Pub Date : 2023-01-01DOI: 10.1177/20597002231153707
J. Kent, B. K. Diduch, Siobhan M Statuta, K. Pugh, J. Macknight
The objective of this study was to investigate the time to recovery after an SRC comparing riboflavin 400mg daily to placebo in a group of elite level athletes from multiple sports. The study was a double-blind randomized placebo-controlled trial with intention to treat conducted from 2016–2020 at two different academic institutions. The study enrolled varsity student-athletes (SA) at each institution. The investigators and participants were blinded to treatment allocation. The treatment group received 14 capsules of either riboflavin 400mg or placebo to take daily until completed. The team physician made the diagnosis of an SRC within 24 h of the injury. A total of sixty participants enrolled in the study. Fifty-two participants completed the study. Subjects in the riboflavin group had a statistically significant lower number of average days to recovery of 9.92 days (CI ± 2.8) compared to placebo of 22.2 days (CI ± 11.5) (P < 0.05). Subjects matched for age, gender, history of SRCs, attention deficit hyperactivity disorder and Periodic Health Questionnaire-9 scores. This is one of the first studies that documents an effective treatment option for an SRC at the time of injury. Riboflavin is safe, inexpensive, and readily available making it an ideal treatment.
{"title":"The impact of riboflavin on the duration of sport-related concussion: A randomized placebo-controlled trial","authors":"J. Kent, B. K. Diduch, Siobhan M Statuta, K. Pugh, J. Macknight","doi":"10.1177/20597002231153707","DOIUrl":"https://doi.org/10.1177/20597002231153707","url":null,"abstract":"The objective of this study was to investigate the time to recovery after an SRC comparing riboflavin 400mg daily to placebo in a group of elite level athletes from multiple sports. The study was a double-blind randomized placebo-controlled trial with intention to treat conducted from 2016–2020 at two different academic institutions. The study enrolled varsity student-athletes (SA) at each institution. The investigators and participants were blinded to treatment allocation. The treatment group received 14 capsules of either riboflavin 400mg or placebo to take daily until completed. The team physician made the diagnosis of an SRC within 24 h of the injury. A total of sixty participants enrolled in the study. Fifty-two participants completed the study. Subjects in the riboflavin group had a statistically significant lower number of average days to recovery of 9.92 days (CI ± 2.8) compared to placebo of 22.2 days (CI ± 11.5) (P < 0.05). Subjects matched for age, gender, history of SRCs, attention deficit hyperactivity disorder and Periodic Health Questionnaire-9 scores. This is one of the first studies that documents an effective treatment option for an SRC at the time of injury. Riboflavin is safe, inexpensive, and readily available making it an ideal treatment.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46805311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1177/20597002231157947
L. Lecci, K. Dugan, Ken Zeiger, J. Keith, S. Taravath, W. Tseh, Mark Williams
Gait accelerometer (sensor) technology has proven effective in predicting several medical outcomes, but less is known regarding its prediction of concussion symptoms relative to conventional measures of gait and balance. To establish the reliability and validity of gait accelerometer data. We first examine test-retest reliability and the impact of footwear and walking surfaces on gait. We then examine the convergent validity between gait accelerometer data and the NIH 4-meter gait test. Finally, we compare gait accelerometer data to gait speed and balance measures for predicting concussion symptoms. Study 1 used a crossover study design with 60 participants to evaluate retest reliability and examine the effects of footwear (shoes/no-shoes) and walking surface (tile floor/grass) on gait accelerometer data. Study 2 employed a cross-sectional design with 1008 participants to assess gait accelerometer correlations with NIH 4-meter gait and the prediction of Centers for Disease Control and Prevention (CDC) concussion symptoms relative to previously validated gait and balance measures. Retest reliability (4-day average retest interval) for the no shoes/tile surface condition ranged from .72-.91 (mean = .80). Significant effects of footwear and especially walking surface revealed by Analysis of Variances (ANOVAs) on gait accelerometer data for the power, stride, balance, and symmetry domains indicate the need to standardize these variables. Gait accelerometer data correlates significantly with NIH 4-meter gait scores. Regression analyses found that gait accelerometer data predicts CDC concussion symptom endorsement, outperforming the BESS and NIH 4-meter gait at least three-fold. When standardized on footwear and walking surface, gait accelerometers achieve strong test-retest reliability, converge with established measures of gait speed, and are superior to established measures of gait speed and balance when predicting concussion symptoms. Gait accelerometers represent a rapid tool for collecting additional gait information to quantify the behavioral sequelae of concussion and potentially inform return-to-play decision-making.
