Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics & Numerical Data], Physical Therapy Specialty/sn [Statistics & Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {*Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics \& Numerical Data], Physical Therapy Specialty/sn [Statistics \& Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Koerte, I K; Hufschmidt, J; Muehlmann, M; Tripodis, Y; Stamm, J M; Pasternak, O; Giwerc, M Y; Coleman, M J; Baugh, C M; Fritts, N G; Heinen, F; Lin, A; Stern, R A; Shenton, M E
Cavum Septi Pellucidi in Symptomatic Former Professional Football Players Journal Article
In: Journal of Neurotrauma, vol. 33, no. 4, pp. 346–353, 2016.
Abstract | BibTeX | Tags: *Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged
@article{Koerte2016,
title = {Cavum Septi Pellucidi in Symptomatic Former Professional Football Players},
author = {Koerte, I K and Hufschmidt, J and Muehlmann, M and Tripodis, Y and Stamm, J M and Pasternak, O and Giwerc, M Y and Coleman, M J and Baugh, C M and Fritts, N G and Heinen, F and Lin, A and Stern, R A and Shenton, M E},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {4},
pages = {346--353},
abstract = {Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p \< 0.0001; septum length: rho = 0.93; ICC 0.96; p \< 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p \< 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall},
keywords = {*Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged},
pubstate = {published},
tppubtype = {article}
}
Kriz, P K; Zurakowski, R D; Almquist, J L; Reynolds, J; Ruggieri, D; Collins, C L; D'Hemecourt, P A; Comstock, R D
Eye Protection and Risk of Eye Injuries in High School Field Hockey Journal Article
In: Pediatrics, vol. 136, no. 3, pp. 521–527, 2015.
Abstract | BibTeX | Tags: *Eye Injuries/pc [Prevention & Control], *Eye Protective Devices, *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention & Control], Craniocerebral Trauma/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention & Control], Eye Injuries/ep [Epidemiology], Facial Injuries/ep [Epidemiology], Facial Injuries/pc [Prevention & Control], Female, Humans, Incidence, Orbit/in [Injuries], Prospective Studies, Virginia/ep [Epidemiology]
@article{Kriz2015,
title = {Eye Protection and Risk of Eye Injuries in High School Field Hockey},
author = {Kriz, P K and Zurakowski, R D and Almquist, J L and Reynolds, J and Ruggieri, D and Collins, C L and D'Hemecourt, P A and Comstock, R D},
year = {2015},
date = {2015-01-01},
journal = {Pediatrics},
volume = {136},
number = {3},
pages = {521--527},
abstract = {OBJECTIVE: To determine if injury rates among female field hockey players differ before and after implementation of a national mandate for protective eyewear (MPE). METHODS: We analyzed girls' field hockey exposure and injury data collected from national (High School Reporting Information Online [RIO]) and regional (Fairfax County Public Schools) high school sports injury databases in 2 seasons before (2009/10 and 2010/11) and 2 seasons after (2011/12 and 2012/13) a national MPE. RESULTS: The incidence of eye/orbital injuries was significantly higher in states without MPE (0.080 injuries per 1000 athletic exposures [AEs]) than in states with MPE (before the 2011/12 mandate) and the postmandate group (0.025 injuries per 1000 AEs) (odds ratio 3.20, 95% confidence interval 1.47-6.99},
keywords = {*Eye Injuries/pc [Prevention \& Control], *Eye Protective Devices, *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention \& Control], Craniocerebral Trauma/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention \& Control], Eye Injuries/ep [Epidemiology], Facial Injuries/ep [Epidemiology], Facial Injuries/pc [Prevention \& Control], Female, Humans, Incidence, Orbit/in [Injuries], Prospective Studies, Virginia/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Freitag, A; Kirkwood, G; Scharer, S; Ofori-Asenso, R; Pollock, A M
Systematic review of rugby injuries in children and adolescents under 21 years Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 511–519, 2015.
Abstract | BibTeX | Tags: *Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult
@article{Freitag2015a,
title = {Systematic review of rugby injuries in children and adolescents under 21 years},
author = {Freitag, A and Kirkwood, G and Scharer, S and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {511--519},
abstract = {A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {*Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Walter, K D; Halstead, M E
Concussion in Teenage Athletes Journal Article
In: Adolescent Medicine, vol. 26, no. 1, pp. 39–52, 2015.
