Westermann, Robert W; Kerr, Zachary Y; Wehr, Peter; Amendola, Annuziato
Increasing Lower Extremity Injury Rates Across the 2009-2010 to 2014-2015 Seasons of National Collegiate Athletic Association Football Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 12, pp. 3230–3236, 2016, ISBN: 03635465.
Abstract | BibTeX | Tags: *ANKLE wounds, *BRAIN -- Concussion, *COLLEGE athletes, *COLLEGE sports, *EPIDEMIOLOGY, *FOOTBALL injuries, *KNEE -- Wounds & injuries, *LEG -- Wounds & injuries, *PREVENTION, *SPORTS -- Societies, ankle injury, Concussion, CONFIDENCE intervals, DATA analysis -- Software, DESCRIPTIVE statistics, etc., football, IOWA, knee, LONGITUDINAL method, ODDS ratio, RESEARCH, RESEARCH -- Finance, RESEARCH -- Methodology, rule change, UNITED States
@article{Westermann2016,
title = {Increasing Lower Extremity Injury Rates Across the 2009-2010 to 2014-2015 Seasons of National Collegiate Athletic Association Football},
author = {Westermann, Robert W and Kerr, Zachary Y and Wehr, Peter and Amendola, Annuziato},
isbn = {03635465},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {12},
pages = {3230--3236},
abstract = {Background: Sports-related concussions (SRCs) have gained increased societal interest in the past decade. The National Collegiate Athletic Association (NCAA) has implemented legislation and rule changes to decrease the incidence and risk of head injury impacts. The “targeting” rule forbids initiating contact with the crown of a helmet and targeting defenseless players in the head and neck area; however, there are concerns that this rule change has unintentionally led to an increased incidence of lower extremity injuries. Purpose/Hypothesis: The purpose of this study was to evaluate the change in lower extremity injury rates in NCAA football during the 2009-2010 to 2014-2015 seasons. We hypothesized that the lower extremity injury rate has increased across the time period. Study Design: Descriptive epidemiology study. Methods: Sixty-eight NCAA football programs provided 153 team-seasons of data to the NCAA Injury Surveillance Program. Lower extremity injuries (ie, hip/groin, upper leg/thigh, knee, lower leg/Achilles, foot/toes) and SRCs sustained during NCAA football games were examined. We calculated injury rates per 1000 athlete-exposures (AEs) for lower extremity injuries and SRCs. Rate ratios (RRs) compared injury rates between the 2009-2010 to 2011-2012 and 2012-2013 to 2014-2015 seasons. Results: Overall, 2400 lower extremity injuries were reported during the 2009-2010 to 2014-2015 seasons; most were to the knee (33.6%) and ankle (28.5%) and caused by player contact (59.2%). The lower extremity injury rate increased in 2012-2013 to 2014-2015 compared with 2009-2010 to 2011-2012 (23.55 vs 20.45/1000 AEs, respectively; RR, 1.15; 95% CI, 1.06-1.25). This finding was retained when restricted to injuries due to player contact (RR, 1.19; 95% CI, 1.07-1.32) but not for injuries due to noncontact/overuse (RR, 0.96; 95% CI, 0.80-1.14). When examining player contact injury rates by anatomic site, only ankle injuries had an increase (RR, 1.36; 95% CI, 1.13-1.64). The SRC rate also increased in 2012-2013 to 2014-2015 compared with 2009-2010 to 2011-2012 (3.52 vs 2.63/1000 AEs, respectively; RR, 1.34; 95% CI, 1.08-1.66). Conclusion: The lower extremity injury rate has increased in NCAA football athletes. Similarly, SRC rates have increased, although this may be caused by concurrent policies related to better education, identification, and management. Targeting rule changes may be contributing to increased rates of player contact\textendashrelated ankle injuries. Alongside continued surveillance research to examine longitudinal time trends, more in-depth individual-level examinations of how targeting rule changes influence coaching and player behaviors are warranted. ABSTRACT FROM AUTHOR},
keywords = {*ANKLE wounds, *BRAIN -- Concussion, *COLLEGE athletes, *COLLEGE sports, *EPIDEMIOLOGY, *FOOTBALL injuries, *KNEE -- Wounds \& injuries, *LEG -- Wounds \& injuries, *PREVENTION, *SPORTS -- Societies, ankle injury, Concussion, CONFIDENCE intervals, DATA analysis -- Software, DESCRIPTIVE statistics, etc., football, IOWA, knee, LONGITUDINAL method, ODDS ratio, RESEARCH, RESEARCH -- Finance, RESEARCH -- Methodology, rule change, UNITED States},
pubstate = {published},
tppubtype = {article}
}
van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje
Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.
