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Pangrazio O, Forriol F, Aguirre AS, Beletanga MD, Torres AR. Enhancing Protocols for Concussion Management in Professional Soccer Events. Cureus 2024; 16:e64064. [PMID: 39114186 PMCID: PMC11304360 DOI: 10.7759/cureus.64064] [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] [Accepted: 07/07/2024] [Indexed: 08/10/2024] Open
Abstract
AIM Every year, there are an estimated 1.7 to 3.8 million sports-related traumatic brain injuries. A sports concussion results from an external force or a blow to the head or body, causing cranial encephalic trauma that can affect motor skills and brain function, producing varying symptoms related to an alteration in neurological functioning. Soccer poses a risk of concussions due to heading, where the player's head directly hits the ball to redirect or accelerate it. However, most concussions are caused by contact between players, such as head-to-head or head-to-elbow contact. This study analyzed the incidence of concussions or mild traumatic brain injuries in professional soccer during the "Copa America 2019" to understand the feasibility of soccer concussion protocols and propose evidence-based enhancements. METHODS The data were previously collected by our first two authors, O. Pangrazio and F. Forriol, during the 46th edition of the "Copa America 2019," where the South American Football Confederation implemented the Concussion Fast Recognition Protocol to detect traumatic brain injuries. The descriptive basic data will help to raise awareness and motivate further research in this field. We have analyzed and correlated it with global data to provide a comprehensive review and tangible evidence of the population size where soccer protocols are typically applied, thus calculating incidence rates to measure it mathematically. RESULTS Our study reveals that the incidence rate of concussions during the "Copa America 2019" was 5.3 per 1,000 athlete exposures, with a total of three concussions occurring among 567 players. Despite the effectiveness of current protocols in detecting concussions rapidly and accurately, the relatively low incidence rate at this level of professional competition poses a challenge to validating these protocols. These results indicate that while the protocols in place are efficient, the testing and validation of new tools and approaches would be more beneficial at different levels of play where the incidence rates of concussions are higher. In environments with a greater frequency of concussions, the robustness and reliability of these protocols can be more thoroughly evaluated, ensuring they provide optimal protection and care for athletes. CONCLUSION The incidence of concussions is low in professional soccer tournaments. Protocols are necessary to protect players and educate sports professionals. However, their validation is difficult given the low incidence of concussions at this level of competition. Our proposed protocol helps unify a basic approach in the field and an advanced approach in any emergency department, providing better detection of concussions and improved outcomes for players. This protocol should be validated in populations with higher incidence rates to demonstrate its effectiveness.
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Affiliation(s)
- Osvaldo Pangrazio
- Orthopedics, South American Football Confederation (CONMEBOL), Luque, PRY
| | - Francisco Forriol
- Family Medicine, South American Football Confederation (CONMEBOL), Luque, PRY
| | - Alex S Aguirre
- Pediatrics, Boston University Chobania and Avedisian School of Medicine, Boston Medical Center, Boston, USA
| | - Maria D Beletanga
- General Practice, Boston University Chobanian and Avedisian School of Medicine, Boston Medical Center, Boston, USA
| | - Alcy R Torres
- Pediatrics, Boston University School of Medicine, Boston, USA
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2
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Vedung F, Fahlström M, Wall A, Antoni G, Lubberink M, Johansson J, Tegner Y, Stenson S, Haller S, Weis J, Larsson EM, Marklund N. Chronic cerebral blood flow alterations in traumatic brain injury and sports-related concussions. Brain Inj 2022; 36:948-960. [PMID: 35950271 DOI: 10.1080/02699052.2022.2109746] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PRIMARY OBJECTIVE Traumatic brain injury (TBI) and sports-related concussion (SRC) may result in chronic functional and neuroanatomical changes. We tested the hypothesis that neuroimaging findings (cerebral blood flow (CBF), cortical thickness, and 1H-magnetic resonance (MR) spectroscopy (MRS)) were associated to cognitive function, TBI severity, and sex. RESEARCH DESIGN Eleven controls, 12 athletes symptomatic following ≥3SRCs and 6 patients with moderate-severe TBI underwent MR scanning for evaluation of cortical thickness, brain metabolites (MRS), and CBF using pseudo-continuous arterial spin labeling (ASL). Cognitive screening was performed using the RBANS cognitive test battery. MAIN OUTCOMES AND RESULTS RBANS-index was impaired in both injury groups and correlated with the injury severity, although not with any neuroimaging parameter. Cortical thickness correlated with injury severity (p = 0.02), while neuronal density, using the MRS marker ((NAA+NAAG)/Cr, did not. On multivariate analysis, injury severity (p = 0.0003) and sex (p = 0.002) were associated with CBF. Patients with TBI had decreased gray (p = 0.02) and white matter (p = 0.02) CBF compared to controls. CBF was significantly lower in total gray, white matter and in 16 of the 20 gray matter brain regions in female but not male athletes when compared to female and male controls, respectively. CONCLUSIONS Injury severity correlated with CBF, cognitive function, and cortical thickness. CBF also correlated with sex and was reduced in female, not male, athletes. Chronic CBF changes may contribute to the persistent injury mechanisms in TBI and rSRC.
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Affiliation(s)
- Fredrik Vedung
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden
| | | | - Anders Wall
- PET Centre, Uppsala University Hospital, Uppsala, Sweden.,Department of Surgical Sciences, Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden
| | - Gunnar Antoni
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Mark Lubberink
- Medical Physics, Uppsala University Hospital, Uppsala, Sweden.,PET Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Jakob Johansson
- Department of Surgical Sciences, Anesthesiology, Uppsala University, Uppsala, Sweden
| | - Yelverton Tegner
- Department of Health Sciences, Luleå University of Technology, Uppsala, Sweden
| | - Staffan Stenson
- Department of Neuroscience, Rehabilitation Medicine, Uppsala, Sweden
| | - Sven Haller
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Affidea CDRC Centre de Diagnostic Radiologique de Carouge SA, Geneva, Switzerland
| | - Jan Weis
- Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Elna-Marie Larsson
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Niklas Marklund
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden.,Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skåne University Hospital, Lund, Sweden
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3
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Kosziwka G, Champoux L, Cournoyer J, Gilchrist M, Hoshizaki T. Risk of head injury associated with distinct head impact events in elite women's hockey. JOURNAL OF CONCUSSION 2021. [DOI: 10.1177/20597002211058894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Head injuries are a major health concern for sport participants as 90% of emergency department visits for sport-related brain injuries are concussion related.1 Recently, reports have shown a higher incidence of sport-related concussion in female athletes compared to males.3 Few studies have described the events by which concussions occur in women's hockey,2,7,8 however a biomechanical analysis of the risk of concussion has not yet been conducted. Therefore, the purpose of this study was to identify the highest risk concussive events in elite women's hockey and characterize these events through reconstructions to identify the associated levels of peak linear and angular acceleration and strain from finite element analysis. 44 head impact events were gathered from elite women's hockey game video and analyzed for impact event, location and velocity. In total, 27 distinct events based on impact event, location and velocity were reconstructed using a hybrid III headform and various testing setups to obtain dynamic response and brain tissue response. A three-way Multivariate Analysis of Variance (MANOVA) was conducted to determine the influence of event, location and velocity. The results of this study show that head- to-ice impacts resulted in significantly higher responses compared to shoulder-to- head collisions and head-to boards impacts however, shoulder and boards impacts were more frequent. All events produced responses comparable to proposed concussion threshold values.21 This research demonstrates the importance of considering the event, the impact characteristics, the magnitude of response, and the frequency of these impacts when attempting to capture the short and long term risks of brain trauma in women's hockey.
