
author = {Maerlender, A and Rieman, W and Lichtenstein, J and Condiracci, C},
doi = {10.1080/87565641.2015.1067706},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {5},
pages = {273--278},
abstract = {Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery. © 2015 Copyright © 2015 Taylor \& Francis Group, LLC.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Halstead, M E
Pharmacologic Therapies for Pediatric Concussions Journal Article
In: Sports & Health, vol. 8, no. 1, pp. 50–52, 2016.
Abstract | BibTeX | Tags: *Acetaminophen/tu [Therapeutic Use], *Analgesics, *Anti-Inflammatory Agents, *Athletic Injuries/co [Complications], *Brain Concussion/co [Complications], *Post-Traumatic Headache/et [Etiology], 0 (Analgesics, 0 (Anti-Inflammatory Agents, 362O9ITL9D (Acetaminophen), Athletic Injuries/dt [Drug Therapy], Brain Concussion/dt [Drug Therapy], Child, Consensus, Humans, Non-Narcotic), Non-Narcotic/tu [Therapeutic Use], Non-Steroidal), Non-Steroidal/tu [Thera, Physicians'/sn [Statistics & Nu, Post-Traumatic Headache/dt [Drug Therapy], Practice Guidelines as Topic, Practice Patterns, Recovery of Function, Retrospective Studies
@article{Halstead2016,
title = {Pharmacologic Therapies for Pediatric Concussions},
author = {Halstead, M E},
year = {2016},
date = {2016-01-01},
journal = {Sports \& Health},
volume = {8},
number = {1},
pages = {50--52},
abstract = {CONTEXT: Pediatric concussions are common, and emphasis on correct diagnosis and management is stressed in consensus guidelines. Medications may have a role in management of concussion, but no consensus exists regarding appropriate pharmacologic therapy. EVIDENCE ACQUISITION: Nonsystematic review. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: There is limited evidence for hypertonic saline to improve posttraumatic headache in the emergency department setting. There is essentially no evidence for the use of any other medication in management of pediatric sport-related concussion. CONCLUSION: Further research is necessary to determine whether there is benefit to the use of any pharmacotherapy in the management of pediatric-aged athletes with concussions.},
keywords = {*Acetaminophen/tu [Therapeutic Use], *Analgesics, *Anti-Inflammatory Agents, *Athletic Injuries/co [Complications], *Brain Concussion/co [Complications], *Post-Traumatic Headache/et [Etiology], 0 (Analgesics, 0 (Anti-Inflammatory Agents, 362O9ITL9D (Acetaminophen), Athletic Injuries/dt [Drug Therapy], Brain Concussion/dt [Drug Therapy], Child, Consensus, Humans, Non-Narcotic), Non-Narcotic/tu [Therapeutic Use], Non-Steroidal), Non-Steroidal/tu [Thera, Physicians'/sn [Statistics \& Nu, Post-Traumatic Headache/dt [Drug Therapy], Practice Guidelines as Topic, Practice Patterns, Recovery of Function, Retrospective Studies},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Guskiewicz, K M; Barr, W B; Hammeke, T A; Randolph, C; Ahn, K W; Wang, Y; McCrea, M A
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 142–152, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors
@article{Nelson2016b,
title = {Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes},
author = {Nelson, L D and Guskiewicz, K M and Barr, W B and Hammeke, T A and Randolph, C and Ahn, K W and Wang, Y and McCrea, M A},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {142--152},
abstract = {CONTEXT: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. OBJECTIVE: To compare clinical recovery patterns for high school and collegiate athletes. DESIGN: Prospective cohort study. SETTING: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. SUBJECTS: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). RESULTS: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. CONCLUSIONS: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Age Factors, cognition, Female, Football/in [Injuries], Hockey/in [Injuries], Humans, Male, Neuropsychological Tests, Prospective Studies, Racquet Sports/in [Injuries], Recovery of Function, Risk Factors, Soccer/in [Injuries], Students, Time Factors},
pubstate = {published},
tppubtype = {article}
}
Pham, H; Zemek, R
A 15-year-old rugby player with a head injury Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 187, no. 3, pp. 200–202, 2015.
BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Football/in [Injuries], Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ra [Radiography], Brain Concussion/rh [Rehabilitation], Brain Concussion/th [Therapy], Female, Glasgow Coma Scale, Humans, Physical Examination, Recovery of Function, Tomography, X-Ray Computed
@article{Pham2015,
title = {A 15-year-old rugby player with a head injury},
author = {Pham, H and Zemek, R},
year = {2015},
date = {2015-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {187},
number = {3},
pages = {200--202},
keywords = {*Brain Concussion/di [Diagnosis], *Football/in [Injuries], Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ra [Radiography], Brain Concussion/rh [Rehabilitation], Brain Concussion/th [Therapy], Female, Glasgow Coma Scale, Humans, Physical Examination, Recovery of Function, Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
McGinley, A D; Master, C L; Zonfrillo, M R
Sports-Related Head Injuries in Adolescents: A Comprehensive Update Journal Article
In: Adolescent Medicine, vol. 26, no. 3, pp. 491–506, 2015.
BibTeX | Tags: Adolescent, Athletic Injuries, brain concussion, Brain Injuries, Brain Injury, Chronic, CONVALESCENCE, human, Humans, injury scale, Recovery of Function, sport injury, Trauma Severity Indices
@article{McGinley2015,
title = {Sports-Related Head Injuries in Adolescents: A Comprehensive Update},
author = {McGinley, A D and Master, C L and Zonfrillo, M R},
year = {2015},
date = {2015-01-01},
journal = {Adolescent Medicine},
volume = {26},
number = {3},
pages = {491--506},
keywords = {Adolescent, Athletic Injuries, brain concussion, Brain Injuries, Brain Injury, Chronic, CONVALESCENCE, human, Humans, injury scale, Recovery of Function, sport injury, Trauma Severity Indices},
pubstate = {published},
tppubtype = {article}
}
Maerlender, A; Rieman, W; Lichtenstein, J; Condiracci, C
Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study Journal Article
In: Developmental Neuropsychology, vol. 40, no. 5, pp. 273–278, 2015.
Abstract | Links | BibTeX | Tags: adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome
@article{Maerlender2015a,
title = {Programmed physical exertion in recovery from sports-related concussion: A randomized pilot study},
author = {Maerlender, A and Rieman, W and Lichtenstein, J and Condiracci, C},
doi = {10.1080/87565641.2015.1067706},
year = {2015},
date = {2015-01-01},
journal = {Developmental Neuropsychology},
volume = {40},
number = {5},
pages = {273--278},
abstract = {Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery. © 2015 Copyright © 2015 Taylor \& Francis Group, LLC.},
keywords = {adult, brain concussion, controlled study, CONVALESCENCE, exercise, Female, human, Humans, Male, motor activity, Physical Exertion, Pilot Projects, pilot study, randomized controlled trial, Recovery of Function, Sport, Sports, time, Time Factors, treatment outcome},
pubstate = {published},
tppubtype = {article}
}