BibTeX | Tags: *Athletes, *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention & Control], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention & Control], Humans, Magnetic Resonance Imaging, Neurocognitive Disorders/di [Diagnosis], Tomography, X-Ray Computed
@article{Walter2015,
title = {Concussion in Teenage Athletes},
author = {Walter, K D and Halstead, M E},
year = {2015},
date = {2015-01-01},
journal = {Adolescent Medicine},
volume = {26},
number = {1},
pages = {39--52},
keywords = {*Athletes, *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention \& Control], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention \& Control], Humans, Magnetic Resonance Imaging, Neurocognitive Disorders/di [Diagnosis], Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Gardner, E C
Head, Face, and Eye Injuries in Collegiate Women's Field Hockey Journal Article
In: American Journal of Sports Medicine, vol. 43, no. 8, pp. 2027–2034, 2015.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/ep [Epidemiology], *Eye Injuries/ep [Epidemiology], *Facial Injuries/ep [Epidemiology], *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention & Control], Eye Injuries/pc [Prevention & Control], Eye Protective Devices, Facial Injuries/pc [Prevention & Control], Female, Head Protective Devices, Humans, Incidence, Students, United States/ep [Epidemiology], Universities
@article{Gardner2015a,
title = {Head, Face, and Eye Injuries in Collegiate Women's Field Hockey},
author = {Gardner, E C},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Sports Medicine},
volume = {43},
number = {8},
pages = {2027--2034},
abstract = {BACKGROUND: While there is concern regarding head, face, and eye injuries in field hockey, prompting some to recommend the use of protective equipment such as goggles and helmets, little has been written about their incidence and mechanism of injury in the modern game of field hockey. The elucidation of this information will better inform the development of maximally effective injury prevention schemes to protect the athlete while maintaining the integrity of the game. PURPOSE: To determine the incidence and epidemiology of head, face, and eye injuries in United States collegiate women's field hockey players from 2004-2005 to 2008-2009. STUDY DESIGN: Descriptive epidemiological study. METHODS: All head, face, and eye injuries reported to the National Collegiate Athletic Association Injury Surveillance System for collegiate women's field hockey athletes from the 2004-2005 through 2008-2009 seasons were analyzed. Data regarding the event type, injury mechanism, body part injured, type of injury, outcome, and time lost were reviewed. The weighted injury incidence per 1000 athlete-exposures (AEs) was calculated using the exposure data set for the same years; 95% CIs were calculated based on a normal approximation to the Poisson distribution. RESULTS: There were 150 reported traumatic injuries during this time period, with a weighted occurrence of 1587.3 injuries. The overall incidence of head, face, and eye injuries in collegiate women's field hockey was 0.94 per 1000 AEs (95% CI, 0.86-1.19). Injuries to the head or face, other than the mouth, nose, and eye, accounted for 75.3% of these injuries. The incidence of eye injuries was 0.07 per 1000 AEs (95% CI, 0.03-0.12); nose injuries occurred at a rate of 0.10 per 1000 AEs (95% CI, 0.05-0.15). The rate of traumatic dental injuries was 0.06 per 1000 AEs (95% CI, 0.04-0.14). Contact with an apparatus caused 72.9% of all injuries; specifically, contact with an elevated ball accounted for 47.9% of all injuries, and contact with an elevated stick caused 21.7% of all injuries. While the majority of players suffering a head, face, or eye injury were able to return to sport that season (90.0%), the remaining athletes suffered season-ending injuries (10%). Concussions accounted for 42.8% of all head, face, and eye injuries reported (0.40 per 1000 AEs; 95% CI, 0.32-0.53). CONCLUSION: Head, face, and eye injuries occur regularly in women's field hockey. This description of the injury profile and mechanisms of injury may be used to design appropriate injury prevention schemes for the sport.Copyright © 2015 The Author(s).},
keywords = {*Craniocerebral Trauma/ep [Epidemiology], *Eye Injuries/ep [Epidemiology], *Facial Injuries/ep [Epidemiology], *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention \& Control], Eye Injuries/pc [Prevention \& Control], Eye Protective Devices, Facial Injuries/pc [Prevention \& Control], Female, Head Protective Devices, Humans, Incidence, Students, United States/ep [Epidemiology], Universities},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M N; Silverberg, N D; Iverson, G L
Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers Journal Article
In: Journal of Neurotrauma, vol. 32, no. 17, pp. 1301–1306, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Cognition Disorders/di [Diagnosis], *Military Personnel/sn [Statistics & Numerical Dat, *Post-Concussion Syndrome/di [Diagnosis], adult, Brain Concussion/ep [Epidemiology], Cognition Disorders/ep [Epidemiology], Cognition Disorders/et [Etiology], Female, Humans, Male, Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], United States/ep [Epidemiology], Young Adult
@article{Dretsch2015,
title = {Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers},