{"title":"Validation of an accelerometer-based gait assessment: Establishing test-retest reliability, convergent validity, and predictive validity for concussion symptom endorsement","authors":"L. Lecci, K. Dugan, Ken Zeiger, J. Keith, S. Taravath, W. Tseh, Mark Williams","doi":"10.1177/20597002231157947","DOIUrl":"https://doi.org/10.1177/20597002231157947","url":null,"abstract":"Gait accelerometer (sensor) technology has proven effective in predicting several medical outcomes, but less is known regarding its prediction of concussion symptoms relative to conventional measures of gait and balance. To establish the reliability and validity of gait accelerometer data. We first examine test-retest reliability and the impact of footwear and walking surfaces on gait. We then examine the convergent validity between gait accelerometer data and the NIH 4-meter gait test. Finally, we compare gait accelerometer data to gait speed and balance measures for predicting concussion symptoms. Study 1 used a crossover study design with 60 participants to evaluate retest reliability and examine the effects of footwear (shoes/no-shoes) and walking surface (tile floor/grass) on gait accelerometer data. Study 2 employed a cross-sectional design with 1008 participants to assess gait accelerometer correlations with NIH 4-meter gait and the prediction of Centers for Disease Control and Prevention (CDC) concussion symptoms relative to previously validated gait and balance measures. Retest reliability (4-day average retest interval) for the no shoes/tile surface condition ranged from .72-.91 (mean = .80). Significant effects of footwear and especially walking surface revealed by Analysis of Variances (ANOVAs) on gait accelerometer data for the power, stride, balance, and symmetry domains indicate the need to standardize these variables. Gait accelerometer data correlates significantly with NIH 4-meter gait scores. Regression analyses found that gait accelerometer data predicts CDC concussion symptom endorsement, outperforming the BESS and NIH 4-meter gait at least three-fold. When standardized on footwear and walking surface, gait accelerometers achieve strong test-retest reliability, converge with established measures of gait speed, and are superior to established measures of gait speed and balance when predicting concussion symptoms. Gait accelerometers represent a rapid tool for collecting additional gait information to quantify the behavioral sequelae of concussion and potentially inform return-to-play decision-making.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47129231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1177/20597002231192763
M. Tsuruike, N. Hirose, Robert S. Nishime
No prior study has examined inversion position testing in individuals who have experienced sports related concussions. To investigate whether the inversion position testing (IPT) would un-mask symptoms in asymptomatic concussed collegiate athletes during the return to play progression assessment. Case-Control Study. Athletic Training Room. One hundred and thirty-nine collegiate student athletes were randomly recruited from 12 different sports belonging to National Collegiate Athletic Association Division I Conference. A baseline concussion symptom questionnaire was administered. Of the 139, 122 participants without any of the suspicious symptoms related to concussions were examined using the Concussion Symptom Inventory (CSI) in connection with IPT. Also, the 18 concussed athletes underwent the IPT when any symptom subsided. Eighteen of the 122 (16.2%) non-concussed athletes showed some post-IPT symptoms, while 5 of 12 (41.7%) concussed athletes showed some post-IPT symptoms in the baseline test. For the latter, neither the interaction ( P = 0.08) nor difference in the total CSI score was observed either from pre- to post-IPT ( P = 0.14) or between the baseline and post-concussion ( P = 0.96). This study demonstrated that symptoms could be exacerbated by the IPT in concussed athletes even when their original symptoms had subsided prior to the testing. The IPT exacerbated post-concussive symptoms may depend on a number of days required for post-concussive symptoms to subside. The innovative instrument of IPT may prove effective in clarifying the degree to which post-concussive symptoms have subsided. Concussion, College athletes, Inversion position, Symptoms.
