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Tashima C, Otomo M, Hosokawa Y. History, Knowledge, and Education of Sport-Related Concussion Among College Athletes in Japan. J Athl Train 2024; 59:793-800. [PMID: 38243738 PMCID: PMC11340669 DOI: 10.4085/1062-6050-0382.23] [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] [Indexed: 01/21/2024]
Abstract
CONTEXT Few authors have investigated sport-related concussion (SRC) awareness and knowledge among athletes in Japan. Sport-related concussion research is scarce among Asian compared with North American and European cohorts. OBJECTIVE To examine previous SRC history, level of SRC knowledge, and previous exposure to SRC education among collegiate athletes in Japan by the level of contact and access to medical staff. DESIGN Cross-sectional study. SETTING Single-university study in Japan. PATIENTS OR OTHER PARTICIPANTS A total of 2103 athletes (48 varsity teams) were contacted to participate in an anonymous survey. Data from athletes with (1) SRC history in the past 3 months, (2) persistent SRC symptoms, (3) nontraditional sports, or (4) incomplete surveys were excluded. As a result, data from 593 athletes representing 43 varsity teams were included in this analysis. MAIN OUTCOME MEASURE(S) Outcome measures were level of contact (contact [CON], limited contact [LTD], noncontact [NC]), access to medical staff (MEDYES, MEDNO), SRC knowledge (maximum score of 49), previous SRC history (self-report; yes, no), and previous SRC education (self-report; yes, no). RESULTS The average SRC knowledge total score was 33.4 ± 6.1 (range, 18-48). The knowledge score in CON was higher than in LTD and NC (P < .001) and in MEDYES than MEDNO (median, MEDYES = 34.0, MEDNO = 32.0; U = 27 841.5, P < .001). Sport-related concussion history was statistically different by the level of contact ( = 27.95, P < .001) and by access to medical staff ( = 4.5, P = .034). The presence of an SRC history and previous SRC education contributed to higher SRC knowledge, independent of the level of contact and access to medical staff (P < .001). CONCLUSIONS Japanese athletes who participated in CON sports had a higher prevalence of SRC history, higher knowledge, and greater exposure to SRC education than those in LTD or NC sports. Access to medical staff was associated with higher SRC knowledge.
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Affiliation(s)
- Chihiro Tashima
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Mana Otomo
- Toin University of Yokohama, Kanagawa, Japan
| | - Yuri Hosokawa
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Kelly LA, Caccese JB, Jain D, Master CL, Lempke L, Memmini AK, Buckley TA, Clugston JR, Mozel A, Eckner JT, Susmarski A, Ermer E, Cameron KL, Chrisman S, Pasquina P, Broglio SP, McAllister TW, McCrea M, Esopenko C. Sex Differences Across Concussion Characteristics in US Service Academy Cadets: A CARE Consortium Study. Sports Med 2024:10.1007/s40279-024-02068-3. [PMID: 38995598 DOI: 10.1007/s40279-024-02068-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE To describe sex differences in concussion characteristics in US Service Academy cadets. DESIGN Descriptive epidemiology study. SETTING Four US service academies. PARTICIPANTS 2209 cadets (n = 867 females, n = 1342 males). INDEPENDENT VARIABLE Sex. OUTCOME MEASURES Injury proportion ratios (IPR) compared the proportion of injuries by sex (females referent) for injury situation, certainty of diagnosis, prolonged recovery, recurrent injuries, mental status alterations, loss of consciousness (LOC), posttraumatic amnesia (PTA), retrograde amnesia (RGA), motor impairments, delayed symptom presentation, and immediate reporting. MAIN RESULTS Concussions from varsity/intercollegiate sports [IPR of 1.73, 95% confidence interval (CI) 1.43-2.10] and intramurals (IPR of 1.53, 95% CI 1.02-2.32) accounted for a larger proportion in males, whereas concussions outside of sport and military activities accounted for a smaller proportion among males (IPR of 0.70, 95% CI 0.58-0.85). The proportion of concussions with prolonged recovery was lower among males (IPR of 0.69, 95% CI 0.60-0.78), while concussions with altered mental status (IPR of 1.23, 95% CI 1.09-1.38), LOC (IPR of 1.67, 95% CI 1.17-2.37), PTA (IPR of 1.94, 95% CI 1.43-2.62), and RGA (IPR of 2.14, 95% CI 1.38-3.31) accounted for a larger proportion among males. A larger proportion of concussions that were immediately reported was observed in males (IPR of 1.15, 95% CI 1.00-2.31). Proportions of other characteristics (e.g., recurrent injuries) were not different between sexes. CONCLUSIONS A higher proportion of concussions occurred outside of sport and military training for female cadets, who also displayed proportionally longer recovery times than males, despite males demonstrating a higher proportion of LOC, PTA, and RGA. Possible factors may include different mechanisms of injury outside of sport and military training, different biopsychosocial states associated with sex or injury context, and delayed injury reporting when outside of an observed environment, possibly secondary to perceived stigma about reporting injuries.
