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Rhim HC, Afifi T, Xu RF, Noble-Taylor K, Gureck AE, Barrack MT, Rauh MJ, Tenforde AS. Epidemiology of injuries in U.S. high school track and field throwing events from 2008 to 2019. PM R 2024. [PMID: 38818973 DOI: 10.1002/pmrj.13188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/01/2024] [Accepted: 03/21/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Injury characteristics of high school track and field throwing athletes in the United States are not well studied. Understanding epidemiology of injuries is important to identify treatment and prevention strategies. OBJECTIVE To describe injury rates and patterns in U.S. high school track and field throwing events from a longitudinal national sports injury surveillance system. DESIGN Descriptive epidemiology study. SETTING Data were provided by the National High School Sports Related Injury Surveillance System, High School RIO (Reporting Information Online). METHODS Athletic trainers reported injury and exposure data through the High School RIO website on a weekly basis. An athlete exposure (AE) was defined as one athlete participating in one school-sanctioned practice or competition. Throwing events of discus, shot put, and javelin were analyzed in this study. MAIN OUTCOME MEASURES Injury rate, rate ratios (RR), injury proportion ratios (IPR). PARTICIPANTS U.S. high school athletes. RESULTS A total of 267 track and field throwing injuries occurred during 5,486,279 AEs. Overall, the rate of injuries in competition was higher than in practice (RR 1.35, 95% confidence interval [CI] 1.01-1.80). In practice, the rate of injuries was higher for girls than boys (RR 1.53, 95% CI 1.12-2.08). The most frequently injured body part was the shoulder (21.7%), followed by the ankle (16.5%) and knee (12.0%). The most common types of injury were muscle strains (26.14%) and ligament sprains (25%). Recurrent injuries accounted for a higher proportion of chronic injuries compared to new injuries (IPR 1.85, 95% CI 1.16-2.97). CONCLUSION This study described injury characteristics of high school track and field throwing athletes from 2008 to 2019. Based on our results, injury prevention may be particularly important for female throwers with prior injury.
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Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Toqa Afifi
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Raylin F Xu
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kayle Noble-Taylor
- Michigan State University College of Human Medicine, Grand Rapids, USA
- Department of Orthopedic Surgery, Corewell Health, Grand Rapids, USA
| | - Ashley E Gureck
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Michelle T Barrack
- Department of Family and Consumer Sciences, California State University, Long Beach, California, USA
| | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, California, USA
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
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Gupta P, Thomas GM, Arabandi PR, Abdo MG, Dhanireddy KN, Amdur R, Doerre T. Shoulder, upper arm and elbow injuries in high school men's American football. Res Sports Med 2024; 32:457-464. [PMID: 36111698 DOI: 10.1080/15438627.2022.2125318] [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: 04/28/2022] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
In order to reduce shoulder, upper arm and elbow injury rates in American football, identifying injury risk factors and any underlying associations is needed. No prior study has done such characterization at the high school level. A descriptive epidemiology study was performed using data from the National Athletic Treatment, Injury, and Outcomes Network Surveillance Program (NATION-SP) from the years 2011/12 to 2013/14 on high school football athletes. Four hundred and sixty total injuries were found in the dataset. Acromioclavicular (AC) sprains had the highest incidence of all injuries (0.060 injuries per 1000 exposures). Fractures lead to the greatest time lost (42.24 days). Most injuries occurred in older athletes (juniors and seniors, 30% and 32%, respectively), were related to tackling (31%), and in running back and linebacker positions (15% each). Orthopaedic surgeons and other sports medicine specialists can use these findings to educate players, coaches and families about injury risks and for improving injury prevention guidelines.
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Affiliation(s)
- Puneet Gupta
- Department of Orthopaedic Surgery, School of Medicine and Health Sciences, George Washington University, Washington, D.C, USA
| | - George M Thomas
- Department of Orthopaedic Surgery, School of Medicine and Health Sciences, George Washington University, Washington, D.C, USA
| | - Prudvi R Arabandi
- Department of Orthopaedic Surgery, School of Medicine and Health Sciences, George Washington University, Washington, D.C, USA
| | - Magid G Abdo
- Department of Orthopaedic Surgery, School of Medicine and Health Sciences, George Washington University, Washington, D.C, USA
| | - Karthik N Dhanireddy
- Department of Orthopaedic Surgery, School of Medicine and Health Sciences, George Washington University, Washington, D.C, USA
| | - Richard Amdur
- Department of Orthopaedic Surgery, School of Medicine and Health Sciences, George Washington University, Washington, D.C, USA
| | - Teresa Doerre
- Department of Orthopaedic Surgery, School of Medicine and Health Sciences, George Washington University, Washington, D.C, USA
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Wells A, Rigby J, Castel C, Castel D. Pulsed Red and Blue Photobiomodulation for the Treatment of Thigh Contusions and Soft Tissue Injury: A Randomized Controlled Trial. J Sport Rehabil 2024; 33:20-26. [PMID: 37917978 DOI: 10.1123/jsr.2022-0334] [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: 09/07/2022] [Revised: 05/09/2023] [Accepted: 08/19/2023] [Indexed: 11/04/2023]
Abstract
CONTEXT Contusion and soft tissue injuries are common in sports. Photobiomodultion, light and laser therapy, is an effective aid to increase healing rates and improve function after various injury mechanisms. However, it is unclear how well photobiomodulation improves function after a contusion soft tissue injury. This study aimed to determine the effects of a pulsed red and blue photobiomodulation light patch on muscle function following a human thigh contusion injury. DESIGN Single-blinded randomized control trial design. METHODS We enrolled 46 healthy participants. Participants completed 5 visits on consecutive days. On the first visit, participants completed a baseline isokinetic quadriceps strength testing protocol at 60°/s and 180°/s. On the second visit, participants were struck in the rectus femoris of the anterior thigh with a tennis ball from a serving machine. Immediately following, participants were treated for 30 minutes with an active or placebo photobiomodulation patch (CareWear light patch system, CareWear Corp). Following the treatment, participants completed the same isokinetic quadriceps strength testing protocol. Participants completed the treatment and isokinetic quadriceps strength test during the following daily visits. We normalized the data by calculating the percent change from baseline. We used a mixed model analysis of covariance, with sex as a covariate, to determine the difference between treatment groups throughout the acute recovery process. RESULTS We found the active photobiomodulation treatment significantly increased over the placebo group, quadriceps peak torque during the 180°/s test (P = .030), and average power during both the 60°/s (P = .041) and 180°/s (P ≤ .001) assessments. The mean peak torque and average power of 180°/s, at day 4, exceeded the baseline levels by 8.9% and 16.8%, respectively. CONCLUSIONS The red and blue photobiomodulation light patch improved muscle strength and power during the acute healing phase of a human thigh contusion injury model.
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Affiliation(s)
- Aaron Wells
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - Justin Rigby
- Department of Physical Therapy and Athletic Training, University of Utah Health, Salt Lake City, UT, USA
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MacLean MA, Muradov JH, Greene R, Van Hameren G, Clarke DB, Dreier JP, Okonkwo DO, Friedman A. Memantine inhibits cortical spreading depolarization and improves neurovascular function following repetitive traumatic brain injury. SCIENCE ADVANCES 2023; 9:eadj2417. [PMID: 38091390 PMCID: PMC10848720 DOI: 10.1126/sciadv.adj2417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023]
Abstract
Cortical spreading depolarization (CSD) is a promising target for neuroprotective therapy in traumatic brain injury (TBI). We explored the effect of NMDA receptor antagonism on electrically triggered CSDs in healthy and brain-injured animals. Rats received either one moderate or four daily repetitive mild closed head impacts (rmTBI). Ninety-three animals underwent craniectomy with electrocorticographic (ECoG) and local blood flow monitoring. In brain-injured animals, ketamine or memantine inhibited CSDs in 44 to 88% and 50 to 67% of cases, respectively. Near-DC/AC-ECoG amplitude was reduced by 44 to 75% and 52 to 67%, and duration by 39 to 87% and 61 to 78%, respectively. Daily memantine significantly reduced spreading depression and oligemia following CSD. Animals (N = 31) were randomized to either memantine (10 mg/kg) or saline with daily neurobehavioral testing. Memantine-treated animals had higher neurological scores. We demonstrate that memantine improved neurovascular function following CSD in sham and brain-injured animals. Memantine also prevented neurological decline in a blinded, preclinical randomized rmTBI trial.