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Affiliation(s)
- G. Kosziwka
- University of Ottawa, Ottawa, Ontario, Canada
| | - L. Champoux
- University of Ottawa, Ottawa, Ontario, Canada
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4
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Xiao M, Nguyen JN, Hwang CE, Abrams GD. Increased Lower Extremity Injury Risk Associated With Player Load and Distance in Collegiate Women's Soccer. Orthop J Sports Med 2021; 9:23259671211048248. [PMID: 34722786 PMCID: PMC8552401 DOI: 10.1177/23259671211048248] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/19/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is limited research regarding the impact of workload on injury risk specific to women's soccer. Wearable global positioning system (GPS) units can track workload metrics such as total distance traveled and player load during games and training sessions. These metrics can be useful in predicting injury risk. PURPOSE To examine the relationship between injury risk and player workload as collected from wearable GPS units in National Collegiate Athletic Association (NCAA) Division I women's soccer players. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Lower extremity injury incidence and GPS workload data (player load, total distance, and high-speed distance) for 65 NCAA Division I women's soccer players were collected over 3 seasons. Accumulated 1-, 2-, 3-, and 4-week loads and acute-to-chronic workload ratios (ACWR) were classified into discrete ranges by z-scores. ACWR was calculated using rolling averages and exponentially weighted moving averages (EWMA) models. Binary logistic regression models were used to compare the 7:28 rolling average and EWMA ACWRs between injured and noninjured players for all GPS/accelerometer variables. The prior 1-, 2-, 3-, and 4-week accumulated loads for all GPS/accelerometer variables were compared between the injured and uninjured cohorts using 2-sample t tests. RESULTS There were a total of 53 lower extremity injuries that resulted in lost time recorded (5.76/1000 hours "on-legs" exposure time; 34 noncontact and 19 contact injuries). The prior 2-week (7242 vs 6613 m/s2; P = .02), 3-week (10,533 vs 9718 m/s2; P = .02), and 4-week (13,819 vs 12,892 m/s2; P = .04) accumulated player loads and 2-week (62.40 vs 57.25 km; P = .04), 3-week (90.97 vs 84.10 km; P = .03), and 4-week (119.31 vs 111.38 km; P = .05) accumulated total distances were significantly higher for injured players compared with noninjured players during the same time frames. There were no significant differences in player load, total distance, or high-speed distance ACWR between injured and noninjured players for both the rolling averages and EWMA calculations. CONCLUSION Higher accumulated player load and total distance, but not ACWR, were associated with injury in women's soccer players.
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Affiliation(s)
- Michelle Xiao
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Jessica N. Nguyen
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Calvin E. Hwang
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Geoffrey D. Abrams
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
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5
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Commotions cérébrales chez les footballeuses particularité et prise en charge. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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6
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Blyth RJ, Alcock M, Tumilty DS. Why are female soccer players experiencing a concussion more often than their male counterparts? A scoping review. Phys Ther Sport 2021; 52:54-68. [PMID: 34419893 DOI: 10.1016/j.ptsp.2021.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND The risk of concussion is particularly high in female soccer players. There is no consensus as to why female soccer players are at an elevated risk. OBJECTIVE To synthesise current evidence investigating reasons for the increased concussion rate in female soccer players. SOURCES Searching of six databases (MEDLINE, Scopus, CINAHL, SportDiscus, Web of Science and the Cochrane Library) and grey literature was performed between 13/07/2020-31/07/2020. Keywords were concussion-related terms, terms relating to female football/soccer and terms relating to the mechanism/cause. No constraints were placed on publication date and quantitative or exploratory studies meeting inclusion criteria were eligible. Exclusion criteria were studies not published in English and qualitative studies. RESULTS Several hypotheses were identified to explain increased concussion rates in female soccer players, these include, reduced neck strength/anthropometrics, increased head acceleration, increased ball-to-head concussions, differences in hormones and brain structure/function, and reduced visual awareness. CONCLUSION Promising ideas/reasons have been identified for increased concussion rates in female soccer players. Despite hypothesis generation there is scarce high-level evidence which is required to guide injury prevention and/or rule changes to protect female soccer players. The level of evidence for included studies is level 2-3 with most being observational cross-sectional or cohort studies.
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Affiliation(s)
- Rebecca Jane Blyth
- School of Physiotherapy, University of Otago, 325 Great King Street, North Dunedin, Dunedin, 9016, New Zealand.
| | - Mark Alcock
- School of Physiotherapy, University of Otago, 325 Great King Street, North Dunedin, Dunedin, 9016, New Zealand
| | - Dr Steve Tumilty
- School of Physiotherapy, University of Otago, 325 Great King Street, North Dunedin, Dunedin, 9016, New Zealand
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Gouttebarge V, Ahmad I, Iqbal Z, Orhant E, Rosenbloom C, Sas K, Kerkhoffs GMMJ. Concussion in European professional football: a view of team physicians. BMJ Open Sport Exerc Med 2021; 7:e001086. [PMID: 34150322 PMCID: PMC8183281 DOI: 10.1136/bmjsem-2021-001086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The objective was to explore the view and thoughts of physicians working in professional football about several aspects (eg, education and use of video footages) likely to enhance concussions' recognition and on-field management. METHODS An observational study based on a cross-sectional design by means of an electronic survey was conducted among physicians working for a professional football club in Belgium, England or France. RESULTS A total of 96 physicians (95% male; mean age: 44 years) completed the survey. Nearly all participants (95%) were in favour of informational sessions about concussion for players or technical staff. Only 5%-10% of the participants mentioned that they had felt pressured by the technical staff or players not to substitute a player with a (potential) concussion. Most participants were in favour of an additional permanent concussion substitution and a temporary concussion substitution. Four out of five participants reported that the availability of instant video footages (side-line) would ease the recognition of concussion. CONCLUSION A better recognition and on-field management of concussions in professional football can only be achieved with a holistic approach, including adequate laws of the football game and protocols. Especially, regular education of players and technical staff should be made mandatory while the medical teams should be provided side-line with instant video footages.
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Affiliation(s)
- Vincent Gouttebarge
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Netherlands
- Section Sports Medicine, University of Pretoria, Pretoria, South Africa
- FIFPRO (Football Players Worldwide), Hoofddorp, Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, Netherlands
| | - Imtiaz Ahmad
- Medical Department, Queens Park Rangers Football and Athletic Club, London, UK
| | - Zafar Iqbal
- Medical Department, Crystal Palace Football Club, London, UK
| | - Emmanuel Orhant
- French Football Federation (FFF), Clairefontaine Medical Centre, FIFA Medical Center of Excellence, Clairefontaine, France
| | - Craig Rosenbloom
- The Football Association, Technical Directorate, Burton-upon-Trent, UK
- Queen Mary University of London, London, UK
| | - Kristof Sas
- Medical Department, Royal Sporting Club Anderlecht, Brussels, Belgium
| | - Gino M M J Kerkhoffs
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, Netherlands
- Academic Center for Evidence based Sports medicine (ACES), Amsterdam Movement Sciences, Amsterdam, Netherlands
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8
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Geertsema C, Geertsema L, Farooq A, Harøy J, Oester C, Weber A, Bahr R. Injury prevention knowledge, beliefs and strategies in elite female footballers at the FIFA Women's World Cup France 2019. Br J Sports Med 2021; 55:801-806. [PMID: 33397672 DOI: 10.1136/bjsports-2020-103131] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study assessed knowledge, beliefs and practices of elite female footballers regarding injury prevention. METHODS A survey was sent to players participating in the FIFA Women's World Cup France 2019. Questions covered three injury prevention domains: (1) knowledge; (2) attitudes and beliefs; (3) prevention practices in domestic clubs. Additionally, ACL injury history was assessed. RESULTS Out of 552 players, 196 women responded (35.5%). More than 80% of these considered injury risk to be moderate or high. Players listed knee, ankle, thigh, head and groin as the most important injuries in women's football. The most important risk factors identified were low muscle strength, followed by poor pitch quality, playing on artificial turf, too much training, reduced recovery and hard tackles. In these elite players, 15% did not have any permanent medical staff in their domestic clubs, yet more than 75% had received injury prevention advice and more than 80% performed injury prevention exercises in their clubs. Players identified the two most important implementation barriers as player motivation and coach attitude. Two-thirds of players used the FIFA 11+ programme in their clubs. CONCLUSIONS This diverse group of elite players demonstrated good knowledge of risk level and injury types in women's football. Of the risk factors emphasised by players, there was only one intrinsic risk factor (strength), but several factors out of their control (pitch quality and type, training volume and hard tackles). Still players had positive attitudes and beliefs regarding injury prevention exercises and indicated a high level of implementation, despite a lack of medical support.