{"title":"Inversion position testing in concussed athletes","authors":"M. Tsuruike, N. Hirose, Robert S. Nishime","doi":"10.1177/20597002231192763","DOIUrl":"https://doi.org/10.1177/20597002231192763","url":null,"abstract":"No prior study has examined inversion position testing in individuals who have experienced sports related concussions. To investigate whether the inversion position testing (IPT) would un-mask symptoms in asymptomatic concussed collegiate athletes during the return to play progression assessment. Case-Control Study. Athletic Training Room. One hundred and thirty-nine collegiate student athletes were randomly recruited from 12 different sports belonging to National Collegiate Athletic Association Division I Conference. A baseline concussion symptom questionnaire was administered. Of the 139, 122 participants without any of the suspicious symptoms related to concussions were examined using the Concussion Symptom Inventory (CSI) in connection with IPT. Also, the 18 concussed athletes underwent the IPT when any symptom subsided. Eighteen of the 122 (16.2%) non-concussed athletes showed some post-IPT symptoms, while 5 of 12 (41.7%) concussed athletes showed some post-IPT symptoms in the baseline test. For the latter, neither the interaction ( P = 0.08) nor difference in the total CSI score was observed either from pre- to post-IPT ( P = 0.14) or between the baseline and post-concussion ( P = 0.96). This study demonstrated that symptoms could be exacerbated by the IPT in concussed athletes even when their original symptoms had subsided prior to the testing. The IPT exacerbated post-concussive symptoms may depend on a number of days required for post-concussive symptoms to subside. The innovative instrument of IPT may prove effective in clarifying the degree to which post-concussive symptoms have subsided. Concussion, College athletes, Inversion position, Symptoms.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45700375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective to cross-culturally adapt the Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST) into Arabic (RoCKAS-ST-A), and to evaluate its psychometric properties (i.e., face validity, internal consistency and test-retest reliability) of the Arabic version 16 of the RoCKAS-ST (RoCKAS-ST-A). Design cross-cultural and preliminary validation of the of the Arabic version of the Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST-A). Setting youth clubs and after-school activities centers around Kuwait. Participants Adolescent and young adults, aged 13–20 years old, both sexes. Independent Variables age, sex, and type of sport (if any). Main Outcome measure RoCKAS-ST-A questionnaire answers and demographics of participants. Results Two hundred and thirty-four adolescent and young adults ( n = 234) participated in this study (mean age = 15.95, SD = 1.92). More than half of the participants were males ( n = 163, 69.66%). The internal consistency for the concussion knowledge index (CKI) and concussion attitude index (CAI) ranged between fair and good (α = 0.31 & 0.97, respectively). The test-retest reliability of CKI score was 0.79 (95% CI = 0.42–0.92, P < 0.05) and of CAI was 0.86 (95% CI =0.66–0.94, P < 0.05). The average time between the 2 tests was 9.35 ± 2.44 days. Conclusion RoCKAS-ST-A is a reliable, valid, and feasible tool to examine the knowledge about and attitudes toward sport-related concussions (SRC) in adolescents and young adults with Arabic as their first language. Decreased knowledge and unsafe attitudes toward SRC was exhibited among adolescents and young adults in Kuwait.
目的对《罗森鲍姆脑震荡知识与态度调查-学生版》(RoCKAS-ST)进行跨文化改编阿拉伯语版(RoCKAS-ST- a)，并评价阿拉伯语版16版RoCKAS-ST (RoCKAS-ST- a)的心理测量特性(即面孔效度、内部一致性和重测信度)。设计罗森鲍姆脑震荡知识和态度调查-学生版(RoCKAS-ST-A)的阿拉伯语版本的跨文化和初步验证。在科威特各地设立青年俱乐部和课外活动中心。参与者为青少年和年轻人，年龄在13-20岁之间，男女不限。独立变量:年龄、性别和运动类型(如果有的话)。主要结果测量RoCKAS-ST-A问卷的答案和参与者的人口统计数据。结果共有234名青少年和青年参与本研究，平均年龄为15.95岁，SD = 1.92。超过一半的参与者是男性(n = 163, 69.66%)。脑震荡知识指数(CKI)和脑震荡态度指数(CAI)的内部一致性介于一般和良好之间(α = 0.31 &分别为0.97)。CKI评分的重测信度为0.79 (95% CI = 0.42 ~ 0.92, P <0.05)， CAI为0.86 (95% CI =0.66 ~ 0.94, P <0.05)。两次检测的平均间隔时间为9.35±2.44 d。结论RoCKAS-ST-A是一种可靠、有效和可行的工具，可用于调查以阿拉伯语为母语的青少年和年轻人对运动相关性脑震荡(SRC)的认知和态度。在科威特的青少年和年轻人中，对SRC的知识和不安全态度有所下降。
{"title":"Cross-cultural adaptation and preliminary validation of the Arabic version of the Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST-A)","authors":"Anwar B. Almutairi, Jouzah Albous, Madhawi Almutairi, Nourah Alenezi, Shaikah Alfadhli, Shouq Aldhafeeri","doi":"10.1177/20597002231212035","DOIUrl":"https://doi.org/10.1177/20597002231212035","url":null,"abstract":"Objective to cross-culturally adapt the Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST) into Arabic (RoCKAS-ST-A), and to evaluate its psychometric properties (i.e., face validity, internal consistency and test-retest reliability) of the Arabic version 16 of the RoCKAS-ST (RoCKAS-ST-A). Design cross-cultural and preliminary validation of the of the Arabic version of the Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST-A). Setting youth clubs and after-school activities centers around Kuwait. Participants Adolescent and young adults, aged 13–20 years old, both sexes. Independent Variables age, sex, and type of sport (if any). Main Outcome measure RoCKAS-ST-A questionnaire answers and demographics of participants. Results Two hundred and thirty-four adolescent and young adults ( n = 234) participated in this study (mean age = 15.95, SD = 1.92). More than half of the participants were males ( n = 163, 69.66%). The internal consistency for the concussion knowledge index (CKI) and concussion attitude index (CAI) ranged between fair and good (α = 0.31 & 0.97, respectively). The test-retest reliability of CKI score was 0.79 (95% CI = 0.42–0.92, P < 0.05) and of CAI was 0.86 (95% CI =0.66–0.94, P < 0.05). The average time between the 2 tests was 9.35 ± 2.44 days. Conclusion RoCKAS-ST-A is a reliable, valid, and feasible tool to examine the knowledge about and attitudes toward sport-related concussions (SRC) in adolescents and young adults with Arabic as their first language. Decreased knowledge and unsafe attitudes toward SRC was exhibited among adolescents and young adults in Kuwait.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135561264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01DOI: 10.1177/20597002221086095
