Pub Date : 2019-01-01DOI: 10.1177/2059700219894104
Jeffrey J. Milroy, D. Wyrick, Lindsey Sanders, Erin Refisteck, E. Beamon
Background Between 1.6 and 3.8 million sports- and recreation-related concussions occur in the United States annually. Reports indicate that a significant number of athletes who have experienced symptoms of a potential sport-related concussion did not disclose their symptoms. Aims The purpose of this study was to investigate the impact of coach communication about concussion disclosure on student-athlete intentions to disclose symptoms of a concussion and encourage another student-athlete to disclose their concussion symptoms. Methods A total of 2881 student-athletes completed a web-based survey during Fall of 2016. Multiple linear regression was conducted to primarily investigate the relationship between coach communication and intentions to disclose concussion symptoms. Secondarily, biological sex, year in school, athletic division, and sport category was also assessed. Results Coach communication predicted greater intentions to disclose symptoms to their coach, athletic trainer/sports medicine sports medicine staff member and encourage another athlete to disclose their symptoms of a concussion. Biological sex and sport category also predicted intentions to disclose concussion symptoms. Discussion Findings from this study provide support for the important role coaches play in an athlete’s regarding concussion safety and introduces preliminary evidence suggesting the impact of coach communication on athlete intentions to disclose concussion symptoms to a coach or athletic trainer/sports medicine staff member. Conclusion Future studies and behavioral interventions ought to consider the inclusion of coach communication or other coach-related variables when exploring concussion disclosure among athletes.
{"title":"Student-athlete concussion disclosure and coach communication within collegiate athletics","authors":"Jeffrey J. Milroy, D. Wyrick, Lindsey Sanders, Erin Refisteck, E. Beamon","doi":"10.1177/2059700219894104","DOIUrl":"https://doi.org/10.1177/2059700219894104","url":null,"abstract":"Background Between 1.6 and 3.8 million sports- and recreation-related concussions occur in the United States annually. Reports indicate that a significant number of athletes who have experienced symptoms of a potential sport-related concussion did not disclose their symptoms. Aims The purpose of this study was to investigate the impact of coach communication about concussion disclosure on student-athlete intentions to disclose symptoms of a concussion and encourage another student-athlete to disclose their concussion symptoms. Methods A total of 2881 student-athletes completed a web-based survey during Fall of 2016. Multiple linear regression was conducted to primarily investigate the relationship between coach communication and intentions to disclose concussion symptoms. Secondarily, biological sex, year in school, athletic division, and sport category was also assessed. Results Coach communication predicted greater intentions to disclose symptoms to their coach, athletic trainer/sports medicine sports medicine staff member and encourage another athlete to disclose their symptoms of a concussion. Biological sex and sport category also predicted intentions to disclose concussion symptoms. Discussion Findings from this study provide support for the important role coaches play in an athlete’s regarding concussion safety and introduces preliminary evidence suggesting the impact of coach communication on athlete intentions to disclose concussion symptoms to a coach or athletic trainer/sports medicine staff member. Conclusion Future studies and behavioral interventions ought to consider the inclusion of coach communication or other coach-related variables when exploring concussion disclosure among athletes.","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/10.1177/2059700219894104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48831009","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: 10.1177/2059700219894108
T. Susa, Ryan D Brandt, K. Kangas, Cathy E. Bammert, Erich N. Ottem, Marguerite T Moore, Joshua M. Carlson
Brain-derived neurotrophic factor (BDNF) helps restore neuronal function following mild traumatic brain injury. BDNF levels can be obtained in blood serum and more recently in saliva. However, the relationship between serum and salivary BDNF is poorly understood—especially in relation to alterations in BDNF levels following mild traumatic brain injury. In this study, serum and salivary BDNF were collected from a sample of 42 collegiate student athletes. Half of the participants were recently cleared by a physician and/or an athletic trainer to return-to-play after experiencing a sports-related concussion. The other half had not experienced a concussion within the past year and were matched by age, sex, sport, and time of sample. Results suggest that incidences of depression, anxiety, and stress were all elevated in the concussion group, relative to the control participants. When controlling for stress-related negative affect, serum BDNF was elevated in the concussion group. However, there was no difference in salivary BDNF. Serum and salivary BDNF were uncorrelated across the entire sample. Yet, these measures of BDNF were correlated in the concussion group, but not the control group. In sum, serum BDNF is elevated in concussion post return-to-play; however, further research is needed to explore the utility of salivary BDNF following concussion.