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Affiliation(s)
- Louise A Kelly
- Department of Exercise Science, California Lutheran University, #3400, 60 W. Olsen Road, Thousand Oaks, CA, 91360, USA.
| | - J B Caccese
- College of Medicine School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - D Jain
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C L Master
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - L Lempke
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - A K Memmini
- Department of Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM, USA
| | - T A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - J R Clugston
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA
| | - A Mozel
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - J T Eckner
- Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - A Susmarski
- Medical Associates Clinic, Loras College, Dubuque, IA, USA
| | - E Ermer
- Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - K L Cameron
- Orthopaedic and Sports Medicine, United States Military Academy, West Point, NY, 10996, USA
| | - S Chrisman
- Division of Adolescence Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, 98105, USA
| | - P Pasquina
- Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - S P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - T W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - M McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - C Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Montalvo AM, Wallace JS, Nedimyer AK, Chandran A, Kossman MK, Gildner P, Register-Mihalik JK, Kerr ZY. Does the Association Between Concussion Measures and Social Context Factors Differ in Black and White Parents? J Athl Train 2024; 59:363-372. [PMID: 37681666 PMCID: PMC11064114 DOI: 10.4085/1062-6050-0193.23] [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] [Indexed: 09/09/2023]
Abstract
CONTEXT Middle school (MS) parents may benefit from education supporting timely concussion identification and care-seeking in their young children (aged approximately 10 to 15 years). However, such education may not consider individual needs and different social context factors, including lower socioeconomic status, disadvantaged social determinants of health, and different racial and ethnic backgrounds. OBJECTIVES To examine the relationship between social context factors and concussion knowledge, attitudes, and communication in MS parents and to explore the possible role of race and ethnicity (Black or White) as an effect measure modifier. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS A nationally representative sample of MS parents who completed an online survey (n = 1248). MAIN OUTCOME MEASURE(S) Parent outcomes were a history of concussion education, concussion symptom knowledge and attitudes, and communication with children about concussion. Main exposures were parental race and ethnicity (Black or White) and social context factors. Uni- and multivariable statistical analyses were performed to achieve the study aims. RESULTS Black parents were more likely than White parents to have received concussion education (69.5% versus 60.5%, P = .009), although median concussion knowledge scores were higher for White parents than for Black parents (40 versus 37, P < .001). Few associations were found for social context factors with concussion knowledge, attitudes, and communication in Black and White parents separately. CONCLUSIONS Among MS parents, race and ethnicity may not influence the association between social context factors and concussion-related knowledge, attitudes, or communication. However, differences were present by race and ethnicity regarding previous concussion education and other parental outcomes, concussion symptom knowledge in particular.
