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Manaseer T, Al-nassan SM, Taifour AM. The knowledge and attitude concerning sport-related concussion among coaches: A survey study. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2024; 80:1955. [PMID: 38322656 PMCID: PMC10839240 DOI: 10.4102/sajp.v80i1.1955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/24/2023] [Indexed: 02/08/2024] Open
Abstract
Background There are no studies investigating the level of knowledge about and attitude towards sports-related concussions (SRC) among sports coaches in Jordan. Objectives This study aimed to examine the knowledge about and attitude towards SRC among Jordanian sports coaches. Method Our study was based on a cross-sectional survey. An Arabic version of the questionnaire from the Centers for Disease Control and Prevention was used to collect data. The survey identified participants' demographics and knowledge about (0-10 points with higher scores indicating a higher knowledge) and attitude towards (8-40 with lower scores indicating favourable attitudes) SRC. Descriptive statistics and the Kruskal-Wallis test were used to examine knowledge and attitude differences by demographic factors. Spearman's correlation examined the correlation between the total knowledge and attitude scores. Results Participants included 193 coaches (62 basketball, 66 martial arts, 30 soccer, and 35 swimming). The median total knowledge and attitude scores were 4 and 30, respectively. The total knowledge score was the highest in martial arts coaches (median = 4) and those with graduate degrees (median = 5). The total attitude score was the lowest among basketball coaches (median = 28) and those who were 40-50 years old (median = 28). No significant correlation between knowledge and attitude scores was observed. Conclusion Jordanian coaches have a deficiency in knowledge about SRC and hold attitudes that are not consistent with current practice recommendations. Clinical implications Knowledge and attitude about SRC can be improved through education, access to healthcare providers, and adherence to SRC management guidelines.
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Affiliation(s)
- Thaer Manaseer
- Department of Sport Rehabilitation, Faculty of Physical Education and Sports Sciences, The Hashemite University, Zarqa, Jordan
| | - Saad M. Al-nassan
- Department of Physical Therapy, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Akef M. Taifour
- Department of Sport Management, Faculty of Physical Education and Sport Sciences, The Hashemite University, Zarqa, Jordan
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Baxi S, Cabreros I, Meredith LS, Holliday SB, Martinez J, Piquado T. US Military Healthcare Professionals' Practice, Knowledge, and Misconceptions About Concussion. J Head Trauma Rehabil 2023; 38:391-400. [PMID: 36730959 DOI: 10.1097/htr.0000000000000828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine the US military healthcare professionals' knowledge and training preferences to improve diagnosis and management of concussion sustained in nondeployed settings. PARTICIPANTS US military healthcare professionals (physicians, physician assistants, and nurse practitioners) completed online surveys to investigate practices, knowledge, and attitudes about concussion diagnosis and treatment, as well as preferences on future training. There were 744 responses from active duty US military healthcare providers, all of whom had cared for at least one patient with mild traumatic brain injury (mTBI) in the previous 24 months. RESULTS The majority of physicians reported they were confident in their ability to evaluate a patient for a new mTBI (82.1%) and order appropriate imaging for mTBI (78.3%). Accuracy of identifying "red flag" symptoms ranged between 28.2% and 92.6%. A Likert scale from 1 ("not at all confident") to 4 ("very confident") was used to assess providers' confidence in their ability to perform services for patients with mTBI. With respect to barriers to optimal patient care, nurse practitioners consistently reported highest levels of barriers (90.8%). CONCLUSIONS Although US military providers regularly care for patients with concussion, many report experiencing barriers to providing care, low confidence in basic skills, and inadequate training to diagnose and manage these patients. Customized provider education based on branch of service and occupation, and broader dissemination and utilization of decision support tools or practice guidelines, and patient information tool kits could help improve concussion care.
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Stamm JM, Post EG, Baugh CM, Bell DR. Awareness of Concussion-Education Requirements, and -Management Plans and Concussion Knowledge in High School and Club Sport Coaches. J Athl Train 2020; 55:1054-1061. [PMID: 32966575 PMCID: PMC7594606 DOI: 10.4085/1062-6050-0394-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2024]
Abstract
CONTEXT A growing number of high-school-aged athletes participate on club sport teams. Some, but not all, state concussion laws apply to both interscholastic and private sport organizations. However, concussion education, management plans, and knowledge have not been examined in club coaches who coach high school-aged athletes. OBJECTIVE To determine if differences in concussion education, management plans, and knowledge exist between high school coaches and coaches of club sport teams. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS A total of 769 coaches (497 high school coaches, 272 club coaches coaching high school-aged athletes; 266 women [34.6%], 503 men [65.4%]) completed an anonymous online questionnaire. MAIN OUTCOME MEASURE(S) The questionnaire consisted of demographic and team information, requirements for concussion-education and -management plans, and concussion knowledge. RESULTS High school coaches were more likely than club coaches to report that their organizing bodies or leagues required them to receive concussion-education information (97.4% versus 80.4%; P < .001) and that their organizing bodies or leagues had a concussion-management plan (94.0% versus 70.2%; P < .001). High school coaches were more likely than club coaches to correctly agree that most concussions resolve in 7 to 10 days (48.6% versus 40.1%; P = .02) and disagree that loss of consciousness is required to diagnose a concussion (87.1% versus 80.9%; P = .02). CONCLUSIONS Club coaches were less likely to be aware of requirements for concussion-education and -management plans from their parent organizations and scored lower on specific concussion-knowledge questions than high school coaches despite the same education requirements across groups under their state concussion laws. These results raise concerns regarding the proper management of concussions in club sports and suggest a need for greater oversight and enforcement of state laws in the club sport setting.