{"title":"Elevated levels of serum, but not salivary, brain-derived neurotrophic factor following mild traumatic brain injury in collegiate athletes post return-to-play","authors":"T. Susa, Ryan D Brandt, K. Kangas, Cathy E. Bammert, Erich N. Ottem, Marguerite T Moore, Joshua M. Carlson","doi":"10.1177/2059700219894108","DOIUrl":"https://doi.org/10.1177/2059700219894108","url":null,"abstract":"Brain-derived neurotrophic factor (BDNF) helps restore neuronal function following mild traumatic brain injury. BDNF levels can be obtained in blood serum and more recently in saliva. However, the relationship between serum and salivary BDNF is poorly understood—especially in relation to alterations in BDNF levels following mild traumatic brain injury. In this study, serum and salivary BDNF were collected from a sample of 42 collegiate student athletes. Half of the participants were recently cleared by a physician and/or an athletic trainer to return-to-play after experiencing a sports-related concussion. The other half had not experienced a concussion within the past year and were matched by age, sex, sport, and time of sample. Results suggest that incidences of depression, anxiety, and stress were all elevated in the concussion group, relative to the control participants. When controlling for stress-related negative affect, serum BDNF was elevated in the concussion group. However, there was no difference in salivary BDNF. Serum and salivary BDNF were uncorrelated across the entire sample. Yet, these measures of BDNF were correlated in the concussion group, but not the control group. In sum, serum BDNF is elevated in concussion post return-to-play; however, further research is needed to explore the utility of salivary BDNF following concussion.","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/10.1177/2059700219894108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43229870","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: 10.1177/2059700219870685
D. Bailey
In an article in the Janurary 2013 issue of The Journal of Trauma and Acute Care Surgery, a line in the abstract (p. 69) requires correction. The penultimate sentence of the results section should read: ‘‘Mortality was significantly lower in the patients that received incompatible plasma during if concurrent with a massive transfusion (8% vs 40%, p=0.044).’’ This error has been noted in the online version of the article, which is available at www.jtrauma.com.
{"title":"Corrigendum","authors":"D. Bailey","doi":"10.1177/2059700219870685","DOIUrl":"https://doi.org/10.1177/2059700219870685","url":null,"abstract":"In an article in the Janurary 2013 issue of The Journal of Trauma and Acute Care Surgery, a line in the abstract (p. 69) requires correction. The penultimate sentence of the results section should read: ‘‘Mortality was significantly lower in the patients that received incompatible plasma during if concurrent with a massive transfusion (8% vs 40%, p=0.044).’’ This error has been noted in the online version of the article, which is available at www.jtrauma.com.","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/10.1177/2059700219870685","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43127706","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: 10.1177/2059700219861200
G. Jackson, M. Makdissi, M. Pedersen, D. Parker, E. Curwood, S. Farquharson, A. Connelly, D. Abbott, P. McCrory
Aim To determine whether acute sport-related concussion is associated with functional brain changes in Australian rules footballers. Methods Twenty acutely concussed professional Australian footballers were studied with 3 T magnetic resonance imaging and compared to 20 age-matched control subjects. We statistically compared whole-brain local functional magnetic resonance imaging connectivity between acutely concussed footballers and controls using voxel-wise permutation testing. Results The acutely concussed football players had significantly decreased local functional magnetic resonance imaging connectivity in the right dorsolateral prefrontal cortex, right inferior parietal lobe, and right anterior insula, compared to controls. No functional brain changes between groups within the default mode network were observed. Discussion Acutely concussed footballers had in common decreased functional connectivity within the right lateralized “cognitive control network” of the brain that is involved in executive functions, and the “salience network” involved in switching between tasks. Dysfunction of these brain regions is a plausible explanation for typical clinical features of concussion.