author = {Dretsch, M N and Silverberg, N D and Iverson, G L},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {17},
pages = {1301--1306},
abstract = {The extent to which multiple past concussions are associated with lingering symptoms or mental health problems in military service members is not well understood. The purpose of this study was to examine the association between lifetime concussion history, cognitive functioning, general health, and psychological health in a large sample of fit-for-duty U.S. Army soldiers preparing for deployment. Data on 458 active-duty soldiers were collected and analyzed. A computerized cognitive screening battery (CNS-Vital Signs()) was used to assess complex attention (CA), reaction time (RT), processing speed (PS), cognitive flexibility (CF), and memory. Health questionnaires included the Neurobehavioral Symptom Inventory (NSI), PTSD Checklist-Military Version (PCL-M), Zung Depression and Anxiety Scales (ZDS; ZAS), Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Alcohol Use and Dependency Identification Test (AUDIT). Soldiers with a history of multiple concussions (i.e., three or more concussions) had significantly greater post-concussive symptom scores compared with those with zero (d=1.83, large effect), one (d=0.64, medium effect), and two (d=0.64, medium effect) prior concussions. Although the group with three or more concussions also reported more traumatic stress symptoms, the results revealed that traumatic stress was a mediator between concussions and post-concussive symptom severity. There were no significant differences on neurocognitive testing between the number of concussions. These results add to the accumulating evidence suggesting that most individuals recover from one or two prior concussions, but there is a greater risk for ongoing symptoms if one exceeds this number of injuries.},
keywords = {*Brain Concussion/co [Complications], *Cognition Disorders/di [Diagnosis], *Military Personnel/sn [Statistics \& Numerical Dat, *Post-Concussion Syndrome/di [Diagnosis], adult, Brain Concussion/ep [Epidemiology], Cognition Disorders/ep [Epidemiology], Cognition Disorders/et [Etiology], Female, Humans, Male, Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], United States/ep [Epidemiology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Logan, B W; Goldman, S; Zola, M; Mackey, A
Concussive brain injury in the military: September 2001 to the present Journal Article
In: Behav Sci Law, vol. 31, no. 6, pp. 803–813, 2013.
Abstract | BibTeX | Tags: *Brain Concussion/th [Therapy], *Military Personnel/px [Psychology], 2003-2011, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Evidence-Based Medicine, Humans, Iraq War, United States/ep [Epidemiology]
@article{Logan2013,
title = {Concussive brain injury in the military: September 2001 to the present},
author = {Logan, B W and Goldman, S and Zola, M and Mackey, A},
year = {2013},
date = {2013-01-01},
journal = {Behav Sci Law},
volume = {31},
number = {6},
pages = {803--813},
abstract = {Since the terrorist attacks of September 11, 2001, 1,348,405 citizens have been deployed to combat in Operation Iraqi Freedom (OIF), Operation New Dawn in Iraq, and Operation Enduring Freedom in Afghanistan (OEF). During this same period 266,810 (20%) of these individuals have been diagnosed with a traumatic brain injury (TBI). The majority of these were Army soldiers, with 155,282 (58%) receiving the diagnosis. Mild TBI comprised 82% of the total, with the remainder being moderate to severe. Over this same period the Department of Defense (DoD) has invested $374.9 million to enhance access and quality of care services, including 57 TBI treatment centers in the combat theater and throughout the U.S. The Army's medical research division, the Medical Research and Material Command (MRMC), has invested an additional $700 million to TBI research during this time. The effort has faced a number of challenges, including limited human subject basic and translational research, limited epidemiological data on combat-related injuries, limited capacity and standards for data acquisition, and a lack of standardized evidenced-based protocols for treatment. All these areas have undergone significant growth and development, leading to the comprehensive system of care present today. A further challenge in this patient population has been the clinical co-morbidity of TBI, post-traumatic stress disorder, and chronic pain syndrome. The Army and the DoD have created treatment programs that are interdisciplinary in clinical approach, targeting particular neuropsychological domains of dysfunction rather than diagnostic category or etiology of injury. This article presents the history of this effort, the challenges to accurate and adequate diagnosis and care that remain, and the future of brain injury clinical and research efforts in the military. Copyright © 2013 John Wiley \& Sons, Ltd.},
keywords = {*Brain Concussion/th [Therapy], *Military Personnel/px [Psychology], 2003-2011, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Evidence-Based Medicine, Humans, Iraq War, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Koerte, I K; Hufschmidt, J; Muehlmann, M; Tripodis, Y; Stamm, J M; Pasternak, O; Giwerc, M Y; Coleman, M J; Baugh, C M; Fritts, N G; Heinen, F; Lin, A; Stern, R A; Shenton, M E
Cavum Septi Pellucidi in Symptomatic Former Professional Football Players Journal Article
In: Journal of Neurotrauma, vol. 33, no. 4, pp. 346–353, 2016.
