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For: Lempke LB, Teel EF, Lynall RC, Hoffman NL, Buckley TA, Eckner JT, McCrea MA, McAllister TW, Broglio SP, Schmidt JD. Early Exercise is Associated with Faster Concussion Recovery Among Collegiate Athletes: Findings from the NCAA-DoD CARE Consortium. Sports Med 2023;53:1987-1999. [PMID: 37209368 DOI: 10.1007/s40279-023-01861-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 05/22/2023]

For:	Lempke LB, Teel EF, Lynall RC, Hoffman NL, Buckley TA, Eckner JT, McCrea MA, McAllister TW, Broglio SP, Schmidt JD. Early Exercise is Associated with Faster Concussion Recovery Among Collegiate Athletes: Findings from the NCAA-DoD CARE Consortium. Sports Med 2023;53:1987-1999. [PMID: 37209368 DOI: 10.1007/s40279-023-01861-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 05/22/2023]

Number

Cited by Other Article(s)

Syrydiuk RA, Boltz AJ, Lempke LB, Caccese JB, McAllister T, McCrea M, Pasquina PF, Broglio SP. SCAT Symptom Evolution in the Acute Concussion Phase: Findings From the NCAA-DoD CARE Consortium. J Neurotrauma 2024. [PMID: 39212662 DOI: 10.1089/neu.2024.0243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open

Abstract

The Sport Concussion Assessment Tool (SCAT) is the most widely used tool following sport-related concussion (SRC). Initial SCAT symptom burden is a strong predictor of recovery in collegiate athletes; however, it is unknown if symptom presentation varies within the acute (<48 hours) post-SRC phase. The purpose of this cohort study was to examine acute SRC symptom presentation among National Collegiate Athletic Association (NCAA) athletes. Concussed NCAA varsity athletes (n=1,780) from thirty universities across the United States that participated in the Concussion Assessment, Research, and Education (CARE) Consortium were included. Time of injury occurrence and SCAT administration data were recorded, from which time-to-SCAT (hours, continuous) was calculated. The main outcome was SCAT total symptom severity [(TSS), 0-126]. Multivariable negative binomial regression was used to examine the association between time (hours) since injury and TSS. Covariates included sex, previous concussion, sport contact level, amnesia/loss of consciousness, immediate reporting of injury, and injury situation. A random effect (person level) accounted for multiple assessments. TSS score ratios (SR) with associated 95% confidence intervals (CI) were provided. The SCAT was administered an average of 14 (25th-75th percentile: 1.2-24) hours post-SRC, and average TSS was 27.35±21.28 across all participants. Time-to-SCAT was associated with a 1% decrease in TSS after adjusting for covariate effects (SR: 0.99, 95% CI: 0.99-0.99, p<0.001). Overall, we observed a small, but significant decrease in TSS with each hour post-SRC. Assessing a concussed athlete once in the acute phase will likely provide a sufficient sense of their symptomatic well-being, as measures did not fluctuate dramatically. Future research should aim to examine how acute symptom evolution influences recovery metrics.

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Jo J, Boltz AJ, Williams KL, Pasquina PF, McAllister TW, McCrea MA, Broglio SP, Zuckerman SL, Terry DP, Arbogast K, Benjamin HJ, Brooks A, Cameron KL, Chrisman SPD, Clugston JR, Collins M, DiFiori J, Eckner JT, Estevez C, Feigenbaum LA, Goldman JT, Hoy A, Kaminski TW, Kelly LA, Kontos AP, Langford D, Lintner LJ, Master CL, McDevitt J, McGinty G, Miles C, Ortega J, Port N, Rowson S, Schmidt J, Susmarski A, Svoboda S. Mechanisms of Injury Leading to Concussions in Collegiate Soccer Players: A CARE Consortium Study. Am J Sports Med 2024;52:1585-1595. [PMID: 38656160 DOI: 10.1177/03635465241240789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]

Abstract

BACKGROUND

Few previous studies have investigated how different injury mechanisms leading to sport-related concussion (SRC) in soccer may affect outcomes.