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Affiliation(s)
- Mark A. MacLean
- Division of Neurosurgery, Dalhousie University, Halifax, Canada
| | - Jamil H. Muradov
- Department of Medical Neuroscience, Dalhousie University, Halifax, Canada
| | - Ryan Greene
- Department of Medical Neuroscience, Dalhousie University, Halifax, Canada
| | - Gerben Van Hameren
- Department of Medical Neuroscience, Dalhousie University, Halifax, Canada
| | - David B. Clarke
- Division of Neurosurgery, Dalhousie University, Halifax, Canada
| | - Jens P. Dreier
- Center for Stroke Research Berlin, Charite University, Berlin, Germany
| | - David O. Okonkwo
- Division of Neurosurgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alon Friedman
- Division of Neurosurgery, Dalhousie University, Halifax, Canada
- Department of Medical Neuroscience, Dalhousie University, Halifax, Canada
- Departments of Brain and Cognitive Sciences, Physiology and Cell Biology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Garcia GGP, Czerniak LL, Lavieri MS, Liebel SW, Van Pelt KL, Pasquina PF, McAllister TW, McCrea MA, Broglio SP. Estimating the Relationship Between the Symptom-Free Waiting Period and Injury Rates After Return-to-Play from Concussion: A Simulation Analysis Using CARE Consortium Data. Sports Med 2023; 53:2513-2528. [PMID: 37610654 DOI: 10.1007/s40279-023-01901-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND A key component of return-to-play (RTP) from sport-related concussion is the symptom-free waiting period (SFWP), i.e., the period during which athletes must remain symptom-free before permitting RTP. Yet, the exact relationship between SFWP and post-RTP injury rates is unclear. OBJECTIVE We design computational simulations to estimate the relationship between the SFWP and rates of repeat concussion and non-concussion time-loss injury up to 30 days post-RTP for male and female collegiate athletes across 13 sports. METHODS We leverage N = 735 female and N = 1,094 male post-injury trajectories from the National Collegiate Athletic Association-Department of Defense Concussion Assessment, Research, and Education Consortium. RESULTS With a 6-day SFWP, the mean [95% CI] rate of repeat concussion per 1,000 simulations was greatest in ice hockey for females (20.31, [20.16, 20.46]) and American football for males (24.16, [24.05, 24.28]). Non-concussion time-loss injury rates were greatest in field hockey for females (153.66, [152.59, 154.74]) and wrestling for males (247.34, [246.20, 248.48]). Increasing to a 13-day SFWP, ice hockey for females (18.88, [18.79, 18.98]) and American football for males (23.16, [23.09, 24.22]) exhibit the greatest decrease in repeat concussion rates across all sports within their respective sexes. Field hockey for females (143.24, [142.53, 143.94]) and wrestling for males (237.73, [236.67, 237.90]) exhibit the greatest decrease in non-concussion time-loss injury rates. Males receive marginally smaller reductions in injury rates for increased SFWP compared to females (OR = 1.003, p ≤ 0.002). CONCLUSION Longer SFWPs lead to greater reductions in post-RTP injury rates for athletes in higher risk sports. Moreover, SFWPs should be tailored to sport-specific post-RTP injury risks.
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Affiliation(s)
- Gian-Gabriel P Garcia
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
| | - Lauren L Czerniak
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Mariel S Lavieri
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Spencer W Liebel
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | | | - Paul F Pasquina
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michael A McCrea
- Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
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Wilmoth K, Brett BL, Emmert NA, Cook CM, Schaffert J, Caze T, Kotsonis T, Cusick M, Solomon G, Resch JE, Cullum CM, Nelson LD, McCrea M. Psychometric Properties of Computerized Cognitive Tools and Standard Neuropsychological Tests Used to Assess Sport Concussion: A Systematic Review. Neuropsychol Rev 2023; 33:675-692. [PMID: 36040610 DOI: 10.1007/s11065-022-09553-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/03/2022] [Indexed: 11/29/2022]
Abstract
Athletic programs are more frequently turning to computerized cognitive tools in order to increase efficiencies in concussion assessment. However, assessment using a traditional neuropsychological test battery may provide a more comprehensive and individualized evaluation. Our goal was to inform sport clinicians of the best practices for concussion assessment through a systematic literature review describing the psychometric properties of standard neuropsychological tests and computerized tools. We conducted our search in relevant databases including Ovid Medline, Web of Science, PsycINFO, and Scopus. Journal articles were included if they evaluated psychometric properties (e.g., reliability, sensitivity) of a cognitive assessment within pure athlete samples (up to 30 days post-injury). Searches yielded 4,758 unique results. Ultimately, 103 articles met inclusion criteria, all of which focused on adolescent or young adult participants. Test-retest reliability estimates ranged from .14 to .93 for computerized tools and .02 to .95 for standard neuropsychological tests, with strongest correlations on processing speed tasks for both modalities, although processing speed tasks were most susceptible to practice effects. Reliability was improved with a 2-factor model (processing speed and memory) and by aggregating multiple baseline exams, yet remained below acceptable limits for some studies. Sensitivity to decreased cognitive performance within 72 h of injury ranged from 45%-93% for computerized tools and 18%-80% for standard neuropsychological test batteries. The method for classifying cognitive decline (normative comparison, reliable change indices, regression-based methods) affected sensitivity estimates. Combining computerized tools and standard neuropsychological tests with the strongest psychometric performance provides the greatest value in clinical assessment. To this end, future studies should evaluate the efficacy of hybrid test batteries comprised of top-performing measures from both modalities.
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Affiliation(s)
- Kristin Wilmoth
- Departments of Psychiatry and Physical Medicine & Rehabilitation, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9055, USA.
| | - Benjamin L Brett
- Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Natalie A Emmert
- Department of Neurology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Carolyn M Cook
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jeffrey Schaffert
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Todd Caze
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Thomas Kotsonis
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Margaret Cusick
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Gary Solomon
- Player Health and Safety Department, National Football League and Department of Neurosurgery, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jacob E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
| | - C Munro Cullum
- Departments of Psychiatry, Neurology, and Neurological Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Lindsay D Nelson
- Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michael McCrea
- Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
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Burghardt WP, Pfeiffer KA, Kuenze C. Assessing the Relationship Between External Workloads and Noncontact Injuries During Summer Conditioning and Preseason Practice in National Collegiate Athletic Association Division 1 Football Players. J Strength Cond Res 2023; 37:816-822. [PMID: 35876439 DOI: 10.1519/jsc.0000000000004325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Burghardt, WP, Pfeiffer, KA, and Kuenze, C. Assessing the relationship between external workloads and noncontact injuries during summer conditioning and preseason practice in National Collegiate Athletic Association Division 1 football players. J Strength Cond Res 37(4): 816-822, 2023-The purpose of this study was to prospectively investigate the relationship between noncontact injuries and workload in collegiate football during summer conditioning and preseason training. Workload and noncontact injury data were collected over the summer conditioning and preseason practice periods for a Division 1 National Collegiate Athletic Association football team ( n = 34). Seven- and 21-day exponentially weighted moving averages (EWMA) were calculated daily for each athlete. The acute:chronic ratio (A:C ratio) of these 2 measures was also calculated daily. Injury rates for noncontact injuries were calculated for both periods. Continuous variable modeling (panel logistic regression and restricted cubic spline) was used to assess the relationship of EWMA A:C ratio and noncontact injury using a 3-day lag period. Athletic exposures (AEs) were defined as individual sport training, practice, or competition sessions. Nine injuries were observed (6.97/1,000 AEs), with 4 injuries resulting in lost time (3.09/1,000 AEs). The mean EWMA A:C ratio was 0.92 ± 0.41 (95% confidence interval: 0.03-2.09). Both the panel logistic regression and the restricted cubic spline models showed a significant relationship between EWMA A:C ratio and noncontact injuries. However, the odds ratio (14.16) in the logistic regression had a very large standard error (14.51) and a wide 95% confidence interval (1.90-105.49). The restricted cubic spline model had a pseudo R2 of 0.136. Injury occurrence at given EWMA ratio values was lower than reported in previous research. Although both continuous models demonstrated a significant relationship between the EWMA A:C ratio and subsequent noncontact injuries over the next 3 days, neither model had sufficient goodness of fit to warrant adoption at this time.
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Affiliation(s)
- William P Burghardt
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
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8
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Bryant AM, Kerr ZY, Walton SR, Barr WB, Guskiewicz KM, McCrea MA, Brett BL. Investigating the association between subjective and objective performance-based cognitive function among former collegiate football players. Clin Neuropsychol 2023; 37:595-616. [PMID: 35670306 PMCID: PMC9726994 DOI: 10.1080/13854046.2022.2083021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/22/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Studies have observed variable associations of prior contact sport participation with subjective and objective measures of cognitive function. This study directly investigated the association between subjective self-report and objective performance-based cognition among former collegiate football players, as well as its relationship to self-reported concussion history. METHODS Former collegiate football players (N = 57; mean age = 37.9 years [SD = 1.49]) retired from sport 15-years prior were enrolled. Linear regression models examined associations between subjective cognition (Quality of Life in Neurological Disorders Cognitive Functioning-Short Form), and performance on a neuropsychological battery. Domain specific (executive function) metrics of subjective (Behavior Rating Inventory of Executive Function-Adult) and objective cognition were also exclusively examined. Associations between self-reported concussion history with subjective and objective measures were tested. Potential influential factors (sleep quality and distress) were included as covariates. RESULTS Subjective cognition was not significantly associated with any objective measures of cognitive functioning (p's > .05). Greater self-reported concussion history was inversely associated with subjective cognition (B = -2.49, p = .004), but not objective performance-based cognition (p's > .05). Distress was significantly related to all metrics of subjective cognition (p's < .001) as well as performance on delayed recall and verbal fluency (p's < .05). Sleep quality was only significantly related to timed visuospatial sequencing (p = .033). CONCLUSIONS Reliance on self-reported measures of cognitive functioning alone is insufficient when assessing cognition in former contact sport athletes. Assessment of other factors known to influence subjective cognitive complaints should also be examined in determining the presence of cognitive deficits.