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Affiliation(s)
- Celeste Geertsema
- Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar .,Weill Cornell Medical College, Doha, Qatar
| | - Liesel Geertsema
- Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar.,Weill Cornell Medical College, Doha, Qatar
| | - Abdulaziz Farooq
- Athlete Health and Performance Research, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Joar Harøy
- Senter for idrettsskadeforskning, Norges Idrettshøgskole, Oslo, Norway.,Oslo Sports Trauma Research Centre, Norwegian School of Sport Sciences, Oslo, Norway
| | - Chelsea Oester
- Federation Internationale de Football Association, Zurich, Switzerland
| | - Alexis Weber
- Medicine & Science, Federation Internationale de Football Association, Zurich, Zürich, Switzerland
| | - Roald Bahr
- Oslo Sports Trauma Research Centre, Norwegian School of Sport Sciences, Oslo, Norway.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
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Women Are at Higher Risk for Concussions Due to Ball or Equipment Contact in Soccer and Lacrosse. Clin Orthop Relat Res 2020; 478:1469-1479. [PMID: 31651591 PMCID: PMC7310326 DOI: 10.1097/corr.0000000000000995] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND There is ample evidence to suggest sex- and gender-based differences in the incidence of sports-related concussions. The mechanisms of concussion may vary between male and female athletes and contribute to this observed difference. Understanding the underlying etiology by pooling data from primary studies across different settings and sport types will inform interventions that can reduce concussion rates. QUESTIONS/PURPOSES Specifically, we asked: (1) In which sports are female athletes less likely to experience concussions from player contact? (2) In which sports are female athletes more likely to experience concussions because of ball or equipment contact? METHODS PubMed, EMBASE, and Cochrane Library databases were searched to identify articles published from January 2000 to December 2018. Ten studies met the inclusion criteria, which were studies that reported concussion incidence by mechanism for both male and female athletes. Exclusion criteria included non-English studies, conference abstracts, and studies on non-sports related concussions. The sports represented by the 10 studies included ice hockey (n = 4), soccer (n = 5), basketball (n = 4), baseball/softball (n = 4), and lacrosse (n = 5). The rate ratio was calculated as the incidence rate in female athletes/male athletes for each concussion mechanism or activity. Data were pooled using the DerSimonian-Laird random-effects model. Study quality was assessed with the Newcastle-Ottawa Scale. RESULTS Female athletes were at lower risk of player-contact-induced concussions in lacrosse (pooled rate ratio 0.33 [95% CI 0.25 to 0.43]; p < 0.001), basketball (pooled rate ratio 0.86 [95% CI 0.76 to 0.97]; p = 0.01), ice hockey (pooled rate ratio 0.64 [95% CI 0.56 to 0.73]; p < 0.001), soccer (pooled rate ratio 0.70 [95% CI 0.66 to 0.75]; p < 0.001), and soccer heading (pooled rate ratio 0.80 [95% CI 0.72 to 0.90]; p < 0.001); in these sports, men were at higher risk of concussions from player contact. Female athletes were more likely to experience concussions because of ball or equipment contact in lacrosse (pooled rate ratio 3.24 [95% CI 2.10 to 4.99]; p < 0.001), soccer (pooled rate ratio 2.04 [95% CI 1.67 to 2.49]; p < 0.001), and soccer heading (pooled rate ratio 2.63 [95% CI 1.84 to 3.77]; p < 0.001). CONCLUSIONS The mechanism or activity underlying concussions differs between male and female athletes across different sports. This finding remains the same regardless of whether there are rule differences between the men's and women's games. The implementation of other interventions are required to further ensure player safety, including protective head equipment, concussion prevention training, or rules limiting player contact in the men's game. LEVEL OF EVIDENCE Level III, retrospective study.
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10
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Saunders TD, Le RK, Breedlove KM, Bradney DA, Bowman TG. Sex differences in mechanisms of head impacts in collegiate soccer athletes. Clin Biomech (Bristol, Avon) 2020; 74:14-20. [PMID: 32097766 DOI: 10.1016/j.clinbiomech.2020.02.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 02/05/2020] [Accepted: 02/11/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND There has been growing interest in head impacts related to sports participation due to potential long- and short-term consequences of head injuries. Our purpose was to compare head impact magnitude and frequency between men's and women's intercollegiate soccer players based on head impact mechanism. METHODS 28 collegiate soccer players (16 women: age = 19.94 (1.06) years, height = 163.75 (5.15) cm, mass = 61.21 (5.09) kg; 12 men: age = 20.25 (1.14) years, height = 180.34 (6.03) cm, mass = 74.09 (9.32) kg) wore xPatch (X2 Biosystems, Seattle, WA) head impact sensors. Each practice and game was video recorded in order to confirm head impacts. The independent variable was impact mechanism (head to head, head to body (other than head), head to ground, ball to head, goal to head, and combination). Sensors collected linear and rotational accelerations and frequency of head impacts per 1000 athlete exposures. FINDINGS Men were more likely to sustain head impacts than women (IRR = 1.74, CI95 = 1.59-1.92). The highest head impact incidence rate for men was head to body (IR = 611.68, CI95 = 553.11-670.25) while the highest impact incidence rate for women was ball to head (IR = 302.29, CI95 = 270.93-333.64). The interaction between sex and mechanism was significant for rotational accelerations (F4, 1720 = 3.757, P = .005, ω2 = 0.013) but not for linear accelerations (F4,1720 = 0.680, P = .606, ω2 < 0.001, 1 - β = 0.223). INTERPRETATION To reduce the frequency of head impacts in men, perhaps rules governing player to player contact should be more strictly enforced as these data confirm frequent player-to-head contact during soccer practices and games. Prevention efforts for women should be focused on limiting the amount of purposeful heading (planned contact between the head and ball) occurring during play especially since these impacts had higher magnitudes compared to men.
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Affiliation(s)
| | - Rachel K Le
- Department of Athletic Training, University of Lynchburg, USA
| | - Katherine M Breedlove
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, USA; Department of Radiology, Harvard Medical School, USA
| | | | - Thomas G Bowman
- Department of Athletic Training, University of Lynchburg, USA.
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11
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Vedung F, Hänni S, Tegner Y, Johansson J, Marklund N. Concussion incidence and recovery in Swedish elite soccer - Prolonged recovery in female players. Scand J Med Sci Sports 2020; 30:947-957. [PMID: 32100894 DOI: 10.1111/sms.13644] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 12/06/2019] [Accepted: 02/05/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Sport-related concussions are an increasingly recognized health problem. Soccer is the most popular sport in the world although recent studies on concussion incidence are scarce. Here, a nationwide prospective study on concussion incidence, symptom severity, risk factors, gender differences, and return-to-play after concussion was performed in 51 Swedish elite soccer teams during the 2017 season. METHODS In the 1st and 2nd soccer leagues for men and women, a Sport Concussion Assessment Tool (SCAT)-based questionnaire study was performed at preseason (baseline) and from 48 hours to 3 months post-concussion. RESULTS We followed 959 players (389 women, 570 men) for 25 146 player game hours (9867 hours for women, 15 279 hours for men). Concussion incidence (n = 36 concussions during the season) was 1.19/1000 player game hours (females 1.22/1000 hours, males 1.18/1000 hours; P = .85). Twenty-seven percent of all players (8% of females, 40% of males) continued to play immediately after the concussion. When compared to male players, female players had worse initial symptom severity scores (median and IQR 30 (17-50.5) vs 11 (4-26.25), P = .02) on SCAT and longer return-to-play (P = .02). Risk factors for concussion were baseline symptoms and previous concussion. CONCLUSION In Swedish elite soccer, the concussion incidence was 1.19/1000 without gender differences. Most players recovered to play within 4 weeks post-injury. Almost one third of players continued to play at time of concussion. Female players had worse initial symptoms and longer return-to-play time than males, and a prolonged recovery beyond 3 months was only observed among female players.
