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Tadmor DI, Chesson L, Till K, Phillips G, Fairbank L, Brown J, Cross M, Gardner AJ, Johnston RD, Owen C, Hendricks S, Stokes KA, Jones B. Non-reporting of sport-related concussion symptoms: a cross-sectional study of community rugby league players in the UK. Inj Prev 2024:ip-2023-045108. [PMID: 39060115 DOI: 10.1136/ip-2023-045108] [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: 09/14/2023] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
Recognising and removing players with suspected sport-related concussions is crucial for community sports. OBJECTIVES Quantify rates and factors associated with non-reporting of concussion symptoms in community rugby league. METHODS Overall, 484 community rugby league players aged ≥18 years and 965 parents of rugby league players aged <18 years completed an online survey, regarding concussion history, knowledge, prevalence and reasons for non-reporting of concussion, long-term implications and perceptions of concussion. RESULTS Thirty-five percent of players aged ≥18 years and 22% of parents of players aged <18 years reported at least one concussion in the last two seasons. Forty-three percent of players aged ≥18 years and 5% of parents of players aged<18 years surveyed stated they did not report concussion-related symptoms sustained during 2020 and 2021 seasons. The two most common reasons for non-reporting of concussion symptoms were 'didn't want to be ruled out of a match' and 'didn't want to let down the team'. Players aged ≥18 years who received external coaching pressures around concussion were more likely to not report concussion symptoms. Over 40% of parents and players were concerned about the potential long-term implications. Ten percent of players aged ≥18 years and 7% of parents of players aged <18 years would encourage their family members/children to not play rugby league. CONCLUSIONS Non-reporting rates of suspected concussion symptoms in adult community players were twice as high as in professional rugby league, with similar reasons (wanting to play and not letting the team down). Engaging coaches to prioritise brain health and providing broader and appropriate education on concussion should be focused on, given the concerns reported by community players and parents.
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Affiliation(s)
- Daniel Isaac Tadmor
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
| | - Lucy Chesson
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
| | - Gemma Phillips
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Hull Kingston Rovers, Hull, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Uno-X Mobility Professional Cycling, Oslo, Norway
| | - Laura Fairbank
- England Performance Unit, Rugby Football League, Manchester, UK
| | - James Brown
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University, Stellenbosch, South Africa
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Matt Cross
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Premiership Rugby, London, UK
| | - Andrew J Gardner
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Faculty of Medicine and Health, Sydney School of Health Sciences, Discipline of Exercise and Sport Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Rich D Johnston
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Brisbane, Queensland, Australia
| | - Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Keith A Stokes
- Centre for Health, and Injury & Illness Prevention in Sport, University of Bath, Bath, UK
- Rugby Football Union, Twickenham, UK
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Premiership Rugby, London, UK
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
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2
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Tadmor D, Till K, Phillips G, Brown J, Fairbank L, Hendricks S, Johnston RD, Longworth T, Stokes K, Jones B. I won't let you down; why 20% of Men's and Women's Super League players underreported suspected concussions. J Sci Med Sport 2023; 26:688-693. [PMID: 37813720 DOI: 10.1016/j.jsams.2023.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 06/27/2023] [Accepted: 09/18/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVES Quantify and identify factors associated with concussion underreporting in Super League rugby league players. DESIGN Cross sectional survey. METHODS During the 2022 season preseason, 422 Men's and Women's Super League players completed an online survey quantifying player demographics, rugby playing history, concussion history, prevalence of, and reasons for underreporting concussion, concussion knowledge and long-term implications and perceptions of concussion. RESULTS Overall, 20% of respondents stated they did not report concussion-related symptoms to medical staff during the 2020 and 2021 seasons. The two most common reasons for underreporting concussion were 'didn't want to be ruled out of a match' (35%) and 'didn't want to let down team' (24%). 65% of players reported an appropriate level of knowledge about concussion and potential long-term implications at the start of their senior rugby career, versus 89% now. In relation to concussion knowledge, symptoms were correctly identified on 74% of occasions. 57% of players surveyed were concerned about the potential long-term implications from concussion, and 11% of players would encourage their/family members' children to not play rugby league. CONCLUSIONS The proportion of Super League players who did not report concussion symptoms was similar to rugby league players in Australia. The main reasons for not reporting concussion appeared to be due to perceptions of what is beneficial for the team, suggesting both performance and medical staff should collectively encourage players to report concussion. A player's attitude towards concussion is potentially an individual modifiable risk factor and should be considered within the concussion management of players.
