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Rotundo MP, Sokol-Randell D, Bleakley C, Donnelly P, Tierney G. Characteristics of potential concussive events in elite hurling: a video-analysis study. Ir J Med Sci 2023; 192:3175-3185. [PMID: 36800054 PMCID: PMC10692028 DOI: 10.1007/s11845-023-03307-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/02/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND High-impact sports such as hurling place participants at risk of sport-related concussion (SRC). AIMS This study will evaluate the characteristics of potential concussive events (PCEs) that occur in elite male hurling to acquire an understanding of how they occur. METHODS The authors recorded PCEs and their characteristics throughout two seasons of inter-county GAA competition using broadcast footage based on a previously validated protocol. RESULTS A total of 183 PCEs were identified over 82 inter-county matches (2.23 per match; 59.5 per 1000 h of exposure). PCEs that occurred in the 4th quarter were significantly more likely to result in signs of SRC. Players most often intended to receive/control the sliotar (36.4%, n = 64) prior to PCEs. The most frequently observed mechanism was shoulder-to-head (20.2%, n = 37). Impacts to the lateral aspect of the head were 2.7 times more likely to result in visible signs than impacts to anteroposterior regions. CONCLUSIONS Players appear to be at a higher risk of SRC later in the match or when receiving the sliotar. Strikes to the lateral aspect of the head and those involving the shoulder appear to produce severe events. These findings provide initial guidance for the development of targeted player protection strategies.
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Affiliation(s)
- Mario P Rotundo
- Sport and Exercise Science Research Institute, Ulster University, Belfast, UK.
- Department of Family Practice, University of British Columbia, Vancouver, Canada.
| | - Darek Sokol-Randell
- Sport and Exercise Science Research Institute, Ulster University, Belfast, UK
- Department of Neurology, Memorial University of Newfoundland, St John's, Canada
| | - Chris Bleakley
- Sport and Exercise Science Research Institute, Ulster University, Belfast, UK
| | - Paul Donnelly
- Sport and Exercise Science Research Institute, Ulster University, Belfast, UK
| | - Gregory Tierney
- Sport and Exercise Science Research Institute, Ulster University, Belfast, UK
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2
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The Effects of Preparedness and Activity on Head Impacts in Lacrosse Athletes. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2023. [DOI: 10.1123/ijatt.2022-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Considering the frequency and magnitude of head impacts occurring during sport participation is important to guide prevention initiatives. Our purpose was to compare magnitude and frequency of lacrosse players’ head impacts based on anticipation level and impact activity. Lacrosse athletes (16 men, 15 women) wore xPatch sensors during games and practices that measured impact magnitude (linear and rotational accelerations) and frequency of video verified head impacts. The interaction between impact activity and preparedness was not significant, multivariate: F(8, 1,730) = ;1.03, p = ;.41, η2 = ;.01. Having a detailed understanding of the characteristics of head impacts could allow for focused interventions to reduce injury risk.
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3
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Weishaar MG, Stephens JA, Conner BT. Personality Predictors of Sports-Related Concussion Incidence: Analysis of Data From a Large, Heterogeneous Undergraduate Sample. Am J Phys Med Rehabil 2022; 101:738-745. [PMID: 34596098 PMCID: PMC8958175 DOI: 10.1097/phm.0000000000001901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Studies investigating the associations between personality and sports-related concussion are limited. The current study aimed to address this gap by examining whether specific personality dimensions predicted self-reported sports-related concussion outcomes. DESIGN This study included 1141 undergraduate students ( Mage = 19.47, SD = 2.14, female = 64.5%) who completed a battery of online personality measures and self-reported sports-related concussion items. The self-reported sports-related concussion outcomes included a single diagnosed sports-related concussion incident (i.e., "diagnosed sports-related concussion incidence") and incidents of multiple diagnosed sports-related concussions (i.e., "multiple diagnosed sports-related concussion incidents"). Analyses included splitting data randomly into training and validation data sets. Multivariate logistic regression models were then fit to each data set to determine predictors of sports-related concussion. RESULTS In both training and validation data sets, extraversion and experience seeking were found to be positively and most strongly associated with both sports-related concussion outcomes, whereas motor inhibition was found to be negatively associated with both outcomes. Additional personality dimensions showed differential relations with each sports-related concussion outcome. CONCLUSIONS The current study highlights the importance of considering personality dimensions in the context of self-reported sports-related concussion outcomes, as there are differential relations between personality dimensions and these outcomes. Thus, prevention efforts for sports-related concussion may benefit from evaluating additional athlete factors, like personality traits.