PURPOSE

To describe injury mechanisms and evaluate injury mechanisms as predictors of symptom severity, return to play (RTP) initiation, and unrestricted RTP (URTP) in a cohort of collegiate soccer players.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

The Concussion Assessment, Research and Education (CARE) Consortium database was used. The mechanism of injury was categorized into head-to-ball, head-to-head, head-to-body, and head-to-ground/equipment. Baseline/acute injury characteristics-including Sports Concussion Assessment Tool-3 total symptom severity (TSS), loss of consciousness (LOC), and altered mental status (AMS); descriptive data; and recovery (RTP and URTP)-were compared. Multivariable regression and Weibull models were used to assess the predictive value of the mechanism of injury on TSS and RTP/URTP, respectively.

RESULTS

Among 391 soccer SRCs, 32.7% were attributed to a head-to-ball mechanism, 27.9% to a head-to-body mechanism, 21.7% to a head-to-head mechanism, and 17.6% to a head-to-ground/equipment mechanism. Event type was significantly associated with injury mechanism [χ2(3) = 63; P < .001), such that more head-to-ball concussions occurred in practice sessions (n = 92 [51.1%] vs n = 36 [17.1%]) and more head-to-head (n = 65 [30.8%] vs n = 20 [11.1]) and head-to-body (n = 76 [36%] vs n = 33 [18.3%]) concussions occurred in competition. The primary position was significantly associated with injury mechanism [χ2(3) = 24; P < .004], with goalkeepers having no SRCs from the head-to-head mechanism (n = 0 [0%]) and forward players having the least head-to-body mechanism (n = 15 [19.2%]). LOC was also associated with injury mechanism (P = .034), with LOC being most prevalent in head-to-ground/equipment. Finally, AMS was most prevalent in head-to-ball (n = 54 [34.2%]) and head-to-body (n = 48 [30.4%]) mechanisms [χ2(3) = 9; P = .029]. In our multivariable models, the mechanism was not a predictor of TSS or RTP; however, it was associated with URTP (P = .044), with head-to-equipment/ground injuries resulting in the shortest mean number of days (14 ± 9.1 days) to URTP and the head-to-ball mechanism the longest (18.6 ± 21.6 days).

CONCLUSION

The mechanism of injury differed by event type and primary position, and LOC and AMS were different across mechanisms. Even though the mechanism of injury was not a significant predictor of acute symptom burden or time until RTP initiation, those with head-to-equipment/ground injuries spent the shortest time until URTP, and those with head-to-ball injuries had the longest time until URTP.

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Affiliation(s)

Jacob Jo Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt University School of Medicine, Nashville, Tennessee, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Adrian J Boltz Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Kristen L Williams Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Paul F Pasquina Department of Physical Medicine and Rehabilitation at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Thomas W McAllister Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Michael A McCrea Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Steven P Broglio Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Scott L Zuckerman Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Douglas P Terry Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt University Medical Center, Nashville, Tennessee, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Kristy Arbogast University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Holly J Benjamin University of Chicago, Chicago, Illinois, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Alison Brooks University of Wisconsin-Madison, Madison, Wisconsin, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Kenneth L Cameron United States Military Academy, West Point, New York, USA) Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Sara P D Chrisman University of Washington, Seattle, Washington, USA) Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
James R Clugston University of Florida, Gainesville, Florida, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Micky Collins University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
John DiFiori Hospital for Special Surgery, New York, New York, USA) Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
James T Eckner University of Michigan, Michigan, USA) Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Carlos Estevez United States Coast Guard Academy, New London, Connecticut, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Luis A Feigenbaum University of Miami, Coral Gables, Florida, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Joshua T Goldman University of California, Los Angeles, Los Angeles, California, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
April Hoy Azusa Pacific University, Azusa, California, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Thomas W Kaminski University of Delaware, Newark, Delaware, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Louise A Kelly California Lutheran University, Thousand Oaks, California, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Anthony P Kontos University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Dianne Langford Temple University, Philadelphia, Pennsylvania, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Laura J Lintner Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Christina L Master University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Jane McDevitt Temple University, Philadelphia, Pennsylvania, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Gerald McGinty United States Air Force Academy, El Paso, Colorado, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Chris Miles Wake Forest University, Winston-Salem, North Carolina, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Justus Ortega California State Polytechnic University, Pomona, California, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Nicholas Port Indiana University, Bloomington, Indiana, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Steve Rowson Virginia Tech, Blacksburg, Virginia, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Julianne Schmidt University of Georgia, Athens, Georgia, USA) Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Adam Susmarski United States Naval Academy, Annapolis, Maryland, USA) Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
Steven Svoboda MedStar Health, Columbia, Maryland, USA Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA