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Affiliation(s)
- Julie M. Stamm
- Department of Kinesiology, University of Wisconsin-Madison
| | - Eric G. Post
- Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute
| | - Christine M. Baugh
- Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora
| | - David R. Bell
- Department of Kinesiology, University of Wisconsin-Madison
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Daugherty J, DePadilla L, Sarmiento K. Assessment of HEADS UP online training as an educational intervention for sports officials/athletic trainers. JOURNAL OF SAFETY RESEARCH 2020; 74:133-141. [PMID: 32951774 PMCID: PMC7644176 DOI: 10.1016/j.jsr.2020.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Sports- and recreation-related concussions are a common injury among children. Sports officials (SOs) and athletic trainers (ATs) are integral to setting the stage for safe play and managing concussions when they occur, and significant numbers of both groups have completed the Centers for Disease Control and Prevention's HEADS UP online concussion training course. However, the utility of the course for these audiences has not been assessed. We hypothesized that sports officials' and athletic trainers' concussion-related knowledge, attitudes, and behavioral intentions will improve from pre- and post-test after completing CDC's HEADS UP online concussion training course. METHOD Respondents' concussion-related knowledge, attitudes, and behavioral intentions were assessed both before and after taking the training course. Differences between pre- and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score or McNemar's test. Effect sizes were interpreted. RESULTS The SOs and ATs who participated in the HEADS UP online training had a high level of concussion knowledge before taking the course: 90% or more of respondents could identify the correct response for at least seven of the 13 knowledge questions in the pre-test. Still, the course was effective at improving the respondents' knowledge about return-to-play protocols and concussion reporting. Further, SOs and ATs demonstrated improvement in their concussion-related attitudes and behavioral intentions between the pre- and post-test. CONCLUSION SOs' and ATs' concussion knowledge, attitudes, and behavioral intentions improved immediately following completion of the CDC HEADS UP online training. Future research could also focus on the long-term retention of this type of training. Practical Applications: This study provides insight into how to better focus concussion-related educational programs to fit SOs' and ATs' needs.
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Affiliation(s)
- Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
| | - Lara DePadilla
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
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Guo D, Verweel L, Reed N. Exploring Gaps in Concussion Knowledge and Knowledge Translation Among Coaches of Youth Female Hockey. Clin J Sport Med 2019; 29:486-493. [PMID: 31688180 DOI: 10.1097/jsm.0000000000000542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To better understand the level of concussion knowledge of youth female hockey coaches and to identify preferred methods of knowledge translation for this population. DESIGN Cross-sectional survey. SETTING Participants independently completed written surveys before in-person concussion information sessions or online surveys through link provided in emails. PARTICIPANTS Convenience sampling yielded 130 coaches of youth female hockey from Canada. MAIN OUTCOME MEASURES Knowledge level on concussion, resources from which coaches obtained information on concussion, opinions on the current level of concussion knowledge, and knowledge translation. RESULTS Coaches demonstrated adequate knowledge on concussion, achieving 84% correct on true-false questions and 92% correct on symptom identification accuracy. However, coaches showed limited awareness of concussion specific to mechanisms for injury (identification) and postconcussion symptoms. Internet resources were rated as the most used resources for concussion yet were not rated very helpful. Nonetheless, coaches indicated online courses and web sites as the most preferred method for concussion knowledge translation. CONCLUSIONS Youth female hockey coaches have overall adequate knowledge of concussion; however, gaps in knowledge do exist. Future efforts to raise the concussion knowledge among coaches of female youth hockey should include information specific to the mechanism of injury, along with sign and symptom identification, with particular attention paid to emotional symptoms. Given the reported preferences and the widespread availability of the Internet, further exploration and research validation of online courses and web sites tailored to the youth female hockey community is encouraged.
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Affiliation(s)
- David Guo
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Lee Verweel
- Rehabilitation Science Institute, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Nick Reed
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Science Institute, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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Provvidenza CF, Hartman LR, Carmichael J, Reed N. Does a picture speak louder than words? The role of infographics as a concussion education strategy. J Vis Commun Med 2019; 42:102-113. [DOI: 10.1080/17453054.2019.1599683] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Christine F. Provvidenza
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Laura R. Hartman
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | | | - Nick Reed
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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The evolving landscape of policies, rules, and law in sport-related concussion. HANDBOOK OF CLINICAL NEUROLOGY 2018; 158:257-267. [PMID: 30482354 DOI: 10.1016/b978-0-444-63954-7.00025-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Beginning in 2009 with the passage of the Zackery Lystedt law in the state of Washington, all 50 states have passed concussion laws that implement a mandatory framework of care for high school and youth athletes. The structure of these laws generally shares the three primary components of the Lystedt law: (1) preseason concussion education; (2) mandatory removal from play with suspected concussion; and (3) clearance from a healthcare professional prior to return to play. These same three policy components are also found at the collegiate and professional levels of sport, either through established policy or labor contracts. This chapter explores concussion-specific legal and policy developments that currently inform concussion management practices across multiple levels of the US athletic system.
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Hildenbrand K, Richards KAR, Wright PM. Physical Education Teachers' Awareness and Understanding of Concussions, and Concussion Policies and Protocols. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2018; 89:361-366. [PMID: 29889625 DOI: 10.1080/02701367.2018.1472735] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Our primary aim was to determine physical educators' current level of understanding of concussion symptoms and response guidelines. METHOD Participants included 404 in-service physical educators (137 male, 266 female, 1 other) recruited through 3 SHAPE America - Society of Health and Physical Educators communication outlets. Participants were asked to complete an online survey. The survey included 8 questions related to previous concussion training, 6 items to measure awareness of concussion policies, 20 items related to concussion symptoms, and 14 items for concussion knowledge. Analyses included descriptive statistics and 2 × 2 (Coaching × Concussion) factorial analyses of variance to examine differences in study variables by coaching status and participants' personal concussion experiences. RESULTS Participants reported they did not have any formal role or responsibility related to concussion management, and more than half reported their districts did not require concussion training. Nevertheless, many physical educators were receiving training (n = 291, 72%). Participants who also coached were more aware of concussion policies and systems than were their counterparts, but there were no differences related to concussion facts. CONCLUSION School districts are generally not requiring concussion management training for physical education teachers or giving them specific responsibilities in the management process, yet many physical educators are getting trained. This training often occurs online and may be required for secondary responsibilities such as coaching. Participants reported being aware of concussion policies and procedures but were less likely to agree that this awareness has resulted in changes in how they teach physical education. Participants also knew more about concussion facts than about the legitimacy of symptoms.
