Kroshus, E; Baugh, C M; Stein, C J; Austin, S B; Calzo, J P
Concussion reporting, sex, and conformity to traditional gender norms in young adults Journal Article
In: Journal of Adolescence, vol. 54, pp. 110–119, 2017.
Abstract | Links | BibTeX | Tags: college, Concussion, gender, Help-seeking, Sport
@article{Kroshus2017,
title = {Concussion reporting, sex, and conformity to traditional gender norms in young adults},
author = {Kroshus, E and Baugh, C M and Stein, C J and Austin, S B and Calzo, J P},
doi = {10.1016/j.adolescence.2016.11.002},
year = {2017},
date = {2017-01-01},
journal = {Journal of Adolescence},
volume = {54},
pages = {110--119},
abstract = {This study assessed whether between-sex differences in concussion reporting intention and behavior among young adults are explained by the extent to which the individual conforms to traditional masculine norms that often characterize contemporary sport culture. A survey of college athletes in the United States (n = 328) found greater symptom reporting intention among females as compared to males, but no difference in their likelihood continued play while experiencing symptoms of a possible concussion. Greater conformity to the norms of risk-taking was associated with greater likelihood of continued play while symptomatic among female athletes but not among male athletes. These findings suggest that gendered behavior, rather than biologically determined sex, is an important consideration for concussion safety in this age group. Addressing elements of the contemporary sport ethos that reinforce risk taking in service of athletic achievement may be a relevant direction for interventions aimed at improving injury reporting among all athletes. © 2016},
keywords = {college, Concussion, gender, Help-seeking, Sport},
pubstate = {published},
tppubtype = {article}
}
Baugh, C M; Kroshus, E; Stamm, J M; Daneshvar, D H; Pepin, M J; Meehan, W P
Clinical practices in collegiate concussion management Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 6, pp. 1391–1399, 2016.
Abstract | Links | BibTeX | Tags: best practices, clinical practice, college, Concussion, Health Policy
@article{Baugh2016,
title = {Clinical practices in collegiate concussion management},
author = {Baugh, C M and Kroshus, E and Stamm, J M and Daneshvar, D H and Pepin, M J and Meehan, W P},
doi = {10.1177/0363546516635639},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {6},
pages = {1391--1399},
abstract = {Background: In recent years, sports leagues and sports medicine experts have developed guidelines for concussion management. The extent to which current clinical practice is consistent with guideline recommendations is unclear. At the collegiate level, there have been few examinations of concussion management practices and the extent to which meaningful differences across divisions of competition exist. Purpose: The purposes of this study were to (1) examine current practices in concussion diagnosis and management at National Collegiate Athletic Association (NCAA) member colleges, (2) explore the extent to which current practices reflect current recommendations for concussion diagnosis and management, and (3) determine whether there are differences in management patterns across divisions of competition. Design: Descriptive epidemiology study. Methods: An electronic questionnaire was sent to sports medicine clinicians at all NCAA member colleges during September and October 2013. Clinicians were asked about baseline assessments, diagnosis and management practices, return-to-play protocols, the perceived prevalence of underdiagnosis, and basic demographic information. Results: Approximately 30% (n = 866) of contacted clinicians, representing nearly 50% (n = 527) of NCAA member colleges, responded to the questionnaire. Preparticipation baseline examinations were administered at the majority of schools (95%), but most (87.5%) administered baseline assessments only to selected high-risk athletes. Computerized neurocognitive testing and balance assessments were most commonly used as preseason baseline and postinjury assessments. Multimodal examination in line with NCAA and other guidance was used only at a minority of institutions. Athletic trainers most commonly administered and interpreted the preseason baseline examination. Most clinicians reported that their institutions' practices were in line with NCAA guidelines during the first 24 hours of an athlete's concussion diagnosis, with exact percentages varying across measures. Differences across divisions of competition included shorter return-to-play time at Division I schools than Division III schools (9.13 vs 10.31 days, respectively) and more frequently referring concussed athletes to a physician within 24 hours of diagnosis at Division I schools. Conclusion: Concussion management at many colleges in the United States incorporates elements recommended by current guidelines; however, there is room to improve. Increasing the use of a multimodal baseline and postinjury examination will elevate the concussion care provided to college athletes and better align with best practice guidance. © American Orthopaedic Society for Sports Medicine.},
