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}
}
Dematteo, Carol; Volterman, Kimberly A; Breithaupt, Peter G; Claridge, Everett A; Adamich, John; Timmons, Brian W
Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015, ISBN: 01959131.
Abstract | BibTeX | Tags: *BRAIN -- Concussion, *BRAIN -- Wounds & injuries, *EXERCISE, *EXERCISE tests, *POSTCONCUSSION syndrome, *SPORTS participation, ADOLESCENCE, adolescents, brain concussion, children, DATA analysis, DATA analysis -- Software, DECISION making in clinical medicine, DESCRIPTIVE statistics, head injury, MULTIPLE regression analysis, ONE-way analysis of variance, postconcussion syndrome, RESEARCH -- Finance, Return to Play, SAMPLING (Statistics), STATISTICS
@article{Dematteo2015b,
title = {Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion},
author = {Dematteo, Carol and Volterman, Kimberly A and Breithaupt, Peter G and Claridge, Everett A and Adamich, John and Timmons, Brian W},
isbn = {01959131},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose: The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods: Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results: Participants had a mean T SD symptom duration of 6.3 T 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions: Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. ABSTRACT FROM AUTHOR},
keywords = {*BRAIN -- Concussion, *BRAIN -- Wounds \& injuries, *EXERCISE, *EXERCISE tests, *POSTCONCUSSION syndrome, *SPORTS participation, ADOLESCENCE, adolescents, brain concussion, children, DATA analysis, DATA analysis -- Software, DECISION making in clinical medicine, DESCRIPTIVE statistics, head injury, MULTIPLE regression analysis, ONE-way analysis of variance, postconcussion syndrome, RESEARCH -- Finance, Return to Play, SAMPLING (Statistics), STATISTICS},
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}
}
Dematteo, Carol; Volterman, Kimberly A; Breithaupt, Peter G; Claridge, Everett A; Adamich, John; Timmons, Brian W
Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015, ISBN: 01959131.
@article{Dematteo2015b,
title = {Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion},
author = {Dematteo, Carol and Volterman, Kimberly A and Breithaupt, Peter G and Claridge, Everett A and Adamich, John and Timmons, Brian W},
isbn = {01959131},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose: The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods: Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results: Participants had a mean T SD symptom duration of 6.3 T 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions: Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. ABSTRACT FROM AUTHOR},
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}
}
Dematteo, Carol; Volterman, Kimberly A; Breithaupt, Peter G; Claridge, Everett A; Adamich, John; Timmons, Brian W
Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015, ISBN: 01959131.
Abstract | BibTeX | Tags: *BRAIN -- Concussion, *BRAIN -- Wounds & injuries, *EXERCISE, *EXERCISE tests, *POSTCONCUSSION syndrome, *SPORTS participation, ADOLESCENCE, adolescents, brain concussion, children, DATA analysis, DATA analysis -- Software, DECISION making in clinical medicine, DESCRIPTIVE statistics, head injury, MULTIPLE regression analysis, ONE-way analysis of variance, postconcussion syndrome, RESEARCH -- Finance, Return to Play, SAMPLING (Statistics), STATISTICS
@article{Dematteo2015b,
title = {Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion},
author = {Dematteo, Carol and Volterman, Kimberly A and Breithaupt, Peter G and Claridge, Everett A and Adamich, John and Timmons, Brian W},
isbn = {01959131},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose: The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods: Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results: Participants had a mean T SD symptom duration of 6.3 T 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions: Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. ABSTRACT FROM AUTHOR},
keywords = {*BRAIN -- Concussion, *BRAIN -- Wounds \& injuries, *EXERCISE, *EXERCISE tests, *POSTCONCUSSION syndrome, *SPORTS participation, ADOLESCENCE, adolescents, brain concussion, children, DATA analysis, DATA analysis -- Software, DECISION making in clinical medicine, DESCRIPTIVE statistics, head injury, MULTIPLE regression analysis, ONE-way analysis of variance, postconcussion syndrome, RESEARCH -- Finance, Return to Play, SAMPLING (Statistics), STATISTICS},
pubstate = {published},
tppubtype = {article}
}