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Affiliation(s)
- Megan G Weishaar
- From the Department of Psychology-Counseling Psychology, Colorado State University, Fort Collins, Colorado (MGW, BTC); and Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado (JAS)
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Cooney NJ, Sowman P, Schilaty N, Bates N, Hewett TE, Doyle TLA. Head and Neck Characteristics as Risk Factors For and Protective Factors Against Mild Traumatic Brain Injury in Military and Sporting Populations: A Systematic Review. Sports Med 2022; 52:2221-2245. [PMID: 35522377 PMCID: PMC9388456 DOI: 10.1007/s40279-022-01683-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 10/25/2022]
Abstract
BACKGROUND Investigators have proposed that various physical head and neck characteristics, such as neck strength and head and neck size, are associated with protection from mild traumatic brain injury (mTBI/concussion). OBJECTIVES To systematically review the literature and investigate potential relationships between physical head and neck characteristics and mTBI risk in athletic and military populations. METHODS A comprehensive search of seven databases was conducted: MEDLINE, EMBASE, CINAHL, Scopus, SPORTDiscus, Cochrane Library, and Web of Science. Potential studies were systematically screened and reviewed. Studies on military and athletic cohorts were included if they assessed the relationship between physical head-neck characteristics and mTBI risk or proxy risk measures such as head impact kinematics. RESULTS The systematic search yielded a total of 11,723 original records. From these, 22 studies met our inclusion criteria (10 longitudinal, 12 cross-sectional). Relevant to our PECO (Population, Exposure, Comparator, and Outcomes) question, exposures included mTBI incidence and head impact kinematics (acceleration, velocity, displacement) for impacts during sport play and training and in controlled laboratory conditions. Outcome characteristics included head and neck size (circumference, mass, length, ratios between these measures), neck strength and endurance, and rate of force development of neck muscles. DISCUSSION We found mixed evidence for head and neck characteristics acting as risk factors for and protective factors against mTBI and increased susceptibility to head impacts. Head-neck strength and size variables were at times associated with protection against mTBI incidence and reduced impact kinematics (14/22 studies found one or more head-neck variable to be associated with protection); however, some studies did not find these relationships (8/22 studies found no significant associations or relationships). Interestingly, two studies found stronger and larger athletes were more at risk of sustaining high impacts during sport. Strength and size metrics may have some predictive power, but impact mitigation seems to be influenced by many other variables, such as behaviour, sex, and impact anticipation. A meta-analysis could not be performed due to heterogeneity in study design and reporting. CONCLUSION There is mixed evidence in the literature for the protective capacity of head and neck characteristics. We suggest field-based mTBI research in the future should include more dynamic anthropometric metrics, such as neck stiffness and response to perturbation. In addition, laboratory-based mTBI studies should aim to standardise design and reporting to help further uncover these complicated relationships.
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Affiliation(s)
- Nicholas J Cooney
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Paul Sowman
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Nathan Schilaty
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA.,Center for Neuromusculoskeletal Research, University of South Florida, Tampa, FL, USA
| | - Nathaniel Bates
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Timothy E Hewett
- Hewett Global Consulting, Minneapolis, MN, USA.,Rocky Mountain Consortium for Sports Injury Research, Aspen, CO, USA
| | - Tim L A Doyle
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
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5
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Farley T, Barry E, Sylvester R, Medici AD, Wilson MG. Poor isometric neck extension strength as a risk factor for concussion in male professional Rugby Union players. Br J Sports Med 2022; 56:616-621. [PMID: 35197247 DOI: 10.1136/bjsports-2021-104414] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Concussion is one of the highest burden injuries within professional Rugby Union ('rugby') and comes with a high health and financial cost to players and teams. Limited evidence exists as to the existence of modifiable intrinsic risk factors for concussion, leaving athletes and clinicians with few options when developing prevention strategies. OBJECTIVE To investigate whether neck strength is significantly associated with concussion incidence in professional male rugby players. METHODS 225 rugby players were assessed for neck strength at three time points throughout the 2018/2019 season using a method of isometric contraction. Associations with clinically diagnosed concussion injuries are presented as incidence rate ratios (IRRs) with 95% CIs. RESULTS Thirty concussions occurred in 29 players during the study period; a rate of 13.7 concussions per 1000 hours played. Greater neck strength was observed at mid and end of season time points versus preseason across the study population. There was a significant association between extension strength and concussion; a 10% increase for extension strength was associated with a 13% reduction in concussion rate (adjusted IRR (95% CI) 0.87 (0.78 to 0.98). No other significant associations were observed between concussion incidence and any other unique neck strength range or composite score. CONCLUSION Higher neck extension strength is associated with lower concussion rates in male rugby players. Neck strength is a modifiable intrinsic risk factor for concussion and may be an important component of a strength and conditioning regime.
