Pub Date : 2020-01-01DOI: 10.1177/2059700220975609
Georgia F Symons, M. Clough, W. O'brien, Joel Ernest, Sabrina Salberg, Daniel M Costello, Mujun Sun, R. Brady, S. McDonald, David K. Wright, O. White, L. Abel, T. O’Brien, J. Mccullough, Roxanne Aniceto, I. Lin, D. Agoston, J. Fielding, R. Mychasiuk, S. Shultz
Mild brain injuries are frequent in athletes engaging in collision sports and have been linked to a range of long-term neurological abnormalities. There is a need to identify how these potential abnormalities manifest using objective measures; determine whether changes are due to concussive and/or sub-concussive injuries; and examine how biological sex affects outcomes. This study investigated cognitive, cellular, and molecular biomarkers in male and female amateur Australian footballers (i.e. Australia’s most participated collision sport). 95 Australian footballers (69 males, 26 females), both with and without a history of concussion, as well as 49 control athletes (28 males, 21 females) with no history of brain trauma or participation in collision sports were recruited to the study. Ocular motor assessment was used to examine cognitive function. Telomere length, a biomarker of cellular senescence and neurological health, was examined in saliva. Serum levels of tau, phosphorylated tau, neurofilament light chain, and 4-hydroxynonenal were used as markers to assess axonal injury and oxidative stress. Australian footballers had reduced telomere length (p = 0.031) and increased serum protein levels of 4-hydroxynonenal (p = 0.001), tau (p = 0.007), and phosphorylated tau (p = 0.036). These findings were independent of concussion history and sex. No significant ocular motor differences were found. Taken together, these findings suggest that engagement in collision sports, regardless of sex or a history of concussion, is associated with shortened telomeres, axonal injury, and oxidative stress. These saliva- and serum-based biomarkers may be useful to monitor neurological injury in collision sport athletes.
{"title":"Shortened telomeres and serum protein biomarker abnormalities in collision sport athletes regardless of concussion history and sex","authors":"Georgia F Symons, M. Clough, W. O'brien, Joel Ernest, Sabrina Salberg, Daniel M Costello, Mujun Sun, R. Brady, S. McDonald, David K. Wright, O. White, L. Abel, T. O’Brien, J. Mccullough, Roxanne Aniceto, I. Lin, D. Agoston, J. Fielding, R. Mychasiuk, S. Shultz","doi":"10.1177/2059700220975609","DOIUrl":"https://doi.org/10.1177/2059700220975609","url":null,"abstract":"Mild brain injuries are frequent in athletes engaging in collision sports and have been linked to a range of long-term neurological abnormalities. There is a need to identify how these potential abnormalities manifest using objective measures; determine whether changes are due to concussive and/or sub-concussive injuries; and examine how biological sex affects outcomes. This study investigated cognitive, cellular, and molecular biomarkers in male and female amateur Australian footballers (i.e. Australia’s most participated collision sport). 95 Australian footballers (69 males, 26 females), both with and without a history of concussion, as well as 49 control athletes (28 males, 21 females) with no history of brain trauma or participation in collision sports were recruited to the study. Ocular motor assessment was used to examine cognitive function. Telomere length, a biomarker of cellular senescence and neurological health, was examined in saliva. Serum levels of tau, phosphorylated tau, neurofilament light chain, and 4-hydroxynonenal were used as markers to assess axonal injury and oxidative stress. Australian footballers had reduced telomere length (p = 0.031) and increased serum protein levels of 4-hydroxynonenal (p = 0.001), tau (p = 0.007), and phosphorylated tau (p = 0.036). These findings were independent of concussion history and sex. No significant ocular motor differences were found. Taken together, these findings suggest that engagement in collision sports, regardless of sex or a history of concussion, is associated with shortened telomeres, axonal injury, and oxidative stress. These saliva- and serum-based biomarkers may be useful to monitor neurological injury in collision sport athletes.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220975609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44893759","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 : 2020-01-01DOI: 10.1177/2059700220904821
{"title":"Thanks to Reviewers","authors":"","doi":"10.1177/2059700220904821","DOIUrl":"https://doi.org/10.1177/2059700220904821","url":null,"abstract":"","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220904821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46609475","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 : 2019-11-01DOI: 10.1177/2059700219886192
S. Bauman, Julie MacDonald, Carolyn Glatt, Iveta Doktor-Inglis, J. Mclean
Background Concussion patients who experience prolonged symptoms may benefit from evidence-based, physician-led, inter-disciplinary care. The success of this approach may depend on a patient’s understanding and adherence to a complex, multi-modal recovery process. Objectives We have developed a novel clinical care guide for post-injury concussion caretermed the “Treatment Passport,” intended to facilitate greater communication and understanding among patients, healthcare providers, family members, teachers, and coaches. This study aims to assess whether the Treatment Passport increases patients’ understanding of their concussion care in an inter-disciplinary setting. Methods Patients presenting with sports- or recreation-related concussions were randomly assigned to the intervention (n = 15) or control (n = 18) group. Subjects in the control group received physician-led, inter-disciplinary