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Affiliation(s)
- Daniel Tadmor
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; Leeds Rhinos Rugby League Club, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom. https://twitter.com/danieltadmor
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; Leeds Rhinos Rugby League Club, United Kingdom. https://twitter.com/ktconditioning
| | - Gemma Phillips
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom; Hull Kingston Rovers, United Kingdom
| | - James Brown
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; Institute of Sport and Exercise Medicine (ISEM), Department of Exercise, Sport and Lifestyle Medicine and Health Sciences, Stellenbosch University, South Africa; Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, The University of Cape Town, South Africa. https://twitter.com/jamesbrown06
| | - Laura Fairbank
- England Performance Unit, Rugby Football League, United Kingdom
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, The University of Cape Town, South Africa. https://twitter.com/sharief_h
| | - Rich D Johnston
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; School of Behavioural and Health Sciences, Australian Catholic University, Australia; Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Australia. https://twitter.com/richjohnston88
| | - Thomas Longworth
- Sports Medicine, Eastern Suburbs Sports Medicine Centre, Australia; Medical, New South Wales Institute of Sport, Australia
| | - Keith Stokes
- Centre for Health, and Injury & Illness Prevention in Sport, University of Bath, United Kingdom; UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, United Kingdom; Rugby Football Union, United Kingdom. https://twitter.com/drkeithstokes
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom; Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, The University of Cape Town, South Africa; School of Behavioural and Health Sciences, Australian Catholic University, Australia; Premiership Rugby, United Kingdom.
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Fetchko TJ, Hart GJ, Aderman MJ, Ross JD, Malvasi SR, Roach MH, Cameron KL, Rooks TF. Measurement of Head Kinematics Using Instrumented Mouthguards During Introductory Boxing Courses in U.S. Military Academy Cadets. Mil Med 2023; 188:584-589. [PMID: 37948285 DOI: 10.1093/milmed/usad249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/02/2023] [Accepted: 06/27/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Use of wearable impact sensor devices to quantitatively measure head impact exposure remains largely unstudied in military-style martial arts training and combat sports, particularly at the beginner levels. The baseline frequency and severity of head impact exposure during introductory military-style martial arts trainings, such as combatives training, is valuable information for developing future programs of instruction and exposure monitoring programs. The purpose of this study was to describe head impact exposures experienced during introductory combatives training (a boxing course) at U.S. Military Academy. METHODS This study used instrumented mouthguards to measure head impact exposure in U.S. Military Academy cadets during a compulsory boxing course. Summary exposures from a preliminary dataset are presented. RESULTS Twenty-two male subjects (19.9 ± 1.1 years, 86.6 ± 11.7 kg) participated in 205 analyzed player-bouts (full contact sparring sessions) with 809 video verified impacts (average 3.9 impacts per player-bout). The mean peak linear acceleration was 16.5 ±7.1 G, with a maximum of 70.8 G. There was a right-skewed distribution, with 640/809 (79.1%) events falling between 10 and 20 G. The mean peak angular acceleration was 1.52 ± 0.96 krad/s2, with a maximum of 8.85 krad/s2. CONCLUSIONS Compared to other high-risk sports at Service Academies, head impacts from beginner boxing were of similar magnitude to those reported for Service Academy football and slightly lower than those reported for Service Academy rugby. Based on these preliminary data, the risk profile for introductory military-style martial arts training, such as boxing or combatives, may be similar to other contact sports like football and rugby, but further research is required to confirm these findings and understand the effects of the exposures in a shorter duration.