@article{Koerte2016,
title = {Cavum Septi Pellucidi in Symptomatic Former Professional Football Players},
author = {Koerte, I K and Hufschmidt, J and Muehlmann, M and Tripodis, Y and Stamm, J M and Pasternak, O and Giwerc, M Y and Coleman, M J and Baugh, C M and Fritts, N G and Heinen, F and Lin, A and Stern, R A and Shenton, M E},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {4},
pages = {346--353},
abstract = {Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p \< 0.0001; septum length: rho = 0.93; ICC 0.96; p \< 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p \< 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kriz, P K; Zurakowski, R D; Almquist, J L; Reynolds, J; Ruggieri, D; Collins, C L; D'Hemecourt, P A; Comstock, R D
Eye Protection and Risk of Eye Injuries in High School Field Hockey Journal Article
In: Pediatrics, vol. 136, no. 3, pp. 521–527, 2015.
@article{Kriz2015,
title = {Eye Protection and Risk of Eye Injuries in High School Field Hockey},
author = {Kriz, P K and Zurakowski, R D and Almquist, J L and Reynolds, J and Ruggieri, D and Collins, C L and D'Hemecourt, P A and Comstock, R D},
year = {2015},
date = {2015-01-01},
journal = {Pediatrics},
volume = {136},
number = {3},
pages = {521--527},
abstract = {OBJECTIVE: To determine if injury rates among female field hockey players differ before and after implementation of a national mandate for protective eyewear (MPE). METHODS: We analyzed girls' field hockey exposure and injury data collected from national (High School Reporting Information Online [RIO]) and regional (Fairfax County Public Schools) high school sports injury databases in 2 seasons before (2009/10 and 2010/11) and 2 seasons after (2011/12 and 2012/13) a national MPE. RESULTS: The incidence of eye/orbital injuries was significantly higher in states without MPE (0.080 injuries per 1000 athletic exposures [AEs]) than in states with MPE (before the 2011/12 mandate) and the postmandate group (0.025 injuries per 1000 AEs) (odds ratio 3.20, 95% confidence interval 1.47-6.99},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Freitag, A; Kirkwood, G; Scharer, S; Ofori-Asenso, R; Pollock, A M
Systematic review of rugby injuries in children and adolescents under 21 years Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 511–519, 2015.
@article{Freitag2015a,
title = {Systematic review of rugby injuries in children and adolescents under 21 years},
author = {Freitag, A and Kirkwood, G and Scharer, S and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {511--519},
abstract = {A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Walter, K D; Halstead, M E
Concussion in Teenage Athletes Journal Article
In: Adolescent Medicine, vol. 26, no. 1, pp. 39–52, 2015.
@article{Walter2015,
title = {Concussion in Teenage Athletes},
author = {Walter, K D and Halstead, M E},
year = {2015},
date = {2015-01-01},
journal = {Adolescent Medicine},
volume = {26},
number = {1},
pages = {39--52},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gardner, E C
Head, Face, and Eye Injuries in Collegiate Women's Field Hockey Journal Article
In: American Journal of Sports Medicine, vol. 43, no. 8, pp. 2027–2034, 2015.
@article{Gardner2015a,
title = {Head, Face, and Eye Injuries in Collegiate Women's Field Hockey},
author = {Gardner, E C},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Sports Medicine},
volume = {43},
number = {8},
pages = {2027--2034},
abstract = {BACKGROUND: While there is concern regarding head, face, and eye injuries in field hockey, prompting some to recommend the use of protective equipment such as goggles and helmets, little has been written about their incidence and mechanism of injury in the modern game of field hockey. The elucidation of this information will better inform the development of maximally effective injury prevention schemes to protect the athlete while maintaining the integrity of the game. PURPOSE: To determine the incidence and epidemiology of head, face, and eye injuries in United States collegiate women's field hockey players from 2004-2005 to 2008-2009. STUDY DESIGN: Descriptive epidemiological study. METHODS: All head, face, and eye injuries reported to the National Collegiate Athletic Association Injury Surveillance System for collegiate women's field hockey athletes from the 2004-2005 through 2008-2009 seasons were analyzed. Data regarding the event type, injury mechanism, body part injured, type of injury, outcome, and time lost were reviewed. The weighted injury incidence per 1000 athlete-exposures (AEs) was calculated using the exposure data set for the same years; 95% CIs were calculated based on a normal approximation to the Poisson distribution. RESULTS: There were 150 reported traumatic injuries during this time period, with a weighted occurrence of 1587.3 injuries. The overall incidence of head, face, and eye injuries in collegiate women's field hockey was 0.94 per 1000 AEs (95% CI, 0.86-1.19). Injuries to the head or face, other than the mouth, nose, and eye, accounted for 75.3% of these injuries. The incidence of eye injuries was 0.07 per 1000 AEs (95% CI, 0.03-0.12); nose injuries occurred at a rate of 0.10 per 1000 AEs (95% CI, 0.05-0.15). The rate of traumatic dental injuries was 0.06 per 1000 AEs (95% CI, 0.04-0.14). Contact with an apparatus caused 72.9% of all injuries; specifically, contact with an elevated ball accounted for 47.9% of all injuries, and contact with an elevated stick caused 21.7% of all injuries. While the majority of players suffering a head, face, or eye injury were able to return to sport that season (90.0%), the remaining athletes suffered season-ending injuries (10%). Concussions accounted for 42.8% of all head, face, and eye injuries reported (0.40 per 1000 AEs; 95% CI, 0.32-0.53). CONCLUSION: Head, face, and eye injuries occur regularly in women's field hockey. This description of the injury profile and mechanisms of injury may be used to design appropriate injury prevention schemes for the sport.Copyright © 2015 The Author(s).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M N; Silverberg, N D; Iverson, G L
Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers Journal Article
In: Journal of Neurotrauma, vol. 32, no. 17, pp. 1301–1306, 2015.