Bhanu Sharma, D. W. Lawrence
Objective Citation analyses identify the most-cited publications in a given field, which aids in understanding areas of the literature that are well-developed and those where additional research is required. Our objective was to perform a citation analysis in concussion to understand the state of the science from a bibliometric perspective. Design We performed a keyword search for articles related to concussion in Harzing's Publish or Perish, which scrapes Google Scholar for citation metrics. This approach was used to identify the 50 articles with the most lifetime citations as well as the 50 articles with the highest citation rate. Main outcome measures Citations and citation rates. Results Per our citation analysis, we found that concussion guidelines are among the most cited publications (comprising ≥20% of each citation cohort), yet there is a dearth of widely cited clinical trials to inform them; only one randomized trial (studying the effects of rest following concussion) was included in our citation analysis. The majority of study designs (≥40% of each citation cohort) were cross-sectional. Concussion recovery and secondary complications of concussion were common study topics, with ≥20% of publications in each citation cohort focused on these issues. The publications included in our analysis were authored by 596 authors from only 12 countries, suggesting a lack of global representation in concussion research. Conclusions Existing reviews and consensus statements have called for additional, high-quality research in concussion; our citation analysis quantifies this need. Further, although concussion is a global problem with its incidence and burden increasing in the developing world, our citation analysis demonstrates that the most-cited and discussed articles in concussion are published by authors from only 12 countries. Going forward, to address the global problem that is concussion, a more global research perspective is called for.
目标引文分析确定了特定领域中被引用最多的出版物，这有助于理解文献中发展完善的领域和需要额外研究的领域。我们的目的是对脑震荡进行引文分析，从文献计量学的角度了解科学的现状。设计我们在Harzing的Publish or Perish中对与脑震荡相关的文章进行了关键词搜索，该搜索从谷歌学者那里搜索引文指标。该方法用于识别终身引用次数最多的50篇文章以及引用率最高的50篇论文。主要结果衡量引文和引文率。结果根据我们的引文分析，我们发现脑震荡指南是被引用最多的出版物之一（占每个引文队列的≥20%），但缺乏被广泛引用的临床试验来为其提供信息；只有一项随机试验（研究脑震荡后休息的影响）被纳入我们的引文分析。大多数研究设计（每个引用队列的≥40%）是横断面的。脑震荡的恢复和继发性脑震荡并发症是常见的研究主题，每个引用队列中≥20%的出版物关注这些问题。我们分析中的出版物由来自12个国家的596位作者撰写，这表明脑震荡研究缺乏全球代表性。结论现有的综述和共识声明要求对脑震荡进行额外的高质量研究；我们的引文分析量化了这种需求。此外，尽管脑震荡是一个全球性问题，其发生率和负担在发展中国家不断增加，但我们的引文分析表明，脑震荡中被引用和讨论最多的文章是由来自12个国家的作者发表的。展望未来，为了解决脑震荡这一全球性问题，需要一个更全球化的研究视角。
{"title":"Top cited articles in concussion: A bibliometric analysis of the state of the science","authors":"Bhanu Sharma, D. W. Lawrence","doi":"10.1177/20597002221086095","DOIUrl":"https://doi.org/10.1177/20597002221086095","url":null,"abstract":"Objective Citation analyses identify the most-cited publications in a given field, which aids in understanding areas of the literature that are well-developed and those where additional research is required. Our objective was to perform a citation analysis in concussion to understand the state of the science from a bibliometric perspective. Design We performed a keyword search for articles related to concussion in Harzing's Publish or Perish, which scrapes Google Scholar for citation metrics. This approach was used to identify the 50 articles with the most lifetime citations as well as the 50 articles with the highest citation rate. Main outcome measures Citations and citation rates. Results Per our citation analysis, we found that concussion guidelines are among the most cited publications (comprising ≥20% of each citation cohort), yet there is a dearth of widely cited clinical trials to inform them; only one randomized trial (studying the effects of rest following concussion) was included in our citation analysis. The majority of study designs (≥40% of each citation cohort) were cross-sectional. Concussion recovery and secondary complications of concussion were common study topics, with ≥20% of publications in each citation cohort focused on these issues. The publications included in our analysis were authored by 596 authors from only 12 countries, suggesting a lack of global representation in concussion research. Conclusions Existing reviews and consensus statements have called for additional, high-quality research in concussion; our citation analysis quantifies this need. Further, although concussion is a global problem with its incidence and burden increasing in the developing world, our citation analysis demonstrates that the most-cited and discussed articles in concussion are published by authors from only 12 countries. Going forward, to address the global problem that is concussion, a more global research perspective is called for.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43925335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/20597002221127551
Ayden Janssen, R. Pope, N. Rando