Abstract | BibTeX | Tags: *ANXIETY, *BRAIN -- Wounds & injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work
@article{VanderHorn2013,
title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},
author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},
isbn = {00039993},
year = {2013},
date = {2013-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {94},
number = {5},
pages = {867--874},
abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},
keywords = {*ANXIETY, *BRAIN -- Wounds \& injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work},
pubstate = {published},
tppubtype = {article}
}
Westermann, Robert W; Kerr, Zachary Y; Wehr, Peter; Amendola, Annuziato
Increasing Lower Extremity Injury Rates Across the 2009-2010 to 2014-2015 Seasons of National Collegiate Athletic Association Football Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 12, pp. 3230–3236, 2016, ISBN: 03635465.
@article{Westermann2016,
title = {Increasing Lower Extremity Injury Rates Across the 2009-2010 to 2014-2015 Seasons of National Collegiate Athletic Association Football},
author = {Westermann, Robert W and Kerr, Zachary Y and Wehr, Peter and Amendola, Annuziato},
isbn = {03635465},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {12},
pages = {3230--3236},
abstract = {Background: Sports-related concussions (SRCs) have gained increased societal interest in the past decade. The National Collegiate Athletic Association (NCAA) has implemented legislation and rule changes to decrease the incidence and risk of head injury impacts. The “targeting” rule forbids initiating contact with the crown of a helmet and targeting defenseless players in the head and neck area; however, there are concerns that this rule change has unintentionally led to an increased incidence of lower extremity injuries. Purpose/Hypothesis: The purpose of this study was to evaluate the change in lower extremity injury rates in NCAA football during the 2009-2010 to 2014-2015 seasons. We hypothesized that the lower extremity injury rate has increased across the time period. Study Design: Descriptive epidemiology study. Methods: Sixty-eight NCAA football programs provided 153 team-seasons of data to the NCAA Injury Surveillance Program. Lower extremity injuries (ie, hip/groin, upper leg/thigh, knee, lower leg/Achilles, foot/toes) and SRCs sustained during NCAA football games were examined. We calculated injury rates per 1000 athlete-exposures (AEs) for lower extremity injuries and SRCs. Rate ratios (RRs) compared injury rates between the 2009-2010 to 2011-2012 and 2012-2013 to 2014-2015 seasons. Results: Overall, 2400 lower extremity injuries were reported during the 2009-2010 to 2014-2015 seasons; most were to the knee (33.6%) and ankle (28.5%) and caused by player contact (59.2%). The lower extremity injury rate increased in 2012-2013 to 2014-2015 compared with 2009-2010 to 2011-2012 (23.55 vs 20.45/1000 AEs, respectively; RR, 1.15; 95% CI, 1.06-1.25). This finding was retained when restricted to injuries due to player contact (RR, 1.19; 95% CI, 1.07-1.32) but not for injuries due to noncontact/overuse (RR, 0.96; 95% CI, 0.80-1.14). When examining player contact injury rates by anatomic site, only ankle injuries had an increase (RR, 1.36; 95% CI, 1.13-1.64). The SRC rate also increased in 2012-2013 to 2014-2015 compared with 2009-2010 to 2011-2012 (3.52 vs 2.63/1000 AEs, respectively; RR, 1.34; 95% CI, 1.08-1.66). Conclusion: The lower extremity injury rate has increased in NCAA football athletes. Similarly, SRC rates have increased, although this may be caused by concurrent policies related to better education, identification, and management. Targeting rule changes may be contributing to increased rates of player contact\textendashrelated ankle injuries. Alongside continued surveillance research to examine longitudinal time trends, more in-depth individual-level examinations of how targeting rule changes influence coaching and player behaviors are warranted. ABSTRACT FROM AUTHOR},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje
Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.
@article{VanderHorn2013,
title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},
author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},
isbn = {00039993},
year = {2013},
date = {2013-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {94},
number = {5},
pages = {867--874},
abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Westermann, Robert W; Kerr, Zachary Y; Wehr, Peter; Amendola, Annuziato
Increasing Lower Extremity Injury Rates Across the 2009-2010 to 2014-2015 Seasons of National Collegiate Athletic Association Football Journal Article
In: American Journal of Sports Medicine, vol. 44, no. 12, pp. 3230–3236, 2016, ISBN: 03635465.