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Bowman TG, Lininger MR, Oldham JR, Smetana RM, Kelshaw PM, Beidler E, Campbell TR, Walton SR, Munce TA, Larson MJ, Didehbani N, Cullum CM, Rosenblum DJ, Cifu DX, Resch JE. Physical activity and recovery following concussion in collegiate athletes: a LIMBIC MATARS Consortium Investigation. Brain Inj 2024:1-8. [PMID: 38324635 DOI: 10.1080/02699052.2024.2310791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/23/2024] [Indexed: 02/09/2024]

Affiliation(s)

Thomas G Bowman Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
Monica R Lininger Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, Arizona, USA
Jessie R Oldham Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
Racheal M Smetana Neuropsychology Assessment Clinic, University of Virginia Health, Charlottesville, Virginia, USA
Patricia M Kelshaw Department of Kinesiology, Brain Research and Assessment Initiative of New Hampshire (BRAIN) Laboratory, University of New Hampshire, Durham, NH, USA
Erica Beidler Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
Thomas R Campbell School of Rehabilitation Sciences, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
Samuel R Walton Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
Thayne A Munce Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
Michael J Larson Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
Nyaz Didehbani Departments of Psychiatry and Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
C Munro Cullum Departments of Psychiatry, Neurology, and Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
Daniel J Rosenblum Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
David X Cifu Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
Jacob E Resch Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA

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Lempke LB, Caccese JB, Syrydiuk RA, Buckley TA, Chrisman SPD, Clugston JR, Eckner JT, Ermer E, Esopenko C, Jain D, Kelly LA, Memmini AK, Mozel AE, Putukian M, Susmarski A, Pasquina PF, McCrea MA, McAllister TW, Broglio SP, Master CL. Female Collegiate Athletes' Concussion Characteristics and Recovery Patterns: A Report from the NCAA-DoD CARE Consortium. Ann Biomed Eng 2023:10.1007/s10439-023-03367-y. [PMID: 37751028 DOI: 10.1007/s10439-023-03367-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023]

Abstract

Concussion has been described in the United States (US) collegiate student-athlete population, but female-specific findings are often underrepresented and underreported. Our study aimed to describe female collegiate student-athletes' initial injury characteristics and return to activity outcomes following concussion. Female collegiate student-athletes (n = 1393) from 30-US institutions experienced a concussion and completed standardized, multimodal concussion assessments from pre-injury through unrestricted return to play (uRTP) in this prospective, longitudinal cohort study. Initial injury presentation characteristics, assessment, and return to activity outcomes [<48-h (acute), return to learn, initiate return to play (iRTP), uRTP] were collected. We used descriptive statistics to report injury characteristics, return to activity outcomes, and post-injury assessment performance change categorization (worsened, unchanged, improved) based on change score confidence rank criteria across sport contact classifications [contact (n = 661), limited (n = 446), non-contact (n = 286)]. The median (25th to 75th percentile) days to return to learn was 6.0 (3.0-10.0), iRTP was 8.1 (4.8-13.8), and uRTP was 14.8 (9.9-24.0), but varied by contact classification. Across contact levels, the majority experienced worse SCAT total symptom severity (72.8-82.6%), ImPACT reaction time (91.2-92.6%), and BSI-18 total score (45.2-51.8%) acutely relative to baseline, but unchanged BESS total errors (58.0-60.9%), SAC total score (71.5-76.1%), and remaining ImPACT domains (50.6-66.5%). Our findings provide robust estimates of the typical female collegiate student-athlete presentation and recovery trajectory following concussion, with overall similar findings to the limited female collegiate student-athlete literature. Overall varying confidence rank classification was observed acutely. Our findings provide clinically-relevant insights for athletes, clinicians, researchers, and policymakers to inform efforts specific to females experiencing concussion.