care, while subjects in the intervention group received the same care, but with the addition of the Treatment Passport. After four weeks of treatment, participants in both groups completed an 11-question survey to assess their understanding of inter-disciplinary concussion care. Results The median age of participants was 20 (range 10–63). Participants in the intervention group showed significant increases in their understanding of inter-disciplinary concussion care when compared to control group members. This was reflected in a 2.1–2.8-fold greater understanding of the cognitive, physical, and vestibular aspects of their care. In addition, 86.7% of control group participants indicated they believed that the Treatment Passport would have helped with their concussion recovery journey. Conclusion The Treatment Passport is a novel clinical tool that facilitates the delivery of standardized inter-disciplinary concussion care by increasing patient-caregiver communication and understanding.
{"title":"A novel clinical practice tool increases patients’ understanding of concussion care within an inter-disciplinary clinic","authors":"S. Bauman, Julie MacDonald, Carolyn Glatt, Iveta Doktor-Inglis, J. Mclean","doi":"10.1177/2059700219886192","DOIUrl":"https://doi.org/10.1177/2059700219886192","url":null,"abstract":"Background Concussion patients who experience prolonged symptoms may benefit from evidence-based, physician-led, inter-disciplinary care. The success of this approach may depend on a patient’s understanding and adherence to a complex, multi-modal recovery process. Objectives We have developed a novel clinical care guide for post-injury concussion caretermed the “Treatment Passport,” intended to facilitate greater communication and understanding among patients, healthcare providers, family members, teachers, and coaches. This study aims to assess whether the Treatment Passport increases patients’ understanding of their concussion care in an inter-disciplinary setting. Methods Patients presenting with sports- or recreation-related concussions were randomly assigned to the intervention (n = 15) or control (n = 18) group. Subjects in the control group received physician-led, inter-disciplinary care, while subjects in the intervention group received the same care, but with the addition of the Treatment Passport. After four weeks of treatment, participants in both groups completed an 11-question survey to assess their understanding of inter-disciplinary concussion care. Results The median age of participants was 20 (range 10–63). Participants in the intervention group showed significant increases in their understanding of inter-disciplinary concussion care when compared to control group members. This was reflected in a 2.1–2.8-fold greater understanding of the cognitive, physical, and vestibular aspects of their care. In addition, 86.7% of control group participants indicated they believed that the Treatment Passport would have helped with their concussion recovery journey. Conclusion The Treatment Passport is a novel clinical tool that facilitates the delivery of standardized inter-disciplinary concussion care by increasing patient-caregiver communication and understanding.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700219886192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43629948","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 : 2019-11-01DOI: 10.1177/2059700219889233
C. Rochefort, J. Cournoyer, A. Post, T. Hoshizaki, R. Zemek, H. Sveistrup
Background Balance impairments present in approximately 30% of concussion cases. Biomechanical reconstructions model the degree and location of brain tissue strain associated with injury. The objective was to examine the relationship between the magnitude and location of brain tissue strain and balance impairment following a concussion. Methods Children one month post-concussion (n = 33) and non-injured children (n = 33) completed two balance conditions while standing on a Wii Balance Board that recorded the centre of pressure during (i) double-leg stance with eyes closed (EC) and (ii) dual-task (DT) combining double-leg stance while completing a cognitive task. Injury reconstructions were performed for 10 of the concussed participants. A 5th percentile Hybrid III headform was used to obtain linear and rotational acceleration time-curves of the head impact. These data were input in the University College Dublin Brain Trauma Model (UCDBTM) to calculate maximum principal strains and cumulative strain damage values at 10% (CSDM-10) and 20% (CSDM-20) for different brain regions. Correlations between balance and reconstruction variables were calculated. Results Out of the 10 reconstructed cases, six participants had impaired balance on the EC condition, six had impaired balance on the DT condition and four had impaired balance on both the EC and DT conditions. For maximum principal strain values, correlations with balance variables ranged from −0.0190 to 0.394 for the DT condition and from −0.225 and 0.152 for the EC condition. For CSDM-10 values, correlations with balance variables ranged from 0.280 to 0.386 for the DT condition and from −0.103 to 0.252 for the EC condition. For CSDM-20 values, correlations with balance variables ranged from 0.0629 to 0.289 for the DT condition and from −0.353 to −0.155 for the EC condition. Conclusions Although a subset of the concussed participants continued to show balance impairments, no association was established between the presence of balance impairment and the magnitude and/or location of brain tissue strain. Maintaining balance is a complex process integrated into multiple subcortical regions, white matter tracts and cranial nerves, which were not represented in the brain model, and as a result the UCDBTM may not be sensitive to damage in these areas.