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Affiliation(s)
- Theo Farley
- Division of Surgery and Interventional Science, University College London, London, UK .,Institute of Sport, Exercise and Health (ISEH), University College London, London, London, UK
| | - Ed Barry
- Georgia Rugby Federation, Tbilisi, Georgia
| | - Richard Sylvester
- Institute of Sport, Exercise and Health (ISEH), University College London, London, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK
| | - Akbar De Medici
- Institute of Sport, Exercise and Health (ISEH), University College London, London, London, UK
| | - Mathew G Wilson
- Division of Surgery and Interventional Science, University College London, London, UK.,Institute of Sport, Exercise and Health (ISEH), University College London, London, London, UK
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Sokol-Randell D, Rotundo MP, Tierney G, Deasy C, Cusimano MD. Characteristics of potential concussive events in elite male gaelic football players: A descriptive video-analysis. J Sports Sci 2021; 39:1700-1708. [PMID: 33722171 DOI: 10.1080/02640414.2021.1896455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2021] [Indexed: 10/21/2022]
Abstract
Gaelic football (GF) is a high-impact sport and Sport-Related Concussion (SRC) is an issue within the game. Our aim was to evaluate the characteristics of Potential Concussive Events (PCEs) that occur in the Gaelic Athletic Association National Football League and extrapolate this data to reduce the incidence and severity of SRC. PCEs may or may not lead to a clinical diagnosis of SRC, but represent high-risk events and therefore may be a useful indicator. A video-analysis approach was undertaken to identify PCEs throughout two seasons of play using broadcast footage, and characteristics of each PCE were measured based on previously validated methods. A total of 242 PCEs were identified over 111 matches (2.18 per match, 58.14 per 1000 hours of exposure). PCEs were frequently not anticipated by the player (40.5%, n = 98). The most common impact locations were the mandibular region (33.1%, n = 80) and the temporal region (21.1%, n = 51), and the most frequently observed mechanism was hand/fist to head (27.3%, n = 66). A second-hit was observed in 34 PCEs (14.0%). The findings provide initial guidance for the development of player protection strategies to reduce the incidence and severity of SRC in Gaelic Football.
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Affiliation(s)
| | | | | | - Conor Deasy
- Cork University Hospital Emergency Department, University College Cork, Cork, Ireland
| | - Michael D Cusimano
- Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Canada
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Shendell DG, Gonzalez L, Listwan TA, Pancella J, Blackborow M, Boyd J. Developing and Piloting a School-Based Online Adolescent Student-Athlete Concussion Surveillance System. THE JOURNAL OF SCHOOL HEALTH 2019; 89:527-535. [PMID: 31016753 DOI: 10.1111/josh.12775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 05/03/2018] [Accepted: 05/12/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Despite increased awareness of concussions, epidemiologic surveillance efforts have been scarce, especially among adolescents. This project, which was developed with school stakeholders (certified athletic trainers [ATCs], nurses, athletic directors), piloted a public secondary school-based online surveillance tool for interscholastic and intramural sports and physical education-related concussions in New Jersey during 2014-2017 school years (SY). METHODS Participating public high schools (5 within 4 districts) and career-technical-vocational education districts (2 with 5 campuses) completed forms anonymously online via PsychData within 5 days. RESULTS There were 208 concussions reported, 115 in 2015-2016 SY and 93 in 2016-2017 SY. In fall 2015, 86 concussions were reported, including 16 from summer preseason. In fall 2016, 56 concussions were reported; 3 occurred during preseason. There were 7 concussions reported in winter 2016 and 16 in winter 2017. Twenty-two concussions were reported in spring of both 2016 and 2017. Most online forms were completed in <10 minutes, usually using either desktop computers or tablets/iPads. School nurses followed by ATCs were primary sources of data entered online, usually by ATCs. CONCLUSIONS Cooperation of nurses and ATCs at participating schools suggested online surveillance was valued and viable. Data inform future concussion prevention education and ongoing injury surveillance.