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Affiliation(s)
- Andrew M. Bryant
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Zachary Y. Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Samuel R. Walton
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | | | - Kevin M. Guskiewicz
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Michael A. McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Benjamin L. Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
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Xi Y. CHARACTERISTICS AND PREVENTION OF SPORTS INJURIES IN ADOLESCENT SOCCER. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
ABSTRACT Introduction: This year is the year of the soccer World Cup. With the adult team unable to participate in the World Cup, society's attention has turned to college soccer. However, as a highly aggressive sport, soccer will inevitably cause various sports injuries. Objective: Investigate the causes and characteristics of sports injuries of young school soccer players in some areas of China, and propose measures to prevent and control sports injuries. Methods: A total of 1024 adolescents aged 6 to 17 years were research volunteers; the causes and characteristics of sports injuries of these young college soccer players were investigated through field investigation, questionnaire survey, expert interview, and mathematical analysis. Results: The results of the survey show that 73.2% (750 people) of the respondents have suffered sports injuries, among which the common injuries in elementary school (6-12 years old) are knee and upper limb joints, and the common injuries in middle school (12-17 years old) are mainly ankle and knee joints, with the same characteristics as adult players. The degree of injury in different segments is the same, with mild injuries being the most common, followed by moderate and severe. As the learning period increased, the mild injuries decreased significantly, while the moderate and severe injuries showed an increasing trend. Most injuries occurred in the summer, with the injury rate during training significantly higher than during competition. The causes of injuries are different in different age groups. Conclusion: Young school soccer players are prone to sports injuries in the sporting process, and specific preventive measures are needed to prevent these injuries from causing adverse effects on young players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
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Affiliation(s)
- Yang Xi
- Xinxiang Vocational and Technical College, China
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10
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Waltzman D, Sarmiento K, Ferrell D, Kern V, Roghaar C. A Description of Suspected Concussions in Football-Related Activities among K-12 Students in Utah. J Sch Nurs 2022:10598405221138731. [PMID: 36408989 PMCID: PMC10413338 DOI: 10.1177/10598405221138731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
The circumstances and nature of concussions among youth who play tackle, flag, or touch football are not well understood. This study used data from Utah's Student Injury Reporting System (SIRS) to explore suspected concussions among K-12 students sustained during participation in football-related activities (tackle, flag, or touch football). Descriptive statistics and chi-square analyses showed that 54.7% of suspected concussions due to football-related activity were among elementary and middle school and 41.3% were among high school students. Most suspected concussions resulted from being struck by or against something (81.9%) and occurred during school-sanctioned games and practices (37.9%), lunch, lunch recess, and recess (34.8%), or physical education class (22.7%). The type of school activity and context for suspected concussions varied by school level. School nurses and others in Utah may use study findings to customize concussion prevention efforts by school level and activity.
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Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Atlanta, GA, USA
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Atlanta, GA, USA
| | - Deanna Ferrell
- Utah Department of Health (UDOH), Violence and Injury Prevention Program (VIPP), Salt Lake City, Utah, USA
| | - Vanonda Kern
- Utah Department of Health (UDOH), Violence and Injury Prevention Program (VIPP), Salt Lake City, Utah, USA
| | - Chloe Roghaar
- Utah Department of Health (UDOH), Violence and Injury Prevention Program (VIPP), Salt Lake City, Utah, USA
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11
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Associations of lifetime concussion history and repetitive head impact exposure with resting-state functional connectivity in former collegiate American football players: An NCAA 15-year follow-up study. PLoS One 2022; 17:e0273918. [PMID: 36084077 PMCID: PMC9462826 DOI: 10.1371/journal.pone.0273918] [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] [Received: 02/27/2022] [Accepted: 08/17/2022] [Indexed: 11/19/2022] Open
Abstract
The objective of this study was to examine associations of lifetime concussion history (CHx) and an advanced metric of lifetime repetitive head impact exposure with resting-state functional connectivity (rsFC) across the whole-brain and among large-scale functional networks (Default Mode; Dorsal Attention; and Frontoparietal Control) in former collegiate football players. Individuals who completed at least one year of varsity collegiate football were eligible to participate in this observational cohort study (n = 48; aged 36–41 years; 79.2% white/Caucasian; 12.5±4.4 years of football played; all men). Individuals were excluded if they reported history/suspicion of psychotic disorder with active symptoms, contraindications to participation in study procedures (e.g., MRI safety concern), or inability to travel. Each participant provided concussion and football playing histories. Self-reported concussion history was analyzed in two different ways based on prior research: dichotomous “High” (≥3 concussions; n = 28) versus “Low” (<3 concussions; n = 20); and four ordinal categories (0–1 concussion [n = 19]; 2–4 concussions [n = 8]; 5–7 concussions [n = 9]; and ≥8 concussions [n = 12]). The Head Impact Exposure Estimate (HIEE) was calculated from football playing history captured via structured interview. Resting-state fMRI and T1-weighted MRI were acquired and preprocessed using established pipelines. Next, rsFC was calculated using the Seitzman et al., (2020) 300-ROI functional atlas. Whole-brain, within-network, and between-network rsFC were calculated using all ROIs and network-specific ROIs, respectively. Effects of CHx and HIEE on rsFC values were examined using separate multivariable linear regression models, with a-priori α set to 0.05. We observed no statistically significant associations between rsFC outcomes and either CHx or HIEE (ps ≥ .12). Neither CHx nor HIEE were associated with neural signatures that have been observed in studies of typical and pathological aging. While CHx and repetitive head impacts have been associated with changes in brain health in older former athletes, our preliminary results suggest that associations with rsFC may not be present in early midlife former football players.
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Barden DC, Thain DPK. Injury surveillance in English youth basketball: A 5-season cohort study to inform injury prevention strategies. Phys Ther Sport 2022; 58:34-40. [DOI: 10.1016/j.ptsp.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/25/2022] [Accepted: 08/28/2022] [Indexed: 11/28/2022]
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13
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Gibson ES, Cairo A, Räisänen AM, Kuntze C, Emery CA, Pasanen K. The Epidemiology of Youth Sport-Related Shoulder Injuries: A Systematic Review. TRANSLATIONAL SPORTS MEDICINE 2022; 2022:8791398. [PMID: 38655170 PMCID: PMC11022765 DOI: 10.1155/2022/8791398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 04/26/2024]
Abstract
Background Youth around the globe place their shoulders at risk for injury when participating in sports. Shoulder injuries may vary in severity, produce the potential for time-loss from sport, and result in functional disability. We sought to explore sport-related shoulder injuries in youth by identifying injury rates, risk factors, injury mechanisms, and injury prevention strategies. Methods All relevant full-text articles were identified by searching MEDLINE, EMBASE, CINAHL, Sport Discus, and the Cochrane Controlled Trials Registry. No date restrictions were used. All full-text studies reporting original research describing sport-related shoulder injury among female and/or male youth from 5 to 18 years old were included. Results Of 3,889 studies screened, 97 described shoulder injury in youth sports. Shoulder injuries were identified in 24 unique sports. The median seasonal prevalence of shoulder injury was 10.9% (range 1.2-28.2%). The most common injury mechanisms identified were contacted with another player, contact with the playing environment, and falling to the ground. Risk factors for shoulder injury identified were side-to-side strength imbalances, weak external rotator muscles, and scapular dyskinesia. One study evaluated a successful training strategy to prevent shoulder injuries, but two other interventions demonstrated no effect. Conclusions Sport-related shoulder injuries are prevalent among youth athletes. Injury risk factors identified included modifiable intrinsic factors such as strength, range of motion, and training load. The most common injury mechanism was direct contact with either another person or an object in the playing environment. Innovative shoulder-specific strategies are needed to reduce shoulder injuries in this population. Trial Registration: PROSPERO ID: CRD42020189142.
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Affiliation(s)
- Eric S. Gibson
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Alexis Cairo
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Anu M. Räisänen
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Physical Therapy Education, College of Health Sciences - Northwest, Western University of Health Sciences, Lebanon, Oregon, USA
| | - Colleen Kuntze
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Carolyn A. Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Kati Pasanen
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
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14
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Hoge C, Sabbagh R, Morgan M, Grawe BM. Epidemiology of youth and high school American football-related injuries presenting to United States emergency departments: 2010-2019. PHYSICIAN SPORTSMED 2022; 50:332-337. [PMID: 34029497 DOI: 10.1080/00913847.2021.1931980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES American football is one of the most popular sports in the United States (US) among youth and high school athletes; however, participation is decreasing due to concerns about safety. This has led to many new safety initiatives over the last decade, but few studies have sought to evaluate if these interventions have made football safer. The purpose of this study is to investigate national-level data on football-related injuries to compare the injury characteristics and specific injury risks of high school and youth athletes over the last decade. METHODS This cross-sectional, retrospective study queried the National Electronic Injury Surveillance System (NEISS) database from 2010-2019 to compare national weighted estimates and injury characteristics of youth (ages 6-12) and high school (ages 14-18) athletes presenting to US emergency departments (EDs) with football-associated injuries. RESULTS The overall injury risk of football-related injuries presenting to US EDs for high school athletes was 16.17 (C.I. 13.85-18.38) per 1,000 participants/year compared to 11.97 (C.I. 10.34-13.41) per 1,000 participants/year in youth athletes. From 2010 to 2019, the overall injury risk for youth athletes participating in football significantly (p < 0.0001) decreased from 13.31 (C.I. 11.23-15.38) per 1,000 participants to 9.93 (C.I. 7.24-12.62) per 1,000 participants. Additionally, the overall injury risk for high school athletes participating in football significantly (p < 0.0001) decreased from 2010 (N = 18.63 [C.I. 16.05-21.21] per 1,000 participants) to 2018 (N = 13.19 [C.I. 9.94-16.44] per 1,000 participants). High school athletes were almost twice as likely and 2.37 times more likely to present with knee and shoulder injuries compared to youth athletes per 1,000 participants/year. CONCLUSION Our study provides evidence that the overall injury risk for both youth and high school football players has significantly decreased since 2010. Furthermore, our study demonstrates that these athletes sustain unique injury characteristics.