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Affiliation(s)
- Fredrik Vedung
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Sofie Hänni
- Department of Surgical Sciences, Anesthesiology, Uppsala University, Uppsala, Sweden
| | - Yelverton Tegner
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Jakob Johansson
- Department of Surgical Sciences, Anesthesiology, Uppsala University, Uppsala, Sweden
| | - Niklas Marklund
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden.,Department of Clinical Sciences Lund, Neurosurgery, Skane University Hospital, Lund University, Lund, Sweden
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12
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La Fountaine MF, Hill-Lombardi V, Hohn AN, Leahy CL, Testa AJ. Preliminary Evidence for a Window of Increased Vulnerability to Sustain a Concussion in Females: A Brief Report. Front Neurol 2019; 10:691. [PMID: 31338057 PMCID: PMC6629886 DOI: 10.3389/fneur.2019.00691] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/13/2019] [Indexed: 01/18/2023] Open
Abstract
A difference exists between sexes for the incidence of concussion injuries and severity of post-injury outcomes with females having a higher incidence rate (in comparable sports) and experience more robust symptoms than males. The basis for this disparity has remained largely unresolved. Recent findings point to a potential biological mechanism that may be related to the menstrual cycle as an arbiter of post-injury outcomes. What has not been addressed, is whether the phase of menstrual cycle (inferred fluctuations of ovarian hormones) contributes to an increased vulnerability to sustain a concussion injury. This prospective, observational study sought to determine if concussions occurred at different frequencies throughout the phase of the menstrual cycle. Female athletes who sustained a concussion injury were queried three times over the 7-day study (e.g., within 48 h of injury, and 4 and 7 days after injury) to recall the number of days that have elapsed since the beginning of their most recent menstruation. Twenty female athletes enrolled after sustaining a concussion; 18 were eumenorrheic and 2 amenorrheic. Among eumenorrheic participants at the time of injury, 2 were in the follicular phase, 4 were in the early luteal phase and 9 were in the late luteal phase. Two athletes were injured on the first and 1 was injured on the second day of menstruation. The greatest number of concussions were sustained during the late luteal phase and during the first 2 days of menstruation. This 9-day window accounted for 2/3rd of the sustained concussions in our study.
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Affiliation(s)
- Michael F La Fountaine
- Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ, United States.,The Institute for Advanced Study of Rehabilitation and Sports Science, Seton Hall University, Nutley, NJ, United States.,Department of Medical Sciences, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, United States.,Department of Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, United States
| | - Vicci Hill-Lombardi
- Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ, United States.,The Institute for Advanced Study of Rehabilitation and Sports Science, Seton Hall University, Nutley, NJ, United States.,Department of Medical Sciences, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, United States.,Department of Athletic Training, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ, United States
| | - Asante N Hohn
- Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ, United States
| | - Caroline L Leahy
- Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ, United States
| | - Anthony J Testa
- Center for Sports Medicine, Seton Hall University, South Orange, NJ, United States
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13
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Quintero LM, Moore JW, Yeager MG, Rowsey K, Olmi DJ, Britton-Slater J, Harper ML, Zezenski LE. Reducing risk of head injury in youth soccer: An extension of behavioral skills training for heading. J Appl Behav Anal 2019; 53:237-248. [PMID: 30924148 DOI: 10.1002/jaba.557] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 02/11/2019] [Indexed: 11/09/2022]
Abstract
Recently, concerns regarding sport-related concussions have increased within the research literature, the media, and popular culture. One potential source of soccer-related concussions involves the purposeful striking of the ball with one's head (i.e., heading). There is currently limited research on an effective teaching method to improve safe heading technique. In the current study, Behavior Skills Training (BST) was evaluated as a method to teach correct heading techniques to youth soccer players. BST increased the percentage of correct steps for each player based on a task analysis of heading. Based on social validity questionnaires administered to players and the coach, BST was rated as an acceptable form of training. After the final training session, experienced coaches rated each player as having improved from baseline to training.
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14
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Neidecker JM, Gealt DB, Luksch JR, Weaver MD. First-Time Sports-Related Concussion Recovery: The Role of Sex, Age, and Sport. J Osteopath Med 2018; 117:635-642. [PMID: 28973180 DOI: 10.7556/jaoa.2017.120] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Concussion is one of the most common injuries in athletes. Current concussion consensus statements propose that female sex may be a modifying factor in concussion management and recovery. Objective To determine whether female athletes in middle school and high school with a first-time, sports-related concussion remained symptomatic longer than their male counterparts. Methods A retrospective medical record analysis was performed among athletes who sustained a concussion between 2011 and 2013. Inclusion criteria consisted of age between 11 and 18 years and diagnosis of first-time concussion sustained while playing organized sports. Using the documented notes in the medical record, length of time that each athlete was symptomatic from his or her concussion was calculated. Results A total of 110 male and 102 female athletes (N=212) met the eligibility criteria for the study. A significant difference was found in the median number of days female athletes remained symptomatic (28 days) when compared with male athletes (11 days) (P<.001). No statistically significant difference was found in symptom duration between age groups. When matched for sex, no statistically significant differences were found in symptom duration between the type of sports played. Conclusion Female athletes aged 11 to 18 years with first-time, sports-related concussions remained symptomatic for a longer period when compared with male athletes of similar age, regardless of sport played. The mechanism behind this difference needs to be further elucidated.
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15
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Asken BM, Bauer RM, Guskiewicz KM, McCrea MA, Schmidt JD, Giza CC, Snyder AR, Houck ZM, Kontos AP, McAllister TW, Broglio SP, Clugston JR, Anderson S, Bazarian J, Brooks A, Buckley T, Chrisman S, Collins M, DiFiori J, Duma S, Dykhuizen B, Eckner JT, Feigenbaum L, Hoy A, Kelly L, Langford TD, Lintner L, McGinty G, Mihalik J, Miles C, Ortega J, Port N, Putukian M, Rowson S, Svoboda S. Immediate Removal From Activity After Sport-Related Concussion Is Associated With Shorter Clinical Recovery and Less Severe Symptoms in Collegiate Student-Athletes. Am J Sports Med 2018; 46:1465-1474. [PMID: 29558195 PMCID: PMC6988451 DOI: 10.1177/0363546518757984] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Timely removal from activity after concussion symptoms remains problematic despite heightened awareness. Previous studies indicated potential adverse effects of continuing to participate in physical activity immediately after sustaining a concussion. Hypothesis/Purpose: The purpose was to determine the effect of timing of removal from play after concussion on clinical outcomes. It was hypothesized that immediate removal from activity after sport-related concussion (SRC) would be associated with less time missed from sport, a shorter symptomatic period, and better outcomes on acute clinical measures. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Data were reported from the National Collegiate Athletic Association and Department of Defense Grand Alliance: Concussion Awareness, Research, and Education (CARE) Consortium. Participants with 506 diagnosed SRCs from 18 sports and 25 institutions and military service academies were analyzed and classified as either immediate removal from activity (I-RFA) or delayed removal from activity (D-RFA). Outcomes of interest included time missed from sport attributed to their SRC, symptom duration, and clinical assessment scores. RESULTS There were 322 participants (63.6%) characterized as D-RFA. I-RFA status was associated with significantly less time missed from sport ( R2 change = .022-.024, P < .001 to P = .001) and shorter symptom duration ( R2 change = .044-.046, P < .001 [all imputations]) while controlling for other SRC recovery modifiers. These athletes missed approximately 3 fewer days from sport participation. I-RFA athletes had significantly less severe acute SRC symptoms and were at lower risk of recovery taking ≥14 days (relative risk = .614, P < .001, small-medium effect size) and ≥21 days (relative risk = .534, P = .010, small effect size). CONCLUSION I-RFA is a protective factor associated with less severe acute symptoms and shorter recovery after SRC. Conveying this message to athletes, coaches, and others involved in the care of athletes may promote timely injury reporting.