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Welch Bacon CE, Kay MC, Weber ML, Tierney DK, Valovich McLeod TC. School Nurses' Perceived Challenges With Concussion Management Procedures in the Secondary School Setting. SAGE Open Nurs 2018; 4:2377960818798437. [PMID: 33415205 PMCID: PMC7774346 DOI: 10.1177/2377960818798437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/03/2018] [Indexed: 11/17/2022] Open
Abstract
School nurses have an integral role in managing student health concerns throughout the school day, yet little is known about their specific role in concussion management. Therefore, the purpose of this study was to explore the challenges encountered by school nurses regarding concussion management in the secondary school setting. Twenty-two school nurses employed in the secondary school setting were interviewed via phone. We analyzed the data via the consensual qualitative research paradigm. Overall, we found school nurses face consistent challenges with their role on the concussion management team, specifically related to education of school personnel, parents, and community health-care providers. Challenging topics included the inconsistency of community health-care provider recommendations and others' perceptions of school nurses' preparation and training to be important members of the concussion management team. Efforts to increase concussion education and improve communication across all stakeholders of the concussion management team should be implemented.
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10
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Nanos KN, Franco JM, Larson D, Mara K, Laskowski ER. Youth Sport-Related Concussions: Perceived and Measured Baseline Knowledge of Concussions Among Community Coaches, Athletes, and Parents. Mayo Clin Proc 2017; 92:1782-1790. [PMID: 29202937 DOI: 10.1016/j.mayocp.2017.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/19/2017] [Accepted: 10/03/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess concussion knowledge of athletes, coaches, and parents/guardians in a community setting and to understand trends/gaps in knowledge among subgroups to tailor efforts toward creating educational interventions. PARTICIPANTS AND METHODS This prospective cross-sectional study involved 262 individuals (142 [55%] female): 115 athletes participating in noncontact and contact sports (ages 13-19 years), 15 coaches, and 132 parents. Recruitment occurred from August 30, 2015, through August 30, 2016, at 3 local high schools. Participants completed a questionnaire developed by the investigators to assess concussion experience and basic knowledge. RESULTS Females, health care employees, and parents showed stronger concern for potential long-term sequelae of concussion, whereas athletes were most concerned about not being able to return to sport. Those with higher perceived concussion knowledge were slightly older (median age, 42.5 vs 33 years), more educated (college or higher: 42 [70%] vs 100 [50%]), and more likely to be health care workers (22 [37.9%] vs 34 [17.7%]) and scored higher on knowledge questions (average correct: 75.5% vs 60%). Most participants could identify potential concussion sequelae, but only 86 (34.3%) identified a concussion as a brain injury. Of the subgroups, coaches scored highest on knowledge questions. Those with a concussion history tended to consider themselves more knowledgeable but were also less concerned about sequelae. Overall, those with a concussion history scored slightly higher on knowledge questions (average correct: 69.8% vs 61.9%). Participants involved in contact sports were more likely to have had a concussion vs those in noncontact sports (57 [26%] vs 4 [10.3%]). CONCLUSION Significant differences in perceived and actual concussion knowledge across different subgroups of study participants involved in high school sports were identified.
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Affiliation(s)
- Katherine N Nanos
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN; Department of Orthopedics, Sports, and Spine, Emory University, Atlanta, GA.
| | - John M Franco
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Dirk Larson
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Kristin Mara
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Edward R Laskowski
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN; Mayo Clinic Sports Medicine, Mayo Clinic, Rochester, MN
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O'Brien MJ, Howell DR, Pepin MJ, Meehan WP. Sport-Related Concussions: Symptom Recurrence After Return to Exercise. Orthop J Sports Med 2017; 5:2325967117732516. [PMID: 29085846 PMCID: PMC5648095 DOI: 10.1177/2325967117732516] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Current guidelines dictate a gradual exercise progression after a concussion; however, it is unclear what proportion of athletes experience a recurrence of symptoms once they are symptom free at rest. Estimating the proportion of athletes and predictors of symptom recurrence would help shape return-to-play protocols. Purpose: To determine the proportion and associated risk factors of athletes who have a recurrence of concussion symptoms with exercise after being symptom free at rest. Study Design: Case-control study; Level of evidence, 3. Methods: Between October 1, 2009 and July 31, 2011, we studied patients from a sport concussion clinic located within a tertiary care regional children’s hospital. Patients were queried at every visit using a standardized questionnaire. Our main outcome variable was recurrence of symptoms with exercise after being symptom free at rest at some point in their recovery. Cofactors included age, sex, loss of consciousness with injury, prior concussion (diagnosed and undiagnosed), Post-Concussion Symptom Scale (PCSS) score, time until clinical presentation, and duration of symptoms. Results: Of the 217 patients included, 25 (12%) experienced a return of symptoms. Losing consciousness at the time of injury and a longer duration between injury and clinical presentation were associated with a decreased risk of symptoms recurring with exercise. Conversely, athletes who had sustained previously undiagnosed concussions and had suffered a longer duration of symptoms at rest were at an increased risk of symptom recurrence with exercise. Conclusion: Relatively few athletes who are symptom free at rest after a concussion will have a recurrence of symptoms when they resume exercise. The risk of symptoms recurring with exercise may be greater among those athletes who sustained previously undiagnosed concussions and had a longer period of symptoms at rest. The early identification of athletes who may be at risk of symptom recurrence will help mold treatment guidelines and exercise progression protocols.
