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Tadmor D, Till K, Phillips G, Brown J, Fairbank L, Hendricks S, Johnston RD, Longworth T, Stokes K, Jones B. I won't let you down; why 20% of Men's and Women's Super League players underreported suspected concussions. J Sci Med Sport 2023; 26:688-693. [PMID: 37813720 DOI: 10.1016/j.jsams.2023.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 06/27/2023] [Accepted: 09/18/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVES Quantify and identify factors associated with concussion underreporting in Super League rugby league players. DESIGN Cross sectional survey. METHODS During the 2022 season preseason, 422 Men's and Women's Super League players completed an online survey quantifying player demographics, rugby playing history, concussion history, prevalence of, and reasons for underreporting concussion, concussion knowledge and long-term implications and perceptions of concussion. RESULTS Overall, 20% of respondents stated they did not report concussion-related symptoms to medical staff during the 2020 and 2021 seasons. The two most common reasons for underreporting concussion were 'didn't want to be ruled out of a match' (35%) and 'didn't want to let down team' (24%). 65% of players reported an appropriate level of knowledge about concussion and potential long-term implications at the start of their senior rugby career, versus 89% now. In relation to concussion knowledge, symptoms were correctly identified on 74% of occasions. 57% of players surveyed were concerned about the potential long-term implications from concussion, and 11% of players would encourage their/family members' children to not play rugby league. CONCLUSIONS The proportion of Super League players who did not report concussion symptoms was similar to rugby league players in Australia. The main reasons for not reporting concussion appeared to be due to perceptions of what is beneficial for the team, suggesting both performance and medical staff should collectively encourage players to report concussion. A player's attitude towards concussion is potentially an individual modifiable risk factor and should be considered within the concussion management of players.
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Affiliation(s)
- Daniel Tadmor
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; Leeds Rhinos Rugby League Club, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom. https://twitter.com/danieltadmor
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; Leeds Rhinos Rugby League Club, United Kingdom. https://twitter.com/ktconditioning
| | - Gemma Phillips
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom; Hull Kingston Rovers, United Kingdom
| | - James Brown
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; Institute of Sport and Exercise Medicine (ISEM), Department of Exercise, Sport and Lifestyle Medicine and Health Sciences, Stellenbosch University, South Africa; Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, The University of Cape Town, South Africa. https://twitter.com/jamesbrown06
| | - Laura Fairbank
- England Performance Unit, Rugby Football League, United Kingdom
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, The University of Cape Town, South Africa. https://twitter.com/sharief_h
| | - Rich D Johnston
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; School of Behavioural and Health Sciences, Australian Catholic University, Australia; Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Australia. https://twitter.com/richjohnston88
| | - Thomas Longworth
- Sports Medicine, Eastern Suburbs Sports Medicine Centre, Australia; Medical, New South Wales Institute of Sport, Australia
| | - Keith Stokes
- Centre for Health, and Injury & Illness Prevention in Sport, University of Bath, United Kingdom; UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, United Kingdom; Rugby Football Union, United Kingdom. https://twitter.com/drkeithstokes
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, United Kingdom; England Performance Unit, Rugby Football League, United Kingdom; Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, The University of Cape Town, South Africa; School of Behavioural and Health Sciences, Australian Catholic University, Australia; Premiership Rugby, United Kingdom.
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Martin EM, Byrd M, Amador A, Ridenhour E, Charalambous C. The Influence of Athletic Identity, Passion, and Perceptions of Severity of Concussions on Athletes' Willingness to Report Concussion Symptoms. J Sport Rehabil 2023; 32:757-763. [PMID: 37236616 DOI: 10.1123/jsr.2022-0246] [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: 06/27/2022] [Revised: 03/28/2023] [Accepted: 04/16/2023] [Indexed: 05/28/2023]
Abstract
CONTEXT The influence of several psychological characteristics on the willingness of athletes to report concussion behaviors has not been well explored. Therefore, the purpose of this study was to understand how athletic identity and sport passion predicted participants' willingness to report symptoms above what was explained by athlete demographics, concussion knowledge, and perceived seriousness of concussions. DESIGN The study was cross-sectional. METHODS Three-hundred and twenty-two male and female high school and club sport athletes completed survey measures of concussion knowledge, athletic identity, harmonious and obsessive passion, and degree to which athletes indicated they would report concussions and concussion symptoms. RESULTS Athletes scored moderately high on their knowledge of symptoms and other concussion information (mean = 16.21; ± = 2.88) and above the midpoint on their attitudes and behaviors toward reporting concussion symptoms (mean = 3.64; ± = 0.70). There were no differences between gender, t(299) = -.78, P = .44, and previous concussion education, t(296) = 1.93, P = .06, related to concussion knowledge. Results of a hierarchical regression indicated that after entering athlete demographics, concussion knowledge, and perceived seriousness of concussions, of the 3 psychological variables in the final stage of the model, only obsessive passion was a significant predictor of athlete's attitudes to report a concussion. CONCLUSIONS Perceived seriousness of concussion, perceived threat to long-term health, and obsessive passion were the strongest predictors of athlete's willingness to report concussions. Athletes who did not believe concussions posed a threat to their current or future health, and those that held an obsessive passion for sport were most at risk for not reporting concussions. Future research should continue to investigate the relationship between reporting behaviors and psychological factors.