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Affiliation(s)
- Breton M. Asken
- Address correspondence to Breton M. Asken, MS, ATC, Department of Clinical and Health Psychology, University of Florida, PO Box 100165, Gainesville, FL 32610, USA ()
| | | | | | | | | | | | | | | | | | | | | | | | | | - Scott Anderson
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Jeff Bazarian
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Alison Brooks
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Thomas Buckley
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Sara Chrisman
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Michael Collins
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - John DiFiori
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Stefan Duma
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Brian Dykhuizen
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - James T Eckner
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Luis Feigenbaum
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - April Hoy
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Louise Kelly
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - T Dianne Langford
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Laura Lintner
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Gerald McGinty
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Jason Mihalik
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Christopher Miles
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Justus Ortega
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Nicholas Port
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Margot Putukian
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Steve Rowson
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
| | - Steven Svoboda
- Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).,Investigation performed at the University of Florida, Gainesville, Florida, USA
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Do Neurocognitive SCAT3 Baseline Test Scores Differ Between Footballers (Soccer) Living With and Without Disability? A Cross-Sectional Study. Clin J Sport Med 2018; 28:43-50. [PMID: 28107219 DOI: 10.1097/jsm.0000000000000407] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine if baseline Sport Concussion Assessment Tool, third Edition (SCAT3) scores differ between athletes with and without disability. DESIGN Cross-sectional comparison of preseason baseline SCAT3 scores for a range of England international footballers. SETTING Team doctors and physiotherapists supporting England football teams recorded players' SCAT 3 baseline tests from August 1, 2013 to July 31, 2014. PARTICIPANTS A convenience sample of 249 England footballers, of whom 185 were players without disability (male: 119; female: 66) and 64 were players with disability (male learning disability: 17; male cerebral palsy: 28; male blind: 10; female deaf: 9). ASSESSMENT AND OUTCOME MEASURES Between-group comparisons of median SCAT3 total and section scores were made using nonparametric Mann-Whitney-Wilcoxon ranked-sum test. MAIN RESULTS All footballers with disability scored higher symptom severity scores compared with male players without disability. Male footballers with learning disability demonstrated no significant difference in the total number of symptoms, but recorded significantly lower scores on immediate memory and delayed recall compared with male players without disability. Male blind footballers' scored significantly higher for total concentration and delayed recall, and male footballers with cerebral palsy scored significantly higher on balance testing and immediate memory, when compared with male players without disability. Female footballers with deafness scored significantly higher for total concentration and balance testing than female footballers without disability. CONCLUSIONS This study suggests that significant differences exist between SCAT3 baseline section scores for footballers with and without disability. Concussion consensus guidelines should recognize these differences and produce guidelines that are specific for the growing number of athletes living with disability.
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17
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Seifert T. The relationship of migraine and other headache disorders to concussion. HANDBOOK OF CLINICAL NEUROLOGY 2018; 158:119-126. [DOI: 10.1016/b978-0-444-63954-7.00012-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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18
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Larruskain J, Lekue JA, Diaz N, Odriozola A, Gil SM. A comparison of injuries in elite male and female football players: A five-season prospective study. Scand J Med Sci Sports 2017; 28:237-245. [PMID: 28207979 DOI: 10.1111/sms.12860] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2017] [Indexed: 11/30/2022]
Abstract
The aim was to compare the epidemiology of injuries between elite male and female football players from the same club. Injuries and individual exposure time in a male team and a female team, both playing in the Spanish first division, were prospectively recorded by the club's medical staff for five seasons (2010-2015) following the FIFA consensus statement. Total, training, and match exposure hours per player-season were 20% higher for men compared to women (P<.01). Total, training, and match injury incidence were 30%-40% higher in men (P≤.04) mainly due to a 4.82 (95% confidence interval [CI] 2.30-10.08) times higher incidence of contusions, as there were no differences in the incidence of muscle and joint/ligament injuries (P≥.44). The total number of absence days was 21% larger in women owing to a 5.36 (95% CI 1.11-25.79) times higher incidence of severe knee and ankle ligament injuries. Hamstring strains and pubalgia cases were 1.93 (95% CI 1.16-3.20) and 11.10 (95% CI 1.48-83.44) times more frequent in men, respectively; whereas quadriceps strains, anterior cruciate ligament ruptures, and ankle syndesmosis injuries were 2.25 (95% CI 1.22-4.17), 4.59 (95% CI 0.93-22.76), and 5.36 (95% CI 1.11-25.79) times more common in women, respectively. In conclusion, prevention strategies should be tailored to the needs of male and female football players, with men more predisposed to hamstring strains and hip/groin injuries, and women to quadriceps strains and severe knee and ankle ligament injuries.
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Affiliation(s)
- J Larruskain
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - J A Lekue
- Medical Services, Athletic Club, Lezama, Spain.,Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - N Diaz
- Medical Services, Athletic Club, Lezama, Spain
| | - A Odriozola
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - S M Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
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19
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Young TE, Chen M. One-Year Concussion Prevalence in Marion County, Florida High School Athletes. J Chiropr Med 2016; 15:204-7. [PMID: 27660597 DOI: 10.1016/j.jcm.2016.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/05/2016] [Accepted: 02/18/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate data on concussion prevalence in 1 geographic location and to identify which sports have a higher prevalence of concussion in the Marion County, Florida, school district. METHODS High school athletic trainers in Marion County, Florida, are required to compile statistics related to number of participants and concussions sustained in the county school district during each season. They provided the data for the 2011-2012 school year to independent analysts with the permission of the athletic director. The study evaluated 3689 student-athletes (2102 male, 1587 female), and 34 concussions (24 male, 10 female) were reported. Concussions were self-reported by the athletes and diagnosed by trainers on field or by follow-up after physician referral. Consent was included in consent to participate in interscholastic athletics, and all athletes enrolling in a sport during the 2011-2012 academic year were included regardless of participation level. Number of participants and concussions sustained was calculated per 100 participants for each sport and in total for 1 year. RESULTS The percentages of concussions per sport were as follows: basketball, 1.83%; cheerleading, 0.40%; football, 2.83%; soccer, 1.84%; track and field, 0.44%; and wrestling, 0.70%. Ten additional sports were included in the study but had no reported concussions. Total prevalence for the district was 0.922% (1.14% male, 0.63% female) during a 1-year period. CONCLUSION The concussion prevalence in this district during the 2011-2012 school year was just under 1%. The sport reporting the highest prevalence was football, followed by soccer. Females reported a higher rate of concussions than males in sports played by both male and female participants. This highlights the need to minimize risk for concussion, especially in noncollision contact sports, and in female athletes.
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Affiliation(s)
| | - Mark Chen
- Private Practice, Chiropractic USA, Ocala, FL
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20
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21
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Song H, Xu L, Zhang R, Cao Z, Zhang H, Yang L, Guo Z, Qu Y, Yu J. Rosemary extract improves cognitive deficits in a rats model of repetitive mild traumatic brain injury associated with reduction of astrocytosis and neuronal degeneration in hippocampus. Neurosci Lett 2016; 622:95-101. [DOI: 10.1016/j.neulet.2016.04.048] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 04/08/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
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22
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Asken BM, McCrea MA, Clugston JR, Snyder AR, Houck ZM, Bauer RM. "Playing Through It": Delayed Reporting and Removal From Athletic Activity After Concussion Predicts Prolonged Recovery. J Athl Train 2016; 51:329-35. [PMID: 27111584 DOI: 10.4085/1062-6050-51.5.02] [Citation(s) in RCA: 193] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Preclinical research has demonstrated a window of vulnerability in the immediate aftermath of concussion wherein continued activity and stimulation can impair or prolong neurobehavioral recovery. However, this concept has not been quantified in a human population. OBJECTIVE To examine the effect of delayed reporting and removal from athletic activity after concussion on recovery time. DESIGN Cross-sectional study. SETTING A National Collegiate Athletic Association Division I university. PATIENTS OR OTHER PARTICIPANTS Ninety-seven athletes who sustained a sport-related concussion between 2008 and 2015 were analyzed (age = 20.4 ± 1.3 years). Athletes were grouped as immediate removal from activity (I-RFA) or delayed removal from activity (D-RFA). MAIN OUTCOME MEASURE(S) Days missed was defined as the number of days between the concussion-causing event and clearance for return to contact. Associations between RFA group and prolonged (8 or more days') versus normal (7 or fewer days') recovery were also analyzed. RESULTS Fifty (51.5%) of the 97 athletes did not immediately report concussion symptoms. The D-RFA athletes averaged 4.9 more days missed than the I-RFA athletes. Membership in the specific RFA group predicted days missed even after controlling for sex, concussion history, learning disability or attention-deficit/hyperactivity disorder diagnosis, diagnosed psychological disorder, and acute symptom severity (R( 2) change = 0.097, β = .319, P = .002). The D-RFA athletes were approximately 2.2 times more likely to have a prolonged recovery (8 or more days) compared with the I-RFA athletes (χ(2) = 10.268, P = .001, ϕ = 0.325). CONCLUSIONS Athletes who do not immediately report symptoms of a concussion and continue to participate in athletic activity are at risk for longer recoveries than athletes who immediately report symptoms and are immediately removed from activity. Continuing to participate in athletic activity during the immediate aftermath of a concussion potentially exposes the already injured brain to compounded neuropathophysiologic processes.
