References

2016

Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L

Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article

In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.

Abstract | Links | BibTeX | Tags: Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting

@article{Silverberg2016,

title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},

author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},

doi = {10.1097/JSM.0000000000000241},

year = {2016},

date = {2016-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {26},

number = {3},

pages = {226--231},

abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},

keywords = {Adolescent, adult, Article, Athletes, balance disorder, brain concussion, cognition, cognition assessment, cohort analysis, cross-sectional study, descriptive research, Dizziness, drowsiness, emotionality, fatigue, Female, headache, high school, human, human experiment, Immediate Post Concussion Assessment and Cognitive, irritability, Male, memory disorder, mental concentration, nausea, nervousness, neuropsychological test, night sleep, normal human, observational study, paresthesia, Post Concussion Symptom Scale, postconcussion syndrome, priority journal, response time, sadness, sex difference, sleep deprivation, sleep disorder, sleep initiation and maintenance disorders, sleep time, UNITED States, verbal memory, visual disorder, visual memory, vomiting},

pubstate = {published},

tppubtype = {article}

}

Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L

Point of health care entry for youth with concussion within a large pediatric care network Journal Article

In: JAMA Pediatr, vol. 170, no. 7, 2016.

Abstract | Links | BibTeX | Tags: Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race

@article{Arbogast2016,

title = {Point of health care entry for youth with concussion within a large pediatric care network},

author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},

doi = {10.1001/jamapediatrics.2016.0294},

year  = {2016},

date = {2016-01-01},

journal = {JAMA Pediatr},

volume = {170},

number = {7},

abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},

keywords = {Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race},

pubstate = {published},

tppubtype = {article}

}

Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.

2015

Gardner, A J; Iverson, G L; Quinn, T N; Makdissi, M; Levi, C R; Shultz, S R; Wright, D K; Stanwell, P

A preliminary video analysis of concussion in the National Rugby League Journal Article

In: Brain Injury, vol. 29, no. 10, pp. 1182–1185, 2015.

Abstract | Links | BibTeX | Tags: Article, athlete, Athletes, brain concussion, case study, clinical article, Concussion, descriptive research, EPIDEMIOLOGY, human, Incidence, Injury surveillance, observational study, rugby, sport injury, unconsciousness, videorecording

@article{Gardner2015b,

title = {A preliminary video analysis of concussion in the National Rugby League},

author = {Gardner, A J and Iverson, G L and Quinn, T N and Makdissi, M and Levi, C R and Shultz, S R and Wright, D K and Stanwell, P},

doi = {10.3109/02699052.2015.1034179},

year  = {2015},

date = {2015-01-01},

journal = {Brain Injury},

volume = {29},

number = {10},

pages = {1182--1185},

abstract = {Primary objective: To conduct the first video analysis of concussion in the Australian National Rugby League (NRL) and describe player and injury characteristics, situational factors and time to return to play.Research design: Descriptive, observational case series.Methods and procedures: Video analysis of 20 medically diagnosed concussions for three consenting clubs during the 2013 NRL season.Main outcome and results: Most concussions (83%) occurred during a high tackle, and all injured ball carriers were hit high. Loss of consciousness was observed in 30% of cases. Common observable signs of injury included clutching of the head, balance problems or wobbly legs and a blank or vacant state. There were no post-concussive seizures. All players with loss of consciousness were removed from play. However, only half of the total sample was removed from play and one athlete who was removed returned to play in the same match. Of the players who were removed from play, the large majority returned the following week. Illegal play accounted for 25% of all concussions.Conclusions: Video analysis may be a useful method to study the incidence, mechanism and management of concussion in sports such as Rugby League. Future studies may include larger numbers to validate this preliminary data and may also investigate other levels of play and age ranges. © 2015 Taylor and Francis Group, LLC.},

keywords = {Article, athlete, Athletes, brain concussion, case study, clinical article, Concussion, descriptive research, EPIDEMIOLOGY, human, Incidence, Injury surveillance, observational study, rugby, sport injury, unconsciousness, videorecording},

pubstate = {published},

tppubtype = {article}

}

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

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

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

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

@article{Meehan2015,

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

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

doi = {10.1097/JSM.0000000000000107},

year  = {2015},

date = {2015-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {25},

number = {2},

pages = {133--137},

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

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

pubstate = {published},

tppubtype = {article}

}

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

2014

Buzas, David; Jacobson, Nathan A; Morawa, Lawrence G

Concussions From 9 Youth Organized Sports: Results From NEISS Hospitals Over an 11-Year Time Frame, 2002-2012 Journal Article