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Affiliation(s)
- Travis J Fetchko
- Injury Biomechanics and Protection Group, United States Army Aeromedical Research Laboratory, Fort Novosel, AL 36362, USA
- Department of Orthopaedic Research, Keller Army Community Hospital, West Point, NY 10996, USA
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN 37831, USA
| | - Gerald J Hart
- Department of Physical Education, United States Military Academy, West Point, NY 10996, USA
| | - Michael J Aderman
- Department of Orthopaedic Research, Keller Army Community Hospital, West Point, NY 10996, USA
| | - Jeremy D Ross
- Department of Orthopaedic Research, Keller Army Community Hospital, West Point, NY 10996, USA
| | - Steven R Malvasi
- Department of Orthopaedic Research, Keller Army Community Hospital, West Point, NY 10996, USA
| | - Megan H Roach
- Department of Orthopaedic Research, Keller Army Community Hospital, West Point, NY 10996, USA
| | - Kenneth L Cameron
- Department of Orthopaedic Research, Keller Army Community Hospital, West Point, NY 10996, USA
| | - Tyler F Rooks
- Injury Biomechanics and Protection Group, United States Army Aeromedical Research Laboratory, Fort Novosel, AL 36362, USA
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Kelly JT, Wilkes JR, Slobounov SM. An Examination of Visual Quality of Life and Functional Vision Among Collision and Non-Collision Athletes Over a Competitive Season. Arch Clin Neuropsychol 2023; 38:1115-1123. [PMID: 37097732 DOI: 10.1093/arclin/acad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 04/26/2023] Open
Abstract
OBJECTIVE Repetitive head impacts (RHIs) experienced during sports are gaining attention due to potential long-term neurological dysfunction, absent of a diagnosed concussion. One area susceptible to dysfunction is vision. The goal of this study was to evaluate changes in visual quality of life (VQOL) and functional vision scores from pre- to post-season among collision and non-collision athletes. METHODS The Visual Functioning Questionnaire-25 and Neuro-Ophthalmic Supplement (NOS), as well as functional vision testing (Mobile Universal Lexicon Evaluation System - MULES) were completed pre- and post-season by three groups: collision athletes, non-collision athletes, and minimally active controls (MACs). RESULTS There were 42 participants, with 41 (21 male, 20 female) completing both testing sessions, with a mean (standard deviation [SD]) age of 21 (2.46) years (collision group, n = 14; non-collision group, n = 13, MACs, n = 14). Baseline analyses revealed no significant differences between groups for VQOL or MULES scores. However, those with a family history of psychiatric disorder scored significantly worse on NOS. Post-season/follow-up testing revealed no significant differences between groups for VQOL scores. Non-collision athletes significantly improved on the MULES test by 2.46 ± 3.60 (SD) s (35.0 [95% confidence interval, 0.29-4.63]; p = .03). Change score results from pre- to post-season were not significant. CONCLUSION Although the groups were not significantly different from one another, non-collision athletes significantly improved MULES scores, whereas collision athletes performed the worst, suggesting exposure to RHIs may impact functional vision. Thus, further evaluation of RHIs and their impact on vision is warranted.
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Affiliation(s)
- Jon T Kelly
- Department of Kinesiology, Penn State University, University Park, PA, USA
| | - James R Wilkes
- Department of Kinesiology, Penn State University, University Park, PA, USA
| | - Semyon M Slobounov
- Department of Kinesiology, Penn State University, University Park, PA, USA
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Corbin-Berrigan LA, Teel E, Vinet SA, P De Koninck B, Guay S, Beaulieu C, De Beaumont L. The Use of Electroencephalography as an Informative Tool in Assisting Early Clinical Management after Sport-Related Concussion: a Systematic Review. Neuropsychol Rev 2023; 33:144-159. [PMID: 32577950 DOI: 10.1007/s11065-020-09442-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 06/07/2020] [Indexed: 12/21/2022]
Abstract
Sport-related concussion (SRC) is managed primarily through serial clinical evaluations throughout recovery. However, studies suggest that clinical measures may not be suitable to detect subtle alterations in functioning and are limited by numerous internal and external factors. Electroencephalography (EEG) has been used for over eight decades to discern altered function following illnesses and injuries, including traumatic brain injury. This study evaluated the associations between EEG measures and clinical presentation within three-months following SRC. A systematic review of the literature was performed in Medline, Embase, PsycINFO, CINAHL and Web of Science databases following Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines, yielding a total of 13 peer-reviewed articles. Most studies showed low to moderate bias and moderate to high quality. The majority of the existing literature on the impact of concussion within the first 3 months post-injury suggests that individuals with concussion show altered brain function, with EEG abnormalities outlasting clinical dysfunction. Of all EEG biomarkers evaluated, P300 shows the most promise and should be explored further. Despite the relatively high quality of included articles, significant limitations are still present within this body of literature, including potential conflicts of interest and proprietary algorithms, making it difficult to draw strong and meaningful conclusions on the use of EEG in the early stages of SRC. Therefore, further exploration of the relationship between EEG measures and acute clinical presentation is warranted to determine if EEG provides additional benefits over current clinical assessments and is a feasible tool in clinical settings.