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Affiliation(s)
- Derek G Shendell
- Department of Environmental and Occupational Health, Rutgers School of Public Health, 683 Hoes Lane West, 3rd Floor SPH Building, Suite 399, Piscataway, NJ 08854-8020
- NJ Safe Schools Program, Rutgers School of Public Health, Piscataway, NJ
| | - Lauren Gonzalez
- NJ Safe Schools Program, Rutgers School of Public Health, Piscataway, NJ
| | - Tracy A Listwan
- Department of Environmental and Occupational Health, Rutgers School of Public Health, Piscataway, NJ
| | - Joseph Pancella
- West Deptford High School Athletic Department, West Deptford, NJ
| | - Mary Blackborow
- Brain Injury Alliance of NJ-Concussion in Youth Sports Committee, North Brunswick, NJ
- North Brunswick High School, North Brunswick, NJ
| | - Joanna Boyd
- Brain Injury Alliance of NJ-Concussion in Youth Sports Committee, North Brunswick, NJ
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8
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Abstract
Concussion is a common pediatric problem, and the best point of intervention would be to prevent a concussion from occurring. Unfortunately, information in this area has inconsistent support for the various methods that have been attempted. In infants, concussions are typically related to safety hazards in the environment and attempts to make the environment safer have resulted in decreased injuries over time. Toddlers also face environmental hazards that are slightly different in light of their increased mobility. School-aged children and adolescents primarily sustain concussions in the course of participation in organized contact sports. Although much research has been devoted to protective equipment, there is not a clearly effective piece of equipment that prevents concussions. Some effect has been demonstrated with changes in rules and policy that limit or eliminate certain kinds of dangerous contact. Research is still being performed to adequately evaluate methods that are already being used, as well as to find new methods in the future that may help protect today's children from concussions.
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9
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Rice T, Curtis R. Parental knowledge of concussion: Evaluation of the CDC's "Heads up to parents" educational initiative. JOURNAL OF SAFETY RESEARCH 2019; 69:85-93. [PMID: 31235239 DOI: 10.1016/j.jsr.2019.02.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 01/16/2019] [Accepted: 02/21/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Potential negative outcomes associated with sport-related concussion drive the need for resources to educate parents about prevention, recognition, and management of concussion in the youth athlete. Parents play a critical role in the recognition and management of concussion for their child. PURPOSE This study aims to (a) investigate current knowledge of concussion among parents whose children age 5-18 years play a club sport and (b) identify effects of an online video versus online print educational intervention on concussion knowledge change and learning. METHODS 140 parents whose children played a club sport answered questions regarding their knowledge of sport-related concussion pre- and post-random assignment to an educational intervention: CDC Concussion Awareness video or CDC Concussion Fact Sheet for Parents. RESULTS Participating parents demonstrated a moderate level of pre-intervention knowledge, but critical gaps in knowledge were identified. Knowledge of concussion improved slightly following intervention regardless of intervention type. CONCLUSIONS This study confirms the presence of gaps in knowledge of concussion in parents whose children play club sports. Without the protection of concussion legislation, those athletes who participate in club sports are at particular risk due to lack of concussion knowledge and education. This study confirms that education can have a positive impact on parental knowledge of concussion. Practical applications: Pre-knowledge of concussion is the greatest predictor of post-knowledge of concussion, therefore pre-assessment of target audience knowledge followed by a custom educational intervention taking into account principles of adult learning, would be the most beneficial to increasing concussion knowledge.
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Affiliation(s)
- Tracy Rice
- School of Medicine, Division of Physical Therapy, West Virginia University, P.O. Box 9226, Morgantown, WV 26506, United States.
| | - Reagan Curtis
- Department of Learning Sciences & Human Development, College of Education and Human Services, West Virginia University, Allen Hall 507D, Morgantown, WV, United States
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Season and Sport-Specific Adolescent Concussions via Online Surveillance in New Jersey Public High Schools 2015–2017. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2018. [DOI: 10.1123/ijatt.2017-0083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Despite increased awareness of concussions among student-athletes, local epidemiologic surveillance efforts are limited, especially among adolescents. We analyzed data reported through a state public-school-based online surveillance tool during the fall (summer preseason and regular season), winter, and spring seasons of the 2015–2017 school years at seven participating public high schools across New Jersey. Concussions were sustained during interscholastic and intramural sports and in physical education classes. There were 208 concussions: 142 in fall (123 regular season), 22 in winter (21 regular season), and 44 in spring. Reports stated 75% were first concussions, but 17% were second and 2% were third concussions.