Objective To identify and synthesise research evidence regarding psychometric properties and clinical utility of the Buffalo Concussion Treadmill Test (BCTT) and Buffalo Concussion Bike Test (BCBT) for use with patients with acute concussion, post-concussion syndrome (PCS) or physiological post-concussion disorder (PPCD). Data sources ProQuest (ProQuest Central), PEDro, Medline (Ovid), Emcare (Ovid), EBSCOhost (Health collection) and Google Scholar, searched September 8th-12th, 2020. Study selection Two authors independently selected studies that met eligibility criteria. Studies were selected if they were original research of any design, that investigated the properties of the testing protocols in either concussed or uninjured participants. Articles not published in English, that were not original research or that used significantly different testing protocols were excluded. The search yielded 250 articles, 11 of which were eligible and included in this review. Data extraction Included studies were critically appraised independently by two authors, using the Mixed Methods Appraisal Tool (MMAT). Data relating to study characteristics and key findings were extracted from the studies, documented in tables, and used to inform a critical narrative synthesis of findings. Data synthesis To provide recommendations relating to each aim of the review, a strength of evidence scoring system was used. Available evidence supported use of the BCTT, with strong evidence supporting the safety and construct validity of the test and moderate evidence supporting its prognostic value. There has been very limited research investigating use of the BCBT. Conclusion The findings support a recommendation for use of the BCTT in clinical settings for management of acute concussion, PCS and PPCD. There is limited evidence available for the BCBT. Additional studies are needed of both tests to further establish their clinical value.
{"title":"Clinical application of the Buffalo Concussion Treadmill Test and the Buffalo Concussion Bike Test: A systematic review","authors":"Ayden Janssen, R. Pope, N. Rando","doi":"10.1177/20597002221127551","DOIUrl":"https://doi.org/10.1177/20597002221127551","url":null,"abstract":"Objective To identify and synthesise research evidence regarding psychometric properties and clinical utility of the Buffalo Concussion Treadmill Test (BCTT) and Buffalo Concussion Bike Test (BCBT) for use with patients with acute concussion, post-concussion syndrome (PCS) or physiological post-concussion disorder (PPCD). Data sources ProQuest (ProQuest Central), PEDro, Medline (Ovid), Emcare (Ovid), EBSCOhost (Health collection) and Google Scholar, searched September 8th-12th, 2020. Study selection Two authors independently selected studies that met eligibility criteria. Studies were selected if they were original research of any design, that investigated the properties of the testing protocols in either concussed or uninjured participants. Articles not published in English, that were not original research or that used significantly different testing protocols were excluded. The search yielded 250 articles, 11 of which were eligible and included in this review. Data extraction Included studies were critically appraised independently by two authors, using the Mixed Methods Appraisal Tool (MMAT). Data relating to study characteristics and key findings were extracted from the studies, documented in tables, and used to inform a critical narrative synthesis of findings. Data synthesis To provide recommendations relating to each aim of the review, a strength of evidence scoring system was used. Available evidence supported use of the BCTT, with strong evidence supporting the safety and construct validity of the test and moderate evidence supporting its prognostic value. There has been very limited research investigating use of the BCBT. Conclusion The findings support a recommendation for use of the BCTT in clinical settings for management of acute concussion, PCS and PPCD. There is limited evidence available for the BCBT. Additional studies are needed of both tests to further establish their clinical value.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47988757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/20597002221075007
Sungwon Kim, D. Connaughton, J. Spengler
Objectives In an effort to reduce the negative health consequences often associated with concussions among young athletes, all U.S. states and the District of Columbia enacted youth concussion legislation between 2009 and 2014. This study explored youth sport parents’ (1) familiarity with their state's concussion legislation, and (2) perceptions about the need for additional legislative provisions not currently found in such laws. Methods Cross-sectional online survey data were obtained from parents (n = 430) of youth sport athletes from 22 U.S states. Results Primary findings suggest that 67% of parents were moderately to extremely familiar with the removal from play requirement; 69.9% were moderately to extremely familiar with mandatory concussion training for coaches; and 75.1% were moderately to extremely familiar with the medical clearance requirement for athletes to return to play. In regard to perceptions, approximately half (50.2%) believed it is essential to mandate parent/guardian notification when a child suffers a potential concussion; and 42.8% believed it is essential to include a penalty/sanction for violating the statute. Based on the results of a multivariable logistic regression model, a significantly greater familiarity of concussion legislation was found among parents who were White/Caucasian, had advanced degrees, had higher household incomes, or were urban residents. Conclusions Our findings suggest that most youth sport parents have a sound understanding of concussion legislation and believe that the laws should be revised to improve best practices in preventing and managing concussions. Parents who face socio-cultural and economic barriers can benefit most from having access to credible information about their state's concussion law.