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Affiliation(s)
- Alicia M Montalvo
- College of Health Solutions, Arizona State University, Phoenix
- Emory Sports Performance and Research Center, Flowery Branch, GA
- Sports Medicine and Community Health Research Lab, University of Southern Mississippi, Hattiesburg
| | | | - Aliza K Nedimyer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Avinash Chandran
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Melissa K Kossman
- School of Health Professions, University of Southern Mississippi, Hattiesburg
- Sports Medicine and Community Health Research Lab, University of Southern Mississippi, Hattiesburg
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina at Chapel Hill
| | - Johna K Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
- Injury Prevention Research Center, University of North Carolina at Chapel Hill
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
- Injury Prevention Research Center, University of North Carolina at Chapel Hill
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Buckley TA, Passalugo SW, Gallo CA, Bodt B, Evans KM, Munkasy BA. Collegiate student-athletes concussion knowledge and attitudes: what a difference a decade Makes. Brain Inj 2024; 38:288-294. [PMID: 38369869 PMCID: PMC10911450 DOI: 10.1080/02699052.2024.2314549] [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] [Received: 09/25/2023] [Accepted: 01/31/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The purpose of this study was to assess changes in concussion knowledge and attitudes amongst incoming intercollegiate student-athletes over the course of a decade (2010-2012 vs 2021-2023). METHODS There were 592 student-athletes from 2 cohorts (2010-2012, 2021-2023) who completed the Rosenbaum Concussion Knowledge and Attitudes Survey (ROCKaS) questionnaire which is comprised of a concussion knowledge index (CKI, 0-24) and attitude index (CAI, 15-75) with higher scores reflecting better performance. A three factor ANOVA (Group, Sex, Concussion History) compared performance on the CKI and CAI. Individual questions were compared between groups with a Chi-Square analysis. RESULTS For the CKI, there was a significant main effect for Group (2010-2012: 18.5 ± 2.6, 2021-2023: 19.4 ± 2.5, p < 0.001, η 2 = 0.032 ) . For the CAI, there was also a significant main effect for group (2010-2012: 52.9 ± 6.0, 2021-2023: 62.2 ± 6.5, p < 0.001, η 2 = 0.359 ) . CONCLUSIONS The results of this study show a modest increase in concussion knowledge; however, large improvements in concussion attitudes were observed between groups. These results suggest a continued improvement in student-athlete concussion awareness and provide specific areas to continue addressing persistent misconceptions.
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Affiliation(s)
- Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Scott W Passalugo
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Caitlin A Gallo
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Barry Bodt
- College of Health Sciences, University of Delaware, Newark, Delaware, USA
| | - Kelsey M Evans
- Department of General Surgery, Orlando Health, Orlando, Florida, USA
| | - Barry A Munkasy
- School of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, Georgia, USA
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Abstract
OBJECTIVES The aims of the study were to assess prevalence and management of head impacts in stunt performers and to evaluate performers' quality of life and ability to work after head injury. METHODS Stunt performers completed an online survey about head impacts/head whips history, diagnosed concussions, reasons for not reporting injuries, health care sought after head impacts, attitudes toward on-set concussion management, perceived ability to work as a stunt performer, and health-related quality of life. RESULTS One hundred seventy-three performers (80%) indicated at least one head impact/head whip during their stunt career. Of these, 86% exhibited concussion-like symptoms and 38% received one or more concussion diagnoses. Sixty-five percent continued working with concussion-like symptoms. Short Form-12 mental component scores were suggestive of depression in 42%. CONCLUSIONS Concussion seems to be a serious occupational health issue in stunt performers. We suggest that concussion management, risk reduction, and education should be addressed in this community.