{"title":"Brain tissue strain and balance impairments in children following a concussion: An exploratory study","authors":"C. Rochefort, J. Cournoyer, A. Post, T. Hoshizaki, R. Zemek, H. Sveistrup","doi":"10.1177/2059700219889233","DOIUrl":"https://doi.org/10.1177/2059700219889233","url":null,"abstract":"Background Balance impairments present in approximately 30% of concussion cases. Biomechanical reconstructions model the degree and location of brain tissue strain associated with injury. The objective was to examine the relationship between the magnitude and location of brain tissue strain and balance impairment following a concussion. Methods Children one month post-concussion (n = 33) and non-injured children (n = 33) completed two balance conditions while standing on a Wii Balance Board that recorded the centre of pressure during (i) double-leg stance with eyes closed (EC) and (ii) dual-task (DT) combining double-leg stance while completing a cognitive task. Injury reconstructions were performed for 10 of the concussed participants. A 5th percentile Hybrid III headform was used to obtain linear and rotational acceleration time-curves of the head impact. These data were input in the University College Dublin Brain Trauma Model (UCDBTM) to calculate maximum principal strains and cumulative strain damage values at 10% (CSDM-10) and 20% (CSDM-20) for different brain regions. Correlations between balance and reconstruction variables were calculated. Results Out of the 10 reconstructed cases, six participants had impaired balance on the EC condition, six had impaired balance on the DT condition and four had impaired balance on both the EC and DT conditions. For maximum principal strain values, correlations with balance variables ranged from −0.0190 to 0.394 for the DT condition and from −0.225 and 0.152 for the EC condition. For CSDM-10 values, correlations with balance variables ranged from 0.280 to 0.386 for the DT condition and from −0.103 to 0.252 for the EC condition. For CSDM-20 values, correlations with balance variables ranged from 0.0629 to 0.289 for the DT condition and from −0.353 to −0.155 for the EC condition. Conclusions Although a subset of the concussed participants continued to show balance impairments, no association was established between the presence of balance impairment and the magnitude and/or location of brain tissue strain. Maintaining balance is a complex process integrated into multiple subcortical regions, white matter tracts and cranial nerves, which were not represented in the brain model, and as a result the UCDBTM may not be sensitive to damage in these areas.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700219889233","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43091436","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 : 2019-10-19DOI: 10.1177/2059700220941985
Victoria Waterworth, A. Procyk, E. Canetti, W. Hing, S. Gough
Objectives Concussions have emerged as one of the most prevalent and controversial injuries sustained within the sporting context. The objective of this review was to determine the influence that education has on decision making concerning athlete’s return to sport following a concussion injury and if the risk is worth it in the eyes of the athletes. Study design Systematic review. Methods A rapid literature review was performed in PubMed, CINAHL, SPORTDiscus, Embase and Web of Science looking for articles that discussed concussions and any three of the four following search terms: (a) decision making, (b) education/knowledge, (c) sport/return to sport and (d) risk. Results Sixteen of 1243 articles were included in this review based on eligibility criteria. Ten were cohort studies, four were cross-sectional studies and two were qualitative research. There was a good agreement between the authors for all studies when determining risk of bias, presenting a Cohen’s κ of 0.901 (95% CI, 0.834, 0.968), p < 0.001. Conclusion Education can make a difference in athlete’s decision making process to return to sport; however, their awareness of the health risks that they put themselves in by returning to sport too soon is clouded by other external and internal factors. What is not fully understood is why do they put themselves at this risk? Further studies should explore athletes’ risk aversion behaviour and how it impacts their decision to return to sport following a concussion.