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Affiliation(s)
- Laurie-Ann Corbin-Berrigan
- Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Research Center, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Quebec, Canada
| | | | | | - Béatrice P De Koninck
- Research Center, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Quebec, Canada.,Université de Montréal, Montréal, Quebec, Canada
| | - Samuel Guay
- Research Center, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Quebec, Canada.,Université de Montréal, Montréal, Quebec, Canada
| | | | - Louis De Beaumont
- Research Center, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Quebec, Canada. .,Université de Montréal, Montréal, Quebec, Canada.
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Abstract
OBJECTIVES The aims of the study were to assess prevalence and management of head impacts in stunt performers and to evaluate performers' quality of life and ability to work after head injury. METHODS Stunt performers completed an online survey about head impacts/head whips history, diagnosed concussions, reasons for not reporting injuries, health care sought after head impacts, attitudes toward on-set concussion management, perceived ability to work as a stunt performer, and health-related quality of life. RESULTS One hundred seventy-three performers (80%) indicated at least one head impact/head whip during their stunt career. Of these, 86% exhibited concussion-like symptoms and 38% received one or more concussion diagnoses. Sixty-five percent continued working with concussion-like symptoms. Short Form-12 mental component scores were suggestive of depression in 42%. CONCLUSIONS Concussion seems to be a serious occupational health issue in stunt performers. We suggest that concussion management, risk reduction, and education should be addressed in this community.
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Brown DA, Leung FT, Evans K, Grant G, Hides JA. Cervical spine characteristics differ in competitive combat athletes compared with active control participants. Musculoskelet Sci Pract 2022; 61:102614. [PMID: 35763910 DOI: 10.1016/j.msksp.2022.102614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/13/2022] [Accepted: 06/19/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Injury to the head and neck are common in combat sport athletes. Impairments of the cervical spine have been found in some athletes who participate in sports with high forces and collisions. There is a lack of research on the effects of combat sports on the cervical spine. OBJECTIVE The primary study aim was to investigate differences in cervical spine characteristics between combat athletes and a similarly aged active control group. The secondary aim was to investigate the relationship between symptom-based outcome measures and characteristics of the cervical spine. DESIGN Cross-sectional. METHOD 40 male adult combat sport athletes and 40 male adult control participants were recruited from 4 combat sport clubs and a university campus, Australia. Cervical spine assessments were conducted at a private physiotherapy clinic. The Neck Disability Index and the Post-Concussion Symptom Scale were used as symptom-based outcome measures. RESULTS Combat sport athletes had a reduced range of cervical motion, but greater isometric strength and endurance compared with a control group (p < 0.05). The Neck Disability Index and Post-Concussion Symptom Scale were negatively correlated with cervical spine range of motion and isometric strength, meaning that higher scores correlated with a reduction in function. CONCLUSIONS Differences were observed in characteristics of the cervical spine in combat sport athletes compared with a control group. Higher symptom-based outcome scores correlated with reduced range of motion and strength of cervical spine muscles. Further investigation to establish clinical cut-off scores for functional impairment may be warranted.
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Affiliation(s)
- Daniel A Brown
- School of Health Science and Social Work, 170 Kessels Rd, Nathan, Griffith University, Brisbane, QLD, 4111, Australia.
| | - Felix T Leung
- School of Health Science and Social Work, 170 Kessels Rd, Nathan, Griffith University, Brisbane, QLD, 4111, Australia.
| | - Kerrie Evans
- Faculty of Medicine and Health, 75 East Street, Lidcombe, The University of Sydney, NSW, 2141, Australia; Healthia Limited, Australia, 25 Montpelier Road, Bowen Hills, QLD, 4006, Australia.
| | - Gary Grant
- School of Pharmacy and Pharmacology, 1 Parklands Dr, Southport, Griffith University, Gold Coast, QLD, 4215, Australia.
| | - Julie A Hides
- School of Health Science and Social Work, 170 Kessels Rd, Nathan, Griffith University, Brisbane, QLD, 4111, Australia.