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Bretzin AC, Anderson M, Bhandari N, Schmitt AJ, Beidler E. Concussion Nondisclosure in Youth Sports. J Athl Train 2022; 57:688-695. [PMID: 35045181 PMCID: PMC9528706 DOI: 10.4085/1062-6050-534-21] [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] [Indexed: 11/09/2022]
Abstract
CONTEXT Researchers conducting studies about sport-related concussion (SRC) reporting behaviors and reasons for nondisclosure primarily focus on older athletic populations. Youth athletes participating in contact sports are also at risk for SRC; however, little is known about their SRC disclosure patterns and reasons for nondisclosure. OBJECTIVE To examine the self-reported SRC history and reasons for SRC nondisclosure of youth athletes aged 8-14 years. DESIGN Cross-sectional study. SETTING Youth athletes in organized football, ice hockey, lacrosse, or soccer. PATIENTS OR OTHER PARTICIPANTS A total of 411 youth athletes (boys = 70.0% [n = 287/410]; median age = 11 [interquartile range = 10-13] years). MAIN OUTCOME MEASURE(S) A 15-minute survey including self-reported demographics, diagnosed and nondisclosed SRC history, and reasons for nondisclosure of suspected SRCs. RESULTS Ten percent of respondents (n = 41/411) recounted ≥1 diagnosed SRC, 12.7% (n = 52/411) did not report a suspected SRC, 13.1% (n = 53/404) indicated they continued to practice, and 12.3% (n = 50/406) reported they continued to play in a game after a suspected SRC. Significant associations between sport and nondisclosure existed (P values < .001) but not with self-reported concussion history (P = .14). In sex-comparable analyses, boys' lacrosse players had a higher frequency of nondisclosure than girls (P = .05). The most common reasons for nondisclosure were not wanting to lose playing time (66.7%, n = 32/48), miss a game (56.3%, n = 27/48), and let the team down (43.8%, n = 21/48) and uncertainty over injury severity and the presence of SRC (43.8%, n = 21/48). CONCLUSIONS Ten percent of youth athletes self-reported at least 1 diagnosed SRC. However, they also described continuing to practice or play in a game after a suspected SRC. Reasons for nondisclosure at this age were similar to those reported in high school and collegiate athletes. Recent researchers suggested negative consequences of continued play with SRC, especially in the acute stages. Anyone conducting future educational initiatives should emphasize these risks and focus on reasons why athletes of both sexes withhold reporting.
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Affiliation(s)
- Abigail C. Bretzin
- Department of Biostatistics, Epidemiology and Informatics, Penn Injury Science Center, University of Pennsylvania, Philadelphia
| | | | - Neha Bhandari
- Department of Biology, Duquesne University, Pittsburgh, PA
| | - Ara J. Schmitt
- Department of Counseling, Psychology, and Special Education, Duquesne University, Pittsburgh, PA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, PA
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Martini DN, Wilhelm J, Lee L, Brumbach BH, Chesnutt J, Skorseth P, King LA. Exploring clinical and patient characteristics for rehabilitation referrals following a concussion: a retrospective analysis. Arch Rehabil Res Clin Transl 2022; 4:100183. [PMID: 35756984 PMCID: PMC9214303 DOI: 10.1016/j.arrct.2022.100183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective To explore patterns of postconcussion care at a level 1 trauma center. Design Retrospective cohort study. Setting U.S. level 1 trauma center and local satellite units. Participants Patients of any age with a concussion diagnosis that reported to level 1 trauma center and local satellite units between 2016 and 2018 (N=2417). Intervention Not applicable. Main Outcome Measures Age, sex, point of entry, rehabilitation referrals, and pre-existing comorbidity diagnosis. Results Patient age (mean [SD]) significantly differed among points of entry, from youngest to oldest: 26.0 (14.0) years in sports medicine, 29.3 (23.0) years in the emergency department, 34.6 (23.6) years at primary care providers, and 46.0 (19.7) years at specialty care departments. Sex also significantly differed among points of entry; emergency departments reported more men (55.6%), whereas the other points of entry reported more women (59.3%-65.6%). Patients were more likely to receive a referral from sports medicine (odds ratio [OR]unadjusted=75.05, P<.001), primary care providers (ORunadjusted=7.98, P<.001), and specialty care departments (ORunadjusted=7.62, P<.001) than from the emergency department. Women were more likely to receive a referral (ORunadjusted=1.92, P<.0001), regardless of point of entry. Lastly, patients with a preexisting comorbidity were more likely (ORadjusted=2.12, P<.001) to get a rehabilitation referral than patients without a comorbidity. Conclusions Point of entry, age, sex, and preexisting comorbidities are associated with postconcussion care rehabilitation referral patterns. Improving concussion education dissemination across all entry points of a level 1 trauma center may standardize the postconcussion rehabilitation referral patterns, potentially improving the time to recovery from a concussion.
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