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Affiliation(s)
- Michael J O'Brien
- Sports Concussion Clinic, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - David R Howell
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA.,Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Michael J Pepin
- Program for Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts, USA
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA.,Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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12
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Griffin SA, Ranson C, Moore I, Mathema P. Concussion knowledge and experience among Welsh amateur rugby union coaches and referees. BMJ Open Sport Exerc Med 2017; 3:e000174. [PMID: 29259806 PMCID: PMC5731226 DOI: 10.1136/bmjsem-2016-000174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2017] [Indexed: 11/08/2022] Open
Abstract
Background Rugby union is a collision sport where participants are at high risk of sustaining a concussion. In settings where there is little qualified medical supervision, certain stakeholders (eg, coaches and officials) should possess sufficient knowledge in regard to the recognition and management of concussion. Aim The aim of this study was to assess the knowledge and experience of various aspects of concussion among coaches and referees involved in Welsh amateur rugby union. Methods A questionnaire was distributed to 1843 coaches and 420 referees. Results A total of 333 coaches and 283 referees completed the questionnaire (18% and 68% response rates, respectively). Participants exhibited greater knowledge of concussion symptom recognition relative to knowledge of both the consequences of concussion and associated return-to-play protocols, both of which could be considered poor. There were no differences in knowledge levels between coaches and referees or between participants with or without a history of concussion. Two-thirds of participants incorrectly believed that headgear could prevent concussion, and nearly 30% of coaches reported having witnessed other coaches allowing a potentially concussed player to continue playing. Conclusions Identification of several misconceptions indicates that concussion management within Welsh amateur rugby union needs to be improved, warranting a multi-faceted educational intervention.
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Affiliation(s)
| | - Craig Ranson
- Sports injury Research Group, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | - Isabel Moore
- Sports injury Research Group, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
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13
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Factors Influencing the Underreporting of Concussion in Sports: A Qualitative Study of Minor Hockey Participants. Clin J Sport Med 2017; 27:375-380. [PMID: 28653965 DOI: 10.1097/jsm.0000000000000372] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The present study is to identify factors contributing to underreporting of concussion in adolescent athletes. DESIGN Qualitative interviews. SETTING Participants were interviewed in an office environment. PARTICIPANTS Interviews were conducted with 31 minor hockey players, 10 parents, 6 coaches, 4 trainers, 2 managers, and one game official. Players were 13 to 15 year old. With selective sampling, an inductive approach of analyzing the interviews was undertaken and themes were identified and analyzed. ASSESSMENT OF RISK FACTORS Underreporting is a complex phenomenon. A number of risk factors related to hockey culture, players, reference others, and rules of play were assessed. MAIN OUTCOME MEASURES Reasons not reporting concussion is accepted in minor hockey. RESULTS Aspects of hockey culture such as an overemphasis on winning games and upheld misperceptions about the risks associated with concussion were identified as relevant to the underreporting of concussions. Various factors relevant to the underreporting of concussions include player's motivation to win, group membership dynamics such as a player's role as the team's "enforcer," coaches' own motivation to win to further their own opportunities in the sport, and parents' personal financial interest or alternative agenda in terms of time commitments and their child's future career prospects. CONCLUSIONS Our findings indicate that underreporting of concussion among those players interviewed appears to be prevalent and associated with misconceptions about injury risk, and a culture that both reinforces and encourages underreporting with tacit or overt complicity of parents and coaches. Our findings support the need to alter the culture of violence and tough play in hockey by education, rule changes, economic measures, and changes in governance of the sport. Interviewing more stakeholders and policy makers would shed light on such potential interventions.
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14
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Turner RW, Lucas JW, Margolis LH, Corwell BN. A preliminary study of youth sport concussions: Parents' health literacy and knowledge of return-to-play protocol criteria. Brain Inj 2017; 31:1124-1130. [PMID: 28506094 DOI: 10.1080/02699052.2017.1298003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PRIMARY OBJECTIVE To preliminarily explore parents' health literacy and knowledge of youth sport league rules involving concussion education and training, and return-to-play protocols. RESEARCH DESIGN AND METHODS This study was guided by the Knowledge, Attitude and Practice (KAP) model of health knowledge to examine parents' concussion literacy, and understanding of concussion education and training, and return-to-play protocols in youth sports. The mixed-method design involved 119 participants; that included in-person (n=8) and telephone (n=4) interviews, and web-based surveys administered through Mechanical Turk via Qualtrics (n=98). MAIN OUTCOMES AND RESULTS Most respondents were not familiar with concussion protocols, but trusted coaches' knowledge in return-to-play rules. More than half of the respondents report that the return-to-play concussion criteria have not been clearly explained to them. The majority of respondents were not familiar with the CDC's 'Heads Up' online concussion training programme, nor were they familiar with any other educational/training tool. About one-fifth of the parents had conversations with a coach or medical staff about youth sport concussions. CONCLUSION Parents have a general understanding of how to identify concussion symptoms, but lack knowledge of immediate steps to take following an incident other than seeking medical help.
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Affiliation(s)
- Robert W Turner
- a Center on Biobehavioral Health Disparities Research , Social Science Research Institute, Duke University , Durham , NC , USA
| | - Jeffery W Lucas
- b Department of Sociology , University of Maryland , College Park , MD , USA
| | - Lewis H Margolis
- c Department of Maternal and Child Health, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , NC , USA
| | - Brian N Corwell
- d Emergency Medicine , University of Maryland School of Medicine , Baltimore , MD , USA
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15
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Broglio SP, Baldwin G, Castellani RJ, Chrisman SP, Duma S, Hainline B, Gerstner JC, Guskiewicz K, Kutcher J, Lamba A, McCrea M, Pachman S, Randolph C, McLeod TCV. Summary of the 2015 University of Michigan Sport Concussion Summit. Concussion 2016; 1:CNC23. [PMID: 30202565 PMCID: PMC6096432 DOI: 10.2217/cnc-2016-0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 07/26/2016] [Indexed: 12/14/2022] Open
Abstract
Discussions surrounding concussion have made their way into the public sphere over the previous decade with media attention and coverage of the injury fueling public debate. These conversations have devolved into discussions on banning contact and collision sports and raised legal questions surrounding injury management. Questions raised about concussion eclipse what science can answer, but the University of Michigan Injury Center (MI, USA) hosted a Concussion Summit in September 2015 as a means to condense, solidify and disseminate what is currently known on the topic. Areas for discussion included concussion incidence and prevention, diagnosis and management, legislation and education, legal and social aspects and future directions. A summary of those presentations are included within.