目的脑震荡已成为体育运动中最常见和最具争议的损伤之一。这项审查的目的是确定教育对运动员脑震荡受伤后重返运动的决策的影响，以及这种风险在运动员眼中是否值得。研究设计系统回顾。方法在PubMed、CINAHL、SPORTDiscus、Embase和Web of Science上进行快速文献综述，寻找讨论脑震荡和以下四个搜索词中任何三个的文章：（A）决策，（b）教育/知识，（c）运动/重返运动和（d）风险。结果1243篇文章中有16篇根据资格标准纳入本次审查。10项为队列研究，4项为横断面研究，2项为定性研究。在确定偏倚风险时，所有研究的作者之间都有很好的一致性，Cohenκ为0.901（95%CI，0.834，0.968），p < 0.001.结论教育可以改变运动员重返体育运动的决策过程；然而，他们对过早重返体育运动所带来的健康风险的认识受到了其他外部和内部因素的影响。人们还不完全理解的是，他们为什么要把自己置于这种风险之中？进一步的研究应该探讨运动员的避险行为，以及它如何影响他们在脑震荡后重返赛场的决定。
{"title":"The influence of education in decision making concerning athlete’s return to sport following a concussion injury: A systematic review","authors":"Victoria Waterworth, A. Procyk, E. Canetti, W. Hing, S. Gough","doi":"10.1177/2059700220941985","DOIUrl":"https://doi.org/10.1177/2059700220941985","url":null,"abstract":"Objectives Concussions have emerged as one of the most prevalent and controversial injuries sustained within the sporting context. The objective of this review was to determine the influence that education has on decision making concerning athlete’s return to sport following a concussion injury and if the risk is worth it in the eyes of the athletes. Study design Systematic review. Methods A rapid literature review was performed in PubMed, CINAHL, SPORTDiscus, Embase and Web of Science looking for articles that discussed concussions and any three of the four following search terms: (a) decision making, (b) education/knowledge, (c) sport/return to sport and (d) risk. Results Sixteen of 1243 articles were included in this review based on eligibility criteria. Ten were cohort studies, four were cross-sectional studies and two were qualitative research. There was a good agreement between the authors for all studies when determining risk of bias, presenting a Cohen’s κ of 0.901 (95% CI, 0.834, 0.968), p < 0.001. Conclusion Education can make a difference in athlete’s decision making process to return to sport; however, their awareness of the health risks that they put themselves in by returning to sport too soon is clouded by other external and internal factors. What is not fully understood is why do they put themselves at this risk? Further studies should explore athletes’ risk aversion behaviour and how it impacts their decision to return to sport following a concussion.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700220941985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49584704","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 : 2019-08-01DOI: 10.1177/2059700219870920
Rebecca L. Mokris, A. Kessler, Kathleen Williams, John D. Ranney, J. Webster, K. Stauffer
Purpose To examine faculty and academic support staff members’ awareness and knowledge regarding concussions. Design Cross-sectional, web-based questionnaire. Setting Division II collegiate setting. Subjects A total of 123 collegiate faculty, administrative and academic support staff participated in the study. Measure(s): Participants completed the Faculty and Staff Concussion Awareness and Knowledge Survey. Analysis: Descriptive statistics were compiled for demographic information within the survey. Analysis of variance was performed on concussion awareness and concussion knowledge survey questions. Results The majority of the sample had teaching responsibilities in the University (75%). There was a significant effect of college departments within the university on individuals’ level of awareness (F (5, 117) = 9.74, p < .001). The Athletics department scored the highest in awareness of concussion symptomology, while the Business department scored the lowest. Females demonstrated significantly more awareness of concussion symptoms than males (F (1, 121) = 10.488, p = .002). University department significantly impacted knowledge of concussion treatments (F (5, 117) = 3.67, p < .004). The Health Sciences department scored the highest in knowledge of concussion treatments, while the Business department scored the lowest. Past experience with academic accommodations was associated with respondents’ knowledge of concussion treatment (F (1, 121) = 4.046, p = .047). Conclusions Concussion management in a collegiate setting should include the faculty and academic support staff. Colleges and Universities should consider educational programming regarding etiology and recovery from concussions for effective management when student experience a concussion.