{"title":"Functional brain effects of acute concussion in Australian rules football players","authors":"G. Jackson, M. Makdissi, M. Pedersen, D. Parker, E. Curwood, S. Farquharson, A. Connelly, D. Abbott, P. McCrory","doi":"10.1177/2059700219861200","DOIUrl":"https://doi.org/10.1177/2059700219861200","url":null,"abstract":"Aim To determine whether acute sport-related concussion is associated with functional brain changes in Australian rules footballers. Methods Twenty acutely concussed professional Australian footballers were studied with 3 T magnetic resonance imaging and compared to 20 age-matched control subjects. We statistically compared whole-brain local functional magnetic resonance imaging connectivity between acutely concussed footballers and controls using voxel-wise permutation testing. Results The acutely concussed football players had significantly decreased local functional magnetic resonance imaging connectivity in the right dorsolateral prefrontal cortex, right inferior parietal lobe, and right anterior insula, compared to controls. No functional brain changes between groups within the default mode network were observed. Discussion Acutely concussed footballers had in common decreased functional connectivity within the right lateralized “cognitive control network” of the brain that is involved in executive functions, and the “salience network” involved in switching between tasks. Dysfunction of these brain regions is a plausible explanation for typical clinical features of concussion.","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/10.1177/2059700219861200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43559996","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: 10.1177/2059700219882876
C. Foster, Christopher J D'Lauro, Brian R. Johnson
Under-reporting of concussions is a well-known public health problem. Unfortunately, concussion researchers and practitioners do not have an explicit theoretical foundation for understanding the psychology of concussion non-disclosure. We used interdependence theory, a theory based on the structure of social relationships, to develop a social dilemma model of personal information non-disclosure and apply it to the concussion domain. Self-disclosure becomes problematic when individuals perceive a need to report their concussions but also perceive that disclosure could be detrimental in some way. Individuals who experience these disclosure dilemmas can evaluate the value of concussion self-disclosure using direct outcomes (e.g. losing scholarships, improved recovery), self-concept outcomes (e.g. viewing disclosure as “weak” or “sensible”), and social status outcomes (e.g. being perceived poorly or favorably by teammates). These immediate, personal outcomes are integrated with relationship-specific motives and ethical considerations ultimately leading to disclosure or non-disclosure. Providing an explicit theoretical basis for self-disclosure dilemmas is critical for understanding concussion non-disclosure and mitigating its corresponding harm. Our social dilemma model highlights (a) the foundational psychological basis for concussion non-disclosure, (b) possible reasons that initiatives designed to increase concussion disclosure have been ineffective, and (c) the need to consider the decision-making autonomy of concussed individuals. Although we explain our social dilemma model using concussion self-reporting, we believe that this model is applicable to any domain where individuals are reluctant to disclose personal information to others who need it.