keywords = {best practices, clinical practice, college, Concussion, Health Policy},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},
pubstate = {published},
tppubtype = {article}
}
Sikoglu, E M; Liso Navarro, A A; Czerniak, S M; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study Journal Article
In: Cognitive and Behavioral Neurology, vol. 28, no. 4, pp. 181–187, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult
@article{Sikoglu2015,
title = {Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study},
author = {Sikoglu, E M and {Liso Navarro}, A A and Czerniak, S M and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
doi = {10.1097/WNN.0000000000000076},
year = {2015},
date = {2015-01-01},
journal = {Cognitive and Behavioral Neurology},
volume = {28},
number = {4},
pages = {181--187},
abstract = {Background: Although clinical evaluations and neurocognitive assessments are commonly used to evaluate the extent of and recovery from concussion, brain bioenergetics could provide a more quantitative marker. The neurometabolic response to a concussion is thought to increase neuronal energy consumption and thus the demand for nucleoside triphosphate (NTP). Objective: We investigated the possible disruption in high-energy metabolism within the prefrontal cortex of college athletes who had either had a concussion within the past 6 months (n=14) or had never had a concussion (n=13). We hypothesized that concussed athletes would have imbalanced brain bioenergetics resulting from increased NTP consumption, and these biochemical changes would correspond to impaired cognitive abilities. Methods: We used phosphorus-31 magnetic resonance spectroscopy to quantify high-energy phosphates. We performed the neuroimaging in conjunction with neurocognitive assessments targeting prefrontal cortex-mediated tasks. Results: Our results revealed significantly lower $gamma$-NTP levels in the athletes after concussion. Although the concussed and non-concussed participants performed similarly in neurocognitive assessments, lower levels of $gamma$-NTP were associated with worse scores on neurocognitive tasks. Conclusions: Our results support the concept of increased energy demand in the prefrontal cortex of a concussed brain, and we found that while neurocognitive assessments appear normal, brain energetics may be abnormal. A longitudinal study could help establish brain NTP levels as a biomarker to aid in diagnosis and to assess recovery in concussed patients. © 2015 Wolters Kluwer Health, Inc.},
keywords = {Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Resch, Jacob; Driscoll, Aoife; McCaffrey, Noel; Brown, Cathleen; Ferrara, Michael S; Macciocchi, Stephen; Baumgartner, Ted; Walpert, Kimberly
ImPact Test-Retest Reliability: Reliably Unreliable? Journal Article
In: Journal of Athletic Training, vol. 48, no. 4, pp. 506–511, 2013, ISBN: 1062-6050.
Abstract | Links | BibTeX | Tags: ANALYSIS of variance, Body Weights and Measures, Cognition -- Evaluation, college, Computer Assisted, Continuing (Credit), Cross Sectional Studies, Data Analysis Software, DESCRIPTIVE statistics, DIAGNOSIS, Education, Effect Size, Female, human, Instrument Validation, Intraclass Correlation Coefficient, Ireland, Male, Multicenter Studies, Neuropsychological Tests, ONE-way analysis of variance, Post Hoc Analysis, Repeated Measures, Scales, Students, test-retest reliability, UNITED States, Validation Studies, Young Adult
@article{Resch2013b,
title = {ImPact Test-Retest Reliability: Reliably Unreliable?},
author = {Resch, Jacob and Driscoll, Aoife and McCaffrey, Noel and Brown, Cathleen and Ferrara, Michael S and Macciocchi, Stephen and Baumgartner, Ted and Walpert, Kimberly},
doi = {10.4085/1062-6050-48.3.09},
isbn = {1062-6050},
year = {2013},
date = {2013-01-01},
journal = {Journal of Athletic Training},
volume = {48},
number = {4},