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Affiliation(s)
- Connor Hoge
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Ramsey Sabbagh
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Malik Morgan
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Brian M Grawe
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
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15
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Kobelski GP, Radel LC, Jones JC, O'Brien MJ, Meehan WP, Sugimoto D. Comparison of pre-high school and high school football quarterback injuries. PHYSICIAN SPORTSMED 2022:1-5. [PMID: 35612541 DOI: 10.1080/00913847.2022.2082854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare the common injuries of pre-high school American football quarterbacks (Pre-HS QBs) and high school American football quarterbacks (HS QBs) within the last 15 years. METHODS A retrospective chart review was performed at a sports medicine clinic at a tertiary-level pediatric medical center. Pediatric and adolescent American football quarterback patients who sustained sports-related injuries were extracted. Injury status (acute vs. overuse), injured anatomic locations, injury types, and surgical status were compared by Pre-HS QBs (<14 years old) and HS QBs (14-18 years old). RESULTS A total of 121 injuries were found in 118 male Pre-HS QBs (mean age: 12.4 ± 1.6), while 302 injuries were observed in 256 male HS QBs (mean age: 15.8 ± 1.4). Overall, nearly two-third (2/3) of injuries were acute (64.3%) while a little over one-third (1/3) of injuries were overuse in nature (35.7%), and there were no differences between Pre-HS and HS QBs (58.7% vs. 66.7%, p = 0.114). The top 3 injured anatomic locations for Pre-HS QBs were elbow (20.7%), shoulder (18.2%), and head/neck (14.0%). For HS QBs, the top 3 injured anatomic locations were shoulder (24.5%), knee (17.5%), and head/neck (15.2%). There were significant differences in proportion of elbow (20.7% vs. 10.6%, p = 0.006), hip/trunk/upper leg (10.7% vs. 3.3%, p = 0.002), and knee injuries (9.1% vs. 17.5%, p = 0.028) between Pre-HS and HS QBs. Pre-HS QBs had significantly more bony/cartilaginous/labral injuries than their older counterparts (60.3% vs. 46.3%, p = 0.009) while HS QBs experienced significantly more ligamentous injuries than Pre-HS QBs (14.2% vs. 5.8%, p = 0.015). CONCLUSIONS QB-associated injuries were distinctively different between Pre-HS and HS QBs. Future studies are warranted to investigate relatively high proportions of elbow injuries as well as bony/cartilaginous/labral injuries found in Pre-HS QBs.
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Affiliation(s)
- Greggory P Kobelski
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
| | - Luke C Radel
- Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jacob C Jones
- Department of Pediatric Sports Medicine, Scottish Rite for Children, Dallas, TX, USA.,Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX, USA
| | - Michael J O'Brien
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Faculty of Sport Sciences, Waseda University, Tokyo, Japan
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16
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Hoffman JR, Ostfeld I, Zamir A, Amedi R, Fonville TR, Horstemeyer MF, Gepner Y. Examination of Cognitive Function, Neurotrophin Concentrations, and both Brain and Systemic Inflammatory Markers Following a Simulated Game of American Football. J Strength Cond Res 2022; 36:686-694. [DOI: 10.1519/jsc.0000000000004218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Holoyda KA, Donato DP, Magno-Padron DA, Simpson AM, Agarwal JP. Hand and wrist injuries among collegiate athletes vary with athlete division. Inj Epidemiol 2021; 8:69. [PMID: 34906242 PMCID: PMC8670021 DOI: 10.1186/s40621-021-00363-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rates, severity and consequences of hand and wrist injuries sustained by National Collegiate Athletic Association athletes are not well characterized. This study describes the epidemiology of hand and wrist injuries among collegiate athletes competing in different divisions. METHODS The National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) was accessed from 2004 to 2015 for the following sports: baseball, basketball, football, ice hockey, lacrosse, soccer, wrestling, field hockey, gymnastics, softball and volleyball. The data were used to identify all hand and wrist injuries, the specific injury diagnosis, mean time loss of activity following injury, and need for surgery following injury. These were then stratified by gender. Descriptive statistics were performed to examine the association between sports, event type and division. Student's t test was used to calculate p-values for independent variables. Chi-Square test was used to calculate odds ratio. P < 0.05 was considered significant. RESULTS 103,098 hand and wrist injuries were reported in in the studied NCAA sports from 2004 to 2015. Male athletes sustained 72,423 injuries (6.01/10,000 athlete exposure) and female athletes sustained 30,675 injuries (4.13/10,000 athlete exposure). Division I athletes sustained significantly more injuries compared to divisions II and III. Overall, 3.78% of hand and wrist injuries required surgical intervention. A significantly higher percentage of division I athletes (both male and female) underwent surgical intervention compared to divisions II and III. The mean time lost due to hand and wrist injury was 7.14 days for all athletes. Division I athletes missed the fewest days due to injury at 6.29 days though this was not significant. CONCLUSIONS Hand and wrist injuries are common among collegiate athletes. Division I athletes sustain higher rates of injuries and higher surgical intervention rates, while tending to miss fewer days due to injury. Improved characterization of divisional differences in hand and wrist injuries can assist injury management and prevention.
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Affiliation(s)
- Kathleen A Holoyda
- Division of Plastic and Reconstructive Surgery, University of Utah, School of Medicine, 30 N 1900 E, 3B400, Salt Lake City, UT, 84132, USA
| | - Daniel P Donato
- Division of Plastic and Reconstructive Surgery, University of Utah, School of Medicine, 30 N 1900 E, 3B400, Salt Lake City, UT, 84132, USA
| | - David A Magno-Padron
- Division of Plastic and Reconstructive Surgery, University of Utah, School of Medicine, 30 N 1900 E, 3B400, Salt Lake City, UT, 84132, USA
| | - Andrew M Simpson
- Division of Plastic and Reconstructive Surgery, University of Utah, School of Medicine, 30 N 1900 E, 3B400, Salt Lake City, UT, 84132, USA
| | - Jayant P Agarwal
- Division of Plastic and Reconstructive Surgery, University of Utah, School of Medicine, 30 N 1900 E, 3B400, Salt Lake City, UT, 84132, USA.
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18
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Pankow MP, Syrydiuk RA, Kolstad AT, Hayden AK, Dennison CR, Mrazik M, Hagel BE, Emery CA. Head Games: A Systematic Review and Meta-analysis Examining Concussion and Head Impact Incidence Rates, Modifiable Risk Factors, and Prevention Strategies in Youth Tackle Football. Sports Med 2021; 52:1259-1272. [PMID: 34894348 DOI: 10.1007/s40279-021-01609-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aims were to (1) examine the rates and mechanisms of concussion and head impact in youth football (high school level or younger); (2) identify modifiable risk factors for concussion and head impact; and (3) evaluate the effectiveness of prevention strategies in tackle football at any level. METHODS Nine databases (CINAHL Plus with Full Text; Cochrane Central Register of Controlled Trials; EMBASE; ERIC; Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily; ProQuest Dissertations & Theses Global Database; PsycINFO; Scopus; and SPORTDiscus with Full Text) were searched using the search strategy focusing on four main concepts: concussion/head impact, tackle football, modifiable risk factors, and primary prevention. Two reviewers completed title, abstract, and full-text screening as well as risk of bias assessment (using the Downs and Black checklist), with a third author available to resolve any disagreements. MAIN RESULTS After removing duplicates, 1911 articles were returned. Fifty-eight articles were included in the review and 20 in the meta-analysis. The overall combined rates of concussion (including game and practice-related concussion) based on the meta-analysis were 0.78 concussions/1000 athlete exposures [95% confidence interval (CI) 0.67-0.89] for high school football (ages 13-19) and 1.15 concussions/1000 athlete exposures (95% CI 0.89-1.41) for minor football players (ages 5-15). There is evidence that contact training and practice contact restrictions have reduced the rate of head impacts and concussion. Heads Up Football (an intervention focused on coach education and contact training) has been shown to reduce the rate of concussion by 32% and head impacts by 38% amongst high school football players. Limiting contact practices in high schools to 2 days per week reduced practice head impacts per player-season by 42%, and limiting full contact in practice to 75 min per week in the second week of the season and 60 min in week 3 and beyond resulted in a 54% decrease in the practice-related concussion rate (p = 0.003). CONCLUSIONS This review identified a critical need for interventions to address the high rates of concussion and head impact in youth football. To date, contact training and contact restrictions have the strongest evidence supporting their effectiveness at reducing these rates. Future research should use consistent concussion definitions and validated injury surveillance systems, and ensure complete reporting of participant characteristics and sampling details. Prospero ID CRD42020193775.