{"title":"A social dilemma model of information self-disclosure, applied to the concussion domain","authors":"C. Foster, Christopher J D'Lauro, Brian R. Johnson","doi":"10.1177/2059700219882876","DOIUrl":"https://doi.org/10.1177/2059700219882876","url":null,"abstract":"Under-reporting of concussions is a well-known public health problem. Unfortunately, concussion researchers and practitioners do not have an explicit theoretical foundation for understanding the psychology of concussion non-disclosure. We used interdependence theory, a theory based on the structure of social relationships, to develop a social dilemma model of personal information non-disclosure and apply it to the concussion domain. Self-disclosure becomes problematic when individuals perceive a need to report their concussions but also perceive that disclosure could be detrimental in some way. Individuals who experience these disclosure dilemmas can evaluate the value of concussion self-disclosure using direct outcomes (e.g. losing scholarships, improved recovery), self-concept outcomes (e.g. viewing disclosure as “weak” or “sensible”), and social status outcomes (e.g. being perceived poorly or favorably by teammates). These immediate, personal outcomes are integrated with relationship-specific motives and ethical considerations ultimately leading to disclosure or non-disclosure. Providing an explicit theoretical basis for self-disclosure dilemmas is critical for understanding concussion non-disclosure and mitigating its corresponding harm. Our social dilemma model highlights (a) the foundational psychological basis for concussion non-disclosure, (b) possible reasons that initiatives designed to increase concussion disclosure have been ineffective, and (c) the need to consider the decision-making autonomy of concussed individuals. Although we explain our social dilemma model using concussion self-reporting, we believe that this model is applicable to any domain where individuals are reluctant to disclose personal information to others who need it.","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/10.1177/2059700219882876","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47872505","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: 10.1177/2059700219838654
C. Thibeault, S. Thorpe, N. Canac, M. O'Brien, Mina Ranjbaran, S. Wilk, R. Hamilton
There is an unquestionable need for quantitative biomarkers of mild traumatic brain injuries. Something that is particularly true for adolescents – where the recovery from these injuries is still poorly understood. However, within this population, it is clear that the vasculature is distinctly affected by a mild traumatic brain injury. In addition, our group recently demonstrated how that effect appears to show a progression of alterations similar but in contrast to that found in severe traumatic injuries. Through measuring an adolescent population with transcranial Doppler ultrasound during a hypercapnia challenge, multiple phases of hemodynamic dysfunction were suggested. Here, we create a generalized model of the hemodynamic responses by fitting a set of inverse models to the dominant features from that work. The resulting model helps define the multiple phases of hemodynamic recovery after a mild traumatic brain injury. This can eventually be generalized, potentially providing a diagnostic tool for clinicians tracking patient’s recovery, and ultimately, resulting in more informed decisions and better outcomes.
{"title":"A model of longitudinal hemodynamic alterations after mild traumatic brain injury in adolescents","authors":"C. Thibeault, S. Thorpe, N. Canac, M. O'Brien, Mina Ranjbaran, S. Wilk, R. Hamilton","doi":"10.1177/2059700219838654","DOIUrl":"https://doi.org/10.1177/2059700219838654","url":null,"abstract":"There is an unquestionable need for quantitative biomarkers of mild traumatic brain injuries. Something that is particularly true for adolescents – where the recovery from these injuries is still poorly understood. However, within this population, it is clear that the vasculature is distinctly affected by a mild traumatic brain injury. In addition, our group recently demonstrated how that effect appears to show a progression of alterations similar but in contrast to that found in severe traumatic injuries. Through measuring an adolescent population with transcranial Doppler ultrasound during a hypercapnia challenge, multiple phases of hemodynamic dysfunction were suggested. Here, we create a generalized model of the hemodynamic responses by fitting a set of inverse models to the dominant features from that work. The resulting model helps define the multiple phases of hemodynamic recovery after a mild traumatic brain injury. This can eventually be generalized, potentially providing a diagnostic tool for clinicians tracking patient’s recovery, and ultimately, resulting in more informed decisions and better outcomes.","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/10.1177/2059700219838654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44758583","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: 10.1177/2059700219886190
D. Davies, K. Yakoub, Ugo Scarpa, Connor Bentley, M. Grey, D. Hammond, V. Sawlani, A. Belli, V. Di Pietro