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Affiliation(s)
- Steven P Broglio
- NeuroTrauma Research Laboratory, University of Michigan Injury Center, University of Michigan, Ann Arbor, MI, USA.,NeuroTrauma Research Laboratory, University of Michigan Injury Center, University of Michigan, Ann Arbor, MI, USA
| | - Grant Baldwin
- Centers for Disease Control & Prevention, Atlanta, GA, USA.,Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Rudy J Castellani
- University of Maryland, Baltimore, MD, USA.,University of Maryland, Baltimore, MD, USA
| | - Sara Pd Chrisman
- Seattle Children's Hospital, University of Washington, Seattle, WA, USA.,Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Stefan Duma
- School of Biomedical Engineering & Sciences, Virginia Tech, Blacksburg, VA, USA.,School of Biomedical Engineering & Sciences, Virginia Tech, Blacksburg, VA, USA
| | - Brian Hainline
- National Collegiate Athletic Association, Indianapolis, IN, USA.,National Collegiate Athletic Association, Indianapolis, IN, USA
| | - Joanne C Gerstner
- School of Journalism, Michigan State University, East Lansing, MI, USA.,School of Journalism, Michigan State University, East Lansing, MI, USA
| | - Kevin Guskiewicz
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jeffrey Kutcher
- The Sports Neurology Clinic, CORE Institute, Brighton, MI, USA.,The Sports Neurology Clinic, CORE Institute, Brighton, MI, USA
| | - Adria Lamba
- Georgetown University Law Center, Washington DC, USA.,Georgetown University Law Center, Washington DC, USA
| | - Michael McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.,Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Steven Pachman
- Montgomery McCracken, Philadelphia, PA, USA.,Montgomery McCracken, Philadelphia, PA, USA
| | - Christopher Randolph
- Department of Neurology, Loyola University Chicago, Chicago, IL, USA.,Department of Neurology, Loyola University Chicago, Chicago, IL, USA
| | - Tamara C Valovich McLeod
- School of Health Sciences, A.T. Still University, Mesa, AZ, USA.,School of Health Sciences, A.T. Still University, Mesa, AZ, USA
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Abstract
OBJECTIVE The primary objective of this study was to examine the proportion of US college coaches who receive annual concussion education from their institution and to describe the content and delivery modalities of this education. This study also tested the hypothesis that coaches receiving concussion education from their institution will have greater knowledge about concussions independent of other individual and institutional characteristics. DESIGN Cross-sectional online survey. SETTING US college sport. PARTICIPANTS College coaches in National Collegiate Athletic Association Division I, II, and III (n = 1818). INDEPENDENT VARIABLES Self-reported receipt of education from institution, sex, sport coached, division of competition. MAIN OUTCOME MEASURES Concussion identification and management knowledge. RESULTS Two-thirds of coaches reported receiving informational materials about concussion from their institution. The content of the education most frequently referred to symptoms of a concussion and information about proper management of a concussion. Coaches who received educational materials from their institution were better able to identify symptoms and had more conservative responses to concussion management scenarios. Male coaches of male contact or collision teams less frequently endorsed safe or correct response as compared with female coaches of noncontact or collision teams. CONCLUSIONS Not all US college coaches receive concussion education from their institution. Male Division I coaches of male contact/collision sport are a population for whom targeted educational outreach may be particularly valuable. CLINICAL RELEVANCE Education for coaches, delivered by clinicians at many institutions, is an important component of ensuring that coaches are prepared to be informed partners in supporting concussion safety.
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Concussed or Not? An Assessment of Concussion Experience and Knowledge Within Elite and Semiprofessional Rugby Union. Clin J Sport Med 2016; 26:320-5. [PMID: 26513391 DOI: 10.1097/jsm.0000000000000256] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The primary aim was to assess experience and knowledge of adult concussion among international, professional and semiprofessional players, coaches, medical staff, and referees within Rugby Union. The secondary aim was to identify preferred education dissemination routes. DESIGN Questionnaires devised specifically for players, coaches, medical staff, and referees. SETTING AND PARTICIPANTS A total of 370 players, 44 coaches, 40 medical staff, and 33 referees from within Wales were surveyed. MAIN OUTCOME MEASURES Knowledge of the signs and symptoms of concussion, return to play guidelines and consequences of concussion were investigated along with experiences of, and attitudes towards, concussion. RESULTS The respondents had extensive experience of sustaining or witnessing rugby-related concussion. Medical staff had the greatest level of concussion knowledge, with coaches having the least. Players and coaches exhibited a disconnection between being "knocked-out" and practically applying this when managing concussion. Almost half of the players and coaches did not indicate concussion could impair performance. Eighty percent of medical staff had felt pressured to clear a concussed player. Most players (82%), coaches (66%), and referees (64%) incorrectly believed protective equipment prevents concussion. Players and coaches prefer concussion education from medical staff, whereas medical staff and referees prefer such education from governing body Web sites or training courses. CONCLUSIONS Several role-specific misconceptions and deficiencies in concussion knowledge were identified and should be targeted through education. Medical staff had the highest level of concussion knowledge and were the preferred sources of education for players and coaches. Therefore, they are encouraged to play a greater role in providing concussion education.