In: Orthopaedic Journal of Sports Medicine, pp. 1–8, 2014.

Links | BibTeX | Tags: ADOLESCENCE, Adolescent Health, Age Factors, Athletic Injuries -- Epidemiology -- In Infancy an, Baseball, BASKETBALL, Brain Concussion -- Epidemiology -- In Infancy and, Child, Child Health, Data Analysis Software, descriptive research, DESCRIPTIVE statistics, Disease Surveillance, emergency care, Epidemiological Research, Female, football, Gymnastics, Hockey, human, Male, MICHIGAN, Pearson's Correlation Coefficient, Preschool, Prospective Studies, Racquet Sports, Soccer, unconsciousness, UNITED States, wrestling

2012

Valovich McLeod, Tamara C; Lam, Kenneth C; Bay, R Curtis; Sauers, Eric L; Snyder Valier, Alison R

Practice-Based Research Networks, Part II: A Descriptive Analysis of the Athletic Training Practice-Based Research Network in the Secondary School Setting Journal Article

In: Journal of Athletic Training, vol. 47, no. 5, pp. 557–566, 2012, ISBN: 1062-6050.

Abstract | Links | BibTeX | Tags: ADOLESCENCE, Adolescent Health, Athletic Injuries -- Therapy, Athletic Training, Athletic Training -- Methods, Continuing (Credit), descriptive research, DESCRIPTIVE statistics, Education, Evidence-Based, Female, Health Care Delivery -- Evaluation, human, Injury Pattern, Job Experience -- Evaluation, Male, Networking, Pilot Studies, Preventive Health Care, Professional, Professional Practice, Prospective Studies, Questionnaires, Record Review, Research-Based, Retrospective Design, Schools, Secondary, Survey Research, World Wide Web

@article{ValovichMcLeod2012b,

title = {Practice-Based Research Networks, Part II: A Descriptive Analysis of the Athletic Training Practice-Based Research Network in the Secondary School Setting},

author = {{Valovich McLeod}, Tamara C and Lam, Kenneth C and Bay, R Curtis and Sauers, Eric L and {Snyder Valier}, Alison R},

doi = {10.4085/1062-6050-47.5.05},

isbn = {1062-6050},

year  = {2012},

date = {2012-01-01},

journal = {Journal of Athletic Training},

volume = {47},

number = {5},

pages = {557--566},

abstract = {Context: Analysis of health care service models requires the collection and evaluation of basic practice characterization data. Practice-based research networks (PBRNs) provide a framework for gathering data useful in characterizing clinical practice. Objective: To describe preliminary secondary school setting practice data from the Athletic Training Practice-Based Research Network (AT-PBRN). Design: Descriptive study. Setting: Secondary school athletic training facilities within the AT-PBRN. Patients or Other Participants: Clinicians (n = 22) and their patients (n = 2523) from the AT-PBRN. Main Outcome Measure(s): A Web-based survey was used to obtain data on clinical practice site and clinician characteristics. Patient and practice characteristics were obtained via deidentified electronic medical record data collected between September 1, 2009, and April 1, 2011. Descriptive data regarding the clinician and CPS practice characteristics are reported as percentages and frequencies. Descriptive analysis of patient encounters and practice characteristic data was performed, with the percentages and frequencies of the type of injuries recorded at initial evaluation, type of treatment received at initial evaluation, daily treatment, and daily sign-in procedures. Results: The AT-PBRN had secondary school sites in 7 states, and most athletic trainers at those sites (78.2%) had less than 5 years of experience. The secondary school sites within the AT-PBRN documented 2523 patients treated across 3140 encounters. Patients most frequently sought care for a current injury (61.3%), followed by preventive services (24.0%), and new injuries (14.7%). The most common diagnoses were ankle sprain/strain (17.9%), hip sprain/strain (12.5%), concussion (12.0%), and knee pain (2.5%). The most frequent procedures were athletic trainer evaluation (53.9%), hot- or cold-pack application (26.0%), strapping (10.3%), and therapeutic exercise (5.7%). The median number of treatments per injury was 3 (interquartile range = 2, 4; range = 2-19). Conclusions: These preliminary data describe services provided by clinicians within the AT-PBRN and demonstrate the usefulness of the PBRN model for obtaining such data.},