{"title":"Youth sport parents’ familiarity and perceptions of concussion legislation","authors":"Sungwon Kim, D. Connaughton, J. Spengler","doi":"10.1177/20597002221075007","DOIUrl":"https://doi.org/10.1177/20597002221075007","url":null,"abstract":"Objectives In an effort to reduce the negative health consequences often associated with concussions among young athletes, all U.S. states and the District of Columbia enacted youth concussion legislation between 2009 and 2014. This study explored youth sport parents’ (1) familiarity with their state's concussion legislation, and (2) perceptions about the need for additional legislative provisions not currently found in such laws. Methods Cross-sectional online survey data were obtained from parents (n = 430) of youth sport athletes from 22 U.S states. Results Primary findings suggest that 67% of parents were moderately to extremely familiar with the removal from play requirement; 69.9% were moderately to extremely familiar with mandatory concussion training for coaches; and 75.1% were moderately to extremely familiar with the medical clearance requirement for athletes to return to play. In regard to perceptions, approximately half (50.2%) believed it is essential to mandate parent/guardian notification when a child suffers a potential concussion; and 42.8% believed it is essential to include a penalty/sanction for violating the statute. Based on the results of a multivariable logistic regression model, a significantly greater familiarity of concussion legislation was found among parents who were White/Caucasian, had advanced degrees, had higher household incomes, or were urban residents. Conclusions Our findings suggest that most youth sport parents have a sound understanding of concussion legislation and believe that the laws should be revised to improve best practices in preventing and managing concussions. Parents who face socio-cultural and economic barriers can benefit most from having access to credible information about their state's concussion law.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41863579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/20597002211070735
N. Senaratne, Alexandra Hunt, Eleanor Sotsman, M. Grey
Premature return to play (RTP) following sports-related concussion (SRC) is associated with significant morbidity including risk of neurological and non-neurological injury, persistent post-concussion symptoms and chronic neurological deficits. Assessing athletes for RTP is critical but these decisions are currently based on clinical assessments that are subject to bias and symptomatic reporting that rely on compliance. An objective and easily obtained biomarker that can indicate recovery following SRC would aid clinicians to make safer RTP decisions. We performed a systematic review to identify potential biomarkers from saliva, urine and blood sources that could inform the clinical RTP decision. The MEDLINE database was searched. Inclusion criteria were studies focusing on adults diagnosed with SRC, fluid biomarkers from blood, saliva or urine and clinical recovery from SRC or at RTP. We assessed each biomarker for their time course post SRC and relationship to clinical recovery. Secondary outcomes included correlation with symptom scores and predictive value for prolonged RTP. We identified 8 studies all investigating blood-based markers of diffuse axonal injury (tau, NFL, SNTF), neuroglial injury (NSE, VLP-1, UCH-L1, S100B, GFAP), inflammation and hormonal disturbances. Tau, SNTF, UCH-1, GFAP, S100B and the inflammatory cytokine MCP-4 are raised post SRC and return to baseline by RTP. Changes in tau, NFL, SNTF, GFAP and MCP-4 post SRC correlate with severity of concussion as measured by symptom severity or RTP duration. There is only preliminary case-reporting for hormonal biomarkers. The evidence is limited by a lack of highly powered studies, variation in use of athletic and Contact sport controls (CSC) and a lack of consistent sampling and assessment protocols. There is promise for biomarkers to aid RTP decisions following SRC, most notably in use alongside clinical assessment in RTP criteria to allow greater precision in identifying mild and severe concussion.