pages = {506--511},
abstract = {Context: Computerized neuropsychological testing is commonly used in the assessment and management of sport-related concussion. Even though computerized testing is widespread, psychometric evidence for test-retest reliability is somewhat limited. Additional evidence for test-retest reliability is needed to optimize clinical decision making after concussion. Objective: To document test-retest reliability for a commercially available computerized neuropsychological test battery (ImPACT) using 2 different clinically relevant time intervals. Design: Cross-sectional study. Setting: Two research laboratories. Patients or Other Participants: Group 1 (n=46) consisted of 25 men and 21 women (age=22.4 ± 1.89 years). Group 2 (n = 45) consisted of 17 men and 28 women (age = 20.9 ± 1.72 years). Intervention(s): Both groups completed ImPACT forms 1, 2, and 3, which were delivered sequentially either at 1-week intervals (group 1) or at baseline, day 45, and day 50 (group 2). Group 2 also completed the Green Word Memory Test (WMT) as a measure of effort. Main Outcome Measures: Intraclass correlation coefficients (ICCs) were calculated for the composite scores of ImPACT between time points. Repeated-measures analysis of variance was used to evaluate changes in ImPACT and WMT results over time. Results: The ICC values for group 1 ranged from 0.26 to 0.88 for the 4 ImPACT composite scores. The ICC values for group 2 ranged from 0.37 to 0.76. In group 1, ImPACT classified 37.0% and 46.0% of healthy participants as impaired at time points 2 and 3, respectively. In group 2, ImPACT classified 22.2% and 28.9% of healthy participants as impaired at time points 2 and 3, respectively. Conclusions: We found variable test-retest reliability for ImPACT metrics. Visual motor speed and reaction time demonstrated greater reliability than verbal and visual memory. Our current data support a multifaceted approach to concussion assessment using clinical examinations, symptom reports, cognitive testing, and balance assessment.},
keywords = {ANALYSIS of variance, Body Weights and Measures, Cognition -- Evaluation, college, Computer Assisted, Continuing (Credit), Cross Sectional Studies, Data Analysis Software, DESCRIPTIVE statistics, DIAGNOSIS, Education, Effect Size, Female, human, Instrument Validation, Intraclass Correlation Coefficient, Ireland, Male, Multicenter Studies, Neuropsychological Tests, ONE-way analysis of variance, Post Hoc Analysis, Repeated Measures, Scales, Students, test-retest reliability, UNITED States, Validation Studies, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Kroshus, E; Baugh, C M; Stein, C J; Austin, S B; Calzo, J P
Concussion reporting, sex, and conformity to traditional gender norms in young adults Journal Article
In: Journal of Adolescence, vol. 54, pp. 110–119, 2017.
@article{Kroshus2017,
title = {Concussion reporting, sex, and conformity to traditional gender norms in young adults},
author = {Kroshus, E and Baugh, C M and Stein, C J and Austin, S B and Calzo, J P},
doi = {10.1016/j.adolescence.2016.11.002},
year = {2017},
date = {2017-01-01},
journal = {Journal of Adolescence},
volume = {54},
pages = {110--119},
abstract = {This study assessed whether between-sex differences in concussion reporting intention and behavior among young adults are explained by the extent to which the individual conforms to traditional masculine norms that often characterize contemporary sport culture. A survey of college athletes in the United States (n = 328) found greater symptom reporting intention among females as compared to males, but no difference in their likelihood continued play while experiencing symptoms of a possible concussion. Greater conformity to the norms of risk-taking was associated with greater likelihood of continued play while symptomatic among female athletes but not among male athletes. These findings suggest that gendered behavior, rather than biologically determined sex, is an important consideration for concussion safety in this age group. Addressing elements of the contemporary sport ethos that reinforce risk taking in service of athletic achievement may be a relevant direction for interventions aimed at improving injury reporting among all athletes. © 2016},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Baugh, C M; Kroshus, E; Stamm, J M; Daneshvar, D H; Pepin, M J; Meehan, W P
Clinical practices in collegiate concussion management Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 6, pp. 1391–1399, 2016.