Establishing a diagnosis of concussion within the context of competitive sport is frequently difficult due to the heterogeneity of presentation. Over the years, many endogenous proteins, including the recent Food and Drug Administration approved for mild-to-moderate traumatic brain injury, glial fibrillary acid protein and ubiquitin carboxy-terminal hydrolase, have been studied as potential biomarkers for the diagnosis of mild traumatic brain injury. Recently, a new class of potential biomarkers, the microRNAs, has shown promise as indicators of traumatic brain injury. In this pilot study, we have analysed the ability of pre-validated serum microRNAs (mi-425-5p and miR-502) to diagnose concussion, in cases without structural pathology. Their performance has been assessed alongside a set of identified protein biomarkers for traumatic brain injury in cohort of 41 concussed athletes. Athletes with a confirmed concussion underwent blood sampling after 48 h from concussion along with magnetic resonance imaging. Serum mi-425-5p and miR-502 were analysed by quantitative reverse transcription polymerase chain reaction, and digital immunoassay was used to determine serum concentrations of ubiquitin carboxy-terminal hydrolase, glial fibrillary acid protein, neurofilament light and Tau. Results were matched with 15 healthy volunteers. No structural/haemorrhagic pathology was identified. Protein biomarkers demonstrated variability among groups reflecting previous performance in the literature. Neurofilament light was the only marker to positively correlate with symptoms reported and SCAT5 scores. Despite the sub optimal timing of sampling beyond the optimal window for many of the protein biomarkers measured, miR-502 was significantly downregulated at all time points within a week form concussion ictus, showing a diagnostic sensitivity in cases beyond 48 h and without structural pathology.
{"title":"Serum miR-502: A potential biomarker in the diagnosis of concussion in a pilot study of patients with normal structural brain imaging","authors":"D. Davies, K. Yakoub, Ugo Scarpa, Connor Bentley, M. Grey, D. Hammond, V. Sawlani, A. Belli, V. Di Pietro","doi":"10.1177/2059700219886190","DOIUrl":"https://doi.org/10.1177/2059700219886190","url":null,"abstract":"Establishing a diagnosis of concussion within the context of competitive sport is frequently difficult due to the heterogeneity of presentation. Over the years, many endogenous proteins, including the recent Food and Drug Administration approved for mild-to-moderate traumatic brain injury, glial fibrillary acid protein and ubiquitin carboxy-terminal hydrolase, have been studied as potential biomarkers for the diagnosis of mild traumatic brain injury. Recently, a new class of potential biomarkers, the microRNAs, has shown promise as indicators of traumatic brain injury. In this pilot study, we have analysed the ability of pre-validated serum microRNAs (mi-425-5p and miR-502) to diagnose concussion, in cases without structural pathology. Their performance has been assessed alongside a set of identified protein biomarkers for traumatic brain injury in cohort of 41 concussed athletes. Athletes with a confirmed concussion underwent blood sampling after 48 h from concussion along with magnetic resonance imaging. Serum mi-425-5p and miR-502 were analysed by quantitative reverse transcription polymerase chain reaction, and digital immunoassay was used to determine serum concentrations of ubiquitin carboxy-terminal hydrolase, glial fibrillary acid protein, neurofilament light and Tau. Results were matched with 15 healthy volunteers. No structural/haemorrhagic pathology was identified. Protein biomarkers demonstrated variability among groups reflecting previous performance in the literature. Neurofilament light was the only marker to positively correlate with symptoms reported and SCAT5 scores. Despite the sub optimal timing of sampling beyond the optimal window for many of the protein biomarkers measured, miR-502 was significantly downregulated at all time points within a week form concussion ictus, showing a diagnostic sensitivity in cases beyond 48 h and without structural pathology.","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/10.1177/2059700219886190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48433326","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: 10.1177/2059700219860641
Thomas S Owens, G. Rose, Christopher J. Marley, Thomas A. Calverley, B. Stacey, P. Williams, John P. Williams, D. Bailey
Introduction Concussion is regularly observed in rugby union and has generated a growing public health concern, yet remains one of the least understood injuries facing the sports medicine community. Evidence suggests that multiple concussions may increase susceptibility to long-term neurological complications that present decades after the initial injury for reasons that remain unclear. We aimed to determine the incidence rate and risk factors for concussion amongst community-level rugby union-15s players active during the 1980s given that it may help to better understand the risks and mechanisms of injury. Methods Injury data were collected from clubs by the coach at the time of injury in players using a 15-item questionnaire (1982–1984). Results Seventy games were recorded throughout 1982–1983 and 1983–1984 rugby union seasons. Forty-two documented