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Exploring minor hockey players' knowledge and attitudes toward concussion: implications for prevention. J Head Trauma Rehabil 2016; 30:219-27. [PMID: 24590152 DOI: 10.1097/htr.0000000000000018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate minor hockey players' attitudes and knowledge about sport concussions. PARTICIPANTS Male and female Pee Wee, Bantam, and Midget level players (n = 183) participating in minor hockey and a comparison group of non-hockey players (n = 57). DESIGN Survey. MAIN MEASURES Player knowledge and attitudes were evaluated with a standardized questionnaire developed for the purpose of this study. Descriptive statistics including cross-tabulations and proportion comparisons were used to report the data. RESULTS Players had foundational knowledge about concussions; however, more than half underestimated the prevalence and more than 30% were unaware of return to play protocols. Although nearly all players knew what they "should" do when concussed, 33% did not follow recommendations. Players reported more concern and appreciation of the seriousness of concussion than non-players, but they tended to minimize their vulnerability. The most common and helpful information sources were parents, doctors, and coaches, and therefore knowledge translation efforts should target theses audiences. CONCLUSION Young athletes continue to demonstrate gaps in their knowledge of concussions. In addition, attitudes toward concussion suggest a developmental trajectory with younger athletes being most likely to ignore current recommended guidelines.
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Kroshus E, Kubzansky LD, Goldman RE, Austin SB. Norms, athletic identity, and concussion symptom under-reporting among male collegiate ice hockey players: a prospective cohort study. Ann Behav Med 2015; 49:95-103. [PMID: 25236670 DOI: 10.1007/s12160-014-9636-5] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Many athletes fail to report concussion symptoms to coaches or medical personnel, putting them at risk for potentially catastrophic neurologic consequences if additional brain trauma is sustained prior to full recovery. PURPOSE The purpose of this study was to determine whether concussion reporting norms prior to the start of the athletic season predicted reporting symptoms of a possible concussion during the season, and whether this association was moderated by athletic identity. METHODS Members of six National Collegiate Athletic Association Division 1 men's ice hockey teams (n = 116) completed written surveys before and after the 2012-2013 collegiate ice hockey season. RESULTS Participants who at pre-season perceived that "most athletes" were likely to report symptoms of a concussion were themselves more likely to report symptoms during the season. Athletic identity weakly moderated this association. CONCLUSIONS Perceived reporting norms may be an important target of interventions aimed at reducing symptom under-reporting among athletes.
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Affiliation(s)
- Emily Kroshus
- Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA,
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20
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Mrazik M, Dennison CR, Brooks BL, Yeates KO, Babul S, Naidu D. A qualitative review of sports concussion education: prime time for evidence-based knowledge translation. Br J Sports Med 2015; 49:1548-53. [DOI: 10.1136/bjsports-2015-094848] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 11/03/2022]
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Kemp JL, Newton JD, White PE, Finch CF. Implementation of concussion guidelines in community Australian Football and Rugby League-The experiences and challenges faced by coaches and sports trainers. J Sci Med Sport 2015; 19:305-10. [PMID: 25981181 DOI: 10.1016/j.jsams.2015.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/25/2015] [Accepted: 03/23/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES While guidelines outlining the appropriate management of sport-related concussion have been developed and adapted for use within community sport, it remains unknown how they are experienced by those responsible for implementing them. DESIGN Longitudinal study. METHODS 111 coaches and sports trainers from community-level Australian Football and Rugby League teams completed pre- and post-season surveys assessing their attitudes towards using concussion guidelines. Participants also provided post-season feedback regarding their experiences in using the guidelines. RESULTS 71% of participants reported using the guidelines in the preceding season. Post-season attitude was related to pre-season attitude (p=0.002), football code (p=0.015), and team role (p=0.045). An interaction between team role and guideline use (p=0.012) was also found, with coaches who had used the guidelines, and sports trainers who had not, reporting more positive post-season attitudes towards using the concussion guidelines. Implementation challenges included disputing of decisions about return-to-play by players, parents, and coaches, and a perceived lack of time. Recommendations for improved guideline materials included using larger fonts and providing for witnessing of advice given to players. CONCLUSIONS This is the first study to examine the implementation of concussion guidelines in community sport. Training of coaches/sports trainers needs enhancement. In addition, new education should be developed for parents/players about the importance of the return-to-play advice given to them by those who follow these guidelines. Information provided by those who attempted to use the guidelines will assist the refinement of implementation and dissemination processes around concussion guidelines across sports.
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Affiliation(s)
- Joanne L Kemp
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Australia.
| | - Joshua D Newton
- Office of the Pro Vice Chancellor, Faculty of Business and Law, Burwood Campus, Deakin University, Australia
| | - Peta E White
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Australia
| | - Caroline F Finch
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Australia
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22
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Kroshus E, Baugh CM, Hawrilenko MJ, Daneshvar DH. Determinants of Coach Communication About Concussion Safety in US Collegiate Sport. Ann Behav Med 2015; 49:532-41. [DOI: 10.1007/s12160-014-9683-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Fedor A, Gunstad J. Limited Knowledge of Concussion Symptoms in College Athletes. APPLIED NEUROPSYCHOLOGY-ADULT 2014; 22:108-13. [DOI: 10.1080/23279095.2013.860604] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Andrew Fedor
- Department of Psychology, Kent State University, Kent, Ohio
| | - John Gunstad
- Department of Psychology, Kent State University, Kent, Ohio
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Mutch WAC, Ellis MJ, Graham MR, Wourms V, Raban R, Fisher JA, Mikulis D, Leiter J, Ryner L. Brain MRI CO2 stress testing: a pilot study in patients with concussion. PLoS One 2014; 9:e102181. [PMID: 25032707 PMCID: PMC4102518 DOI: 10.1371/journal.pone.0102181] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 06/15/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND There is a real need for quantifiable neuro-imaging biomarkers in concussion. Here we outline a brain BOLD-MRI CO2 stress test to assess the condition. METHODS This study was approved by the REB at the University of Manitoba. A group of volunteers without prior concussion were compared to post-concussion syndrome (PCS) patients--both symptomatic and recovered asymptomatic. Five 3-minute periods of BOLD imaging at 3.0 T were studied--baseline 1 (BL1--at basal CO2 tension), hypocapnia (CO2 decreased ∼5 mmHg), BL2, hypercapnia (CO2 increased ∼10 mmHg) and BL3. Data were processed using statistical parametric mapping (SPM) for 1st level analysis to compare each subject's response to the CO2 stress at the p = 0.001 level. A 2nd level analysis compared each PCS patient's response to the mean response of the control subjects at the p = 0.05 level. RESULTS We report on 5 control subjects, 8 symptomatic and 4 asymptomatic PCS patients. Both increased and decreased response to CO2 was seen in all PCS patients in the 2nd level analysis. The responses were quantified as reactive voxel counts: whole brain voxel counts (2.0±1.6%, p = 0.012 for symptomatic patients for CO2 response < controls and 3.0±5.1%, p = 0.139 for CO2 response > controls: 0.49±0.31%, p = 0.053 for asymptomatic patients for CO2 response < controls and 4.4±6.8%, p = 0.281 for CO2 response > controls). CONCLUSIONS Quantifiable alterations in regional cerebrovascular responsiveness are present in concussion patients during provocative CO2 challenge and BOLD MRI and not in healthy controls. Future longitudinal studies must aim to clarify the relationship between CO2 responsiveness and individual patient symptoms and outcomes.