{"title":"Biomarkers to aid the return to play decision following sports-related concussion: a systematic review","authors":"N. Senaratne, Alexandra Hunt, Eleanor Sotsman, M. Grey","doi":"10.1177/20597002211070735","DOIUrl":"https://doi.org/10.1177/20597002211070735","url":null,"abstract":"Premature return to play (RTP) following sports-related concussion (SRC) is associated with significant morbidity including risk of neurological and non-neurological injury, persistent post-concussion symptoms and chronic neurological deficits. Assessing athletes for RTP is critical but these decisions are currently based on clinical assessments that are subject to bias and symptomatic reporting that rely on compliance. An objective and easily obtained biomarker that can indicate recovery following SRC would aid clinicians to make safer RTP decisions. We performed a systematic review to identify potential biomarkers from saliva, urine and blood sources that could inform the clinical RTP decision. The MEDLINE database was searched. Inclusion criteria were studies focusing on adults diagnosed with SRC, fluid biomarkers from blood, saliva or urine and clinical recovery from SRC or at RTP. We assessed each biomarker for their time course post SRC and relationship to clinical recovery. Secondary outcomes included correlation with symptom scores and predictive value for prolonged RTP. We identified 8 studies all investigating blood-based markers of diffuse axonal injury (tau, NFL, SNTF), neuroglial injury (NSE, VLP-1, UCH-L1, S100B, GFAP), inflammation and hormonal disturbances. Tau, SNTF, UCH-1, GFAP, S100B and the inflammatory cytokine MCP-4 are raised post SRC and return to baseline by RTP. Changes in tau, NFL, SNTF, GFAP and MCP-4 post SRC correlate with severity of concussion as measured by symptom severity or RTP duration. There is only preliminary case-reporting for hormonal biomarkers. The evidence is limited by a lack of highly powered studies, variation in use of athletic and Contact sport controls (CSC) and a lack of consistent sampling and assessment protocols. There is promise for biomarkers to aid RTP decisions following SRC, most notably in use alongside clinical assessment in RTP criteria to allow greater precision in identifying mild and severe concussion.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41346282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/20597002221133183
L. Richey, B. Bryant, A. Krieg, M. Bray, A. Esagoff, T. Pradeep, Sahar Jahed, L. Luna, N. Trapp, Jaxon Adkins, Melissa B. Jones, Andrew Bledsoe, D. Stevens, Carrie Roper, E. Goldwaser, LiAnn Morris, Emily Berich-Anastasio, Alexandra Pletnikova, K. Lobner, Daniel J. Lee, M. Lauterbach, S. Ducharme, H. Sair, Matthew E. Peters
Objective To complete a systematic review of the literature examining neuroimaging findings unique to co-occurring syndromal depression in the setting of TBI. Methods A PRISMA compliant literature search was conducted in PubMed (MEDLINE), PsychINFO, EMBASE, and Scopus databases for articles published prior to April of 2022. The database query yielded 4447 unique articles. These articles were narrowed based on specific inclusion criteria (e.g., clear TBI definition, clear depression construct commenting on the syndrome of major depressive disorder, conducted empirical analyses comparing neuroimaging correlates in TBI subjects with depression versus TBI subjects without depression, controlled for the time interval between TBI occurrence and acquisition of neuroimaging). Results A final cohort of 10 articles resulted, comprising the findings from 423 civilians with brain injury, 129 of which developed post-TBI depression. Four articles studied mild TBI, three mild/moderate, one moderate/severe, and two all-comers, with nine articles focusing on single TBI and one including both single and recurrent injuries. Spatially convergent structural abnormalities in individuals with TBI and co-occurring syndromal depression were identified primarily in bilateral frontal regions, particularly in those with damage to the left frontal lobe and prefrontal cortices, as well as temporal regions including bilateral temporal lobes, the left superior temporal gyrus, and bilateral hippocampi. Various parietal regions and the nucleus accumbens were also implicated. EEG studies showed supporting evidence of functional changes in frontal regions. Conclusion Additional inquiry with attention to TBI without depression control groups, consistent TBI definitions, previous TBI, clinically diagnosed syndromal depression, imaging timing post-injury, acute prospective design, functional neuroimaging, and well-defined neuroanatomical regions of interest is crucial to extrapolating finer discrepancies between primary and TBI-related depression.