concussions accounted for ∼6% of injuries corresponding to an incidence rate of 0.64 per 1000 playing hours, more than a third lower than the ‘modern-day’ equivalent. Tackling (relative risk 1.60, p < 0.05), collisions (relative risk 0.95, p < 0.05) and gum shield use (relative risk 1.69, p < 0.05) were independently associated with concussion whereas no associations were observed for ground condition, quarter of play or players playing out of position (p > 0.05). Conclusion Despite limitations due to the retrospective focus and reliance on questionnaire data notwithstanding raised awareness of concussion, the incidence rate of concussion during the 1980s appears to be appreciably lower compared to the present-day game. This is the likely outcome of improvements in the clinical understanding of concussion, data collection tools, reporting methods and clinical management of concussive injuries, including changes to both player and game. However, the findings of this study help better understand the risks and mechanisms of injury once encountered by rugby union players active during the 1980s, of which some of those risks are still apparent.
{"title":"The changing nature of concussion in rugby union: Looking back to look forward","authors":"Thomas S Owens, G. Rose, Christopher J. Marley, Thomas A. Calverley, B. Stacey, P. Williams, John P. Williams, D. Bailey","doi":"10.1177/2059700219860641","DOIUrl":"https://doi.org/10.1177/2059700219860641","url":null,"abstract":"Introduction Concussion is regularly observed in rugby union and has generated a growing public health concern, yet remains one of the least understood injuries facing the sports medicine community. Evidence suggests that multiple concussions may increase susceptibility to long-term neurological complications that present decades after the initial injury for reasons that remain unclear. We aimed to determine the incidence rate and risk factors for concussion amongst community-level rugby union-15s players active during the 1980s given that it may help to better understand the risks and mechanisms of injury. Methods Injury data were collected from clubs by the coach at the time of injury in players using a 15-item questionnaire (1982–1984). Results Seventy games were recorded throughout 1982–1983 and 1983–1984 rugby union seasons. Forty-two documented concussions accounted for ∼6% of injuries corresponding to an incidence rate of 0.64 per 1000 playing hours, more than a third lower than the ‘modern-day’ equivalent. Tackling (relative risk 1.60, p < 0.05), collisions (relative risk 0.95, p < 0.05) and gum shield use (relative risk 1.69, p < 0.05) were independently associated with concussion whereas no associations were observed for ground condition, quarter of play or players playing out of position (p > 0.05). Conclusion Despite limitations due to the retrospective focus and reliance on questionnaire data notwithstanding raised awareness of concussion, the incidence rate of concussion during the 1980s appears to be appreciably lower compared to the present-day game. This is the likely outcome of improvements in the clinical understanding of concussion, data collection tools, reporting methods and clinical management of concussive injuries, including changes to both player and game. However, the findings of this study help better understand the risks and mechanisms of injury once encountered by rugby union players active during the 1980s, of which some of those risks are still apparent.","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/10.1177/2059700219860641","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44266334","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: 10.1177/2059700219872673
K. Sullivan, L. Billing
This study tested the effect of issuing return-to-activity advice on activity intentions at Day 2 and Day 10 days post simulated mild traumatic brain injury. One hundred and twenty-eight volunteers were randomly allocated to one of two groups who received (n = 65) or did not receive standardized post-injury advice (n = 63). To prime the simulation, the participants read a mild traumatic brain injury vignette about a person who is concussed while playing sport. Then the participants role-played the injured person and reported activity intentions for three activity types (cognitive, physical and restful) twice, once for each time frame (i.e. Day 2 and Day 10). The advice was to rest for the first 24–48 h and then gradually resume normal activities. There was no significant group by activity-type interaction (p > .05) at Day 2. When both time frames were considered, there was no significant group × time frame interaction for any activity type or any item, except for an increase in non-manual (clerical) work and weight training at Day 10 compared to Day 2 in the group with the advice. In general, the intentions for all activity types were consistent with the recovery advice (i.e., rest then increasing activity), even when the advice was not given. However, at Day 10, cognitive and physical activity levels were still expected to be lower than usual (pre-injury), and many participants were uncertain about the concept of cognitive rest. These factors, along with individual patient circumstances, should be taken into account in rehabilitation planning.