keywords = {ADOLESCENCE, Adolescent Health, Athletic Injuries -- Therapy, Athletic Training, Athletic Training -- Methods, Continuing (Credit), descriptive research, DESCRIPTIVE statistics, Education, Evidence-Based, Female, Health Care Delivery -- Evaluation, human, Injury Pattern, Job Experience -- Evaluation, Male, Networking, Pilot Studies, Preventive Health Care, Professional, Professional Practice, Prospective Studies, Questionnaires, Record Review, Research-Based, Retrospective Design, Schools, Secondary, Survey Research, World Wide Web},

pubstate = {published},

tppubtype = {article}

}

Context: Analysis of health care service models requires the collection and evaluation of basic practice characterization data. Practice-based research networks (PBRNs) provide a framework for gathering data useful in characterizing clinical practice. Objective: To describe preliminary secondary school setting practice data from the Athletic Training Practice-Based Research Network (AT-PBRN). Design: Descriptive study. Setting: Secondary school athletic training facilities within the AT-PBRN. Patients or Other Participants: Clinicians (n = 22) and their patients (n = 2523) from the AT-PBRN. Main Outcome Measure(s): A Web-based survey was used to obtain data on clinical practice site and clinician characteristics. Patient and practice characteristics were obtained via deidentified electronic medical record data collected between September 1, 2009, and April 1, 2011. Descriptive data regarding the clinician and CPS practice characteristics are reported as percentages and frequencies. Descriptive analysis of patient encounters and practice characteristic data was performed, with the percentages and frequencies of the type of injuries recorded at initial evaluation, type of treatment received at initial evaluation, daily treatment, and daily sign-in procedures. Results: The AT-PBRN had secondary school sites in 7 states, and most athletic trainers at those sites (78.2%) had less than 5 years of experience. The secondary school sites within the AT-PBRN documented 2523 patients treated across 3140 encounters. Patients most frequently sought care for a current injury (61.3%), followed by preventive services (24.0%), and new injuries (14.7%). The most common diagnoses were ankle sprain/strain (17.9%), hip sprain/strain (12.5%), concussion (12.0%), and knee pain (2.5%). The most frequent procedures were athletic trainer evaluation (53.9%), hot- or cold-pack application (26.0%), strapping (10.3%), and therapeutic exercise (5.7%). The median number of treatments per injury was 3 (interquartile range = 2, 4; range = 2-19). Conclusions: These preliminary data describe services provided by clinicians within the AT-PBRN and demonstrate the usefulness of the PBRN model for obtaining such data.

Reference Search

Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L

Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article

In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.

Abstract | Links | BibTeX

@article{Silverberg2016,

title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},

author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},

doi = {10.1097/JSM.0000000000000241},

year  = {2016},

date = {2016-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {26},

number = {3},

pages = {226--231},

abstract = {Objective: Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Design: Cross-sectional observation study. Setting: Preseason concussion testing for high school athletes. Participants: A large sample (n 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Assessment of Risk Factors: Athletes were divided into 4 groups based on their sleep duration the night before testing. Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Results: Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Conclusions: Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinical Relevance: Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L

Point of health care entry for youth with concussion within a large pediatric care network Journal Article

In: JAMA Pediatr, vol. 170, no. 7, 2016.