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Affiliation(s)
- W. Alan C. Mutch
- Department of Anesthesia and Perioperative Medicine, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michael J. Ellis
- Department of Surgery, Section of Neurosurgery, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - M. Ruth Graham
- Department of Anesthesia and Perioperative Medicine, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Vincent Wourms
- Department of Anesthesia and Perioperative Medicine, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Roshan Raban
- Department of Anesthesia and Perioperative Medicine, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Joseph A. Fisher
- Department of Anesthesia and Pain Management, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - David Mikulis
- Department of Radiology, Section of Neuroimaging, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey Leiter
- Department of Surgery, Pan Am Clinic, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lawrence Ryner
- Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba, Canada
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Donaldson A, Newton J, McCrory P, White P, Davis G, Makdissi M, Finch CF. Translating Guidelines for the Diagnosis and Management of Sports-Related Concussion Into Practice. Am J Lifestyle Med 2014; 10:120-135. [PMID: 30202266 DOI: 10.1177/1559827614538751] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 01/20/2014] [Accepted: 03/06/2014] [Indexed: 11/15/2022] Open
Abstract
Sports injuries are a significant clinical and public health concern. There is a growing call to improve the translation of available evidence-based and expert-informed sports injury prevention interventions into sustained use in practice by physicians and others (eg, athletic trainers, coaches, and parents) who care for injured athletes. This article provides a brief overview of the current sport injury prevention implementation literature before focusing specifically on the translation of guidelines (including consensus and position statements) developed to assist physicians and others diagnose and manage athletes with sport-related concussion and the associated return-to-play decisions. The outcomes of more than 20 published studies indicate that physician, athletic trainer, coach, parent, and athlete knowledge, use of, and compliance with sport-related concussion guidelines are limited. More concerted, coordinated, and theory-informed efforts are required to facilitate the widespread dissemination, translation, and implementation of such guidelines. An example is provided of how implementation drivers could be used to inform the development of a comprehensive, multilevel implementation strategy targeting the individual, organizational, and system-level changes necessary to support the translation of available sport-related concussion guidelines in both the clinical and sports settings.
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Affiliation(s)
- Alex Donaldson
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia (AD, PW, CFF, PM).,Deakin University, Burwood, Victoria, Australia (JN).,The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia (PM, GD, MM).,Department of Neurosurgery, Cabrini Hospital, Malvern, Victoria, Australia (GD)
| | - Joshua Newton
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia (AD, PW, CFF, PM).,Deakin University, Burwood, Victoria, Australia (JN).,The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia (PM, GD, MM).,Department of Neurosurgery, Cabrini Hospital, Malvern, Victoria, Australia (GD)
| | - Paul McCrory
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia (AD, PW, CFF, PM).,Deakin University, Burwood, Victoria, Australia (JN).,The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia (PM, GD, MM).,Department of Neurosurgery, Cabrini Hospital, Malvern, Victoria, Australia (GD)
| | - Peta White
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia (AD, PW, CFF, PM).,Deakin University, Burwood, Victoria, Australia (JN).,The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia (PM, GD, MM).,Department of Neurosurgery, Cabrini Hospital, Malvern, Victoria, Australia (GD)
| | - Gavin Davis
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia (AD, PW, CFF, PM).,Deakin University, Burwood, Victoria, Australia (JN).,The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia (PM, GD, MM).,Department of Neurosurgery, Cabrini Hospital, Malvern, Victoria, Australia (GD)
| | - Michael Makdissi
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia (AD, PW, CFF, PM).,Deakin University, Burwood, Victoria, Australia (JN).,The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia (PM, GD, MM).,Department of Neurosurgery, Cabrini Hospital, Malvern, Victoria, Australia (GD)
| | - Caroline F Finch
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia (AD, PW, CFF, PM).,Deakin University, Burwood, Victoria, Australia (JN).,The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia (PM, GD, MM).,Department of Neurosurgery, Cabrini Hospital, Malvern, Victoria, Australia (GD)
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26
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Kerr ZY, Register-Mihalik JK, Marshall SW, Evenson KR, Mihalik JP, Guskiewicz KM. Disclosure and non-disclosure of concussion and concussion symptoms in athletes: Review and application of the socio-ecological framework. Brain Inj 2014; 28:1009-21. [PMID: 24738743 DOI: 10.3109/02699052.2014.904049] [Citation(s) in RCA: 168] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Zachary Y Kerr
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina-Chapel Hill , Chapel Hill, NC , USA
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White PE, Newton JD, Makdissi M, Sullivan SJ, Davis G, McCrory P, Donaldson A, Ewing MT, Finch CF. Knowledge about sports-related concussion: is the message getting through to coaches and trainers? Br J Sports Med 2013; 48:119-24. [DOI: 10.1136/bjsports-2013-092785] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
OBJECTIVE The purpose of this study was to determine college athletes' knowledge regarding concussions and to determine if an educational lecture before their sport season would improve their knowledge and reporting of concussions. DESIGN Cross-sectional study. SETTING University classroom. PARTICIPANTS Seventy National College Athletic Association Division II men's/women's soccer players and men's/women's basketball players. INTERVENTIONS Educational lecture regarding the basics of concussions. MAIN OUTCOME MEASURES Descriptive statistics, ANOVAs, and a paired sample t test determined the athletes' knowledge of concussion before and after the season and the impact of the educational intervention. RESULTS A paired sample t test indicated that the athletes scored better on the postseason concussion knowledge assessment [t(49) = 10.34, P < 0.000, d = 1.47]. CONCLUSIONS After an educational intervention, athletes demonstrated an improvement in their knowledge on concussions.