{"title":"An experimental study of the effect on activity intentions of postconcussion recovery advice","authors":"K. Sullivan, L. Billing","doi":"10.1177/2059700219872673","DOIUrl":"https://doi.org/10.1177/2059700219872673","url":null,"abstract":"This study tested the effect of issuing return-to-activity advice on activity intentions at Day 2 and Day 10 days post simulated mild traumatic brain injury. One hundred and twenty-eight volunteers were randomly allocated to one of two groups who received (n = 65) or did not receive standardized post-injury advice (n = 63). To prime the simulation, the participants read a mild traumatic brain injury vignette about a person who is concussed while playing sport. Then the participants role-played the injured person and reported activity intentions for three activity types (cognitive, physical and restful) twice, once for each time frame (i.e. Day 2 and Day 10). The advice was to rest for the first 24–48 h and then gradually resume normal activities. There was no significant group by activity-type interaction (p > .05) at Day 2. When both time frames were considered, there was no significant group × time frame interaction for any activity type or any item, except for an increase in non-manual (clerical) work and weight training at Day 10 compared to Day 2 in the group with the advice. In general, the intentions for all activity types were consistent with the recovery advice (i.e., rest then increasing activity), even when the advice was not given. However, at Day 10, cognitive and physical activity levels were still expected to be lower than usual (pre-injury), and many participants were uncertain about the concept of cognitive rest. These factors, along with individual patient circumstances, should be taken into account in rehabilitation planning.","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/10.1177/2059700219872673","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44118353","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: 10.1177/2059700219885503
Rebecca A Kenny, Chantel D. Mayo, Samantha Kennedy, A. Varga, L. Stuart-Hill, M. Garcia-Barrera, Amanda McQuarrie, Brian R. Christie, J. Gawryluk
Background Although soccer players routinely head the ball in practice and games, recent research has suggested that cumulative effects of repetitive heading may cause sub-concussive injury with accompanying effects on brain and behavior. The current study aimed to prospectively investigate the effects of repetitive, intentional heading in soccer practice on brain structure and cognitive function, using a within-subjects design. Methods Participants included 10 soccer players (mean age 20.09 years ± 2.88) who were examined immediately pre- and post-heading practice. An accelerometer was used to measure the force of the impact during soccer heading. Magnetic resonance imaging data were acquired on a 3 T GE Scanner with diffusion tensor imaging. Diffusion tensor imaging analyses were completed using functional magnetic resonance imaging of the brain software library’s Tract-Based Spatial Statistics to examine changes in both fractional anisotropy and mean diffusivity due to heading the soccer ball. Behavioral measures were also completed pre- and post-soccer heading and included the Sport Concussion Assessment Tool and three short-computerized executive function tasks; R studio was used to compare behavioral data within subjects. Results Accelerometer data revealed that none of the heading impacts were >10g. At this level of impact, there were no significant pre–post heading differences in either fractional anisotropy or mean diffusivity. Additionally, aside from minimal practice effects, there were no significant differences in Sport Concussion Assessment Tool scores and no significant differences in the performance of the three executive function tasks pre–post heading. Conclusions The results provide initial evidence that repetitive heading in soccer practice, at a g force of 10, does not cause changes in brain structure or executive function. Future research should investigate heading in the context of games and with a greater sample size that would allow for sex-based comparisons.
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