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Affiliation(s)
| | | | - James R Clugston
- Department of Community Health and Family Medicine, and University Athletic Association, University of Florida, Gainesville
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23
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Alworth M, Bond MC, Brady WJ. The sports medicine literature 2013. Am J Emerg Med 2015; 33:1283-7. [DOI: 10.1016/j.ajem.2013.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 09/25/2013] [Accepted: 10/01/2013] [Indexed: 11/26/2022] Open
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25
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Feddermann-Demont N, Straumann D, Dvořák J. Return to play management after concussion in football: recommendations for team physicians. J Sports Sci 2014; 32:1217-28. [PMID: 24902964 DOI: 10.1080/02640414.2014.918273] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A concussion is a rare but potentially serious injury of football players. Thus, an immediate and valid diagnosis, estimate of severity and therapeutic management is required. To summarise the published information on management of concussion with respect to a safe return to play (RTP), a literature search was conducted. Current guidelines on concussion in sports and significant studies on concussion in football were analysed. After concussion, management and RTP decision should remain in the area of clinical judgement on an individualised basis according to the current international guidelines. If a concussion is suspected, the player should not be allowed to RTP the same day. The RTP programme should follow a gradual step-wise procedure. A concussed player should not RTP unless he/she is asymptomatic and the neurological and neuropsychological examinations are normal. Untimely RTP bears an increased risk of sustaining another more severe brain injury and repetitive brain injury of long-term sequelae. In football, the management of concussion should primarily follow the recommendations proposed by the Concussion in Sports Group. Information and education of players and their medical and coaching team help to protect the players' health. Future studies on concussion should include validated and detailed information on RTP protocols.
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Abstract
OBJECTIVE To examine the mechanisms of injury for concussions in university football, ice hockey, and soccer. DESIGN Prospective cohort design. SETTING McGill University Sport Medicine Clinic. PARTICIPANTS Male and female athletes participating in varsity football, ice hockey, and soccer. MAIN OUTCOME MEASURES Athletes were followed prospectively over a 10-year period to determine the mechanisms of injury for concussions and whether contact with certain areas of the body or individual variables predisposed to longer recovery from concussions. For soccer, data were collected on whether concussions occurred while attempting to head the ball. RESULTS There were 226 concussions in 170 athletes over the study period. The side/temporal area of the head or helmet was the most common area to be struck resulting in concussion in all 3 sports. Contact from another player's head or helmet was the most probable mechanism in football and soccer. In hockey, concussion impacts were more likely to occur from contact with another body part or object rather than another head/helmet. Differences in mechanisms of injuries were found between males and females in soccer and ice hockey. Athletes with multiple concussions took longer to return to play with each subsequent concussion. Half of the concussions in soccer were related to attempting to head the soccer ball. CONCLUSIONS The side of the head or helmet was the most common area to be struck resulting in concussion in all 3 sports. In ice hockey and soccer, there are differences in the mechanisms of injury for males and females within the same sport.
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27
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Peck KY, Johnston DA, Owens BD, Cameron KL. The incidence of injury among male and female intercollegiate rugby players. Sports Health 2014; 5:327-33. [PMID: 24459548 PMCID: PMC3899911 DOI: 10.1177/1941738113487165] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The National Collegiate Athletic Association classifies women’s rugby as an emerging sport. Few studies have examined the injury rates in women’s collegiate rugby or compared injury rates between sexes. Hypothesis: Injury rates will differ between female and male intercollegiate club rugby players. Study Design: Descriptive epidemiological study. Methods: Five years of injury data were collected from the men’s and women’s rugby teams at a US service academy using the institution’s injury surveillance system. The primary outcome of interest was the incidence rate of injury during the study period per 10,000 athlete exposures. Incidence rate ratios (IRRs) were calculated using a Poisson distribution to compare the rates by sex. Results: During the study period, the overall incidence rate for injury was 30% higher (IRR = 1.30, 95% CI: 1.09, 1.54) among men when compared with women; however, the distribution of injuries varied by sex. The incidence rate for ACL injury among women was 5.3 times (IRR = 5.32, 95% CI: 1.33, 30.53) higher compared with that among men. Men were 2.5 times (IRR = 2.54, 95% CI: 1.03, 7.52) more likely to sustain a fracture. The rate of acromioclavicular joint injury was 2.2 times (IRR = 2.19, 95% CI: 1.03, 5.19) higher among men when compared with women. Men were 6.6 times (IRR = 6.55, 95% CI: 2.65, 20.91) more likely to have an open wound than women. Conclusion: There are differences in injury rates and patterns between female and male American rugby players. Clinical Relevance: The differences in injury patterns may reflect distinct playing styles, which could be the result of the American football background common among many of the male players.
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Affiliation(s)
- Karen Y Peck
- Keller Army Community Hospital, West Point, New York
| | | | - Brett D Owens
- Keller Army Community Hospital, West Point, New York
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McCrory P, Meeuwisse WH, Aubry M, Cantu RC, Dvořák J, Echemendia RJ, Engebretsen L, Johnston K, Kutcher JS, Raftery M, Sills A, Benson BW, Davis GA, Ellenbogen R, Guskiewicz KM, Herring SA, Iverson GL, Jordan BD, Kissick J, McCrea M, McIntosh AS, Maddocks D, Makdissi M, Purcell L, Putukian M, Schneider K, Tator CH, Turner M. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport, Zurich, November 2012. J Athl Train 2013; 48:554-75. [PMID: 23855364 DOI: 10.4085/1062-6050-48.4.05] [Citation(s) in RCA: 315] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Paul McCrory
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia.