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Affiliation(s)
| | - Megan Byrd
- Georgia Southern University, Statesboro, GA,USA
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Tanaka S, Sagisaka R, Sone E, Tanaka H. Sport level and sex differences in sport-related concussion among Japanese collegiate athletes: Epidemiology, knowledge, reporting behaviors, and reported symptoms. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:229-238. [PMID: 37753424 PMCID: PMC10518792 DOI: 10.1016/j.smhs.2023.07.002] [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: 01/06/2023] [Revised: 06/23/2023] [Accepted: 07/05/2023] [Indexed: 09/28/2023] Open
Abstract
This study investigated the incidence of sport-related concussion (SRC) in sports, effect of athlete knowledge on reporting behavior differences between collegiate and non-collegiate athletes, and differences in SRC symptoms between sexes and level of participation. In this cross-sectional survey, 1 344 Japanese collegiate and non-collegiate athletes from a single institute were analyzed. Using a web-based survey, demographics, general SRC, knowledge of SRC, the most recent SRC reporting behaviors, and symptom presentation were examined. The prevalence of SRC during the academic year 2016-2017 was 2.68 (95% confidence interval [CI]: 1.88-3.69) across all sports. The prevalence of SRC was 33.3 (95% CI: 17.96-51.83) in rugby union and 8.33 (95% CI: 1.03-27.00) in women's soccer. The prevalence of SRC in males (3.47 [95% CI: 2.38-4.86] was 3.65 times higher than that in females (0.95 [95% CI: 0.26-2.41]). In total, the mean total score of knowledge was 5.30 (4.2) across 25 questions; dizziness was the most well-known symptom (867/1 344, 64.5%), followed by headache (59.3%). Being more emotional (44/1 345, 3.3%) was the least frequently known symptom. Level of participation did not affect scores (5.16 [3.96] vs. 5.52 [4.54]; p = 0.131). All 87 disclosing participants experienced drowsiness and irritability and felt more emotional. In terms of sex and participant level, no significant differences were found in any symptoms. This study found very low rates of concussion education in Japan. Dissemination of concussion education is essential in the future to recognize concussion earlier and prevent severe concussive injury.
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Affiliation(s)
- Shota Tanaka
- Research Institute of Disaster Management and EMS, Kokushikan University, Japan
- Kokushikan Sports Promotion Center, Kokushikan University, Japan
| | - Ryo Sagisaka
- Research Institute of Disaster Management and EMS, Kokushikan University, Japan
- Department of Integrated Science and Engineering for Sustainable Societies, Chuo University, Japan
| | - Etsuko Sone
- Research Institute of Disaster Management and EMS, Kokushikan University, Japan
- Kokushikan Sports Promotion Center, Kokushikan University, Japan
| | - Hideharu Tanaka
- Research Institute of Disaster Management and EMS, Kokushikan University, Japan
- Kokushikan Sports Promotion Center, Kokushikan University, Japan
- Department of Sports Medicine, Kokushikan University, Japan
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Heck SJ, Acord-Vira A, Davis DR. Sex differences in college students' knowledge of concussion and concussion education sources. Concussion 2023; 8:CNC108. [PMID: 37691852 PMCID: PMC10488458 DOI: 10.2217/cnc-2023-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/21/2023] [Indexed: 09/12/2023] Open
Abstract
Aim To understand sex differences and sources of concussion education for college students. The literature for college students primarily focuses on sports concussions and general knowledge. Understanding how non-students-athletes learn is critical to developing interventions to improve concussion knowledge. Participants A random sample of 208 students from four-year institutions. Methods A 22-question online survey explored postsecondary students' current knowledge and education regarding concussions. Results Findings indicated that sex differences emerged with concussion knowledge and sources of concussion knowledge (e.g., leaflets, pamphlets, parents, and television). The top choices for where they wanted to learn about concussions were health educators, health centers, and campus peer educators. Conclusion This study provides an initial evaluation and implications for future research on providing concussion education.
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Affiliation(s)
- Stephen J Heck
- Social & Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Amanda Acord-Vira
- Division of Occupational Therapy, West Virginia University, Morgantown, WV 26506, USA
| | - Diana R Davis
- Division of Occupational Therapy, West Virginia University, Morgantown, WV 26506, USA
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Olanrewaju O, Rashid H, Dobbin N. A cross-sectional study examining Nigerian footballers' knowledge and attitudes towards sport-related concussion and associated contextual factors. BRAIN IMPAIR 2023; 24:424-440. [PMID: 38167186 DOI: 10.1017/brimp.2022.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To examine Nigerian footballers' knowledge and attitudes towards sport-related concussion (SRC) and associated contextual factors. METHODS A cross-sectional study design was used with an online questionnaire distributed to Nigerian footballers affiliated with a registered team. The questionnaire included demographic information and the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS-ST). The concussion knowledge index (CKI, 0-25) and attitude index (CAI, 15-75) were calculated. The association between various contextual factors with "high" knowledge and attitude were determined. RESULTS A total of 331 participants completed the questionnaire from 10 football clubs. Mean CKI and CAI scores were 14.0 ± 3.0 (56.2 ± 13.2%) and 54.5 ± 9.4 (72.6 ± 12.5%), respectively, and the association between scores was considered large (r = 0.530; 28%). A small proportion (n = 25; 7.6%) of participants reported a previous diagnosis of an SRC, with a further 40 (12.1%) suspecting they have suffered SRC. Thirty-five participants (10.6%) reported sustaining a SRC but did not seek medical help. Results indicated that men were at 4.8 times greater odds of having a "high[er]" CKI than women, and that those with 5-10 years playing experience had lower odds of a "high" CKI than those with >10 years' experience. Men had 7 times greater odds of having a "high" CAI than women. CONCLUSION The results of this study suggest that Nigerian footballers have a moderate level of SRC knowledge, satisfactory symptom recognition, and high SRC attitudes. Those working with Nigerian football may consider these findings when seeking strategies to improve concussion knowledge, potentially by improving attitudes and considering sex and playing experience.