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Affiliation(s)
- Mark Patrick Pankow
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada. .,O'Brien Institute of Public Health, University of Calgary, Calgary, Canada. .,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada. .,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
| | - R A Syrydiuk
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.,O'Brien Institute of Public Health, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - A T Kolstad
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.,O'Brien Institute of Public Health, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - A K Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, Canada
| | - C R Dennison
- Department of Mechanical Engineering, University of Victoria, Victoria, Canada.,Biomedical Instrumentation Lab, Department of Mechanical Engineering, University of Alberta, Edmonton, Canada
| | - M Mrazik
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
| | - B E Hagel
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.,O'Brien Institute of Public Health, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.,Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - C A Emery
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.,O'Brien Institute of Public Health, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.,Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
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19
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Wallace A, Briggs MS, Onate J, DeWitt J, Rinehart-Thompson L. Perceived Management of Acute Sports Injuries and Medical Conditions by Athletic Trainers and Physical Therapists. Int J Sports Phys Ther 2021; 16:1548-1565. [PMID: 34909260 PMCID: PMC8637240 DOI: 10.26603/001c.29850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 09/28/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND While Athletic Trainers' (ATs) education emphasizes sport event coverage, Physical Therapists' (PTs) education may prepare them for event coverage responsibilities. The objectives of this study were to compare the perceived preparedness and decision-making related to acute injury/medical condition management among ATs and PTs and evaluate the relationship between perceived preparedness and decision-making. HYPOTHESIS ATs would report greater perceived preparedness and appropriate decision-making related to acute injury/medical conditions compared to PTs. STUDY DESIGN Cross-sectional, Online survey. METHODS An electronic survey was disseminated to licensed ATs (n=2,790) and PTs (n=10,207). Survey questions focused on perceived preparedness for management of acute injuries/medical conditions. Respondents also completed questions that assessed clinical decision-making related to acute injury case scenarios. Kruskal-Wallis H-Tests and Spearman's Rho Correlations were used for the analysis. Significance was set to p<0.003 after adjustment for family-wise error. RESULTS Six-hundred and fifty-five respondents (292 ATs, 317 PTs, 46 dual credentialed PT/ATs) completed the entire survey. ATs had the highest level of perceived preparedness of all the groups (p<0.0003). Greater than 75% of PTs responded either "appropriately" or "overly cautious" to 10 of the 17 case scenarios, as opposed to 11 of the 17 case scenarios by ATs. Greater than 75% of the PTs who were board specialty certified in sports responded either "appropriately" or "overly cautious" to 13 case scenarios. CONCLUSION More ATs than PTs perceived themselves to be prepared to manage acute injuries/ medical conditions. Further, results indicate that PTs may be an effective and safe provider of event coverage. Conditions/injuries with low perceived preparedness or poor performance may offer both ATs and PTs an opportunity to identify areas for future training and education to optimize care for athletes with acute injuries or medical conditions. LEVEL OF EVIDENCE Level 3b.
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Affiliation(s)
- Alan Wallace
- Department of Athletics, Kent State University; School of Health and Rehabilitation Sciences, The Ohio State University
| | - Matthew S Briggs
- Ambulatory Rehabilitation, Sports Medicine Research Institute, and Department of Orthopaedics, The Ohio State University Wexner Medical Center
| | - James Onate
- School of Health and Rehabilitation Sciences, The Ohio State University; Sports Medicine Research Institute, The Ohio State University Wexner Medical Center
| | - John DeWitt
- School of Health and Rehabilitation Sciences, The Ohio State University; Sports Medicine Research Institute, The Ohio State University Wexner Medical Center
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20
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Bruce SL, Wilkerson GB. Whole-Body Reactive Agility Metrics to Identify Football Players With a Core and Lower Extremity Injury Risk. Front Sports Act Living 2021; 3:733567. [PMID: 34746776 PMCID: PMC8564038 DOI: 10.3389/fspor.2021.733567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Clinical prediction models are useful in addressing several orthopedic conditions with various cohorts. American football provides a good population for attempting to predict injuries due to their relatively high injury rate. Physical performance can be assessed a variety of ways using an assortment of different tests to assess a diverse set of metrics, which may include reaction time, speed, acceleration, and deceleration. Asymmetry, the difference between right and left performance has been identified as a possible risk factor for injury. The purpose of this study was to determine the whole-body reactive agility metrics that would identify Division I football players who were at elevated risk for core, and lower extremity injuries (CLEI). This cohort study utilized 177 Division I football players with a total of 57 CLEI suffered who were baseline tested prior to the season. Single-task and dual-task whole-body reactive agility movements in lateral and diagonal direction reacting to virtual reality targets were analyzed separately. Receiver operator characteristic (ROC) analyses narrowed the 34 original predictor variables to five variables. Logistic regression analysis determined the three strongest predictors of CLEI for this cohort to be: lateral agility acceleration asymmetry, lateral flanker deceleration asymmetry, and diagonal agility reaction time average. Univariable analysis found odds ratios to range from 1.98 to 2.75 for these predictors of CLEI. ROC analysis had an area under the curve of 0.702 for any combination of two or more risk factors produced an odds ratio of 5.5 for risk of CLEI. These results suggest an asymmetry of 8-15% on two of the identified metrics or a slowed reaction time of ≥0.787 s places someone at increased risk of injury. Sixty-three percent (36/57) of the players who sustained an injury had ≥2 positive predictors In spite of the recognized limitation, these finding support the belief that whole-body reactive agility performance can identify Division I football players who are at elevated risk for CLEI.
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Affiliation(s)
- Scott L Bruce
- Masters of Athletic Training Program, Arkansas State University, Jonesboro, AR, United States
| | - Gary B Wilkerson
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
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21
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Wilkerson GB, Bruce JR, Wilson AW, Huang N, Sartipi M, Acocello SN, Hogg JA, Mansouri M. Perceptual-Motor Efficiency and Concussion History Are Prospectively Associated With Injury Occurrences Among High School and Collegiate American Football Players. Orthop J Sports Med 2021; 9:23259671211051722. [PMID: 34722788 PMCID: PMC8552393 DOI: 10.1177/23259671211051722] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/04/2021] [Indexed: 11/16/2022] Open
Abstract
Background: After a sport-related concussion (SRC), the risk for lower extremity injury is approximately 2 times greater, and the risk for another SRC may be as much as 3 to 5 times greater. Purpose: To assess the predictive validity of screening methods for identification of individual athletes who possess an elevated risk of SRC. Study Design: Case-control study; Level of evidence, 3. Methods: Metrics derived from a smartphone flanker test software application and self-ratings of both musculoskeletal function and overall wellness were acquired from American high school and college football players before study participation. Occurrences of core or lower extremity injury (CLEI) and SRC were documented for all practice sessions and games for 1 season. Receiver operating characteristic and logistic regression analyses were used to identify variables that provided the greatest predictive accuracy for CLEI or SRC occurrence. Results: Overall, there were 87 high school and 74 American college football players included in this study. At least 1 CLEI was sustained by 45% (39/87) of high school players and 55% (41/74) of college players. Predictors of CLEI included the flanker test conflict effect ≥69 milliseconds (odds ratio [OR], 2.12; 90% CI, 1.24-3.62) and a self-reported lifetime history of SRC (OR, 1.70; 90% CI, 0.90-3.23). Of players with neither risk factor, only 38% (29/77) sustained CLEI compared with 61% (51/84) of players with 1 or both of the risk factors (OR, 2.56; 90% CI, 1.50-4.36). SRC was sustained by 7 high school players and 3 college players. Predictors of SRC included the Overall Wellness Index score ≤78 (OR, 9.83; 90% CI, 3.17-30.50), number of postconcussion symptoms ≥4 (OR, 8.35; 90% CI, 2.71-25.72), the Sport Fitness Index score ≤78 (OR, 5.16; 90% CI, 1.70-15.65), history of SRC (OR, 4.03; 90% CI, 1.35-12.03), and the flanker test inverse efficiency ratio ≥1.7 (OR, 3.19; 90% CI, 1.08-9.47). Conclusion: Survey responses and smartphone flanker test metrics predicted greater injury incidence among individual football players classified as high-risk compared with that for players with a low-risk profile.