{"title":"Neuroimaging correlates of syndromal depression following traumatic brain injury: A systematic review of the literature","authors":"L. Richey, B. Bryant, A. Krieg, M. Bray, A. Esagoff, T. Pradeep, Sahar Jahed, L. Luna, N. Trapp, Jaxon Adkins, Melissa B. Jones, Andrew Bledsoe, D. Stevens, Carrie Roper, E. Goldwaser, LiAnn Morris, Emily Berich-Anastasio, Alexandra Pletnikova, K. Lobner, Daniel J. Lee, M. Lauterbach, S. Ducharme, H. Sair, Matthew E. Peters","doi":"10.1177/20597002221133183","DOIUrl":"https://doi.org/10.1177/20597002221133183","url":null,"abstract":"Objective To complete a systematic review of the literature examining neuroimaging findings unique to co-occurring syndromal depression in the setting of TBI. Methods A PRISMA compliant literature search was conducted in PubMed (MEDLINE), PsychINFO, EMBASE, and Scopus databases for articles published prior to April of 2022. The database query yielded 4447 unique articles. These articles were narrowed based on specific inclusion criteria (e.g., clear TBI definition, clear depression construct commenting on the syndrome of major depressive disorder, conducted empirical analyses comparing neuroimaging correlates in TBI subjects with depression versus TBI subjects without depression, controlled for the time interval between TBI occurrence and acquisition of neuroimaging). Results A final cohort of 10 articles resulted, comprising the findings from 423 civilians with brain injury, 129 of which developed post-TBI depression. Four articles studied mild TBI, three mild/moderate, one moderate/severe, and two all-comers, with nine articles focusing on single TBI and one including both single and recurrent injuries. Spatially convergent structural abnormalities in individuals with TBI and co-occurring syndromal depression were identified primarily in bilateral frontal regions, particularly in those with damage to the left frontal lobe and prefrontal cortices, as well as temporal regions including bilateral temporal lobes, the left superior temporal gyrus, and bilateral hippocampi. Various parietal regions and the nucleus accumbens were also implicated. EEG studies showed supporting evidence of functional changes in frontal regions. Conclusion Additional inquiry with attention to TBI without depression control groups, consistent TBI definitions, previous TBI, clinically diagnosed syndromal depression, imaging timing post-injury, acute prospective design, functional neuroimaging, and well-defined neuroanatomical regions of interest is crucial to extrapolating finer discrepancies between primary and TBI-related depression.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45026822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/20597002221082865
M. Hecimovich, D. King, M. Murphy, K. Koyama
Objectives Eye tracking has been gaining increasing attention as a possible assessment and monitoring tool for concussion. The King-Devick test (K-DT) was expanded to include an infrared video-oculography-based eye tracker (K-D ET). Therefore, the aim was to provide evidence on the reliability of the K-D ET system under an exercise condition. Methods Participants (N = 61; 26 male, 35 female; age range 19-25) were allocated to an exercise or sedentary group. Both groups completed a baseline K-D ET measurement and then either two 10-min exercise or sedentary interventions with repeated K-D ET measurements between interventions. Results The test-retest reliability of the K-D ET ranged from good to excellent for the different variables measured. The mean ± SD of the differences for the total number of saccades was 1.04 ± 4.01 and there was an observable difference (p = 0.005) in the trial number. There were no observable differences for the intervention (p = 0.768), gender (p = 0.121) and trial (p = 0.777) for average saccade’s velocity. The mean ± SD of the difference of the total fixations before and after intervention across both trials was 1.04 ± 3.63 and there was an observable difference in the trial number (p = 0.025). The mean ± SD of the differences for the Inter-Saccadic Interval and the fixation polyarea before and after intervention across both trials were 1.86 ± 22.99 msec and 0.51 ± 59.11 mm2 and no observable differences for the intervention, gender and trial. Conclusion The results provide evidence on the reliability of the K-D ET, and the eye-tracking components and demonstrate the relationship between completion time and other variables of the K-D ET system. This is vital as the use of the K-DT may be increasing and the combination of the K-DT and eye tracking as one single package highlights the need to specifically measure the reliability of this combined unit.
{"title":"An investigation into the measurement properties of the King-Devick Eye Tracking system","authors":"M. Hecimovich, D. King, M. Murphy, K. Koyama","doi":"10.1177/20597002221082865","DOIUrl":"https://doi.org/10.1177/20597002221082865","url":null,"abstract":"Objectives Eye tracking has been gaining increasing attention as a possible assessment and monitoring tool for concussion. The King-Devick test (K-DT) was expanded to include an infrared video-oculography-based eye tracker (K-D ET). Therefore, the aim was to provide evidence on the reliability of the K-D ET system under an exercise condition. Methods Participants (N = 61; 26 male, 35 female; age range 19-25) were allocated to an exercise or sedentary group. Both groups completed a baseline K-D ET measurement and then either two 10-min exercise or sedentary interventions with repeated K-D ET measurements between interventions. Results The test-retest reliability of the K-D ET ranged from good to excellent for the different variables measured. The mean ± SD of the differences for the total number of saccades was 1.04 ± 4.01 and there was an observable difference (p = 0.005) in the trial number. There were no observable differences for the intervention (p = 0.768), gender (p = 0.121) and trial (p = 0.777) for average saccade’s velocity. The mean ± SD of the difference of the total fixations before and after intervention across both trials was 1.04 ± 3.63 and there was an observable difference in the trial number (p = 0.025). The mean ± SD of the differences for the Inter-Saccadic Interval and the fixation polyarea before and after intervention across both trials were 1.86 ± 22.99 msec and 0.51 ± 59.11 mm2 and no observable differences for the intervention, gender and trial. Conclusion The results provide evidence on the reliability of the K-D ET, and the eye-tracking components and demonstrate the relationship between completion time and other variables of the K-D ET system. This is vital as the use of the K-DT may be increasing and the combination of the K-DT and eye tracking as one single package highlights the need to specifically measure the reliability of this combined unit.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48104534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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