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Affiliation(s)
- Oluwaseyi Olanrewaju
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Haroon Rashid
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
- Department of Emergency Medicine, Manchester Royal Infirmary, Manchester, UK
| | - Nick Dobbin
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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The effect of Preseason concussion education on self-reported likelihood and confidence in concussion reporting. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fontana J, Cranmer GA, Ash E, Mazer JP, Denham BE. Parent-Child Communication regarding Sport-Related Concussion: An Application of the Theory of Planned Behavior. HEALTH COMMUNICATION 2022; 37:923-934. [PMID: 33487037 DOI: 10.1080/10410236.2021.1876326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Extant research has discussed the importance of social climates surrounding sport-related concussion (SRC) reporting, especially the need to address parents/guardians' role in concussion management. This study explores parents/guardians' intentions toward SRC-related conversations with their children and their seeking of conversational resources via the Theory of Planned Behavior (TPB). Data collected from 292 parents/guardians of 1st-12th graders who play contact sports are examined via a structural equation model. The results indicate that parents/guardians' intention toward communicating with their child about SRC reporting was determined by their attitudes and subjective norms but that perceived behavioral control was not a significant predictor of intention. Furthermore, parents/guardians' intention toward having these conversations was predictive of whether they sought information to aid these conversations. This study answers calls to address parents/guardians' involvement in SRC management and provides preliminary information for persuading parents/guardians to have conversations with their children about SRC reporting.
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Affiliation(s)
| | | | - Erin Ash
- Department of Communication, Clemson University
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Beran KM, Scafide KN. Factors Related to Concussion Knowledge, Attitudes, and Reporting Behaviors in US High School Athletes: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:406-417. [PMID: 35075658 DOI: 10.1111/josh.13140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/17/2021] [Accepted: 08/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Sport-related concussions are a major public health problem with only 50% of concussed teens reporting their symptoms. The purpose of this systematic review was to identify individual and institutional factors that contribute to concussion knowledge, attitude, and reporting behaviors among US high school athletes. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol was used to direct the process of this systematic review. A search for English, peer-reviewed, quantitative studies published between 2010 and 2020 was conducted in 5 scholarly databases. The Joanna Briggs Critical Appraisal Tools were used to assess study quality. RESULTS Twenty-two studies met criteria for inclusion in this systematic review. The study designs were mostly cross-sectional (N = 18). Synthesis revealed individual factors including gender, age, race/ethnicity, grade level, and concussion history were associated with differences in concussion knowledge, attitude, and/or reporting behaviors. Institutional factors identified included school location, concussion education, access to an athletic trainer, sport played, and team climate. Six studies found concussion education had a positive impact on knowledge and reporting behaviors. CONCLUSION This systematic review identified certain populations which may be more vulnerable to underreporting concussion symptoms; therefore, a targeted approach to education and management may be more effective.
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Affiliation(s)
- Krista M Beran
- Doctoral Candidate, , College of Health and Human Services, George Mason University, 4400 University Dr., Fairfax, VA 22030
| | - Katherine N Scafide
- Associate Professor, , College of Health and Human Services, George Mason University, 4400 University Dr., Fairfax, VA 22030
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Jacks DE, Tereshko WD, Moore JB. Diagnosed Concussion and Undiagnosed Head Trauma Is Associated With Long-Term Concussion-Related Symptoms in Former College Football Players. Am J Phys Med Rehabil 2022; 101:250-254. [PMID: 33935151 DOI: 10.1097/phm.0000000000001782] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Head trauma experienced in contact football is a growing health concern, but limited research has been conducted to assess associations between head trauma exposure and long-term concussion-related symptoms among former college football players. DESIGN We surveyed 275 former college football players who were at least 10 yrs after competition to determine the association between head trauma exposure and concussion-related symptoms later in life. Respondents provided data on their youth, high school and college playing experience, undiagnosed head injury, diagnosed concussions, and eight concussion-related symptoms. A Poisson regression was conducted to examine the association between playing experience and reported head trauma with reported symptom count, and significance was set at P ≤ 0.05. RESULTS Few participants reported diagnosed concussions in college (17.5%), but a large number reported undiagnosed football-related head injuries (68.8%) that might have resulted in a concussion. A few participants (40.7%) reported concussion-related symptoms. After controlling for age, high school football participation, and nonfootball concussions (lifetime), diagnosed concussions in high school or college did not significantly predict concussion symptoms later in life. However, undiagnosed football head injury (range = 1-8 injuries) reported 350%-855% greater concussion-related symptoms later in life. CONCLUSIONS Undiagnosed head injuries, which are less likely to be managed by a healthcare professional, were significantly associated with concussion-related symptoms later in life. These findings suggest that proper identification and management of concussions may prevent later symptoms, but more research is needed to test this conclusion.