{"title":"Assessing concussion knowledge and awareness in faculty and staff in a collegiate setting","authors":"Rebecca L. Mokris, A. Kessler, Kathleen Williams, John D. Ranney, J. Webster, K. Stauffer","doi":"10.1177/2059700219870920","DOIUrl":"https://doi.org/10.1177/2059700219870920","url":null,"abstract":"Purpose To examine faculty and academic support staff members’ awareness and knowledge regarding concussions. Design Cross-sectional, web-based questionnaire. Setting Division II collegiate setting. Subjects A total of 123 collegiate faculty, administrative and academic support staff participated in the study. Measure(s): Participants completed the Faculty and Staff Concussion Awareness and Knowledge Survey. Analysis: Descriptive statistics were compiled for demographic information within the survey. Analysis of variance was performed on concussion awareness and concussion knowledge survey questions. Results The majority of the sample had teaching responsibilities in the University (75%). There was a significant effect of college departments within the university on individuals’ level of awareness (F (5, 117) = 9.74, p < .001). The Athletics department scored the highest in awareness of concussion symptomology, while the Business department scored the lowest. Females demonstrated significantly more awareness of concussion symptoms than males (F (1, 121) = 10.488, p = .002). University department significantly impacted knowledge of concussion treatments (F (5, 117) = 3.67, p < .004). The Health Sciences department scored the highest in knowledge of concussion treatments, while the Business department scored the lowest. Past experience with academic accommodations was associated with respondents’ knowledge of concussion treatment (F (1, 121) = 4.046, p = .047). Conclusions Concussion management in a collegiate setting should include the faculty and academic support staff. Colleges and Universities should consider educational programming regarding etiology and recovery from concussions for effective management when student experience a concussion.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700219870920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43744680","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 : 2019-03-01DOI: 10.1177/2059700219839588
Stephanie L Green, M. Keightley, N. Lobaugh, D. Dawson, Alex Mihailidis
Background Concussion represents a growing concern in sports participation for adults and youth alike. Studies exploring the neurocognitive sequelae of concussion, such as speed of processing typically compare mean reaction time scores to a control group. Intraindividual variability measures the consistency of reaction times between trials and has been previously explored in adults post-concussion. Some adult studies show increased variability following injury. Developmentally youth show higher intraindividual variability than adults, which may put them at higher risk of increased intraindividual variability change post-concussion. Exploring intraindividual variability may provide additional insight into fluctuating performance reported following injury. Despite preliminary findings of slowed reaction time in youth, a pre-/post-concussion comparison of intraindividual variability of reaction time has not been explored. Objective To describe and compare pre- and post-concussion measures of processing speed and intraindividual variability in youth. Methods A pre-/post-concussion design was used to compare mean reaction time and the coefficient of variation before and after sports-related concussion in 18 youth athletes aged 10–14 years using verbal and nonverbal working memory tasks. Pre-/post-concussion reaction time and coefficient of variation were compared using t-tests. Results The coefficient of variation for nonverbal working memory was significantly higher following concussion, but no changes in average reaction time were found. Conclusions Preliminary findings suggest that average response times are unchanged following concussion, but the fluctuation across response times is more variable during a nonverbal working memory task in youth. Increased variability in speed of reaction times could have implications for safe return to sports and reduced academic performance.