@article{Baugh2016,
title = {Clinical practices in collegiate concussion management},
author = {Baugh, C M and Kroshus, E and Stamm, J M and Daneshvar, D H and Pepin, M J and Meehan, W P},
doi = {10.1177/0363546516635639},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {6},
pages = {1391--1399},
abstract = {Background: In recent years, sports leagues and sports medicine experts have developed guidelines for concussion management. The extent to which current clinical practice is consistent with guideline recommendations is unclear. At the collegiate level, there have been few examinations of concussion management practices and the extent to which meaningful differences across divisions of competition exist. Purpose: The purposes of this study were to (1) examine current practices in concussion diagnosis and management at National Collegiate Athletic Association (NCAA) member colleges, (2) explore the extent to which current practices reflect current recommendations for concussion diagnosis and management, and (3) determine whether there are differences in management patterns across divisions of competition. Design: Descriptive epidemiology study. Methods: An electronic questionnaire was sent to sports medicine clinicians at all NCAA member colleges during September and October 2013. Clinicians were asked about baseline assessments, diagnosis and management practices, return-to-play protocols, the perceived prevalence of underdiagnosis, and basic demographic information. Results: Approximately 30% (n = 866) of contacted clinicians, representing nearly 50% (n = 527) of NCAA member colleges, responded to the questionnaire. Preparticipation baseline examinations were administered at the majority of schools (95%), but most (87.5%) administered baseline assessments only to selected high-risk athletes. Computerized neurocognitive testing and balance assessments were most commonly used as preseason baseline and postinjury assessments. Multimodal examination in line with NCAA and other guidance was used only at a minority of institutions. Athletic trainers most commonly administered and interpreted the preseason baseline examination. Most clinicians reported that their institutions' practices were in line with NCAA guidelines during the first 24 hours of an athlete's concussion diagnosis, with exact percentages varying across measures. Differences across divisions of competition included shorter return-to-play time at Division I schools than Division III schools (9.13 vs 10.31 days, respectively) and more frequently referring concussed athletes to a physician within 24 hours of diagnosis at Division I schools. Conclusion: Concussion management at many colleges in the United States incorporates elements recommended by current guidelines; however, there is room to improve. Increasing the use of a multimodal baseline and postinjury examination will elevate the concussion care provided to college athletes and better align with best practice guidance. © American Orthopaedic Society for Sports Medicine.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Sikoglu, E M; Liso Navarro, A A; Czerniak, S M; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study Journal Article
In: Cognitive and Behavioral Neurology, vol. 28, no. 4, pp. 181–187, 2015.
@article{Sikoglu2015,
title = {Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study},
author = {Sikoglu, E M and {Liso Navarro}, A A and Czerniak, S M and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
doi = {10.1097/WNN.0000000000000076},
year = {2015},
date = {2015-01-01},
journal = {Cognitive and Behavioral Neurology},
volume = {28},
number = {4},
pages = {181--187},
abstract = {Background: Although clinical evaluations and neurocognitive assessments are commonly used to evaluate the extent of and recovery from concussion, brain bioenergetics could provide a more quantitative marker. The neurometabolic response to a concussion is thought to increase neuronal energy consumption and thus the demand for nucleoside triphosphate (NTP). Objective: We investigated the possible disruption in high-energy metabolism within the prefrontal cortex of college athletes who had either had a concussion within the past 6 months (n=14) or had never had a concussion (n=13). We hypothesized that concussed athletes would have imbalanced brain bioenergetics resulting from increased NTP consumption, and these biochemical changes would correspond to impaired cognitive abilities. Methods: We used phosphorus-31 magnetic resonance spectroscopy to quantify high-energy phosphates. We performed the neuroimaging in conjunction with neurocognitive assessments targeting prefrontal cortex-mediated tasks. Results: Our results revealed significantly lower $gamma$-NTP levels in the athletes after concussion. Although the concussed and non-concussed participants performed similarly in neurocognitive assessments, lower levels of $gamma$-NTP were associated with worse scores on neurocognitive tasks. Conclusions: Our results support the concept of increased energy demand in the prefrontal cortex of a concussed brain, and we found that while neurocognitive assessments appear normal, brain energetics may be abnormal. A longitudinal study could help establish brain NTP levels as a biomarker to aid in diagnosis and to assess recovery in concussed patients. © 2015 Wolters Kluwer Health, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Resch, Jacob; Driscoll, Aoife; McCaffrey, Noel; Brown, Cathleen; Ferrara, Michael S; Macciocchi, Stephen; Baumgartner, Ted; Walpert, Kimberly
ImPact Test-Retest Reliability: Reliably Unreliable? Journal Article
In: Journal of Athletic Training, vol. 48, no. 4, pp. 506–511, 2013, ISBN: 1062-6050.