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Affiliation(s)

Landon B Lempke Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA. Exercise and Sport Science Initiative, University of Michigan, Ann Arbor, MI, USA. , 830 North University Avenue, Suite 4000, Ann Arbor, MI, 48109, USA.
Jaclyn B Caccese School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
Reid A Syrydiuk Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
Thomas A Buckley Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
Sara P D Chrisman Division of Adolescent Medicine, University of Washington, Seattle, WA, USA
James R Clugston Departments of Community Health Family Medicine and Neurology, University of Florida, Gainesville, FL, USA
James T Eckner Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA
Elsa Ermer Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Carrie Esopenko Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Divya Jain Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Louise A Kelly Department of Exercise Science, California Lutheran University, Thousand Oaks, CA, USA
Allyssa K Memmini Department of Health, Exercise & Sports Sciences, University of New Mexico, Albuquerque, NM, USA
Anne E Mozel Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
Margot Putukian Major League Soccer, Princeton, NJ, USA
Adam Susmarski Department of Orthopedics and Sports Medicine, United States Naval Academy, Annapolis, MD, USA
Paul F Pasquina Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Michael A McCrea Center for Neurotrauma Research, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
Thomas W McAllister Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
Steven P Broglio Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
Christina L Master Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA Orthopaedics and Sports Medicine, Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA

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Halabi C, Norton L, Norton K, Smith WS. Headpulse Biometric Measures Following Concussion in Young Adult Athletes. JAMA Netw Open 2023;6:e2328633. [PMID: 37566413 PMCID: PMC10422194 DOI: 10.1001/jamanetworkopen.2023.28633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/24/2023] [Indexed: 08/12/2023] Open

Abstract

Importance

Concussions are common in sports. Return-to-play protocols can be enhanced by objective biometrics.

Objective

To characterize temporal changes of headpulse, a digital biometric, in athletes with sports-related concussion; to explore the association of unstructured physical activity with headpulse changes.

Design, Setting, and Participants

This cohort study included headpulse measurements from players in the highest level of amateur Australian Rules Football in South Australia. Analysis included feasibility and validation phases, with the feasibility cohort recruited between August 5, 2021, and September 10, 2021, and the validation cohort recruited between May 5, 2022, and September 3, 2022. Data were analyzed October 2022 through January 2023.

Interventions

Cranial accelerometry detected micromovements of the head following cardiac contraction (what we have described as "headpulse"). Headpulse was serially recorded for 1 month in concussed individuals.

Main Outcomes and Measures

Headpulse waveforms underwent frequency transformation analysis per prespecified algorithm. Result Z scores were calculated. Headpulse Z scores exceeding 2 (2 SDs from control means) met an abnormality threshold. Headpulse sensitivity, timing, and duration of change were determined.

Results

A total of 59 control and 43 concussed individuals (44 total concussions; 1 control also concussed, 1 concussed individual injured twice) provided headpulse measurements. The feasibility cohort (all male) included 17 control (median [IQR] age, 23 [19-28] years) and 15 concussed individuals (median [IQR] age, 21 [19-23] years). The validation cohort included 25 female (median [IQR] age, 21 [20-22] years) and 17 male (median [IQR] age, 26 [23-29] years) control individuals, and 8 female (median [IQR] age, 28 [20-31] years) and 20 male (median [IQR] age, 21 [19-23] years) concussed individuals. Headpulse reached abnormality threshold in 26 of 32 concussed individuals (81%; 9% on day 0, 50% by day 2, 90% by day 14). Headpulse alterations lasted 14 days longer than symptoms and were exacerbated by return-to-play or unsupervised physical activity.

Conclusions and Relevance

In this study of 101 amateur Australian Rules Football athletes, the digital headpulse biometric was evaluated in 44 sports-related concussions. Compared with controls, new headpulse changes occurred after concussion; this objective metric may complement return-to-play protocols.

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