Abstract | Links | BibTeX

@article{Arbogast2016,

title = {Point of health care entry for youth with concussion within a large pediatric care network},

author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},

doi = {10.1001/jamapediatrics.2016.0294},

year  = {2016},

date = {2016-01-01},

journal = {JAMA Pediatr},

volume = {170},

number = {7},

abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Gardner, A J; Iverson, G L; Quinn, T N; Makdissi, M; Levi, C R; Shultz, S R; Wright, D K; Stanwell, P

A preliminary video analysis of concussion in the National Rugby League Journal Article

In: Brain Injury, vol. 29, no. 10, pp. 1182–1185, 2015.

Abstract | Links | BibTeX

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

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

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

Abstract | Links | BibTeX

@article{Meehan2015,

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

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

doi = {10.1097/JSM.0000000000000107},

year  = {2015},

date = {2015-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {25},

number = {2},

pages = {133--137},

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

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Buzas, David; Jacobson, Nathan A; Morawa, Lawrence G

Concussions From 9 Youth Organized Sports: Results From NEISS Hospitals Over an 11-Year Time Frame, 2002-2012 Journal Article

In: Orthopaedic Journal of Sports Medicine, pp. 1–8, 2014.

Links | BibTeX

Valovich McLeod, Tamara C; Lam, Kenneth C; Bay, R Curtis; Sauers, Eric L; Snyder Valier, Alison R

Practice-Based Research Networks, Part II: A Descriptive Analysis of the Athletic Training Practice-Based Research Network in the Secondary School Setting Journal Article

In: Journal of Athletic Training, vol. 47, no. 5, pp. 557–566, 2012, ISBN: 1062-6050.

Abstract | Links | BibTeX

@article{ValovichMcLeod2012b,

title = {Practice-Based Research Networks, Part II: A Descriptive Analysis of the Athletic Training Practice-Based Research Network in the Secondary School Setting},

author = {{Valovich McLeod}, Tamara C and Lam, Kenneth C and Bay, R Curtis and Sauers, Eric L and {Snyder Valier}, Alison R},

doi = {10.4085/1062-6050-47.5.05},

isbn = {1062-6050},

year  = {2012},

date = {2012-01-01},

journal = {Journal of Athletic Training},

volume = {47},

number = {5},

pages = {557--566},

abstract = {Context: Analysis of health care service models requires the collection and evaluation of basic practice characterization data. Practice-based research networks (PBRNs) provide a framework for gathering data useful in characterizing clinical practice. Objective: To describe preliminary secondary school setting practice data from the Athletic Training Practice-Based Research Network (AT-PBRN). Design: Descriptive study. Setting: Secondary school athletic training facilities within the AT-PBRN. Patients or Other Participants: Clinicians (n = 22) and their patients (n = 2523) from the AT-PBRN. Main Outcome Measure(s): A Web-based survey was used to obtain data on clinical practice site and clinician characteristics. Patient and practice characteristics were obtained via deidentified electronic medical record data collected between September 1, 2009, and April 1, 2011. Descriptive data regarding the clinician and CPS practice characteristics are reported as percentages and frequencies. Descriptive analysis of patient encounters and practice characteristic data was performed, with the percentages and frequencies of the type of injuries recorded at initial evaluation, type of treatment received at initial evaluation, daily treatment, and daily sign-in procedures. Results: The AT-PBRN had secondary school sites in 7 states, and most athletic trainers at those sites (78.2%) had less than 5 years of experience. The secondary school sites within the AT-PBRN documented 2523 patients treated across 3140 encounters. Patients most frequently sought care for a current injury (61.3%), followed by preventive services (24.0%), and new injuries (14.7%). The most common diagnoses were ankle sprain/strain (17.9%), hip sprain/strain (12.5%), concussion (12.0%), and knee pain (2.5%). The most frequent procedures were athletic trainer evaluation (53.9%), hot- or cold-pack application (26.0%), strapping (10.3%), and therapeutic exercise (5.7%). The median number of treatments per injury was 3 (interquartile range = 2, 4; range = 2-19). Conclusions: These preliminary data describe services provided by clinicians within the AT-PBRN and demonstrate the usefulness of the PBRN model for obtaining such data.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