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Affiliation(s)
- Dean E Jacks
- From the Kinesiology and Integrative Physiology, Hanover College, Hanover, Indiana (DEJ, WDT); and Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina (JBM)
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Suzuki K, Imamoto T, Nagai S, Takemura M. Knowledge of, and Attitudes Toward, Concussion in Japanese Male Collegiate Athletes. Front Sports Act Living 2022; 4:835100. [PMID: 35252861 PMCID: PMC8894241 DOI: 10.3389/fspor.2022.835100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
Japan has no streamlined concussion education for collegiate athletes, and guidelines vary by sport. In particular, research on knowledge of, and attitudes toward, concussion is necessary for the establishment of concussion education for Japanese collegiate athletes. The aim of the present study was to assess the knowledge of, and attitudes toward, concussion in Japanese male collegiate athletes and to investigate their experiences with suspected concussion symptoms. An online questionnaire was administered to 390 collegiate athletes participating in the following five sports with a high incidence of concussion: rugby union, soccer, basketball, American football, and judo. Of the 121 valid responses, 91 (77.1%) indicated that they had experienced suspected concussion symptoms at least once and 46 of these 91 respondents had not reported their symptoms of suspected concussion at least once. Athletes who had never experienced concussion symptoms were significantly less likely to recognize the symptoms of concussion (p < 0.001). Most athletes recognized headache and dizziness as suspected concussion symptoms. However, the recognition rate for several symptoms was lower than the prevalence of these symptoms as shown in previous studies. This suggests that educational initiatives might be important to bridge the gap between athletes' knowledge and understanding of frequently occurring concussion symptoms and to improve reporting behavior.
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Affiliation(s)
- Keita Suzuki
- Sports Research and Development Core, University of Tsukuba, Ibaraki, Japan
- *Correspondence: Keita Suzuki
| | - Takashi Imamoto
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Satoshi Nagai
- Faculty of Health Sciences, Tsukuba International University, Ibaraki, Japan
| | - Masahiro Takemura
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
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Concussion Knowledge and Reporting Behaviors Among Collegiate Athletes. Clin J Sport Med 2022; 32:56-61. [PMID: 33914496 DOI: 10.1097/jsm.0000000000000833] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/24/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of the current study was to explore knowledge surrounding sport-related concussions (SRCs) and the impact on reporting behaviors in collegiate athletes, including sex differences. DESIGN Cross-sectional. SETTING Institutional. PARTICIPANTS Participants were 986 collegiate athletes (607 men), aged 19.7 years (SD = 1.4) from 6 institutions, who completed a survey, including items on personal/sport demographics and SRC knowledge and reporting behaviors. INTERVENTIONS Athletes were given a short (15-minute) survey to complete during team meetings and preparticipation physicals. MAIN OUTCOME MEASURES Athletes' scores on the survey, and reporting behaviors (ie, whether or not they failed to report a suspected SRC and reasons for not reporting SRCs), were examined. RESULTS Independent samples t tests revealed female athletes scored significantly higher than male athletes on total SRC knowledge [t (926.6) = -10.6, P < 0.01] and symptom knowledge (t (859) = -7.0, P < 0.01). Approximately one-quarter of athletes reported continuing to play after sustaining a suspected SRC. Chi-square analyses exposed significant differences between male and female athletes failing to report a suspected SRC (χ2 = 7.69, P < 0.01). CONCLUSIONS Given the current findings, educational efforts aimed at collegiate athletes may not be enough. Furthermore, it is apparent that sex differences exist in SRC knowledge and reporting behaviors among collegiate athletes.
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Bretzin AC, Hines JN, Ferguson DP. Concussion Knowledge, Attitudes, and Reporting Behaviors of Sports Car Racing Drivers. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022. [DOI: 10.1249/tjx.0000000000000195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Reporting of Concussion Symptoms by a Nationwide Survey of United States Parents of Middle School Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212070. [PMID: 34831822 PMCID: PMC8622026 DOI: 10.3390/ijerph182212070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/12/2021] [Accepted: 11/14/2021] [Indexed: 11/16/2022]
Abstract
This cross-sectional study assessed concussion symptom knowledge of parents of middle school (MS) children (aged 10-15 years) through a free-response item that solicited concussion symptoms and compared findings to a pre-validated scale-based measure. A self-administered online questionnaire was sent to a panel of randomly selected United States residents who were recruited by a third-party company, aged ≥ 18 years, and identified as parents of MS children. Via a free-response item, parents listed what they believed were concussion symptoms. Multiple sections later, parents identified potential concussion symptoms via a scale measure, which featured 25 items (22 actual symptoms, three distractor symptoms) with three response options: yes, no, maybe. Free-response item responses were coded into specific symptoms. The 1062 eligible parents that provided complete data commonly identified the symptoms of dizziness (90.2%), blurred vision (87.4%), and balance problems (86.4%) on the scale-based measure. However, these and other symptoms were less commonly identified via the free-response item (dizziness: 44.4%; blurred vision: 16.5%; balance problems: 3.5%). Concussion symptoms commonly reported via the scale-based measure were reported less frequently within the free-response item. Future research must explore strategies to help clinicians working with parents and their children to measure and assess concussion symptom reporting and knowledge.