@article{Dretsch2015,
title = {Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers},
author = {Dretsch, M N and Silverberg, N D and Iverson, G L},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {17},
pages = {1301--1306},
abstract = {The extent to which multiple past concussions are associated with lingering symptoms or mental health problems in military service members is not well understood. The purpose of this study was to examine the association between lifetime concussion history, cognitive functioning, general health, and psychological health in a large sample of fit-for-duty U.S. Army soldiers preparing for deployment. Data on 458 active-duty soldiers were collected and analyzed. A computerized cognitive screening battery (CNS-Vital Signs()) was used to assess complex attention (CA), reaction time (RT), processing speed (PS), cognitive flexibility (CF), and memory. Health questionnaires included the Neurobehavioral Symptom Inventory (NSI), PTSD Checklist-Military Version (PCL-M), Zung Depression and Anxiety Scales (ZDS; ZAS), Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Alcohol Use and Dependency Identification Test (AUDIT). Soldiers with a history of multiple concussions (i.e., three or more concussions) had significantly greater post-concussive symptom scores compared with those with zero (d=1.83, large effect), one (d=0.64, medium effect), and two (d=0.64, medium effect) prior concussions. Although the group with three or more concussions also reported more traumatic stress symptoms, the results revealed that traumatic stress was a mediator between concussions and post-concussive symptom severity. There were no significant differences on neurocognitive testing between the number of concussions. These results add to the accumulating evidence suggesting that most individuals recover from one or two prior concussions, but there is a greater risk for ongoing symptoms if one exceeds this number of injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Logan, B W; Goldman, S; Zola, M; Mackey, A
Concussive brain injury in the military: September 2001 to the present Journal Article
In: Behav Sci Law, vol. 31, no. 6, pp. 803–813, 2013.
@article{Logan2013,
title = {Concussive brain injury in the military: September 2001 to the present},
author = {Logan, B W and Goldman, S and Zola, M and Mackey, A},
year = {2013},
date = {2013-01-01},
journal = {Behav Sci Law},
volume = {31},
number = {6},
pages = {803--813},
abstract = {Since the terrorist attacks of September 11, 2001, 1,348,405 citizens have been deployed to combat in Operation Iraqi Freedom (OIF), Operation New Dawn in Iraq, and Operation Enduring Freedom in Afghanistan (OEF). During this same period 266,810 (20%) of these individuals have been diagnosed with a traumatic brain injury (TBI). The majority of these were Army soldiers, with 155,282 (58%) receiving the diagnosis. Mild TBI comprised 82% of the total, with the remainder being moderate to severe. Over this same period the Department of Defense (DoD) has invested $374.9 million to enhance access and quality of care services, including 57 TBI treatment centers in the combat theater and throughout the U.S. The Army's medical research division, the Medical Research and Material Command (MRMC), has invested an additional $700 million to TBI research during this time. The effort has faced a number of challenges, including limited human subject basic and translational research, limited epidemiological data on combat-related injuries, limited capacity and standards for data acquisition, and a lack of standardized evidenced-based protocols for treatment. All these areas have undergone significant growth and development, leading to the comprehensive system of care present today. A further challenge in this patient population has been the clinical co-morbidity of TBI, post-traumatic stress disorder, and chronic pain syndrome. The Army and the DoD have created treatment programs that are interdisciplinary in clinical approach, targeting particular neuropsychological domains of dysfunction rather than diagnostic category or etiology of injury. This article presents the history of this effort, the challenges to accurate and adequate diagnosis and care that remain, and the future of brain injury clinical and research efforts in the military. Copyright © 2013 John Wiley \& Sons, Ltd.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics & Numerical Data], Physical Therapy Specialty/sn [Statistics & Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {*Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics \& Numerical Data], Physical Therapy Specialty/sn [Statistics \& Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Koerte, I K; Hufschmidt, J; Muehlmann, M; Tripodis, Y; Stamm, J M; Pasternak, O; Giwerc, M Y; Coleman, M J; Baugh, C M; Fritts, N G; Heinen, F; Lin, A; Stern, R A; Shenton, M E
Cavum Septi Pellucidi in Symptomatic Former Professional Football Players Journal Article
In: Journal of Neurotrauma, vol. 33, no. 4, pp. 346–353, 2016.