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Miarka B, Soto DAS, Aedo-Muñoz EA, Maurício CA, Müller VT, Bragazzi NL, Brito CJ. Concussion vs. resignation by submission: Technical–tactical behavior analysis considering injury in mixed martial arts. Front Neurol 2022; 13:941829. [PMID: 36119707 PMCID: PMC9473287 DOI: 10.3389/fneur.2022.941829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/22/2022] [Indexed: 11/15/2022] Open
Abstract
This research study verified the technical–tactical actions during the mixed martial arts (MMA) fights to generate serious enough injury to stop the MMA round, determining technical-tactical potential risk factors for injury in official MMA combats, according to Concussion or Resignation per Submission. A total of 990 rounds with concussions and 627 resignations per submission were considered with severe injury (i.e., a fight ended by a doctor or referee). All injuries were diagnosed and managed by attending ringside physicians during the MMA fights and rounds and had a continuous technical–tactical behavior analysis, p ≤ 0.05. The leading cause of concussion was due to head trauma (~90%), with higher dependence on head strikes scored actions. Comparisons between Concussion and Resignation per Submission combats demonstrated differences between distance head strikes actions [13(6,25) vs. 9(4,18) frequencies], clinch head strikes actions [1(0;4) vs. 1(0;3) frequencies], ground head strikes actions [1(0;8) vs. 2(0;10) frequencies] and takedowns actions [0(0;1) vs. 1(0;2) frequencies]. This information may provide significant evidence regarding the doctor stoppage in concussion combats and when it could be called by officials supervising MMA.
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Affiliation(s)
- Bianca Miarka
- Laboratory of Psychophysiology and Performance in Combat and Sports, Physical Education Postgraduate Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dany A. Sobarzo Soto
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Puerto Montt, Chile
- *Correspondence: Dany A. Sobarzo Soto
| | - Esteban A. Aedo-Muñoz
- Department of Physical Education, Sports and Recreation, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile
| | - Clóvis A. Maurício
- Laboratory of Psychophysiology and Performance in Combat and Sports, Physical Education Postgraduate Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vanessa T. Müller
- Laboratory of Psychophysiology and Performance in Combat and Sports, Physical Education Postgraduate Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Nicola L. Bragazzi
- Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics, York University, Toronto, ON, Canada
| | - Ciro José Brito
- Physical Education Postgraduate Program, Juiz de Fora Federal University, Juiz de Fora, Brazil
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Brown DA, Grant G, Evans K, Leung FT, Hides JA. Evaluation of the vestibular/ocular motor screening assessment in active combat sport athletes: an exploratory study. Brain Inj 2022; 36:961-967. [PMID: 35943357 DOI: 10.1080/02699052.2022.2109741] [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: 11/02/2022]
Abstract
OBJECTIVE The first aim of this study was to compare the results of the vestibular/ocular motor screening (VOMS) in combat sport athletes with a healthy control population. Second, to explore differences between athletes with and without a concussion history. Third, to examine the relationship between VOMS and the Post-Concussion Symptom Scale (PCSS) in combat sport athletes. PARTICIPANTS Forty active male combat sport athletes and 40 healthy male control participants were recruited from 4 clubs and a University in Australia. METHODS Participants completed the VOMS in a primary care physiotherapy clinic. Participants completed an injury questionnaire and the PCSS. RESULTS An "abnormal" score in at least one subtest or near point convergence (NPC) was recorded in 45% of the combat group compared with 22.5% of the control group. All VOMS scores and NPC distance were greater in the combat group compared with control group (p < 0.05). The VOMS scores were found to be moderately positively correlated with the PCSS. There was no difference in VOMS between athletes with and without a history of concussion (p > 0.05). CONCLUSION VOMS scores differed between combat sport athletes and control participants. The PCSS may aid clinicians in identifying athletes who have underlying vestibular/oculomotor impairment.