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McCrory P, Meeuwisse W, Aubry M, Cantu B, Dvořák J, Echemendia R, Engebretsen L, Johnston K, Kutcher J, Raftery M, Sills A, Benson B, Davis G, Ellenbogen R, Guskiewicz K, Herring SA, Iverson G, Jordan B, Kissick J, McCrea M, McIntosh A, Maddocks D, Makdissi M, Purcell L, Putukian M, Schneider K, Tator C, Turner M. Consensus statement on Concussion in Sport – The 4th International Conference on Concussion in Sport held in Zurich, November 2012. Phys Ther Sport 2013; 14:e1-e13. [PMID: 23664041 DOI: 10.1016/j.ptsp.2013.03.002] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 02/25/2013] [Indexed: 12/14/2022]
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Consensus statement on Concussion in Sport—The 4th International Conference on Concussion in Sport held in Zurich, November 2012. J Sci Med Sport 2013; 16:178-89. [DOI: 10.1016/j.jsams.2013.02.009] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 02/25/2013] [Indexed: 12/14/2022]
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Berz K, Divine J, Foss KB, Heyl R, Ford KR, Myer GD. Sex-specific differences in the severity of symptoms and recovery rate following sports-related concussion in young athletes. PHYSICIAN SPORTSMED 2013; 41:58-63. [PMID: 23703518 DOI: 10.3810/psm.2013.05.2015] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION While research on adult recovery from concussion indicates sex-specific symptoms and recovery rates, there is little existing data on younger patient populations. OBJECTIVE To determine sex-specific differences in the severity of presenting symptoms and recovery rate between groups of young athletes who presented ≤ 7 or > 7 days after sports-related concussion. METHODS This study was a retrospective review of athletes aged 9 to 17 years who were referred for evaluation of a sports-related concussion over a 24-month period. The study groups were divided by sex and post-injury presentation to the clinic at ≤ 7 days and > 7 days from the date of injury. Athletes with learning disabilities were excluded from the study and data analysis. Age, height, and weight were recorded for each subject. Each subject also reported their initial degree of confusion, amnesia, or loss of consciousness, and whether a helmet was worn when the injury was sustained. A 22-item post-concussion symptom score (SS) scale was completed by both groups on initial assessment (SS1) and follow-up visit (SS2). The recovery rate (SSR) was calculated as (SS2-SS1)/days between SS2 and SS1. Sex and group comparisons for SS1 and SSR were performed using 2 × 2 analysis of variance. A similar analysis was also performed for effects of sex on SS1 and SSR in patients who were not wearing a helmet. RESULTS Thirty-seven athletes aged 15.0 ± 1.9 years were evaluated. Males, regardless of day of presentation, had a lower SS1 evaluation than females (15.8 vs 30.9; P < 0.05). Males without helmets did not differ from females without helmets, but this was not significantly different (14.1 vs 29.6; P = 0.1). There was not a significant difference in SS1 evaluation between the groups who presented at ≤ 7 or > 7 days. The overall mean SSR was -1.2/day, with no significant difference seen between groups or sex. There were no significant differences in degree of loss of consciousness, amnesia, confusion, or age between the sexes or groups. CONCLUSION Whether presenting at ≤ 7 or > 7 days following a sports-related concussion, female athletes reported a higher SS1 evaluation. With SSR being similar between sexes, the current data suggest that young, female athletes may take longer to become symptom free following sports-related concussion. This information may be an important factor in returning a young athlete to sport after sports-related concussion.
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Affiliation(s)
- Kate Berz
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
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McCrory P, Meeuwisse WH, Aubry M, Cantu B, Dvořák J, Echemendia RJ, Engebretsen L, Johnston K, Kutcher JS, Raftery M, Sills A, Benson BW, Davis GA, Ellenbogan R, Guskiewicz K, Herring SA, Iverson GL, Jordan BD, Kissick J, McCrea M, McIntosh AS, Maddocks D, Makdissi M, Purcell L, Putukian M, Schneider K, Tator CH, Turner M. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. J Am Coll Surg 2013; 216:e55-71. [PMID: 23582174 DOI: 10.1016/j.jamcollsurg.2013.02.020] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 02/19/2013] [Indexed: 12/14/2022]
Affiliation(s)
- Paul McCrory
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia.
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Consensus statement on concussion in sport--the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Clin J Sport Med 2013; 23:89-117. [PMID: 23478784 DOI: 10.1097/jsm.0b013e31828b67cf] [Citation(s) in RCA: 231] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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McCrory P, Meeuwisse WH, Aubry M, Cantu RC, Dvořák J, Echemendia RJ, Engebretsen L, Johnston KM, Kutcher JS, Raftery M, Sills A, Benson BW, Davis GA, Ellenbogen R, Guskiewicz KM, Herring SA, Iverson GL, Jordan BD, Kissick J, McCrea M, McIntosh AS, Maddocks DL, Makdissi M, Purcell L, Putukian M, Schneider K, Tator CH, Turner M. Consensus statement on concussion in sport--the 4th International Conference on Concussion in Sport held in Zurich, November 2012. PM R 2013; 5:255-79. [PMID: 23466418 DOI: 10.1016/j.pmrj.2013.02.012] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Paul McCrory
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
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Sports Neuropsychology With Diverse Athlete Populations: Contemporary Findings and Special Considerations. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2012. [DOI: 10.1123/jcsp.6.4.363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This paper aims to familiarize readers with the contemporary scientific literature available on sports concussion as it relates to populations divergent from adult males who play football and hockey. Herein, we focus on important issues such as age, gender, culture, language, sport type, and premorbid conditions (such as learning disabilities [LD] and attention deficit/hyperactive disorder [ADHD]) that can influence concussion incidence, severity, and recovery.
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Brainard LL, Beckwith JG, Chu JJ, Crisco JJ, McAllister TW, Duhaime AC, Maerlender AC, Greenwald RM. Gender differences in head impacts sustained by collegiate ice hockey players. Med Sci Sports Exerc 2012; 44:297-304. [PMID: 21716150 DOI: 10.1249/mss.0b013e31822b0ab4] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to quantify the frequency, magnitude, and location of head impacts sustained by male and female collegiate ice hockey players during two seasons of play. METHODS During two seasons, 88 collegiate athletes (51 females, 37 males) on two female and male National Collegiate Athletic Association varsity ice hockey teams wore instrumented helmets. Each helmet was equipped with six single-axis accelerometers and a miniature data acquisition system to capture and record head impacts sustained during play. Data collected from the helmets were postprocessed to compute linear and rotational accelerations of the head as well as impact location. The head impact exposure data (frequency, location, and magnitude) were then compared between genders. RESULTS Female hockey players experienced a significantly lower (P < 0.001) number of impacts per athlete exposure than males (females = 1.7 ± 0.7, males = 2.9 ± 1.2). The frequency of impacts by location was the same between genders (P > 0.278) for all locations except the right side of the head, where males received fewer impacts than females (P = 0.031). Female hockey players were 1.1 times more likely than males to sustain an impact less than 50 g, whereas males were 1.3 times more likely to sustain an impact greater than 100 g. Similarly, males were 1.9 times more likely to sustain an impact with peak rotational acceleration greater than 5000 rad·s(-2) and 3.5 times more likely to sustain an impact greater than 10,000 rad·s(-2). CONCLUSIONS Although the incidence of concussion has typically been higher for female hockey players than male hockey players, female players sustain fewer impacts and impacts resulting in lower head acceleration than males. Further study is required to better understand the intrinsic and extrinsic risk factors that lead to higher rates of concussion for females that have been previously reported.
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Levy ML, Kasasbeh AS, Baird LC, Amene C, Skeen J, Marshall L. Concussions in soccer: a current understanding. World Neurosurg 2011; 78:535-44. [PMID: 22120567 DOI: 10.1016/j.wneu.2011.10.032] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 09/14/2011] [Accepted: 10/20/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Traumatic brain injury (TBI) is a significant public health problem in the United States, with approximately 1.5-2 million TBIs occurring each year. However, it is believed that these figures underestimate the true toll of TBI. Soccer is the most popular sport in the world and has a following of millions in the United States. Soccer is a sport not traditionally identified as high-risk for concussions, yet several studies have shown that concussion rates in soccer are comparable to, and often exceed those of, other contact sports. As many as 22% of all soccer injuries are concussions. METHODS Soccer is a sport not traditionally identified as high risk for concussions, yet several studies have shown that concussion rates in soccer are comparable to, and often exceed those of, other contact sports. As many as 22% of all soccer injuries are concussions. Head injury during soccer is usually the result of either "direct contact" or contact with the ball while "heading" the ball. Relationships between the number of headers sustained in a single season and the degree of cognitive impairment (attention and visual/verbal memory) have been demonstrated. It is also likely that multiple concussions may cause cumulative neuropsychologic impairment in soccer players. RESULTS Although our understanding of risk factors for sports-related concussions is far from complete, there is great potential for prevention in sports-related concussions. Several measures must be taken to avert the development of concussions in soccer and, when they take place, reduce their effects. These include the development and testing of effective equipment during play, the maintenance of regulatory standards for all such equipment, educating young athletes on the safe and appropriate techniques used during play, and strict adherence to the rules of competition. CONCLUSIONS In spite of such preventive measures, concussions in soccer will continue to occur. Considering the frequency of concussions in soccer, the serious sequelae of these concussions, and because almost half of concussed soccer players were noncompliant with recommended American Academy of Neurology return-to-play guidelines, further measures must be taken to protect players, in addition to understanding those criteria that result in removing an injured player from competition and the steps by which to safely return an athlete to competition after injury.