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Kneavel M, Ernst W. Cognitions That Support Concussion Reporting in Collegiate Athletes: An Analysis of a Worksheet Activity. HEALTH EDUCATION & BEHAVIOR 2021; 49:548-559. [PMID: 34636271 DOI: 10.1177/10901981211046535] [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
BACKGROUND Sports related concussions continue to be a public health concern and improving reporting behavior a focus of educational programs. While educational programs have addressed changes in knowledge of concussion symptoms, it has been challenging to design educational programs which have lasting effects on reporting behavior. AIMS The current analysis describes an intervention in which thoughts about reporting behavior are actively written down in a worksheet exercise to "pre-arm" athletes with cognitions designed to enhance reporting behavior prior to the injury event. METHOD A total of 503 male and female college athletes participating in collision (football, field hockey, ice hockey, lacrosse, and soccer) and contact sports (baseball, basketball, and softball) from 7 colleges/universities competing across all three NCAA divisions provided data collected during a randomized trial of a peer concussion education program. RESULTS Qualitative analysis revealed 10 themes that would improve reporting including short-term benefits, faster recover, safe and healthy return to play, reporting helps the team, reporting protects the brain, risk aversion, long-term benefits, coach will be supportive, teammates will be supportive and understanding, and academic performance will be affected. DISCUSSION Athletes had awareness of key risks involved in concussions and understood both short- and long-term consequences. CONCLUSION These findings have important implications for understanding how to change athletes' thoughts about reporting concussions.
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Affiliation(s)
- Meredith Kneavel
- Department of Urban Public Health and Nutrtion, La Salle University, Philadelphia, PA, USA.,Center for Concussion Education and Research, Chestnut Hill College, Philadelphia, PA, USA
| | - William Ernst
- Department of Professional Psychology, Chestnut Hill College, Philadelphia, PA, USA.,Center for Concussion Education and Research, Chestnut Hill College, Philadelphia, PA, USA
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De Araújo AVL, Areza-Fegyveres R, Guariglia CC, Ianof JN, Baratho RM, Demario JLC, Watanabe RGS, Anghinah R. Level of knowledge and misconceptions about brain concussion in Brazilian adults. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:469-477. [PMID: 34320052 DOI: 10.1590/0004-282x-anp-2019-0436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 08/04/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Brain concussion (BC) is seen as a public health priority due to its high incidence and morbidity rate, among thousands of people around the world. There are needs for fast identification, accurate diagnosis and correct management in order to reduce the short and long-term problems relating to BC. Proper knowledge of BC in the population and among clinicians is a critical factor in achieving this. OBJECTIVES To evaluate the level of self-reported BC knowledge and gaps/misconceptions, and to identify variables correlated with this level. METHODS A cross-sectional descriptive survey was performed. A Brain Concussion Knowledge Questionnaire (BCKQ) that had been created to capture data was widely distributed. Total scores, domain partial scores and percentages of correct and incorrect answers were calculated to ascertain the level of knowledge relating to BC. RESULTS The sample was formed by 1,247 Brazilian adults (age: 41.7±11.8 years). Partial scores of the BCKQ revealed the existence of poor knowledge and misconceptions in all domains of the questionnaire, especially regarding questions about recovery from and management of BC. Moderate correlations between BCKQ scores and professions (p=0.312; P=0.00) or previous brain concussion knowledge (p=0.489; P=0.00) were observed. In a multiple linear regression model, age, profession and sports practice were predictors of BC knowledge. CONCLUSION This first study to analyze the level of BC knowledge in a sample of Brazilian adults suggests that poor knowledge and misconceptions are present. Thus, meaningful and useful information was provided by this study for developing health education programs about BC for the population in order to improve fast diagnosis and correct BC management.