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11
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Paquin H, Taylor A, Meehan WP. Office-based concussion evaluation, diagnosis, and management: pediatric. HANDBOOK OF CLINICAL NEUROLOGY 2018; 158:107-117. [PMID: 30482337 DOI: 10.1016/b978-0-444-63954-7.00011-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
More children and adolescents are participating in competitive sports than ever before, causing an overall increase in sport-related injuries. Concussion is a common injury in the pediatric population and its prevalence has increased with increased visibility and awareness. This chapter will discuss the clinical presentation, evaluation, and management of concussions sustained by pediatric athletes, while addressing the distinctive factors that pertain to this population. Management of concussion should be tailored to patients' symptoms and should focus on an early and gradual return to both cognitive and noncontact low-risk physical activity. A multidisciplinary approach is often helpful in addressing more specific symptoms, which fall into the somatic, cognitive, vestibular, emotional, and sleep domains. A prolonged recovery is defined by symptoms lasting more than 4 weeks. Individualized return-to-play decisions should focus on the safety of the young athlete.
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Affiliation(s)
- Hugo Paquin
- Division of Pediatric Emergency Medicine, CHU Ste-Justine, Montreal, QC, Canada.
| | - Alex Taylor
- Division of Neurology and Psychiatry, Boston Children's Hospital, Boston, MA, United States
| | - William P Meehan
- Division of Sports Medicine, Boston Children's Hospital, Boston, MA, United States
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12
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Hendricks S, O'Connor S, Lambert M, Brown JC, Burger N, Mc Fie S, Readhead C, Viljoen W. Video analysis of concussion injury mechanism in under-18 rugby. BMJ Open Sport Exerc Med 2016; 2:e000053. [PMID: 27900149 PMCID: PMC5125416 DOI: 10.1136/bmjsem-2015-000053] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Understanding the mechanism of injury is necessary for the development of effective injury prevention strategies. Video analysis of injuries provides valuable information on the playing situation and athlete-movement patterns, which can be used to formulate these strategies. Therefore, we conducted a video analysis of the mechanism of concussion injury in junior-level rugby union and compared it with a representative and matched non-injury sample. METHODS Injury reports for 18 concussion events were collected from the 2011 to 2013 under-18 Craven Week tournaments. Also, video footage was recorded for all 3 years. On the basis of the injury events, a representative 'control' sample of matched non-injury events in the same players was identified. The video footage, which had been recorded at each tournament, was then retrospectively analysed and coded. 10 injury events (5 tackle, 4 ruck, 1 aerial collision) and 83 non-injury events were analysed. RESULTS All concussions were a result of contact with an opponent and 60% of players were unaware of the impending contact. For the measurement of head position on contact, 43% had a 'down' position, 29% the 'up and forward' and 29% the 'away' position (n=7). The speed of the injured tackler was observed as 'slow' in 60% of injurious tackles (n=5). In 3 of the 4 rucks in which injury occurred (75%), the concussed player was acting defensively either in the capacity of 'support' (n=2) or as the 'jackal' (n=1). CONCLUSIONS Training interventions aimed at improving peripheral vision, strengthening of the cervical muscles, targeted conditioning programmes to reduce the effects of fatigue, and emphasising safe and effective playing techniques have the potential to reduce the risk of sustaining a concussion injury.