Most Referenced Keywords

Show all

2016

Silverberg, N D; Berkner, P D; Atkins, J E; Zafonte, R; Iverson, G L

Relationship between Short Sleep Duration and Preseason Concussion Testing Journal Article

In: Clinical Journal of Sport Medicine, vol. 26, no. 3, pp. 226–231, 2016.

@article{Silverberg2016,

title = {Relationship between Short Sleep Duration and Preseason Concussion Testing},

author = {Silverberg, N D and Berkner, P D and Atkins, J E and Zafonte, R and Iverson, G L},

doi = {10.1097/JSM.0000000000000241},

year = {2016},

date = {2016-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {26},

number = {3},

pages = {226--231},

pubstate = {published},

tppubtype = {article}

}

Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L

Point of health care entry for youth with concussion within a large pediatric care network Journal Article

In: JAMA Pediatr, vol. 170, no. 7, 2016.

@article{Arbogast2016,

title = {Point of health care entry for youth with concussion within a large pediatric care network},

author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},

doi = {10.1001/jamapediatrics.2016.0294},

year  = {2016},

date = {2016-01-01},

journal = {JAMA Pediatr},

volume = {170},

number = {7},

abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},

keywords = {Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race},

pubstate = {published},

tppubtype = {article}

}

2015

Gardner, A J; Iverson, G L; Quinn, T N; Makdissi, M; Levi, C R; Shultz, S R; Wright, D K; Stanwell, P

A preliminary video analysis of concussion in the National Rugby League Journal Article

In: Brain Injury, vol. 29, no. 10, pp. 1182–1185, 2015.

@article{Gardner2015b,

title = {A preliminary video analysis of concussion in the National Rugby League},

author = {Gardner, A J and Iverson, G L and Quinn, T N and Makdissi, M and Levi, C R and Shultz, S R and Wright, D K and Stanwell, P},

doi = {10.3109/02699052.2015.1034179},

year  = {2015},

date = {2015-01-01},

journal = {Brain Injury},

volume = {29},

number = {10},

pages = {1182--1185},

abstract = {Primary objective: To conduct the first video analysis of concussion in the Australian National Rugby League (NRL) and describe player and injury characteristics, situational factors and time to return to play.Research design: Descriptive, observational case series.Methods and procedures: Video analysis of 20 medically diagnosed concussions for three consenting clubs during the 2013 NRL season.Main outcome and results: Most concussions (83%) occurred during a high tackle, and all injured ball carriers were hit high. Loss of consciousness was observed in 30% of cases. Common observable signs of injury included clutching of the head, balance problems or wobbly legs and a blank or vacant state. There were no post-concussive seizures. All players with loss of consciousness were removed from play. However, only half of the total sample was removed from play and one athlete who was removed returned to play in the same match. Of the players who were removed from play, the large majority returned the following week. Illegal play accounted for 25% of all concussions.Conclusions: Video analysis may be a useful method to study the incidence, mechanism and management of concussion in sports such as Rugby League. Future studies may include larger numbers to validate this preliminary data and may also investigate other levels of play and age ranges. © 2015 Taylor and Francis Group, LLC.},

keywords = {Article, athlete, Athletes, brain concussion, case study, clinical article, Concussion, descriptive research, EPIDEMIOLOGY, human, Incidence, Injury surveillance, observational study, rugby, sport injury, unconsciousness, videorecording},

pubstate = {published},

tppubtype = {article}

}

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

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

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

@article{Meehan2015,

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

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

doi = {10.1097/JSM.0000000000000107},

year  = {2015},

date = {2015-01-01},

journal = {Clinical Journal of Sport Medicine},

volume = {25},

number = {2},

pages = {133--137},

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

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

pubstate = {published},

tppubtype = {article}

}

2014

Buzas, David; Jacobson, Nathan A; Morawa, Lawrence G

Concussions From 9 Youth Organized Sports: Results From NEISS Hospitals Over an 11-Year Time Frame, 2002-2012 Journal Article

In: Orthopaedic Journal of Sports Medicine, pp. 1–8, 2014.