Abstract | BibTeX | Tags: *Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged
@article{Koerte2016,
title = {Cavum Septi Pellucidi in Symptomatic Former Professional Football Players},
author = {Koerte, I K and Hufschmidt, J and Muehlmann, M and Tripodis, Y and Stamm, J M and Pasternak, O and Giwerc, M Y and Coleman, M J and Baugh, C M and Fritts, N G and Heinen, F and Lin, A and Stern, R A and Shenton, M E},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurotrauma},
volume = {33},
number = {4},
pages = {346--353},
abstract = {Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p \< 0.0001; septum length: rho = 0.93; ICC 0.96; p \< 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p \< 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall},
keywords = {*Athletes, *Football/in [Injuries], *Septum Pellucidum/pa [Pathology], adult, aged, Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Humans, Male, middle aged},
pubstate = {published},
tppubtype = {article}
}
Kriz, P K; Zurakowski, R D; Almquist, J L; Reynolds, J; Ruggieri, D; Collins, C L; D'Hemecourt, P A; Comstock, R D
Eye Protection and Risk of Eye Injuries in High School Field Hockey Journal Article
In: Pediatrics, vol. 136, no. 3, pp. 521–527, 2015.
Abstract | BibTeX | Tags: *Eye Injuries/pc [Prevention & Control], *Eye Protective Devices, *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention & Control], Craniocerebral Trauma/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention & Control], Eye Injuries/ep [Epidemiology], Facial Injuries/ep [Epidemiology], Facial Injuries/pc [Prevention & Control], Female, Humans, Incidence, Orbit/in [Injuries], Prospective Studies, Virginia/ep [Epidemiology]
@article{Kriz2015,
title = {Eye Protection and Risk of Eye Injuries in High School Field Hockey},
author = {Kriz, P K and Zurakowski, R D and Almquist, J L and Reynolds, J and Ruggieri, D and Collins, C L and D'Hemecourt, P A and Comstock, R D},
year = {2015},
date = {2015-01-01},
journal = {Pediatrics},
volume = {136},
number = {3},
pages = {521--527},
abstract = {OBJECTIVE: To determine if injury rates among female field hockey players differ before and after implementation of a national mandate for protective eyewear (MPE). METHODS: We analyzed girls' field hockey exposure and injury data collected from national (High School Reporting Information Online [RIO]) and regional (Fairfax County Public Schools) high school sports injury databases in 2 seasons before (2009/10 and 2010/11) and 2 seasons after (2011/12 and 2012/13) a national MPE. RESULTS: The incidence of eye/orbital injuries was significantly higher in states without MPE (0.080 injuries per 1000 athletic exposures [AEs]) than in states with MPE (before the 2011/12 mandate) and the postmandate group (0.025 injuries per 1000 AEs) (odds ratio 3.20, 95% confidence interval 1.47-6.99},
keywords = {*Eye Injuries/pc [Prevention \& Control], *Eye Protective Devices, *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention \& Control], Craniocerebral Trauma/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention \& Control], Eye Injuries/ep [Epidemiology], Facial Injuries/ep [Epidemiology], Facial Injuries/pc [Prevention \& Control], Female, Humans, Incidence, Orbit/in [Injuries], Prospective Studies, Virginia/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Freitag, A; Kirkwood, G; Scharer, S; Ofori-Asenso, R; Pollock, A M
Systematic review of rugby injuries in children and adolescents under 21 years Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 511–519, 2015.
Abstract | BibTeX | Tags: *Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult
@article{Freitag2015a,
title = {Systematic review of rugby injuries in children and adolescents under 21 years},
author = {Freitag, A and Kirkwood, G and Scharer, S and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {511--519},
abstract = {A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK. Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {*Football/in [Injuries], Absenteeism, Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Child, Contusions/ep [Epidemiology], Craniocerebral Trauma/ep [Epidemiology], Dislocations/ep [Epidemiology], Extremities/in [Injuries], Female, Hematoma/ep [Epidemiology], Humans, Incidence, Lacerations/ep [Epidemiology], Male, Neck Injuries/ep [Epidemiology], RISK assessment, Sprains and Strains/ep [Epidemiology], Torso/in [Injuries], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Walter, K D; Halstead, M E
Concussion in Teenage Athletes Journal Article
In: Adolescent Medicine, vol. 26, no. 1, pp. 39–52, 2015.