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Affiliation(s)
| | - Renata Areza-Fegyveres
- Universidade de São Paulo, Ambulatório de Reabilitação Cognitiva Pós-Trauma Cranioencefálico, São Paulo, SP, Brazil
| | - Carla Cristina Guariglia
- Universidade de São Paulo, Ambulatório de Reabilitação Cognitiva Pós-Trauma Cranioencefálico, São Paulo, SP, Brazil
| | - Jéssica Natuline Ianof
- Universidade de São Paulo, Ambulatório de Reabilitação Cognitiva Pós-Trauma Cranioencefálico, São Paulo, SP, Brazil
| | | | | | - Rafael Gustavo Sato Watanabe
- Universidade de São Paulo, Ambulatório de Reabilitação Cognitiva Pós-Trauma Cranioencefálico, São Paulo, SP, Brazil
| | - Renato Anghinah
- Universidade de São Paulo, Ambulatório de Reabilitação Cognitiva Pós-Trauma Cranioencefálico, São Paulo, SP, Brazil
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16
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McCarthy KS, Kneavel M, Ernst W. Psychometric properties of concussion knowledge and cognitive mediators of reporting measures. Brain Inj 2021; 35:1210-1217. [PMID: 34347541 DOI: 10.1080/02699052.2021.1959064] [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: 10/20/2022]
Abstract
Context: Concussion education and prevention programs require reliable and valid instruments to evaluate the theory, mechanisms, and outcome of these interventions Objective: To assess the psychometric properties of measures evaluating concussion education and prevention programsDesign: Descriptive epidemiological Setting: 10 NCAA-member universities Patients or Other Participants: 841 student-athletes in an RCT control group testing an ecological, peer-led concussion education program Main Outcome Measures: Instruments adapted for assessing concussion knowledge and Theory of Planned Behavior/Theory of Reasoned Action (TPB/TRA) cognitive mediators of reporting behavior (attitudes, subjective norms, perceived control, and intentions to report concussion). Participants completed measures at baseline, after one hour, and after one month Results: Internal consistency and test-retest reliability were moderate for both the concussion knowledge and cognitive mediator measures. TPB/TRA was supported subscale intercorrelation and item factor analysis in the cognitive mediator scale. Factor analysis of the concussion knowledge measure revealed subscales for physical/cognitive, psychological/affective, and non-symptoms. The intermediate TPB/TRA mediators of attitudes, norms, and perceived control predicted greater intention-to-report, which predicted increased likelihood of reporting concussion one month later.Conclusions: Measures of concussion knowledge and cognitive mediators of reporting adapted from the literature show adequate psychometric properties and support TPB/TRA application for concussion reporting behaviors.
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Affiliation(s)
- Kevin S McCarthy
- , Chestnut Hill College, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Meredith Kneavel
- School of Nursing and Health Sciences, La Salle University, Philadelphia, Pennsylvania, USA.,Center for Concussion Education and Research of Chestnut Hill College
| | - William Ernst
- , Chestnut Hill College, Philadelphia, Pennsylvania, USA
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17
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Kneavel M, Ernst W, Brandsma L. Collegiate athletes' perceptions of the culture of concussion reporting. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:435-443. [PMID: 31662115 DOI: 10.1080/07448481.2019.1679816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/13/2019] [Accepted: 10/06/2019] [Indexed: 06/10/2023]
Abstract
The current study was designed to understand the culture of concussion among college student-athletes. Participants: Eight men's lacrosse and seven women's soccer players. Methods: A focus group was conducted to understand thoughts, barriers, team culture, and what was needed to feel safe reporting symptoms. Thematic analysis was conducted to identify key themes. Results: Themes included concerns about being taken out, pushing through, wanting to play, severity influencing reporting, changes about concussion reporting, uncertainty about symptoms, concussion have changed the game, reporting a teammate, wanting someone else to make the call, desire to raise awareness, deception, wanting professors to have more understanding, circumstances influencing reporting, helmets specific for concussion, malingering, and the return to play protocol being too long. Conclusion: Factors ranging from intrinsic to more distal cultural and environmental factors appear to influence reporting concussions. Student-athletes identified factors unique to the college athlete environment.
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Affiliation(s)
- Meredith Kneavel
- Department of Psychology, Chestnut Hill College, Philadelphia, Pennsylvania, USA
| | - William Ernst
- Department of Professional Psychology, Chestnut Hill College, Philadelphia, Pennsylvania, USA
| | - Lynn Brandsma
- Department of Psychology, Chestnut Hill College, Philadelphia, Pennsylvania, USA
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18
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Deuschle C, Keith J, Dugan K, Williams M, Taravath S, Lecci L. Baseline Concussion Testing Increases Agreement With Favorable Concussion Safety Decisions in Hypothetical Scenarios. HEALTH EDUCATION & BEHAVIOR 2021; 49:732-739. [PMID: 33853415 DOI: 10.1177/10901981211003509] [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: 11/17/2022]
Abstract
BACKGROUND Dangers of sports-related concussion are well documented, and those participating in sports involving significant contact are at an even higher risk relative to the general population. Despite extensive concussion education, athletes still make decisions that would be considered unsafe, such as underreporting and continuing to play despite experiencing symptoms. Although baseline testing is an increasingly common practice at all levels of sport, little is known about its ability to improve player safety perceptions. AIMS The current study examines whether taking part in a standardized baseline concussion assessment changes athletes' knowledge, attitudes, or perceptions of concussion safety decisions. METHOD A total of 229 club and National Collegiate Athletic Association athletes completed a modified Rosenbaum Concussion Knowledge and Attitudes Survey-Student Version (RoCKAS-ST), which was used to evaluate knowledge, attitudes, and perceptions of concussion safety decisions in hypothetical scenarios. Athletes were randomly assigned to either complete baseline concussion testing prior to the RoCKAS-ST or complete baseline testing after the RoCKAS-ST. RESULTS Athletes randomly assigned to complete baseline testing before the RoCKAS-ST demonstrated greater agreement with favorable concussion safety decisions in hypothetical scenarios relative to athletes completing baseline testing after the RoCKAS-ST. The two conditions did not differ with respect to concussion knowledge or attitudes. DISCUSSION Baseline testing appears to have an added benefit of resulting in more favorable perceptions toward making safe decisions following suspected concussions. CONCLUSION Baseline testing may provide an effective means of improving a broader constellation of concussion safety behavior, particularly in club athletes, who are typically underserved in terms of concussion-related resources and care.