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Affiliation(s)
- Gary B Wilkerson
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Jeremy R Bruce
- Department of Orthopaedic Surgery, University of Tennessee College of Medicine, Chattanooga, Tennessee, USA
| | - Andrew W Wilson
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Neal Huang
- Department of Orthopaedic Surgery, University of Tennessee College of Medicine, Chattanooga, Tennessee, USA
| | - Mina Sartipi
- Center for Urban Informatics and Progress, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Shellie N Acocello
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Jennifer A Hogg
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Misagh Mansouri
- Center for Urban Informatics and Progress, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
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22
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Iverson GL, Büttner F, Caccese JB. Age of First Exposure to Contact and Collision Sports and Later in Life Brain Health: A Narrative Review. Front Neurol 2021; 12:727089. [PMID: 34659092 PMCID: PMC8511696 DOI: 10.3389/fneur.2021.727089] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/27/2021] [Indexed: 12/11/2022] Open
Abstract
A controversial theory proposes that playing tackle football before the age of 12 causes later in life brain health problems. This theory arose from a small study of 42 retired National Football League (NFL) players, which reported that those who started playing tackle football at a younger age performed worse on selected neuropsychological tests and a word reading test. The authors concluded that these differences were likely due to greater exposure to repetitive neurotrauma during a developmentally sensitive maturational period in their lives. Several subsequent studies of current high school and collegiate contact/collision sports athletes, and former high school, collegiate, and professional tackle football players have not replicated these findings. This narrative review aims to (i) discuss the fundamental concepts, issues, and controversies surrounding existing research on age of first exposure (AFE) to contact/collision sport, and (ii) provide a balanced interpretation, including risk of bias assessment findings, of this body of evidence. Among 21 studies, 11 studies examined former athletes, 8 studies examined current athletes, and 2 studies examined both former and current athletes. Although the literature on whether younger AFE to tackle football is associated with later in life cognitive, neurobehavioral, or mental health problems in former NFL players is mixed, the largest study of retired NFL players (N = 3,506) suggested there was not a significant association between earlier AFE to organized tackle football and worse subjectively experienced cognitive functioning, depression, or anxiety. Furthermore, no published studies of current athletes show a significant association between playing tackle football (or other contact/collision sports) before the age of 12 and cognitive, neurobehavioral, or mental health problems. It is important to note that all studies were judged to be at high overall risk of bias, indicating that more methodologically rigorous research is needed to understand whether there is an association between AFE to contact/collision sports and later in life brain health. The accumulated research to date suggests that earlier AFE to contact/collision sports is not associated with worse cognitive functioning or mental health in (i) current high school athletes, (ii) current collegiate athletes, or (iii) middle-aged men who played high school football. The literature on former NFL players is mixed and does not, at present, clearly support the theory that exposure to tackle football before age 12 is associated with later in life cognitive impairment or mental health problems.
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Affiliation(s)
- Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Spaulding Research Institute, Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Sports Concussion Program, MassGeneral Hospital for Children, Boston, MA, United States
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, United States
| | - Fionn Büttner
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Jaclyn B. Caccese
- School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH, United States
- Chronic Brain Injury Program, The Ohio State University, Columbus, OH, United States
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Chandran A, Morris SN, Powell JR, Boltz AJ, Robison HJ, Collins CL. Epidemiology of Injuries in National Collegiate Athletic Association Men's Football: 2014-2015 Through 2018-2019. J Athl Train 2021; 56:643-650. [PMID: 34280281 DOI: 10.4085/1062-6050-447-20] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Football is among the most popular collegiate sports in the United States, and participation in National Collegiate Athletic Association (NCAA) football has risen in recent years. BACKGROUND Continued monitoring of football injuries is important for capturing the evolving burden of injuries in NCAA football. The purpose of this study was to describe the epidemiology of football-related injuries among men's NCAA football players during the 2014-2015 through 2018-2019 academic years. METHODS Exposure and injury data collected in the NCAA Injury Surveillance Program were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. RESULTS The overall injury rate was 9.31 per 1000 athlete-exposures. Most injuries occurred during general play (17.5%), blocking (15.8%), and tackling (14.0%). Concussions (7.5%), lateral ligament complex tears (6.9%), and hamstring tears (4.7%) were the most commonly reported injuries. CONCLUSIONS Results of this study were generally consistent with previous findings, though changes over time in rates of commonly reported injuries warrant attention. Continued monitoring of injury incidence is needed to appraise the effectiveness of recently implemented rules changes.
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Affiliation(s)
- Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Sarah N Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Jacob R Powell
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Curriculum in Human Movement Science, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill
| | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
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Chandran A, Morris SN, Wasserman EB, Boltz AJ, Collins CL. Methods of the National Collegiate Athletic Association Injury Surveillance Program, 2014-2015 Through 2018-2019. J Athl Train 2021; 56:616-621. [PMID: 34280278 DOI: 10.4085/1062-6050-406-20] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Since 1982, the National Collegiate Athletic Association (NCAA) has collaborated with athletic trainers (ATs) to create the largest ongoing collegiate sports injury database in the world. This report provides an operational update of the NCAA Injury Surveillance Program (NCAA ISP) during the academic years 2014-2015 through 2018-2019. SURVEILLANCE SYSTEM STRUCTURE The NCAA ISP used a convenience sampling technique via a rolling recruitment model. The ATs at contributing institutions voluntarily submitted data into their respective electronic medical record systems; common data elements were pushed to and maintained by the Datalys Center. The ATs provided information about all team-related activities, even if no injury occurred during that activity, as well as detailed reports on each injury, including condition and circumstances. SUMMARY The NCAA ISP has a long-standing role in supplying NCAA stakeholders with crucial injury surveillance data, playing a critical part in safeguarding student-athletes participating in collegiate sports.
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Affiliation(s)
- Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Sarah N Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | | | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
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25
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Mehta NK, Siegel J, Cowan B, Johnson J, Hojjat H, Chung MT, Carron MA. Head and Neck Injury Patterns among American Football Players. Ann Otol Rhinol Laryngol 2021; 131:463-470. [PMID: 34142563 DOI: 10.1177/00034894211026478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
IMPORTANCE American football is a popular high-impact sport, leading to 2.7 million injuries in the United States annually. Recent evidence in football-related neurological damage has spurred national interest in player-safety. Football players injure their head and neck in up to 26% of total injuries. Variation in injury patterns between age groups and correlated hospitalizations for football-related head and neck injury has yet to be characterized. OBJECTIVE Our aim is to evaluate injury patterns among American-football related head and neck trauma. METHODS A retrospective cohort study of patients with football-related head and neck injury in the National Electronic Injury Surveillance System (NEISS). RESULTS Nearly 100 000 ED visits for football-related head and neck injuries occur annually. Males comprised 95% of patients, with a median age of 13. The head comprised 70% of injuries followed by the face (13%). The most common diagnoses were concussions (39%), internal organ injury (26%), and lacerations (11%). Pediatric patients were more likely to sustain concussions while adults experienced more lacerations (P < .05%). Fractures and nerve damage were rare injuries but caused a disproportionate share of hospitalizations. CONCLUSION Pediatric males are most likely to present for emergency care from football-related injury to the head and neck. Evaluating physicians can anticipate concussions, internal organ injury, and lacerations among presenting patients. Concussions, facial fractures, and nerve damage are injuries most likely to lead to hospitalization.
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Affiliation(s)
- Neil K Mehta
- Wayne State University, Department of Otolaryngology, Division of Facial Plastic Surgery, Detroit, MI, USA
| | - Justin Siegel
- Wayne State University, Department of Otolaryngology, Division of Facial Plastic Surgery, Detroit, MI, USA
| | - Brandon Cowan
- Wayne State University, Department of Otolaryngology, Division of Facial Plastic Surgery, Detroit, MI, USA
| | - Jared Johnson
- Wayne State University, Department of Otolaryngology, Division of Facial Plastic Surgery, Detroit, MI, USA
| | - Houmehr Hojjat
- Wayne State University, Department of Otolaryngology, Division of Facial Plastic Surgery, Detroit, MI, USA
| | - Michael T Chung
- Wayne State University, Department of Otolaryngology, Division of Facial Plastic Surgery, Detroit, MI, USA
| | - Michael A Carron
- Wayne State University, Department of Otolaryngology, Division of Facial Plastic Surgery, Detroit, MI, USA
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Data-Driven Risk Classification of Concussion Rates: A Systematic Review and Meta-Analysis. Sports Med 2021; 51:1227-1244. [PMID: 33721284 DOI: 10.1007/s40279-021-01428-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Concussion is a growing public health concern and generating concussion prevention programs depends on identifying high-risk sports and characteristics. Identifying the roles of sport, sex, and participation level (e.g., high school versus collegiate athletics) in concussion risk would facilitate more informed decision-making regarding sports participation and generate better targeted prevention strategies. OBJECTIVES The current study's objectives were to: (1) determine the magnitude and hierarchy of sports-related concussion (SRC) risk across an array of events and (2) evaluate the modifying roles of sex, participation level, and session type on SRC rates. METHODS A literature search was conducted on PubMed, searching concussion studies published between 2001 and December 2019. Inclusion criteria for studies required: (1) concussion occurred during sport, (2) that the SRC was clinically diagnosed, and (3) athlete exposures and concussions could be extracted or estimated. A study was excluded if it: (1) was not an original research article, (2) was not written in English language, (3) was an animal study, (4) did not have enough data to calculate SRC rates, (5) included professional or youth sample, and/or (6) contained data collected prior to 2001. The meta-analysis and meta-regression analyses were fit using a random effects model. RESULTS Search results returned 2695 unique research articles, with 83 studies included in analyses. Sport, sex, participation level, and session type all significantly influenced SRC rates. Overall, rugby had the highest concussion rate and was classified as the highest risk sport (28.25 concussions per 10,000 athlete exposures). Overall, females had a higher concussion rate than males. Only lacrosse demonstrated a higher concussion rate for males compared to females. Collegiate athletes had higher concussion rates than high school athletes. Games were associated with 2.01 more concussions per 10,000 AEs than practices. CONCLUSIONS This meta-analysis demonstrated rugby has the highest concussion risk, followed by American Football, ice hockey, and wrestling. Concussion risk was influenced by sport, sex, participation, and session. Identifying the factors and environments that influence concussion risk can facilitate risk reduction and prevention strategies.