BibTeX | Tags: *Athletes, *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention & Control], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention & Control], Humans, Magnetic Resonance Imaging, Neurocognitive Disorders/di [Diagnosis], Tomography, X-Ray Computed
@article{Walter2015,
title = {Concussion in Teenage Athletes},
author = {Walter, K D and Halstead, M E},
year = {2015},
date = {2015-01-01},
journal = {Adolescent Medicine},
volume = {26},
number = {1},
pages = {39--52},
keywords = {*Athletes, *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pc [Prevention \& Control], Brain Concussion/ep [Epidemiology], Brain Concussion/pc [Prevention \& Control], Humans, Magnetic Resonance Imaging, Neurocognitive Disorders/di [Diagnosis], Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Gardner, E C
Head, Face, and Eye Injuries in Collegiate Women's Field Hockey Journal Article
In: American Journal of Sports Medicine, vol. 43, no. 8, pp. 2027–2034, 2015.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/ep [Epidemiology], *Eye Injuries/ep [Epidemiology], *Facial Injuries/ep [Epidemiology], *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention & Control], Eye Injuries/pc [Prevention & Control], Eye Protective Devices, Facial Injuries/pc [Prevention & Control], Female, Head Protective Devices, Humans, Incidence, Students, United States/ep [Epidemiology], Universities
@article{Gardner2015a,
title = {Head, Face, and Eye Injuries in Collegiate Women's Field Hockey},
author = {Gardner, E C},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Sports Medicine},
volume = {43},
number = {8},
pages = {2027--2034},
abstract = {BACKGROUND: While there is concern regarding head, face, and eye injuries in field hockey, prompting some to recommend the use of protective equipment such as goggles and helmets, little has been written about their incidence and mechanism of injury in the modern game of field hockey. The elucidation of this information will better inform the development of maximally effective injury prevention schemes to protect the athlete while maintaining the integrity of the game. PURPOSE: To determine the incidence and epidemiology of head, face, and eye injuries in United States collegiate women's field hockey players from 2004-2005 to 2008-2009. STUDY DESIGN: Descriptive epidemiological study. METHODS: All head, face, and eye injuries reported to the National Collegiate Athletic Association Injury Surveillance System for collegiate women's field hockey athletes from the 2004-2005 through 2008-2009 seasons were analyzed. Data regarding the event type, injury mechanism, body part injured, type of injury, outcome, and time lost were reviewed. The weighted injury incidence per 1000 athlete-exposures (AEs) was calculated using the exposure data set for the same years; 95% CIs were calculated based on a normal approximation to the Poisson distribution. RESULTS: There were 150 reported traumatic injuries during this time period, with a weighted occurrence of 1587.3 injuries. The overall incidence of head, face, and eye injuries in collegiate women's field hockey was 0.94 per 1000 AEs (95% CI, 0.86-1.19). Injuries to the head or face, other than the mouth, nose, and eye, accounted for 75.3% of these injuries. The incidence of eye injuries was 0.07 per 1000 AEs (95% CI, 0.03-0.12); nose injuries occurred at a rate of 0.10 per 1000 AEs (95% CI, 0.05-0.15). The rate of traumatic dental injuries was 0.06 per 1000 AEs (95% CI, 0.04-0.14). Contact with an apparatus caused 72.9% of all injuries; specifically, contact with an elevated ball accounted for 47.9% of all injuries, and contact with an elevated stick caused 21.7% of all injuries. While the majority of players suffering a head, face, or eye injury were able to return to sport that season (90.0%), the remaining athletes suffered season-ending injuries (10%). Concussions accounted for 42.8% of all head, face, and eye injuries reported (0.40 per 1000 AEs; 95% CI, 0.32-0.53). CONCLUSION: Head, face, and eye injuries occur regularly in women's field hockey. This description of the injury profile and mechanisms of injury may be used to design appropriate injury prevention schemes for the sport.Copyright © 2015 The Author(s).},
keywords = {*Craniocerebral Trauma/ep [Epidemiology], *Eye Injuries/ep [Epidemiology], *Facial Injuries/ep [Epidemiology], *Hockey/in [Injuries], Brain Concussion/ep [Epidemiology], Craniocerebral Trauma/pc [Prevention \& Control], Eye Injuries/pc [Prevention \& Control], Eye Protective Devices, Facial Injuries/pc [Prevention \& Control], Female, Head Protective Devices, Humans, Incidence, Students, United States/ep [Epidemiology], Universities},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M N; Silverberg, N D; Iverson, G L
Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers Journal Article
In: Journal of Neurotrauma, vol. 32, no. 17, pp. 1301–1306, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/co [Complications], *Cognition Disorders/di [Diagnosis], *Military Personnel/sn [Statistics & Numerical Dat, *Post-Concussion Syndrome/di [Diagnosis], adult, Brain Concussion/ep [Epidemiology], Cognition Disorders/ep [Epidemiology], Cognition Disorders/et [Etiology], Female, Humans, Male, Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], United States/ep [Epidemiology], Young Adult