{"title":"Exploring changes in processing speed and intraindividual variability in youth following sports-related concussion","authors":"Stephanie L Green, M. Keightley, N. Lobaugh, D. Dawson, Alex Mihailidis","doi":"10.1177/2059700219839588","DOIUrl":"https://doi.org/10.1177/2059700219839588","url":null,"abstract":"Background Concussion represents a growing concern in sports participation for adults and youth alike. Studies exploring the neurocognitive sequelae of concussion, such as speed of processing typically compare mean reaction time scores to a control group. Intraindividual variability measures the consistency of reaction times between trials and has been previously explored in adults post-concussion. Some adult studies show increased variability following injury. Developmentally youth show higher intraindividual variability than adults, which may put them at higher risk of increased intraindividual variability change post-concussion. Exploring intraindividual variability may provide additional insight into fluctuating performance reported following injury. Despite preliminary findings of slowed reaction time in youth, a pre-/post-concussion comparison of intraindividual variability of reaction time has not been explored. Objective To describe and compare pre- and post-concussion measures of processing speed and intraindividual variability in youth. Methods A pre-/post-concussion design was used to compare mean reaction time and the coefficient of variation before and after sports-related concussion in 18 youth athletes aged 10–14 years using verbal and nonverbal working memory tasks. Pre-/post-concussion reaction time and coefficient of variation were compared using t-tests. Results The coefficient of variation for nonverbal working memory was significantly higher following concussion, but no changes in average reaction time were found. Conclusions Preliminary findings suggest that average response times are unchanged following concussion, but the fluctuation across response times is more variable during a nonverbal working memory task in youth. Increased variability in speed of reaction times could have implications for safe return to sports and reduced academic performance.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700219839588","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45416846","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 : 2019-01-01DOI: 10.1177/2059700219878291
Marie-Ève Gagné, B. McFadyen, I. Cossette, P. Fait, I. Gagnon, Katia Sirois, S. Blanchet, N. Le Sage, M. Ouellet
Objectives To compare dual-task performance involving different cognitive-locomotor combinations between healthy controls and participants with sub-acute mild traumatic brain injury (mTBI) and to correlate dual-task performances to history of prior head injuries. Methods Eighteen participants having recently sustained mTBI and 15 controls performed nine dual-tasks combining locomotor (level-walking, narrow obstacle, deep obstacle) and cognitive (Stroop task, Verbal fluency, Counting backwards) tasks. Previous history of concussion was also investigated. Results Slower gait speeds were observed in the mTBI group compared to controls during both single and dual-tasks. Longer response times to cognitive tasks in the mTBI group further suggested the presence of residual impairments two months following injury. No combination of dual-task was more sensitive. Correlations were observed between history of mTBI and several measures of dual-task performance, underlying the need to further consider the effects of multiple injuries in relation to dual-task walking. Conclusion Dual-tasks using simultaneously locomotor and cognitive functions represent an ecological way for clinicians to detect residual, but subtle, alterations post-mTBI. History of previous mTBI needs to be considered as a personal characteristic which may influence dual-task walking performance.
{"title":"Alterations in dual-task walking persist two months after mild traumatic brain injury in young adults","authors":"Marie-Ève Gagné, B. McFadyen, I. Cossette, P. Fait, I. Gagnon, Katia Sirois, S. Blanchet, N. Le Sage, M. Ouellet","doi":"10.1177/2059700219878291","DOIUrl":"https://doi.org/10.1177/2059700219878291","url":null,"abstract":"Objectives To compare dual-task performance involving different cognitive-locomotor combinations between healthy controls and participants with sub-acute mild traumatic brain injury (mTBI) and to correlate dual-task performances to history of prior head injuries. Methods Eighteen participants having recently sustained mTBI and 15 controls performed nine dual-tasks combining locomotor (level-walking, narrow obstacle, deep obstacle) and cognitive (Stroop task, Verbal fluency, Counting backwards) tasks. Previous history of concussion was also investigated. Results Slower gait speeds were observed in the mTBI group compared to controls during both single and dual-tasks. Longer response times to cognitive tasks in the mTBI group further suggested the presence of residual impairments two months following injury. No combination of dual-task was more sensitive. Correlations were observed between history of mTBI and several measures of dual-task performance, underlying the need to further consider the effects of multiple injuries in relation to dual-task walking. Conclusion Dual-tasks using simultaneously locomotor and cognitive functions represent an ecological way for clinicians to detect residual, but subtle, alterations post-mTBI. History of previous mTBI needs to be considered as a personal characteristic which may influence dual-task walking performance.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700219878291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48767411","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 : 2019-01-01DOI: 10.1177/2059700219878292
J. A. Charles
Objective To report the observed effect of erenumab in mild posttraumatic headache migraine phenotype with and without aura. Background There is no clinical algorithm of pharmacotherapy for migraine following posttraumatic headache. Most migraine preventatives that are typically used are either ineffective or not tolerated. Methods Seven patients who met the clinical criteria for migraine with or without aura following posttraumatic headache who failed or were intolerant of conventional migraine preventatives were treated with erenumab 140 mg subcutaneously. Most had no history of migraine. In those patients with a history of migraine, the posttraumatic headache migraine headaches were different than the past migraine experience. Descriptive headache intensity or disability using the Head Impact Test-6 and monthly headache days were recorded before and after treatment. All patients were debilitated on presentation and demonstrated no signs of spontaneous resolution. Results Patients responded with a 95% (SD 1.22, p < .001) reduction in headache days. All Head Impact Test-6 scores went from disabling to non-disabling without adverse effects. Most required only one dose of erenumab with no migraine recurrence. Onset of efficacy often became apparent within days to four weeks. Extended follow-up six months after treatment revealed no relapses. Conclusions Erenumab is effective in the treatment of posttraumatic headache with migraine phenotype in this small cohort. Large-scale studies are urgently required for this highly prevalent, disabling, condition which has no effective established treatment.