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Affiliation(s)
| | - Julian Keith
- University of North Carolina Wilmington, NC, USA
| | - Kelly Dugan
- University of North Carolina Wilmington, NC, USA
| | - Mark Williams
- New Hanover Regional Medical Center, Wilmington, NC, USA
| | - Sasi Taravath
- New Hanover Regional Medical Center, Wilmington, NC, USA
| | - Len Lecci
- University of North Carolina Wilmington, NC, USA
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19
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Wallace J, Affagato R, Brooke M, McAllister-Deitrick J, Moran RN, Covassin T. Racial disparities in parent knowledge of concussion and recognition of signs and symptoms. JOURNAL OF SAFETY RESEARCH 2020; 75:166-172. [PMID: 33334474 DOI: 10.1016/j.jsr.2020.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/08/2020] [Accepted: 09/16/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Concussion is a type of traumatic brain injury that can be sustained through participation in different sports. It is important that a parent be able to identify common and uncommon symptoms of a concussion to ensure the safety and good health of their child. The purpose of this study was to compare knowledge of concussion scores among White and African American parents and guardians. METHODOLOGY This cross-sectional study consisted of a single survey of 53 questions that was given to parents/guardians of high school athletes at a preseason parent meeting. Parent and guardian knowledge of concussion was assessed through a series of 45 questions. Participants were asked to correctly identify signs and symptoms of concussion, answer questions regarding the anatomy of a concussion (i.e. a concussion is an injury to the brain), answer true/false questions about general concussion knowledge, select from a list the consequences of multiple concussions and select from a list the consequences of returning to play too soon from a concussion. Knowledge of concussion was calculated by summing correct responses for the 45 knowledge questions. Racial differences were calculated using an ANCOVA, controlling for socioeconomic school type. The statistical significance level was set a priori p ≤ 0.05 for all analyses. RESULTS Participants of this study consisted of 176 [115 (65.3%) White, 61 (34.7%) African American] parents/guardians of high school athletes. Significant differences in knowledge of concussion scores between White parents/guardians [38.50 ± 4.55 (85.6% correct)], and African American parents/guardians [35.15 ± 4.97, 78.1% correct)] were identified (F(1,172) = 4.82, p = 0.03). CONCLUSION Knowledge of concussion disparities exist between African American and White parents/guardians. This disparity could cause complications from concussion to surface among children and adolescents participating in sport as their parents/guardians may not be able to correctly identify the signs and symptoms in order to seek proper medical care. Practical Application: Findings from this study highlight quantitative differences in concussion knowledge of parents from different demographics. These findings underline disparities and inequities in access to concussion-health resources that need to be addressed.
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Affiliation(s)
- Jessica Wallace
- The University of Alabama, Department of Health Science, Tuscaloosa, AL 35401, United States.
| | - Rachel Affagato
- Youngstown State University, Department of Kinesiology & Sport Science, Youngstown, OH 44555, United States
| | - Maxwell Brooke
- Youngstown State University, Department of Kinesiology & Sport Science, Youngstown, OH 44555, United States.
| | | | - Ryan N Moran
- The University of Alabama, Department of Health Science, Tuscaloosa, AL 35401, United States.
| | - Tracey Covassin
- Athletic Training Program, Michigan State University, 105 IM Circle, East Lansing, MI 48840, United States.
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20
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Chandran A, Nedimyer AK, Kerr ZY, O'Neal C, Mensch J, Yeargin SW. Concussion Knowledge, Attitudes, and Self-Reporting Intentions in Youth Athletes. J Athl Train 2020; 55:1027-1034. [PMID: 33032324 DOI: 10.4085/1062-6050-232-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Although it has been suggested that developmental and sociological factors play a role in concussion reporting, the empirical evidence related to this is limited. OBJECTIVE To examine the influences of sex, school level, school location, concussion-reporting history, and socioeconomic status on concussion-related knowledge, attitudes, and reporting intentions among middle school and high school athletes. DESIGN Cross-sectional study. SETTING Master students and High School athletes attending pre-participation examinations (PPEs) were asked to complete paper-based surveys. PATIENTS OR OTHER PARTICIPANTS Overall, 541 athletes representing 18 sports returned fully completed surveys. MAIN OUTCOME MEASURE(S) Outcomes were concussion-related knowledge, perceived seriousness, positive feelings about reporting, and self-reporting intentions. We examined group differences in these outcomes across levels of the explanatory variables of sex, school level (middle school versus high school), school location (urban versus rural), concussion self-reporting history (yes or no), and socioeconomic status (free or reduced-price lunch versus no free or reduced-price lunch) using Wilcoxon rank sum tests. Then we used multivariable ordinal logistic regression models to identify predictors of higher score levels for each outcome. Odds ratio (OR) estimates with 95% confidence intervals (CIs) excluding 1.00 were deemed significant. RESULTS Odds of higher levels of knowledge were higher in urban versus rural school student-athletes (ORAdjusted = 1.81; 95% CI = 1.03, 3.17), and lower in student-athletes on free or reduced-price lunch versus those not on free or reduced-price lunch (ORAdjusted = 0.52; 95% CI = 0.36, 0.77). Similarly, odds of higher levels of seriousness were lower in male versus female student-athletes (ORAdjusted = 0.48; 95% CI = 0.32, 0.72). Further, odds of higher levels of self-reporting intentions were lower among male versus female student-athletes (ORAdjusted = 0.53; 95% CI = 0.37, 0.75). CONCLUSIONS Developmental and sociological factors were differentially associated with concussion-related knowledge, attitudes, and self-reporting intentions. These results can inform medical providers, parents, and coaches with regard to context-specific clinical assessments of concussion symptoms.