@article{Dretsch2015,
title = {Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers},
author = {Dretsch, M N and Silverberg, N D and Iverson, G L},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {17},
pages = {1301--1306},
abstract = {The extent to which multiple past concussions are associated with lingering symptoms or mental health problems in military service members is not well understood. The purpose of this study was to examine the association between lifetime concussion history, cognitive functioning, general health, and psychological health in a large sample of fit-for-duty U.S. Army soldiers preparing for deployment. Data on 458 active-duty soldiers were collected and analyzed. A computerized cognitive screening battery (CNS-Vital Signs()) was used to assess complex attention (CA), reaction time (RT), processing speed (PS), cognitive flexibility (CF), and memory. Health questionnaires included the Neurobehavioral Symptom Inventory (NSI), PTSD Checklist-Military Version (PCL-M), Zung Depression and Anxiety Scales (ZDS; ZAS), Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Alcohol Use and Dependency Identification Test (AUDIT). Soldiers with a history of multiple concussions (i.e., three or more concussions) had significantly greater post-concussive symptom scores compared with those with zero (d=1.83, large effect), one (d=0.64, medium effect), and two (d=0.64, medium effect) prior concussions. Although the group with three or more concussions also reported more traumatic stress symptoms, the results revealed that traumatic stress was a mediator between concussions and post-concussive symptom severity. There were no significant differences on neurocognitive testing between the number of concussions. These results add to the accumulating evidence suggesting that most individuals recover from one or two prior concussions, but there is a greater risk for ongoing symptoms if one exceeds this number of injuries.},
keywords = {*Brain Concussion/co [Complications], *Cognition Disorders/di [Diagnosis], *Military Personnel/sn [Statistics \& Numerical Dat, *Post-Concussion Syndrome/di [Diagnosis], adult, Brain Concussion/ep [Epidemiology], Cognition Disorders/ep [Epidemiology], Cognition Disorders/et [Etiology], Female, Humans, Male, Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], United States/ep [Epidemiology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Logan, B W; Goldman, S; Zola, M; Mackey, A
Concussive brain injury in the military: September 2001 to the present Journal Article
In: Behav Sci Law, vol. 31, no. 6, pp. 803–813, 2013.
Abstract | BibTeX | Tags: *Brain Concussion/th [Therapy], *Military Personnel/px [Psychology], 2003-2011, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Evidence-Based Medicine, Humans, Iraq War, United States/ep [Epidemiology]
@article{Logan2013,
title = {Concussive brain injury in the military: September 2001 to the present},
author = {Logan, B W and Goldman, S and Zola, M and Mackey, A},
year = {2013},
date = {2013-01-01},
journal = {Behav Sci Law},
volume = {31},
number = {6},
pages = {803--813},
abstract = {Since the terrorist attacks of September 11, 2001, 1,348,405 citizens have been deployed to combat in Operation Iraqi Freedom (OIF), Operation New Dawn in Iraq, and Operation Enduring Freedom in Afghanistan (OEF). During this same period 266,810 (20%) of these individuals have been diagnosed with a traumatic brain injury (TBI). The majority of these were Army soldiers, with 155,282 (58%) receiving the diagnosis. Mild TBI comprised 82% of the total, with the remainder being moderate to severe. Over this same period the Department of Defense (DoD) has invested $374.9 million to enhance access and quality of care services, including 57 TBI treatment centers in the combat theater and throughout the U.S. The Army's medical research division, the Medical Research and Material Command (MRMC), has invested an additional $700 million to TBI research during this time. The effort has faced a number of challenges, including limited human subject basic and translational research, limited epidemiological data on combat-related injuries, limited capacity and standards for data acquisition, and a lack of standardized evidenced-based protocols for treatment. All these areas have undergone significant growth and development, leading to the comprehensive system of care present today. A further challenge in this patient population has been the clinical co-morbidity of TBI, post-traumatic stress disorder, and chronic pain syndrome. The Army and the DoD have created treatment programs that are interdisciplinary in clinical approach, targeting particular neuropsychological domains of dysfunction rather than diagnostic category or etiology of injury. This article presents the history of this effort, the challenges to accurate and adequate diagnosis and care that remain, and the future of brain injury clinical and research efforts in the military. Copyright © 2013 John Wiley \& Sons, Ltd.},
keywords = {*Brain Concussion/th [Therapy], *Military Personnel/px [Psychology], 2003-2011, Afghan Campaign 2001-, Brain Concussion/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Evidence-Based Medicine, Humans, Iraq War, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}