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Affiliation(s)
- Michael L Levy
- Division of Pediatric Neurosurgery Rady Children's Hospital of San Diego, San Diego, CA, USA.
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McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, Cantu R. Consensus statement on concussion in sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. J Athl Train 2010; 44:434-48. [PMID: 19593427 DOI: 10.4085/1062-6050-44.4.434] [Citation(s) in RCA: 181] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Giannotti M, Al-Sahab B, McFaull S, Tamim H. Epidemiology of acute head injuries in Canadian children and youth soccer players. Injury 2010; 41:907-12. [PMID: 19878944 DOI: 10.1016/j.injury.2009.09.040] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 09/16/2009] [Accepted: 09/30/2009] [Indexed: 02/02/2023]
Abstract
BACKGROUND Limited studies have been done to assess head injury characteristics for children and youth soccer players in Canada. OBJECTIVES To describe acute head injury characteristics in children and youth soccer players and identify the characteristics of patients who required hospital admission. METHODS Analysis was based on the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). Soccer-related head injuries amongst 5-19 year old children presenting at 16 hospital emergency departments during 1994-2004 were selected in the study. All head injury-related variables (nature of injury, mechanism of injury, location of play, soccer type and season of play) were stratified by age and sex. A logistic regression model, consisting of the injury-related variables, sex and age as the independent variables, was performed to examine the characteristics of those head-injured patients who required hospital admission. RESULTS Overall, there were 4720 head injury cases identified (15% of all soccer-related emergency department visits). The highest proportion of head injuries was amongst males (70%) and children aged 10-14 years (50%). Of head injury cases, 35% were superficial and/or open wounds, 28% minor head injuries, 11% concussions, 9% eye injuries and 5% fractures. The total number of cases that required hospital admission was 164 (3.5%). Based on logistic regression analysis, head-injured youth aged 15-19 years were almost two times more likely to be admitted to hospital than their younger counterparts (OR=2.2, 95% CI: 1.3-3.6). Compared to ball contact injuries, contact with structures/surfaces, other players/persons and other unspecified objects increased the odds of hospital admission at least by two-folds. Moreover, those who played unorganised soccer were significantly more likely to be admitted to the hospital as compared to those who played organised soccer (OR=1.7, 95% CI: 1.2-2.6). Finally, playing in the non-winter seasons had increased likelihood of hospital admissions. CONCLUSIONS Head injuries constituted a significant proportion of soccer-related injuries presenting to emergency departments. Future studies need to evaluate the nature and safety of the playing surfaces/turf and other structures on or around the field of play.
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Affiliation(s)
- Maria Giannotti
- School of Kinesiology and Health Science, York University, Bethune College, 4700 Keele Street, Toronto, Canada
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Injuries in women's soccer: a 1-year all players prospective field study of the women's Bundesliga (German premier league). Clin J Sport Med 2010; 20:264-71. [PMID: 20606511 DOI: 10.1097/jsm.0b013e3181e78e33] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To obtain precise information on injury patterns in the women's premier soccer league in Germany. DESIGN One-year, prospective, epidemiologic cohort study. SETTING Institutional level German Football Association. PARTICIPANTS All 254 players from all 12 women's premier league teams were included. INTERVENTIONS Base information by standardized personal interviews. Evaluation of all injury-associated medical data transmitted by standardized documentation forms. ASSESSMENT OF RISK FACTORS Injuries incidence rates (average, 95% confidence intervals) based on the exposure in matches and at practice. MAIN OUTCOME MEASURES All time loss diagnoses, number and context of injuries related to their anatomical localization, severity, and rehabilitation period were recorded. RESULTS All 254 players finished the study [average age, 22.8 years (16-35 years)]. Two hundred forty-six injuries amounted to an injury rate of 3.3 per 1000 hours (games, 18.5 per 1000 hours; practice, 1.4 per 1000 hours). Injury distribution: knee, 31.0%; ankle, 22.1%; thigh, 12.9%; and head, 7.1%. The seasonal peak was at the beginning of the competitive season. Injury rates doubled after the 60th minute. Twenty-nine percent of the injuries were severe, and 37% were moderate. CONCLUSIONS Female players suffer a high amount of head injuries and severe knee and ankle injuries. The most common single injury is a sprained ankle. Torn ligaments in the ankle and knee are the most common injuries that require a long recovery period. Most of the severe injuries (>30 days) are due to noncontact intrinsic mechanisms. Almost one-quarter of all injuries consist of exertion syndromes not yet correlated with certain seasonal periods.
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Abstract
Sport-related concussion is a common problem encountered by pediatricians and other primary care physicians. Assessment of concussion is based on clinical evaluation. The Zurich consensus statement provides a basic framework to guide concussion management decisions and recommends an individualized approach and the exercising of clinical judgment in return-to-play decisions. This article reviews practice aspects of concussion for the adolescent athletes who present in the primary care office or clinic setting.
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Consensus statement on concussion in sport--the 3rd International Conference on concussion in sport, held in Zurich, November 2008. J Clin Neurosci 2009; 16:755-63. [PMID: 19410148 DOI: 10.1016/j.jocn.2009.02.002] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 02/24/2009] [Indexed: 10/20/2022]
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McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, Cantu R. Consensus statement on concussion in sport - the Third International Conference on Concussion in Sport held in Zurich, November 2008. PHYSICIAN SPORTSMED 2009; 37:141-59. [PMID: 20048521 DOI: 10.3810/psm.2009.06.1721] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This paper is a revision and update of the recommendations developed following the 1st (Vienna) and 2nd (Prague) International Symposia on Concussion in Sport. The Zurich Consensus statement is designed to build on the principles outlined in the original Vienna and Prague documents and to develop further conceptual understanding of this problem using a formal consensus-based approach. A detailed description of the consensus process is outlined at the end of this document under the "background" section (see Section 11). This document is developed for use by physicians, therapists, certified athletic trainers, health professionals, coaches and other people involved in the care of injured athletes, whether at the recreational, elite, or professional level. While agreement exists pertaining to principal messages conveyed within this document, the authors acknowledge that the science of concussion is evolving, and therefore management and return-to-play (RTP) decisions remain in the realm of clinical judgment on an individualized basis. Readers are encouraged to copy and distribute freely the Zurich Consensus document and/or the Sports Concussion Assessment Tool (SCAT2) card, and neither is subject to any copyright restriction. The authors request, however, that the document and/or the SCAT2 card be distributed in their full and complete format.
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Affiliation(s)
- Paul McCrory
- Center for Health, Exercise and Sports Medicine, University of Melbourne, Parkville, Australia 3010.
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Consensus Statement on Concussion in Sport - The 3rdInternational Conference on Concussion in Sport Held in Zurich, November 2008. PM R 2009; 1:406-20. [DOI: 10.1016/j.pmrj.2009.03.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Accepted: 03/13/2009] [Indexed: 11/23/2022]
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Reider B. Dazed and confused. Am J Sports Med 2009; 37:875-6. [PMID: 19411654 DOI: 10.1177/0363546509335814] [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: 01/31/2023]
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47
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Consensus statement on Concussion in Sport 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Clin J Sport Med 2009; 19:185-200. [PMID: 19423971 DOI: 10.1097/jsm.0b013e3181a501db] [Citation(s) in RCA: 254] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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48
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McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, Cantu R. Consensus statement on Concussion in Sport--the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. J Sci Med Sport 2009; 12:340-51. [PMID: 19362052 DOI: 10.1016/j.jsams.2009.02.004] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- P McCrory
- Centre for Health, Exercise & Sports Medicine, University of Melbourne, Australia.
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