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Saunders EA, Burdette GT, Metzler JN, Joyner AB, Buckley TA. Knowledge of Coaching Education Students Regarding Sport-Related Concussions. ACTA ACUST UNITED AC 2013. [DOI: 10.3928/19425864-20121217-02] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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30
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Current world literature. Curr Opin Pediatr 2012; 24:770-9. [PMID: 23146873 DOI: 10.1097/mop.0b013e32835af8de] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Tomei KL, Doe C, Prestigiacomo CJ, Gandhi CD. Comparative analysis of state-level concussion legislation and review of current practices in concussion. Neurosurg Focus 2012. [PMID: 23199423 DOI: 10.3171/2012.9.focus12280] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Forty-two states and the District of Columbia have passed legislation based on the Lystedt law of Washington state, enacted in 2009 to protect young athletes who have sustained a concussion. The aim of this study was to note the several similarities and differences among the various laws.
Methods
Concussion legislation was compared for 50 states and the District of Columbia. Evaluation parameters of this study included stipulations of concussion education, criteria for removal from play, requirements for evaluation and return to play after concussion, and individuals required to assess young athletes. Other parameters that were not consistent across states were also noted.
Results
Forty-three states and the District of Columbia have passed concussion legislation, and an additional 4 states have pending legislation. All states with existing legislation support concussion education for coaches; however, only 48% require coaches to undergo formal education. Athletes must be educated on concussion in 86% of states and parents in 88.7%. Suspicion of concussion is a criterion for removal from play in 75% of states; signs and symptoms of concussion are criteria for removal from play in 16% of states. The individuals allowed to evaluate and clear an athlete for return to play differ greatly among states.
Conclusions
Injury prevention legislation holds historical precedent, and given the increasing attention to long-term sequelae of repeated head trauma and concussion, concussion legislation has been rapidly passed in 43 states and the District of Columbia. Although the exact stipulations of these laws vary among states, the overall theme is to increase recognition of concussion in young athletes and ensure that they are appropriately cleared for return to play after concussion.
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Zonfrillo MR, Master CL, Grady MF, Winston FK, Callahan JM, Arbogast KB. Pediatric providers' self-reported knowledge, practices, and attitudes about concussion. Pediatrics 2012; 130:1120-5. [PMID: 23147981 DOI: 10.1542/peds.2012-1431] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine the self-reported practices and attitudes surrounding concussion diagnosis and management in a single, large pediatric care network. METHODS A cross-sectional survey was distributed to pediatric primary care and emergency medicine providers in a single, large pediatric care network. For all survey participants, practices and attitudes about concussion diagnosis and treatment were queried. RESULTS There were 145 responses from 276 eligible providers, resulting in a 53% response rate, of which 91% (95% confidence interval [CI]: 86%-95%) had cared for at least 1 concussion patient in the previous 3 months. A Likert scale from 1 "not a barrier" to 5 "significant barrier" was used to assess providers' barriers to educating families about the diagnosis of concussion. Providers selected 4 or 5 on the scale for the following barriers and frequencies: inadequate training to educate 16% (95% CI: 11%-23%), inadequate time to educate 15% (95% CI: 12%-24%), and not my role to educate 1% (95% CI: 0.4%-5%). Ninety-six percent (95% CI: 91%-98%) of providers without a provider decision support tool (such as a clinical pathway or protocol) specific to concussion, and 100% (95% CI: 94%-100%) of providers without discharge instructions specific to concussion believed these resources would be helpful. CONCLUSIONS Although pediatric primary care and emergency medicine providers regularly care for concussion patients, they may not have adequate training or infrastructure to systematically diagnose and manage these patients. Specific provider education, decision support tools, and patient information could help enhance and standardize concussion management.
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Affiliation(s)
- Mark R Zonfrillo
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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Epidemiology, trends, assessment and management of sport-related concussion in United States high schools. Curr Opin Pediatr 2012; 24:696-701. [PMID: 23042252 DOI: 10.1097/mop.0b013e3283595175] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Sport-related concussion affects athletes at every level of participation. The short and long-term effects of concussions that occur during childhood and adolescence are not fully understood. The purpose of this review is to describe the current burden of disease, current practice patterns and current recommendations for the assessment and management of sport-related concussions sustained by United States high school athletes. RECENT FINDINGS Millions of high school students participate in organized sports in the United States. Current estimates suggest that, across all sports, approximately 2.5 concussions occur for every 10 000 athletic exposures, in which an athletic exposure is defined as one athlete participating in one game or practice. At schools that employ at least one athletic trainer, most high school athletes who sustain sport-related concussions will be cared for by athletic trainers and primary care physicians. Approximately 40% will undergo computerized neurocognitive assessment. SUMMARY The number of high school athletes being diagnosed with sport-related concussions is rising. American football has the highest number of concussions in high school with girls' soccer having the second highest total number. Fortunately, coaches are becoming increasingly aware of these injuries and return-to-play guidelines are being implemented.
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Current world literature. Curr Opin Pediatr 2012; 24:134-44. [PMID: 22245849 DOI: 10.1097/mop.0b013e328350498a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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