@article{Resch2013b,
title = {ImPact Test-Retest Reliability: Reliably Unreliable?},
author = {Resch, Jacob and Driscoll, Aoife and McCaffrey, Noel and Brown, Cathleen and Ferrara, Michael S and Macciocchi, Stephen and Baumgartner, Ted and Walpert, Kimberly},
doi = {10.4085/1062-6050-48.3.09},
isbn = {1062-6050},
year = {2013},
date = {2013-01-01},
journal = {Journal of Athletic Training},
volume = {48},
number = {4},
pages = {506--511},
abstract = {Context: Computerized neuropsychological testing is commonly used in the assessment and management of sport-related concussion. Even though computerized testing is widespread, psychometric evidence for test-retest reliability is somewhat limited. Additional evidence for test-retest reliability is needed to optimize clinical decision making after concussion. Objective: To document test-retest reliability for a commercially available computerized neuropsychological test battery (ImPACT) using 2 different clinically relevant time intervals. Design: Cross-sectional study. Setting: Two research laboratories. Patients or Other Participants: Group 1 (n=46) consisted of 25 men and 21 women (age=22.4 ± 1.89 years). Group 2 (n = 45) consisted of 17 men and 28 women (age = 20.9 ± 1.72 years). Intervention(s): Both groups completed ImPACT forms 1, 2, and 3, which were delivered sequentially either at 1-week intervals (group 1) or at baseline, day 45, and day 50 (group 2). Group 2 also completed the Green Word Memory Test (WMT) as a measure of effort. Main Outcome Measures: Intraclass correlation coefficients (ICCs) were calculated for the composite scores of ImPACT between time points. Repeated-measures analysis of variance was used to evaluate changes in ImPACT and WMT results over time. Results: The ICC values for group 1 ranged from 0.26 to 0.88 for the 4 ImPACT composite scores. The ICC values for group 2 ranged from 0.37 to 0.76. In group 1, ImPACT classified 37.0% and 46.0% of healthy participants as impaired at time points 2 and 3, respectively. In group 2, ImPACT classified 22.2% and 28.9% of healthy participants as impaired at time points 2 and 3, respectively. Conclusions: We found variable test-retest reliability for ImPACT metrics. Visual motor speed and reaction time demonstrated greater reliability than verbal and visual memory. Our current data support a multifaceted approach to concussion assessment using clinical examinations, symptom reports, cognitive testing, and balance assessment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kroshus, E; Baugh, C M; Stein, C J; Austin, S B; Calzo, J P
Concussion reporting, sex, and conformity to traditional gender norms in young adults Journal Article
In: Journal of Adolescence, vol. 54, pp. 110–119, 2017.
Abstract | Links | BibTeX | Tags: college, Concussion, gender, Help-seeking, Sport
@article{Kroshus2017,
title = {Concussion reporting, sex, and conformity to traditional gender norms in young adults},
author = {Kroshus, E and Baugh, C M and Stein, C J and Austin, S B and Calzo, J P},
doi = {10.1016/j.adolescence.2016.11.002},
year = {2017},
date = {2017-01-01},
journal = {Journal of Adolescence},
volume = {54},
pages = {110--119},
abstract = {This study assessed whether between-sex differences in concussion reporting intention and behavior among young adults are explained by the extent to which the individual conforms to traditional masculine norms that often characterize contemporary sport culture. A survey of college athletes in the United States (n = 328) found greater symptom reporting intention among females as compared to males, but no difference in their likelihood continued play while experiencing symptoms of a possible concussion. Greater conformity to the norms of risk-taking was associated with greater likelihood of continued play while symptomatic among female athletes but not among male athletes. These findings suggest that gendered behavior, rather than biologically determined sex, is an important consideration for concussion safety in this age group. Addressing elements of the contemporary sport ethos that reinforce risk taking in service of athletic achievement may be a relevant direction for interventions aimed at improving injury reporting among all athletes. © 2016},
keywords = {college, Concussion, gender, Help-seeking, Sport},
pubstate = {published},
tppubtype = {article}
}
Baugh, C M; Kroshus, E; Stamm, J M; Daneshvar, D H; Pepin, M J; Meehan, W P
Clinical practices in collegiate concussion management Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 6, pp. 1391–1399, 2016.