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27
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Employing Standardised Methods to Compare Injury Risk Across Seven Youth Team Sports. Int J Sports Med 2021; 42:1019-1026. [PMID: 33461229 DOI: 10.1055/a-1327-3009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Injury surveillance systems seek to describe injury risk for a given sport, in order to inform preventative strategies. This often leads to comparisons between studies, although these inferences may be inappropriate, considering the range of methods adopted. This study aimed to describe the injury epidemiology of seven youth sports, enabling valid comparisons of injury risk. Consistent methods were employed across seven sports [male American football, basketball, soccer, rugby league, rugby union; female soccer and rugby union] at a high school in England. A 24-hour time-loss injury definition was adopted. Descriptive statistics and injury incidence (/1000 match-hours) are reported. In total, 322 injuries were sustained by 240 athletes (mean age=17.7±1.0) in 10 273 player-match hours. American football had a significantly greater injury incidence (86/1000 h; 95% CI 61-120) than all sports except female rugby union (54/1000 h; 95% CI 37-76). Concussion was the most common injury (incidence range 0.0-26.7/1000 h), while 59% of injuries occurred via player contact. This study employed standardized data collection methods, allowing valid and reliable comparisons of injury risk between youth sports. This is the first known study to provide epidemiological data for female rugby union, male basketball and American football in an English youth population, enabling the development of preventative strategies.
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28
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Abstract
Sport-related concussions are common in the United States. Concussion rates have increased over time, likely due to improved recognition and awareness. Concussion rates vary across level (high school vs college), sex, and sport. Concussion rates are the highest among men, particularly in football, wrestling, ice hockey, and lacrosse where collisions and contact are inherent to the sports, although girls'/women's soccer rates are high. In gender-comparable sports, women have higher concussion rates. Continued data collection will increase understanding of sport-related concussion and provide areas for targeted prevention in the future.
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Affiliation(s)
- Lauren A Pierpoint
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 100, Vail, CO 81657, USA.
| | - Christy Collins
- Datalys Center for Sports Injury Research and Prevention, 401 West Michigan Street, Suite 500, Indianapolis, IN 46202, USA
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29
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Schoeb T, Peterhans L, Fröhlich S, Frey WO, Gerber C, Spörri J. Health problems in youth competitive alpine skiing: A 12‐month observation of 155 athletes around the growth spurt. Scand J Med Sci Sports 2020; 30:1758-1768. [DOI: 10.1111/sms.13740] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 03/02/2020] [Accepted: 05/25/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Thierry Schoeb
- Sports Medical Research GroupDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
| | - Loris Peterhans
- Sports Medical Research GroupDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
| | - Stefan Fröhlich
- Sports Medical Research GroupDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
- University Centre for Prevention and Sports MedicineDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
| | - Walter O. Frey
- University Centre for Prevention and Sports MedicineDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
| | - Christian Gerber
- Team Shoulder & ElbowDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
| | - Jörg Spörri
- Sports Medical Research GroupDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
- University Centre for Prevention and Sports MedicineDepartment of OrthopaedicsBalgrist University HospitalUniversity of Zurich Zurich Switzerland
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30
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Chan LLY, Wong AYL, Wang MH. Associations between sport participation and knee symptoms: a cross-sectional study involving 3053 undergraduate students. BMC Sports Sci Med Rehabil 2020; 12:20. [PMID: 32226627 PMCID: PMC7092581 DOI: 10.1186/s13102-020-00169-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/04/2020] [Indexed: 11/21/2022]
Abstract
Background While a number of studies have investigated knee symptoms among elite athletes, few have directly compared the association between engagement in different sports and knee symptoms among young adults in the general population. The current study aimed to investigate the relation between sports participation hours, type/ number of sports engaged, self-rated competitiveness and knee symptoms among undergraduates. Methods Undergraduates were invited to participate in a self-administered online survey through invitation emails. Respondents were instructed to provide demographic information (e.g., age, gender, sports participation hours, types of engaged sports, self-rated competitiveness in sports and anxiety level etc.) and to report knee symptoms (current, the last 7 days, the last 12 months, and lifetime). Multiple logistic regressions were conducted to investigate the association between sports participation and current knee symptoms. Results Of 17,552 invitees, 3744 responded to the survey. Valid data from 3053 respondents was used for analysis. Forty-four percent of the respondents engaged in sports regularly (≥once per week). Running, cross-training and swimming were the most frequently participated sports among the respondents. The current prevalence rate of knee symptoms was 6.4%. Hours spent participating in combat sports, soccer, yoga, and basketball participation hours were significantly associated with current knee symptoms. Respondents who rated themselves as “competitive” demonstrated a higher risk of having current knee symptoms than “recreational” players. Number of engaged sports was not associated with current knee symptoms among undergraduates. Conclusions Certain sports types were associated with current knee symptoms. Compared to self-rated “recreational” players, self-rated “competitive” players were more likely to have current knee symptoms. Students should take preventive measures to minimize their risk of developing knee symptoms, especially when participating in combat sports, soccer, yoga, and basketball, or engaging in sports at a highly competitive level.
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Affiliation(s)
- Lloyd L Y Chan
- 1School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052 Australia
| | - Arnold Y L Wong
- 2The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Maggie H Wang
- 3JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,4Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
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31
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Dec KL, Kelly KC, Gilman JB. Management of Adult Sports Concussion. Concussion 2020. [DOI: 10.1016/b978-0-323-65384-8.00011-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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32
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Asken BM, Houck ZM, Clugston JR, Larrabee GJ, Broglio SP, McCrea MA, McAllister TW, Bauer RM. Word-reading ability as a "hold test" in cognitively normal young adults with history of concussion and repetitive head impact exposure: A CARE Consortium Study. Clin Neuropsychol 2019; 34:919-936. [PMID: 31698991 DOI: 10.1080/13854046.2019.1680735] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: Neuropsychological evaluations include hold tests like word-reading ability as estimates of premorbid intellect thought to be resilient to the effects of neurologic insult. We tested the alternative hypothesis that exposure to concussion or repetitive subclinical head impacts throughout early life may stunt acquisition of word-reading skills.Method: Data were obtained from student-athletes within the CARE Consortium that completed the Wechsler Test of Adult Reading (WTAR). Measures of head trauma burden included self-reported concussion history and cumulative years of exposure to collision sports. We evaluated the effects of head trauma, sociodemographic (race, SES), and academic (SAT/ACT scores, learning disorder) variables on WTAR standard score using linear regression. Analyses were repeated in a football-only subsample estimating age of first exposure to football as a predictor.Results: We analyzed data from 6,598 participants (72.2% white, 39.6% female, mean ± SD age = 18.8 ± 1.2 years). Head trauma variables collectively explained 0.1% of the variance in WTAR standard scores, with years of collision sport exposure weakly predicting lower WTAR standard scores (β = .026-.035, very small effect). In contrast, sociodemographic and academic variables collectively explained 20.9-22.5% of WTAR standard score variance, with strongest effects noted for SAT/ACT scores (β = .313-.337, medium effect), LD diagnosis (β = -.115 to -.131, small effect), and SES (β = .101-.108, small effect). Age of first exposure to football did not affect WTAR scores in a football-only sample.Conclusion: Wechsler Test of Adult Reading performance appears unrelated to history of self-reported concussion(s) and/or repetitive subclinical head trauma exposure in current collegiate athletes. Sociodemographic and academic variables should be incorporated in test score interpretations for diverse populations like athletes.
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Affiliation(s)
- Breton M Asken
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Zachary M Houck
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - James R Clugston
- Department of Community Health and Family Medicine, University Athletic Association, University of Florida, Gainesville, FL, USA
| | | | - Steven P Broglio
- Michigan Concussion Center, School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Russell M Bauer
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Kerr ZY, Chandran A, Nedimyer AK, Arakkal A, Pierpoint LA, Zuckerman SL. Concussion Incidence and Trends in 20 High School Sports. Pediatrics 2019; 144:peds.2019-2180. [PMID: 31615955 DOI: 10.1542/peds.2019-2180] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Ongoing monitoring of concussion rates and distributions is important in assessing temporal patterns. Examinations of high school sport-related concussions need to be updated. This study describes the epidemiology of concussions in 20 high school sports during the 2013-2014 to 2017-2018 school years. METHODS In this descriptive epidemiology study, a convenience sample of high school athletic trainers provided injury and athlete exposure (AE) data to the National High School Sports-Related Injury Surveillance Study (High School Reporting Information Online). Concussion rates per 10 000 AEs with 95% confidence intervals (CIs) and distributions were calculated. Injury rate ratios and injury proportion ratios examined sex differences in sex-comparable sports (soccer, basketball, baseball and softball, cross country, track, and swimming). We also assessed temporal trends across the study period. RESULTS Overall, 9542 concussions were reported for an overall rate of 4.17 per 10 000 AEs (95% CI: 4.09 to 4.26). Football had the highest concussion rate (10.40 per 10 000 AEs). Across the study period, football competition-related concussion rates increased (33.19 to 39.07 per 10 000 AEs); practice-related concussion rates decreased (5.47 to 4.44 per 10 000 AEs). In all sports, recurrent concussion rates decreased (0.47 to 0.28 per 10 000 AEs). Among sex-comparable sports, concussion rates were higher in girls than in boys (3.35 vs 1.51 per 10 000 AEs; injury rate ratio = 2.22; 95% CI: 2.07 to 2.39). Also, among sex-comparable sports, girls had larger proportions of concussions that were recurrent than boys did (9.3% vs 6.4%; injury proportion ratio = 1.44; 95% CI: 1.11 to 1.88). CONCLUSIONS Rates of football practice-related concussions and recurrent concussions across all sports decreased. Changes in concussion rates may be associated with changes in concussion incidence, diagnosis, and management. Future research should continue to monitor trends and examine the effect of prevention strategies.