{"title":"Treatment of posttraumatic headache migraine phenotype with erenumab – An observational study","authors":"J. A. Charles","doi":"10.1177/2059700219878292","DOIUrl":"https://doi.org/10.1177/2059700219878292","url":null,"abstract":"Objective To report the observed effect of erenumab in mild posttraumatic headache migraine phenotype with and without aura. Background There is no clinical algorithm of pharmacotherapy for migraine following posttraumatic headache. Most migraine preventatives that are typically used are either ineffective or not tolerated. Methods Seven patients who met the clinical criteria for migraine with or without aura following posttraumatic headache who failed or were intolerant of conventional migraine preventatives were treated with erenumab 140 mg subcutaneously. Most had no history of migraine. In those patients with a history of migraine, the posttraumatic headache migraine headaches were different than the past migraine experience. Descriptive headache intensity or disability using the Head Impact Test-6 and monthly headache days were recorded before and after treatment. All patients were debilitated on presentation and demonstrated no signs of spontaneous resolution. Results Patients responded with a 95% (SD 1.22, p < .001) reduction in headache days. All Head Impact Test-6 scores went from disabling to non-disabling without adverse effects. Most required only one dose of erenumab with no migraine recurrence. Onset of efficacy often became apparent within days to four weeks. Extended follow-up six months after treatment revealed no relapses. Conclusions Erenumab is effective in the treatment of posttraumatic headache with migraine phenotype in this small cohort. Large-scale studies are urgently required for this highly prevalent, disabling, condition which has no effective established treatment.","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700219878292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47763686","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 : 2019-01-01DOI: 10.1177/2059700219861863
Kelly Sarmiento, Zoe Donnell, Elizabeth Bell, Bethany Tennant, Rosanne Hoffman
Background: Concussion, a commonly reported injury among young athletes, can lead to short- and long-term physical, cognitive, emotional, and sleep-related symptoms. Parents are in a unique position to help identify a possible concussion and to support an athlete's recovery.
Methods: This qualitative study used a focus group methodology to explore five research questions focused on two main topics: (1) parents' perception of concussion and (2) parent-athlete communication. Two authors independently reviewed notes from each of the focus groups and then generated a list of emerging themes related to five research questions.
Results: Parents in this study valued and were interested in discussing concussion with their athletes. However, parents were uncertain about their role in promoting concussion safety and often rely on coaches to communicate with athletes about concussion reporting and recovery. Participants described barriers their athletes may face in concussion reporting and suggested strategies to improve communication about both reporting and recovery.
Conclusion: Concussion education efforts may benefit from promoting specific actions parents can take to prevent concussion and how to communicate effectively with their child about reporting a possible concussion.
{"title":"A qualitative study of barriers and opportunities for concussion communication and management among parents of youth sports athletes.","authors":"Kelly Sarmiento, Zoe Donnell, Elizabeth Bell, Bethany Tennant, Rosanne Hoffman","doi":"10.1177/2059700219861863","DOIUrl":"https://doi.org/10.1177/2059700219861863","url":null,"abstract":"<p><strong>Background: </strong>Concussion, a commonly reported injury among young athletes, can lead to short- and long-term physical, cognitive, emotional, and sleep-related symptoms. Parents are in a unique position to help identify a possible concussion and to support an athlete's recovery.</p><p><strong>Methods: </strong>This qualitative study used a focus group methodology to explore five research questions focused on two main topics: (1) parents' perception of concussion and (2) parent-athlete communication. Two authors independently reviewed notes from each of the focus groups and then generated a list of emerging themes related to five research questions.</p><p><strong>Results: </strong>Parents in this study valued and were interested in discussing concussion with their athletes. However, parents were uncertain about their role in promoting concussion safety and often rely on coaches to communicate with athletes about concussion reporting and recovery. Participants described barriers their athletes may face in concussion reporting and suggested strategies to improve communication about both reporting and recovery.</p><p><strong>Conclusion: </strong>Concussion education efforts may benefit from promoting specific actions parents can take to prevent concussion and how to communicate effectively with their child about reporting a possible concussion.</p>","PeriodicalId":92541,"journal":{"name":"Journal of concussion","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059700219861863","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37867235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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