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Affiliation(s)
- Sharief Hendricks
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Sam O'Connor
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Michael Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - James C Brown
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Nicholas Burger
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Sarah Mc Fie
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Clint Readhead
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- South African Rugby Union (SARU), Cape Town, South Africa
| | - Wayne Viljoen
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- South African Rugby Union (SARU), Cape Town, South Africa
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13
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Morin M, Langevin P, Fait P. Cervical Spine Involvement in Mild Traumatic Brain Injury: A Review. JOURNAL OF SPORTS MEDICINE (HINDAWI PUBLISHING CORPORATION) 2016; 2016:1590161. [PMID: 27529079 PMCID: PMC4977400 DOI: 10.1155/2016/1590161] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/30/2016] [Accepted: 06/19/2016] [Indexed: 06/06/2023]
Abstract
Background. There is a lack of scientific evidence in the literature on the involvement of the cervical spine in mTBI; however, its involvement is clinically accepted. Objective. This paper reviews evidence for the involvement of the cervical spine in mTBI symptoms, the mechanisms of injury, and the efficacy of therapy for cervical spine with concussion-related symptoms. Methods. A keyword search was conducted on PubMed, ICL, SportDiscus, PEDro, CINAHL, and Cochrane Library databases for articles published since 1990. The reference lists of articles meeting the criteria (original data articles, literature reviews, and clinical guidelines) were also searched in the same databases. Results. 4,854 records were screened and 43 articles were retained. Those articles were used to describe different subjects such as mTBI's signs and symptoms, mechanisms of injury, and treatments of the cervical spine. Conclusions. The hypothesis of cervical spine involvement in post-mTBI symptoms and in PCS (postconcussion syndrome) is supported by increasing evidence and is widely accepted clinically. For the management and treatment of mTBIs, few articles were available in the literature, and relevant studies showed interesting results about manual therapy and exercises as efficient tools for health care practitioners.
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Affiliation(s)
- Michael Morin
- Department of Human Kinetics, Université du Québec à Trois-Rivières (UQTR), Trois-Rivières, QC, Canada G9A 5H7
- Research Group on Neuromusculoskeletal Dysfunctions (GRAN), UQTR, Trois-Rivières, QC, Canada G9A 5H7
| | - Pierre Langevin
- Cortex Médecine et Réadaptation Concussion Clinic, Quebec City, QC, Canada G1W 0C5
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC, Canada G1V 0A6
| | - Philippe Fait
- Department of Human Kinetics, Université du Québec à Trois-Rivières (UQTR), Trois-Rivières, QC, Canada G9A 5H7
- Research Group on Neuromusculoskeletal Dysfunctions (GRAN), UQTR, Trois-Rivières, QC, Canada G9A 5H7
- Cortex Médecine et Réadaptation Concussion Clinic, Quebec City, QC, Canada G1W 0C5
- Research Center in Neuropsychology and Cognition (CERNEC), Montreal, QC, Canada H3C 3J7
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Abstract
Sports-related concussions (SRC) are common in all ages and occur in all sports. The diagnosis based on clinical suspicion after more serious injury is ruled out. Symptoms of concussion are due to a temporary and reversible neurometabolic cascade resulting in blood flow changes, neuronal excitotoxicity, ionic shifts, and mitochondrial changes. Symptoms are nonspecific, and commonly include headache, cognitive complaints, photophobia, and phonophobia. Loss of consciousness is rare in SRC and has limited influence on recovery and prognosis. Imaging has a limited role in the management of concussion and should be used to evaluate for more serious intracranial pathology. Treatment is based on symptoms and an understanding of the typical, rapid (7-10 days) recovery. No athlete should return to play until their symptoms have resolved and they have completed a supervised, step-wise return to play protocol. The article covers the most recent literature on the diagnosis and management of SRC, including evidence-based recommendations and expert-based consensus opinion. The article will also discuss issues regarding medical retirement, legislation, and future concepts in concussion diagnosis and management.
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15
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Bressan S, Babl FE. Diagnosis and management of paediatric concussion. J Paediatr Child Health 2016; 52:151-7. [PMID: 26174579 DOI: 10.1111/jpc.12967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2015] [Indexed: 01/01/2023]
Abstract
Heightened recognition of concussions and concerns about their sequelae in children has become an increasing community and public health concern. Biomarkers and clinical tests are being explored, but the diagnosis of concussion in the emergency department continues to be based on clinical signs and symptoms. While the majority of children go on to recover from post-concussive symptoms within 2 weeks, it is unclear which patients with concussion will go on to develop short- or long-term sequelae. A number of more or less evidence-based guidelines have become available which seek to guide clinicians on how to manage children post-concussion. In general, care after the emergency department is focused on reducing the risk of re-injury and rest until cerebral recovery with a graduated return to school and then play.
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Affiliation(s)
- Silvia Bressan
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Women's and Child's Health, Department of Pediatrics, University of Padova, Padova, Italy
| | - Franz E Babl
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Pediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Affiliation(s)
- Philip E Stieg
- Department of Neurological Surgery, Weill Medical College, New York, New York, USA.
| | - Kenneth Perrine
- Department of Neurological Surgery, Weill Medical College, New York, New York, USA
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