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Affiliation(s)
- Zachary Y Kerr
- Department of Exercise and Sport Science, and .,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Avinash Chandran
- Department of Exercise and Sport Science, and.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Aliza K Nedimyer
- Human Movement Science Curriculum.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alan Arakkal
- Department of Epidemiology, Anschutz Medical Campus, University of Colorado Denver, Aurora, Colorado
| | | | - Scott L Zuckerman
- Department of Neurological Surgery, and Sports Concussion Center, School of Medicine, Vanderbilt University, Nashville, Tennessee
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Yaramothu C, Goodman AM, Alvarez TL. Epidemiology and Incidence of Pediatric Concussions in General Aspects of Life. Brain Sci 2019; 9:brainsci9100257. [PMID: 31569649 PMCID: PMC6827131 DOI: 10.3390/brainsci9100257] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Concussions are one of the most common head injuries acquired within the pediatric population. While sport-related concussions are well documented, concussions within other aspects of a child's life are not as well researched. The purpose of this study is to examine the incidence of a large pediatric concussion population in a broad range of daily activities. METHODS Patients' gender and nature of injury were extracted from 1408 medical records of patients who were diagnosed with a concussion at Saint Peter's Sports Medicine Institute. Statistical analyses were conducted for activities and environmental settings using chi-squared tests. RESULTS Concussions were most prevalent in organized sports (53.3%), followed by injuries within the following settings: school (16.5%), recreational (6.7%), motor vehicle collisions (6.6%), home (5.5%), and other (11.3%). Specifically, soccer (12.9%), school physical education (PE) class (10.6%), and football (9.8%) subcategories recorded the most incidences of concussion. For the PE class cohort (n = 149), significantly more females were diagnosed with a concussion compared to males (p < 0.001). CONCLUSIONS PE-related concussions had the second highest incidence rate after organized sports. A significant gender difference was observed in PE class. Awareness about concussions and methods to reduce the risk of concussion is suggested for PE classes.
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Affiliation(s)
- Chang Yaramothu
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA.
| | - Arlene M Goodman
- Saint Peter's Sports Medicine Institute, Saint Peter's University Hospital, Somerset, NJ 08873, USA.
| | - Tara L Alvarez
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA.
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35
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Comstock RD. Reply. J Athl Train 2019; 54:832-833. [PMID: 31441686 DOI: 10.4085/1062-6050-54.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- R Dawn Comstock
- Principal Investigator, HS RIO Professor of Epidemiology Colorado School of Public Health University of Colorado School of Medicine, Pediatrics Program for Injury Prevention, Education, and Research (PIPER) Aurora
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36
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Eberman LE, Neil ER, Nottingham SL, Kasamatsu TM, Bacon CEW. Athletic Trainers' Practice Patterns Regarding Medical Documentation. J Athl Train 2019; 54:822-830. [PMID: 31386576 DOI: 10.4085/1062-6050-230-18] [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] [Indexed: 11/09/2022]
Abstract
CONTEXT Medical documentation is a required component of patient care in all health care professions. OBJECTIVE To evaluate athletic trainers' perceived behaviors toward, barriers to, and confidence in their medical documentation. DESIGN Cross-sectional study. SETTING Web-based survey. PATIENTS OR OTHER PARTICIPANTS We purchased a list of randomly selected e-mails from the National Athletic Trainers' Association. Of the 9578 participants, 1150 accessed our questionnaire (12.0% access rate), 1053 completed at least 1 portion, and 904 completed the questionnaire in its entirety (85.8% completion rate). Of the participants, 60.1% (n = 569/947) were female, 66.6% (n = 632/949) held a master's degree, 39.3% (n = 414/1053) worked in a collegiate or university setting, and 36.1% (n = 381/1053) worked in a secondary school setting. MAIN OUTCOME MEASURE(S) We used a 31-item questionnaire with demographics (12 items), medical documentation behaviors (16 items), barriers (2 items), and perceptions (1 multipart item) sections. The questionnaire explored athletic trainers' behaviors as well as confidence in, comfort with, and concerns about their documentation practices (Cronbach α = 0.887). We used descriptive statistics to identify characteristics of central tendency (mean, standard deviation, mode, frequency). RESULTS Participants always (45.7%, n = 478/1046) or very frequently (39.0%, n = 408/1046) used a double documentation system consisting of electronic and paper records (50.4%, n = 523/1038). They most often documented to provide legal protection (86.8%, n = 914/1053), because it is a legal obligation (79.1%, n = 833/1053), or to track patient progress (83.9%, n = 883/1053). The most frequently cited barriers to medical documentation were time (76.5%, n = 806/1053), managing too many patients (51.9%, n = 547/1053), technological concerns (17.2%, n = 181/1053), and software limitations (17.2%, n = 181/1053). Respondents believed they were competent, comfortable, and confident in their documentation practices. CONCLUSIONS We were able to evaluate the generalizability of previous research while adding to the understanding of the behaviors toward, barriers to, and perceptions about medical documentation. We confirmed that time and patient load affected the ability to perform high-quality medical documentation.
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Affiliation(s)
- Lindsey E Eberman
- Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory, Indiana State University, Terre Haute
| | - Elizabeth R Neil
- Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory, Indiana State University, Terre Haute
| | - Sara L Nottingham
- Department of Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque
| | | | - Cailee E Welch Bacon
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ
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Beachy G. Letter to the Editor. J Athl Train 2019; 54:831. [DOI: 10.4085/1062-6050-54.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Glenn Beachy
- Retired Athletic TrainerPunahou SchoolHonolulu, HI
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Wayment HA, Huffman AH, Lane TS, Lininger MR. Relationship of athletic and academic identity to concussion reporting intentions. Musculoskelet Sci Pract 2019; 42:186-192. [PMID: 31014920 DOI: 10.1016/j.msksp.2019.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/26/2019] [Accepted: 04/09/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Understanding concussed athletes' motivations for reporting concussion symptoms is important for health care professionals who are charged with the care, management, and prevention of future injury. OBJECTIVES To examine if athletic and academic identity predict concussion symptom reporting intentions above and beyond traditional socio-cognitive predictors. DESIGN Cross-sectional study using self-report measures during the 2016 collegiate football season. METHOD In a sample of National Collegiate Athletic Association (NCAA) Division I American football athletes (N = 205) we examined the relationship of athletic and academic identity with three indices of symptom reporting behavior: reporting during a game, reporting 24 h after a game, and reporting on behalf of a teammate. We used descriptive statistical analyses, correlations, and linear regression to examine hypotheses. RESULTS Controlling for traditional predictors, athletic identity was associated with a lower likelihood to report symptoms during a game (β = -0.22, t = -3.28, p < .001) or within 24 h (β = -0.28, t = -4.12, p < .001). Academic identity was positively associated with reporting intentions during a game (β = 0.12, t = 1.68, p < .05), 24 h later (β = 0.13, t = 1.85, p < .05), and on behalf of a teammate (β = 0.22, t = -3.36, p < .001). CONCLUSIONS Athletic and academic identities offer additional insight into athletes' motivation for concussion symptom reporting intentions, above and beyond traditional socio-cognitive predictors. Discussion focuses on the benefit of incorporating these important self-identities into educational health interventions to improve their impact.
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Affiliation(s)
- Heidi A Wayment
- Psychological Sciences, 1100 S. Beaver Street, Northern Arizona University, Flagstaff, AZ, 86011, USA.
| | - Ann H Huffman
- Psychological Sciences, 1100 S. Beaver Street, Northern Arizona University, Flagstaff, AZ, 86011, USA; W.A. Franke College of Business, 101 E. McConnell, Northern Arizona University, Flagstaff, AZ, 86011, USA.
| | - Taylor S Lane
- Interdisciplinary Health PhD Program, 1100 S. Beaver Street, Northern Arizona University, Flagstaff, AZ, 86011, USA.
| | - Monica R Lininger
- Physical Therapy and Athletic Training, 208 E. Pine Knoll Drive, Northern Arizona University, Flagstaff, AZ, USA.
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LaBella C. Youth Tackle Football: Perception and Reality. Pediatrics 2019; 143:peds.2019-0519. [PMID: 30936252 DOI: 10.1542/peds.2019-0519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Cynthia LaBella
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; and Department of Pediatrics, Northwestern Univerity's Feinberg School of Medicine, Chicago, Illinois
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