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Affiliation(s)
- Daniel A Brown
- School of Health Sciences and Social Work, Nathan, Griffith University, Brisbane, Australia
| | - Gary Grant
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, Australia
| | - Kerrie Evans
- Faculty of Medicine and Health, the University of Sydney, Lidcombe, Australia.,Healthia Limited, Bowen Hills, Australia
| | - Felix T Leung
- School of Health Sciences and Social Work, Nathan, Griffith University, Brisbane, Australia
| | - Julie A Hides
- School of Health Sciences and Social Work, Nathan, Griffith University, Brisbane, Australia
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10
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du Preez J, Jhala P, Lystad RP. Availability and content of concussion guidelines in Australian combat sports. J Sci Med Sport 2022; 25:800-804. [PMID: 35871904 DOI: 10.1016/j.jsams.2022.07.005] [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: 06/03/2021] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the availability and content of publicly available concussion information published by peak amateur and professional combat sport governing bodies in Australia. DESIGN Cross-sectional study; document analysis. METHODS Publicly available concussion information was retrieved from the websites of eleven peak Australian amateur and professional combat sport governing bodies. Data on type of source material, concussion definition, provision of medical services, concussion evaluation, and return-to-sport information were extracted. The quality of the information was assessed using a modified version of the Global Rating Scale. RESULTS Eight out of eleven combat sport governing bodies provided concussion information in source documents ranging from competition rules to position statements to specific policies. Five governing bodies provided information on post-contest concussion evaluation or testing, four of which mentioned the Sport Concussion Assessment Tool. Eight governing bodies provided information on return-to-sport, of which six stipulated mandatory minimum rest periods and four indicated that athletes should complete a graduated return-to-sport protocol. The provided concussion information was generally of low quality, with a median score of 3 out of 9 (range: 1-4). CONCLUSIONS There is substantial scope and an urgent need for improving concussion guidelines across peak combat sport governing bodies in Australia to improve the health and safety of their athletes.
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Affiliation(s)
- James du Preez
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia.
| | - Prashant Jhala
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
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11
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Lota KS, Malliaropoulos N, Blach W, Kamitani T, Ikumi A, Korakakis V, Maffulli N. Rotational head acceleration and traumatic brain injury in combat sports: a systematic review. Br Med Bull 2022; 141:33-46. [PMID: 35107134 PMCID: PMC9351374 DOI: 10.1093/bmb/ldac002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) in combat sports is relatively common, and rotational acceleration (RA) is a strong biomechanical predictor of TBI. This review summarizes RA values generated from head impacts in combat sport and puts them in the context of present evidence regarding TBI thresholds. SOURCES OF DATA PubMed, EMBASE, Web of Science, Cochrane Library and Scopus were searched from inception to 31st December 2021. Twenty-two studies presenting RA data from head impacts across boxing, taekwondo, judo, wrestling and MMA were included. The AXIS tool was used to assess the quality of studies. AREAS OF AGREEMENT RA was greater following direct head strikes compared to being thrown or taken down. RA from throws and takedowns was mostly below reported injury thresholds. Injury thresholds must not be used in the absence of clinical assessment when TBI is suspected. Athletes displaying signs or symptoms of TBI must be removed from play and medically evaluated immediately. AREAS OF CONTROVERSY Methodological heterogeneity made it difficult to develop sport-specific conclusions. The role of headgear in certain striking sports remains contentious. GROWING POINTS RA can be used to suggest and assess the effect of safety changes in combat sports. Gradual loading of training activities based on RA may be considered when planning sessions. Governing bodies must continue to work to minimize RA generated from head impacts. AREAS TIMELY FOR DEVELOPING RESEARCH Prospective research collecting real-time RA data is required to further understanding of TBI in combat sports.