Abstract | Links | BibTeX | Tags: best practices, clinical practice, college, Concussion, Health Policy
@article{Baugh2016,
title = {Clinical practices in collegiate concussion management},
author = {Baugh, C M and Kroshus, E and Stamm, J M and Daneshvar, D H and Pepin, M J and Meehan, W P},
doi = {10.1177/0363546516635639},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {6},
pages = {1391--1399},
abstract = {Background: In recent years, sports leagues and sports medicine experts have developed guidelines for concussion management. The extent to which current clinical practice is consistent with guideline recommendations is unclear. At the collegiate level, there have been few examinations of concussion management practices and the extent to which meaningful differences across divisions of competition exist. Purpose: The purposes of this study were to (1) examine current practices in concussion diagnosis and management at National Collegiate Athletic Association (NCAA) member colleges, (2) explore the extent to which current practices reflect current recommendations for concussion diagnosis and management, and (3) determine whether there are differences in management patterns across divisions of competition. Design: Descriptive epidemiology study. Methods: An electronic questionnaire was sent to sports medicine clinicians at all NCAA member colleges during September and October 2013. Clinicians were asked about baseline assessments, diagnosis and management practices, return-to-play protocols, the perceived prevalence of underdiagnosis, and basic demographic information. Results: Approximately 30% (n = 866) of contacted clinicians, representing nearly 50% (n = 527) of NCAA member colleges, responded to the questionnaire. Preparticipation baseline examinations were administered at the majority of schools (95%), but most (87.5%) administered baseline assessments only to selected high-risk athletes. Computerized neurocognitive testing and balance assessments were most commonly used as preseason baseline and postinjury assessments. Multimodal examination in line with NCAA and other guidance was used only at a minority of institutions. Athletic trainers most commonly administered and interpreted the preseason baseline examination. Most clinicians reported that their institutions' practices were in line with NCAA guidelines during the first 24 hours of an athlete's concussion diagnosis, with exact percentages varying across measures. Differences across divisions of competition included shorter return-to-play time at Division I schools than Division III schools (9.13 vs 10.31 days, respectively) and more frequently referring concussed athletes to a physician within 24 hours of diagnosis at Division I schools. Conclusion: Concussion management at many colleges in the United States incorporates elements recommended by current guidelines; however, there is room to improve. Increasing the use of a multimodal baseline and postinjury examination will elevate the concussion care provided to college athletes and better align with best practice guidance. © American Orthopaedic Society for Sports Medicine.},
keywords = {best practices, clinical practice, college, Concussion, Health Policy},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},
pubstate = {published},
tppubtype = {article}
}
Sikoglu, E M; Liso Navarro, A A; Czerniak, S M; McCafferty, J; Eisenstock, J; Stevenson, J H; King, J A; Moore, C M
Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study Journal Article
In: Cognitive and Behavioral Neurology, vol. 28, no. 4, pp. 181–187, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult
@article{Sikoglu2015,
title = {Effects of Recent Concussion on Brain Bioenergetics: A Phosphorus-31 Magnetic Resonance Spectroscopy Study},
author = {Sikoglu, E M and {Liso Navarro}, A A and Czerniak, S M and McCafferty, J and Eisenstock, J and Stevenson, J H and King, J A and Moore, C M},
doi = {10.1097/WNN.0000000000000076},
year = {2015},
date = {2015-01-01},
journal = {Cognitive and Behavioral Neurology},
volume = {28},
number = {4},
pages = {181--187},
abstract = {Background: Although clinical evaluations and neurocognitive assessments are commonly used to evaluate the extent of and recovery from concussion, brain bioenergetics could provide a more quantitative marker. The neurometabolic response to a concussion is thought to increase neuronal energy consumption and thus the demand for nucleoside triphosphate (NTP). Objective: We investigated the possible disruption in high-energy metabolism within the prefrontal cortex of college athletes who had either had a concussion within the past 6 months (n=14) or had never had a concussion (n=13). We hypothesized that concussed athletes would have imbalanced brain bioenergetics resulting from increased NTP consumption, and these biochemical changes would correspond to impaired cognitive abilities. Methods: We used phosphorus-31 magnetic resonance spectroscopy to quantify high-energy phosphates. We performed the neuroimaging in conjunction with neurocognitive assessments targeting prefrontal cortex-mediated tasks. Results: Our results revealed significantly lower $gamma$-NTP levels in the athletes after concussion. Although the concussed and non-concussed participants performed similarly in neurocognitive assessments, lower levels of $gamma$-NTP were associated with worse scores on neurocognitive tasks. Conclusions: Our results support the concept of increased energy demand in the prefrontal cortex of a concussed brain, and we found that while neurocognitive assessments appear normal, brain energetics may be abnormal. A longitudinal study could help establish brain NTP levels as a biomarker to aid in diagnosis and to assess recovery in concussed patients. © 2015 Wolters Kluwer Health, Inc.},
keywords = {Adolescent, adult, Article, athlete, Athletic Injuries, biochemical analysis, bioenergy, brain concussion, clinical article, cognition, college, Concussion, energy consumption, Energy Metabolism, Female, high energy phosphate, human, Humans, Longitudinal studies, longitudinal study, Magnetic Resonance Spectroscopy, Male, metabolism, MR spectroscopy (phosphorus-31), neuroimaging, NTP, NUCLEAR magnetic resonance spectroscopy, nucleoside, nucleoside triphosphate, Nucleosides, Pathophysiology, phosphate, Phosphates, phosphorus, Phosphorus Isotopes, phosphorus nuclear magnetic resonance, PHYSIOLOGY, Prefrontal Cortex, priority journal, procedures, sport injury, Universities, university, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Resch, Jacob; Driscoll, Aoife; McCaffrey, Noel; Brown, Cathleen; Ferrara, Michael S; Macciocchi, Stephen; Baumgartner, Ted; Walpert, Kimberly
ImPact Test-Retest Reliability: Reliably Unreliable? Journal Article
In: Journal of Athletic Training, vol. 48, no. 4, pp. 506–511, 2013, ISBN: 1062-6050.