Abstract | BibTeX | Tags: *ANKLE wounds, *BRAIN -- Concussion, *COLLEGE athletes, *COLLEGE sports, *EPIDEMIOLOGY, *FOOTBALL injuries, *KNEE -- Wounds & injuries, *LEG -- Wounds & injuries, *PREVENTION, *SPORTS -- Societies, ankle injury, Concussion, CONFIDENCE intervals, DATA analysis -- Software, DESCRIPTIVE statistics, etc., football, IOWA, knee, LONGITUDINAL method, ODDS ratio, RESEARCH, RESEARCH -- Finance, RESEARCH -- Methodology, rule change, UNITED States
@article{Westermann2016,
title = {Increasing Lower Extremity Injury Rates Across the 2009-2010 to 2014-2015 Seasons of National Collegiate Athletic Association Football},
author = {Westermann, Robert W and Kerr, Zachary Y and Wehr, Peter and Amendola, Annuziato},
isbn = {03635465},
year = {2016},
date = {2016-01-01},
journal = {American Journal of Sports Medicine},
volume = {44},
number = {12},
pages = {3230--3236},
abstract = {Background: Sports-related concussions (SRCs) have gained increased societal interest in the past decade. The National Collegiate Athletic Association (NCAA) has implemented legislation and rule changes to decrease the incidence and risk of head injury impacts. The “targeting” rule forbids initiating contact with the crown of a helmet and targeting defenseless players in the head and neck area; however, there are concerns that this rule change has unintentionally led to an increased incidence of lower extremity injuries. Purpose/Hypothesis: The purpose of this study was to evaluate the change in lower extremity injury rates in NCAA football during the 2009-2010 to 2014-2015 seasons. We hypothesized that the lower extremity injury rate has increased across the time period. Study Design: Descriptive epidemiology study. Methods: Sixty-eight NCAA football programs provided 153 team-seasons of data to the NCAA Injury Surveillance Program. Lower extremity injuries (ie, hip/groin, upper leg/thigh, knee, lower leg/Achilles, foot/toes) and SRCs sustained during NCAA football games were examined. We calculated injury rates per 1000 athlete-exposures (AEs) for lower extremity injuries and SRCs. Rate ratios (RRs) compared injury rates between the 2009-2010 to 2011-2012 and 2012-2013 to 2014-2015 seasons. Results: Overall, 2400 lower extremity injuries were reported during the 2009-2010 to 2014-2015 seasons; most were to the knee (33.6%) and ankle (28.5%) and caused by player contact (59.2%). The lower extremity injury rate increased in 2012-2013 to 2014-2015 compared with 2009-2010 to 2011-2012 (23.55 vs 20.45/1000 AEs, respectively; RR, 1.15; 95% CI, 1.06-1.25). This finding was retained when restricted to injuries due to player contact (RR, 1.19; 95% CI, 1.07-1.32) but not for injuries due to noncontact/overuse (RR, 0.96; 95% CI, 0.80-1.14). When examining player contact injury rates by anatomic site, only ankle injuries had an increase (RR, 1.36; 95% CI, 1.13-1.64). The SRC rate also increased in 2012-2013 to 2014-2015 compared with 2009-2010 to 2011-2012 (3.52 vs 2.63/1000 AEs, respectively; RR, 1.34; 95% CI, 1.08-1.66). Conclusion: The lower extremity injury rate has increased in NCAA football athletes. Similarly, SRC rates have increased, although this may be caused by concurrent policies related to better education, identification, and management. Targeting rule changes may be contributing to increased rates of player contact\textendashrelated ankle injuries. Alongside continued surveillance research to examine longitudinal time trends, more in-depth individual-level examinations of how targeting rule changes influence coaching and player behaviors are warranted. ABSTRACT FROM AUTHOR},
keywords = {*ANKLE wounds, *BRAIN -- Concussion, *COLLEGE athletes, *COLLEGE sports, *EPIDEMIOLOGY, *FOOTBALL injuries, *KNEE -- Wounds \& injuries, *LEG -- Wounds \& injuries, *PREVENTION, *SPORTS -- Societies, ankle injury, Concussion, CONFIDENCE intervals, DATA analysis -- Software, DESCRIPTIVE statistics, etc., football, IOWA, knee, LONGITUDINAL method, ODDS ratio, RESEARCH, RESEARCH -- Finance, RESEARCH -- Methodology, rule change, UNITED States},
pubstate = {published},
tppubtype = {article}
}
van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje
Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.
Abstract | BibTeX | Tags: *ANXIETY, *BRAIN -- Wounds & injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work
@article{VanderHorn2013,
title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},
author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},
isbn = {00039993},
year = {2013},
date = {2013-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {94},
number = {5},
pages = {867--874},
abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},
keywords = {*ANXIETY, *BRAIN -- Wounds \& injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work},
pubstate = {published},
tppubtype = {article}
}