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Affiliation(s)
- Kabir Singh Lota
- Barts and The London School of Medicine and Dentistry, London, E1 2AD, UK.,Centre for Sports and Exercise Medicine, Queen Mary University of London, E1 4DG, UK
| | - Nikos Malliaropoulos
- Centre for Sports and Exercise Medicine, Queen Mary University of London, E1 4DG, UK.,Sports and Exercise Medicine Clinic, Asklipiou 17, 54639 Thessaloniki, Greece.,Rheumatology Department, Sports Clinic, Barts Health NHS Trust, London, E1 4DG, UK
| | - Wiesław Blach
- Department of Physical Education and Sport, University School of Physical Education, Wrocław 51-612, Poland
| | - Takeshi Kamitani
- School of Sport and Health Science, Tokai Gakuen University, 21-233 Nishinohora, Ukigai, Miyoshi, Aichi, 470-0207, Japan
| | - Akira Ikumi
- Department of Orthopedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, 3-2-7 Miyamachi, Mito, Ibaraki 310-0015, Japan
| | | | - Nicola Maffulli
- Centre for Sports and Exercise Medicine, Queen Mary University of London, E1 4DG, UK.,Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, Baronissi, Salerno 84081, Italy.,School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, Stoke-on-Trent, ST4 7QB, UK
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12
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Vestibular and oculomotor function in male combat sport athletes. J Sci Med Sport 2022; 25:524-528. [DOI: 10.1016/j.jsams.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/13/2022] [Accepted: 02/13/2022] [Indexed: 11/23/2022]
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13
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Hypophyse und Kontaktsportarten. GYNAKOLOGISCHE ENDOKRINOLOGIE 2021. [DOI: 10.1007/s10304-021-00397-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Tulendiyeva A, Saliev T, Andassova Z, Issabayev A, Fakhradiyev I. Historical overview of injury prevention in traditional martial arts. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00785-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Brown DA, Grant G, Evans K, Leung FT, Hides JA. The association of concussion history and symptom presentation in combat sport athletes. Phys Ther Sport 2021; 48:101-108. [PMID: 33406456 DOI: 10.1016/j.ptsp.2020.12.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The purpose of this study was to describe the concussion-related symptoms reported among combat sport athletes with and without a history of concussion, and a history of neck injury. DESIGN Cross-sectional survey. SETTING Data were collected using an online survey instrument. PARTICIPANTS Three hundred and nine adult combat sport athletes. MAIN OUTCOME MEASURES Self-reported 12-month concussion history and neck injury history and a 22-item symptom checklist. RESULTS A history of concussion was reported by 19.1% of athletes, a history of neck injury was reported by 23.0%, and 13.6% reported both injuries. Neck pain was the most frequently reported symptom. Athletes with a history of injury had significantly greater proportions of 'high' total symptoms and symptom severity scores compared with athletes with no history of injury. Athletes with a history of concussion had 2.35 times higher odds of reporting 'high' total symptoms and symptoms severity scores. CONCLUSION Athletes with a history of concussion or neck injury have greater odds of presenting with higher symptom scores. The presence of high total symptom scores and high symptom severity scores may indicate a need for further investigation into domains commonly associated with concussion.
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Affiliation(s)
- Daniel A Brown
- School of Allied Health Science, 170 Kessels Rd, Nathan, Griffith University, Brisbane, QLD, 4111, Australia.
| | - Gary Grant
- School of Pharmacy and Pharmacology, 1 Parklands Dr, Southport, Griffith University, Gold Coast, QLD, 4215, Australia.
| | - Kerrie Evans
- Faculty of Medicine and Health, 75 East Street, Lidcombe, The University of Sydney, NSW, 2141, Australia; Healthia Limited, Australia, 25 Montpelier Road, Bowen Hills, QLD, 4006, Australia.
| | - Felix T Leung
- School of Allied Health Science, 170 Kessels Rd, Nathan, Griffith University, Brisbane, QLD, 4111, Australia.
| | - Julie A Hides
- School of Allied Health Science, 170 Kessels Rd, Nathan, Griffith University, Brisbane, QLD, 4111, Australia.