Abstract | Links | BibTeX | Tags: ANALYSIS of variance, Body Weights and Measures, Cognition -- Evaluation, college, Computer Assisted, Continuing (Credit), Cross Sectional Studies, Data Analysis Software, DESCRIPTIVE statistics, DIAGNOSIS, Education, Effect Size, Female, human, Instrument Validation, Intraclass Correlation Coefficient, Ireland, Male, Multicenter Studies, Neuropsychological Tests, ONE-way analysis of variance, Post Hoc Analysis, Repeated Measures, Scales, Students, test-retest reliability, UNITED States, Validation Studies, Young Adult
@article{Resch2013b,
title = {ImPact Test-Retest Reliability: Reliably Unreliable?},
author = {Resch, Jacob and Driscoll, Aoife and McCaffrey, Noel and Brown, Cathleen and Ferrara, Michael S and Macciocchi, Stephen and Baumgartner, Ted and Walpert, Kimberly},
doi = {10.4085/1062-6050-48.3.09},
isbn = {1062-6050},
year = {2013},
date = {2013-01-01},
journal = {Journal of Athletic Training},
volume = {48},
number = {4},
pages = {506--511},
abstract = {Context: Computerized neuropsychological testing is commonly used in the assessment and management of sport-related concussion. Even though computerized testing is widespread, psychometric evidence for test-retest reliability is somewhat limited. Additional evidence for test-retest reliability is needed to optimize clinical decision making after concussion. Objective: To document test-retest reliability for a commercially available computerized neuropsychological test battery (ImPACT) using 2 different clinically relevant time intervals. Design: Cross-sectional study. Setting: Two research laboratories. Patients or Other Participants: Group 1 (n=46) consisted of 25 men and 21 women (age=22.4 ± 1.89 years). Group 2 (n = 45) consisted of 17 men and 28 women (age = 20.9 ± 1.72 years). Intervention(s): Both groups completed ImPACT forms 1, 2, and 3, which were delivered sequentially either at 1-week intervals (group 1) or at baseline, day 45, and day 50 (group 2). Group 2 also completed the Green Word Memory Test (WMT) as a measure of effort. Main Outcome Measures: Intraclass correlation coefficients (ICCs) were calculated for the composite scores of ImPACT between time points. Repeated-measures analysis of variance was used to evaluate changes in ImPACT and WMT results over time. Results: The ICC values for group 1 ranged from 0.26 to 0.88 for the 4 ImPACT composite scores. The ICC values for group 2 ranged from 0.37 to 0.76. In group 1, ImPACT classified 37.0% and 46.0% of healthy participants as impaired at time points 2 and 3, respectively. In group 2, ImPACT classified 22.2% and 28.9% of healthy participants as impaired at time points 2 and 3, respectively. Conclusions: We found variable test-retest reliability for ImPACT metrics. Visual motor speed and reaction time demonstrated greater reliability than verbal and visual memory. Our current data support a multifaceted approach to concussion assessment using clinical examinations, symptom reports, cognitive testing, and balance assessment.},
keywords = {ANALYSIS of variance, Body Weights and Measures, Cognition -- Evaluation, college, Computer Assisted, Continuing (Credit), Cross Sectional Studies, Data Analysis Software, DESCRIPTIVE statistics, DIAGNOSIS, Education, Effect Size, Female, human, Instrument Validation, Intraclass Correlation Coefficient, Ireland, Male, Multicenter Studies, Neuropsychological Tests, ONE-way analysis of variance, Post Hoc Analysis, Repeated Measures, Scales, Students, test-retest reliability, UNITED States, Validation Studies, Young Adult},
pubstate = {published},
tppubtype = {article}
}