2012

Valovich McLeod, Tamara C; Lam, Kenneth C; Bay, R Curtis; Sauers, Eric L; Snyder Valier, Alison R

Practice-Based Research Networks, Part II: A Descriptive Analysis of the Athletic Training Practice-Based Research Network in the Secondary School Setting Journal Article

In: Journal of Athletic Training, vol. 47, no. 5, pp. 557–566, 2012, ISBN: 1062-6050.

@article{ValovichMcLeod2012b,

title = {Practice-Based Research Networks, Part II: A Descriptive Analysis of the Athletic Training Practice-Based Research Network in the Secondary School Setting},

author = {{Valovich McLeod}, Tamara C and Lam, Kenneth C and Bay, R Curtis and Sauers, Eric L and {Snyder Valier}, Alison R},

doi = {10.4085/1062-6050-47.5.05},

isbn = {1062-6050},

year  = {2012},

date = {2012-01-01},

journal = {Journal of Athletic Training},

volume = {47},

number = {5},

pages = {557--566},

abstract = {Context: Analysis of health care service models requires the collection and evaluation of basic practice characterization data. Practice-based research networks (PBRNs) provide a framework for gathering data useful in characterizing clinical practice. Objective: To describe preliminary secondary school setting practice data from the Athletic Training Practice-Based Research Network (AT-PBRN). Design: Descriptive study. Setting: Secondary school athletic training facilities within the AT-PBRN. Patients or Other Participants: Clinicians (n = 22) and their patients (n = 2523) from the AT-PBRN. Main Outcome Measure(s): A Web-based survey was used to obtain data on clinical practice site and clinician characteristics. Patient and practice characteristics were obtained via deidentified electronic medical record data collected between September 1, 2009, and April 1, 2011. Descriptive data regarding the clinician and CPS practice characteristics are reported as percentages and frequencies. Descriptive analysis of patient encounters and practice characteristic data was performed, with the percentages and frequencies of the type of injuries recorded at initial evaluation, type of treatment received at initial evaluation, daily treatment, and daily sign-in procedures. Results: The AT-PBRN had secondary school sites in 7 states, and most athletic trainers at those sites (78.2%) had less than 5 years of experience. The secondary school sites within the AT-PBRN documented 2523 patients treated across 3140 encounters. Patients most frequently sought care for a current injury (61.3%), followed by preventive services (24.0%), and new injuries (14.7%). The most common diagnoses were ankle sprain/strain (17.9%), hip sprain/strain (12.5%), concussion (12.0%), and knee pain (2.5%). The most frequent procedures were athletic trainer evaluation (53.9%), hot- or cold-pack application (26.0%), strapping (10.3%), and therapeutic exercise (5.7%). The median number of treatments per injury was 3 (interquartile range = 2, 4; range = 2-19). Conclusions: These preliminary data describe services provided by clinicians within the AT-PBRN and demonstrate the usefulness of the PBRN model for obtaining such data.},

keywords = {ADOLESCENCE, Adolescent Health, Athletic Injuries -- Therapy, Athletic Training, Athletic Training -- Methods, Continuing (Credit), descriptive research, DESCRIPTIVE statistics, Education, Evidence-Based, Female, Health Care Delivery -- Evaluation, human, Injury Pattern, Job Experience -- Evaluation, Male, Networking, Pilot Studies, Preventive Health Care, Professional, Professional Practice, Prospective Studies, Questionnaires, Record Review, Research-Based, Retrospective Design, Schools, Secondary, Survey Research, World Wide Web},

pubstate = {published},

tppubtype = {article}

}

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