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16
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Follmer B, Varga AA, Zehr EP. Understanding concussion knowledge and behavior among mixed martial arts, boxing, kickboxing, and Muay Thai athletes and coaches. PHYSICIAN SPORTSMED 2020; 48:417-423. [PMID: 32067547 DOI: 10.1080/00913847.2020.1729668] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objectives: In combat sports, strikes to the head are not just incidental but a deliberate and clear determinant of success. Concussion is a complex injury that is poorly understood and inappropriate practices are often observed among athletes and coaches. The purpose of this study was to investigate concussion knowledge and behavior as well as address recommendations for combat sports athletes and coaches. Methods: 70 athletes and 35 coaches from combat sports disciplines completed an online-validated survey and a personal questionnaire about concussion knowledge, training experience, and knowledge translation. Athletes were divided into subgroups for analysis according to sex (male n = 55, female n = 15), skill level (amateur n = 52, professional n = 18), and weight classes (<66.2 kg: n = 25, 66.6 to 77.5 kg: n = 30, and >78 kg: n = 15). Results: The likely absence of health-care professionals during training was confirmed by 68.5% of coaches, and athletes declared that self-diagnosis (79%) and coaches' diagnosis (43.3%) were the most used method of suspected concussion assessment. Merely 5.7% of coaches properly recognized the level of traumatic brain injury a concussion represents, 68.8% were unfamiliar with any sideline assessment tools, and only 14.3% often seek out concussion knowledge. Athletes who were aware of the level of brain injury a concussion represents performed fewer sparring sessions per week (mild: 1.27 ± 1.1; severe: 3.17 ± 2.81; p = .05, d = .89) and had a greater likelihood of reporting concussive episodes. Most professional (55.5%), female (54.5%), and under 66.2 kg (50%) athletes returned to full practice within 1 week following a concussion diagnosis. Conclusions: Relevant key gaps of knowledge and behavior were verified in combat sports athletes and coaches. The awareness of basic concepts may improve injury reporting and safer behavior in athletes. Knowledge translation strategies with accessible language are recommended for coaches, in particular on how to identify acute symptoms and perform basic assessment.
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Affiliation(s)
- Bruno Follmer
- School of Exercise Science, Physical, and Health Education, University of Victoria , Victoria, Canada.,Rehabilitation Neuroscience Laboratory, University of Victoria , Victoria, Canada
| | | | - E Paul Zehr
- School of Exercise Science, Physical, and Health Education, University of Victoria , Victoria, Canada.,Rehabilitation Neuroscience Laboratory, University of Victoria , Victoria, Canada.,Human Discovery Science, International Collaboration on Repair Discoveries (ICORD) , Vancouver, Canada.,Centre for Biomedical Research, University of Victoria , Victoria, Canada.,Division of Medical Sciences, University of Victoria , Victoria, Canada.,Division of Neurology, Department of Medicine, Faculty of Medicine, University of British Columbia , Victoria, Canada
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Abstract
PURPOSE After traumatic brain injury was accepted as an important etiologic factor of pituitary dysfunction (PD), awareness of risk of developing PD following sports-related traumatic brain injury (SR-TBI) has also increased. However there are not many studies investigating PD following SR-TBIs yet. We aimed to summarize the data reported so far and to discuss screening algorithms and treatment strategies. METHODS Recent data on pituitary dysfunction after SR-TBIs is reviewed on basis of diagnosis, clinical perspectives, therapy, screening and possible prevention strategies. RESULTS Pituitary dysfunction is reported to occur in a range of 15-46.6% following SR-TBIs depending on the study design. Growth hormone is the most commonly reported pituitary hormone deficiency in athletes. Pituitary hormone deficiencies may occur during acute phase after head trauma, may improve with time or new deficiencies may develop during follow-up. Central adrenal insufficiency is the only and most critical impairment that requires urgent detection and replacement during acute phase. Decision on replacement of growth hormone and gonadal deficiencies should be individualized. Moreover these two hormones are abused by many athletes and a therapeutic use exemption from the league's drug policy may be required. CONCLUSIONS Even mild and forgotten SR-TBIs may cause PD that may have distressing consequences in some cases if remain undiagnosed. More studies are needed to elucidate epidemiology and pathophysiology of PD after SR-TBIs. Also studies to establish screening algorithms for PD as well as strategies for prevention of SR-TBIs are urgently required.
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Affiliation(s)
- Aysa Hacioglu
- Department of Endocrinology and Metabolism, Erciyes University Medical School, Kayseri, Turkey.
| | | | - Fatih Tanriverdi
- Memorial Kayseri Hospital, Endocrinology Clinic, Kayseri, Turkey
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