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Affiliation(s)
- Avinash Chandran
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Matthew Gfeller Sport-Related TBI Research Center, University of North Carolina at Chapel Hill
| | - Aliza K Nedimyer
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill.,Matthew Gfeller Sport-Related TBI Research Center, University of North Carolina at Chapel Hill
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Matthew Gfeller Sport-Related TBI Research Center, University of North Carolina at Chapel Hill
| | - Cathleen O'Neal
- Department of Exercise Science, University of South Carolina, Columbia
| | - James Mensch
- Department of Exercise Science, University of South Carolina, Columbia
| | - Susan W Yeargin
- Department of Exercise Science, University of South Carolina, Columbia
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21
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Daugherty J, DePadilla L, Sarmiento K. Assessment of HEADS UP online training as an educational intervention for sports officials/athletic trainers. JOURNAL OF SAFETY RESEARCH 2020; 74:133-141. [PMID: 32951774 PMCID: PMC7644176 DOI: 10.1016/j.jsr.2020.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Sports- and recreation-related concussions are a common injury among children. Sports officials (SOs) and athletic trainers (ATs) are integral to setting the stage for safe play and managing concussions when they occur, and significant numbers of both groups have completed the Centers for Disease Control and Prevention's HEADS UP online concussion training course. However, the utility of the course for these audiences has not been assessed. We hypothesized that sports officials' and athletic trainers' concussion-related knowledge, attitudes, and behavioral intentions will improve from pre- and post-test after completing CDC's HEADS UP online concussion training course. METHOD Respondents' concussion-related knowledge, attitudes, and behavioral intentions were assessed both before and after taking the training course. Differences between pre- and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score or McNemar's test. Effect sizes were interpreted. RESULTS The SOs and ATs who participated in the HEADS UP online training had a high level of concussion knowledge before taking the course: 90% or more of respondents could identify the correct response for at least seven of the 13 knowledge questions in the pre-test. Still, the course was effective at improving the respondents' knowledge about return-to-play protocols and concussion reporting. Further, SOs and ATs demonstrated improvement in their concussion-related attitudes and behavioral intentions between the pre- and post-test. CONCLUSION SOs' and ATs' concussion knowledge, attitudes, and behavioral intentions improved immediately following completion of the CDC HEADS UP online training. Future research could also focus on the long-term retention of this type of training. Practical Applications: This study provides insight into how to better focus concussion-related educational programs to fit SOs' and ATs' needs.
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Affiliation(s)
- Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
| | - Lara DePadilla
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
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22
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Waltzman D, Daugherty J, Snedaker K, Bouton J, Wang D. Concussion reporting, return to learn, and return to play experiences in a sample of private preparatory high school students. Brain Inj 2020; 34:1193-1201. [PMID: 32697613 DOI: 10.1080/02699052.2020.1793388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The objective of this study is to describe concussion reporting and return to learn and play among high school students. METHODS Self-reported survey data of 1,999 New England private preparatory high school students who played sports or engaged in recreational activities were collected in 2018. Descriptive and bivariate statistics are presented. RESULTS Three in ten respondents (31.4%) reported ever sustaining a concussion and 22.0% did not report at least one concussion to an adult. The most common reasons for not reporting included wanting to keep playing their sport (58.0%) and not thinking the injury was that serious (53.6%). Girls and students in higher grades took longer to return to school and sports. A quarter of students reported pretending to have a faster recovery in order to return to school or sports. CONCLUSION Private school students who play sports or engage in recreational activity may be at risk of sustaining concussions and may not report their symptoms due to a lack of understanding the seriousness of concussion, not wanting to fall behind in school, or out of desire to continue playing their sport. Teachers, coaches, and parents can stress reporting as the first step in recovery.
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Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention , Atlanta, GA, USA
| | - Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention , Atlanta, GA, USA
| | | | - Jason Bouton
- PINK Concussions , Norwalk, CT, USA.,King School , Stamford, CT, USA
| | - David Wang
- Elite Sports Medicine, Connecticut Children's Medical Center , Hartford, CT, USA.,Sports Medicine, Quinnipiac University, Hamden, CT, USA
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23
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Provance AJ, Howell DR, Potter MN, Wilson PE, D'Lauro AM, Wilson JC. Presence of Neck or Shoulder Pain Following Sport-Related Concussion Negatively Influences Recovery. J Child Neurol 2020; 35:456-462. [PMID: 32192408 DOI: 10.1177/0883073820909046] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Our objective was to examine the effect of current neck or shoulder pain on concussion outcomes. Variables included symptom resolution and return-to-sport time, symptom severity, amount of school missed, and sleep disturbances. Three hundred twelve patients (37% female; median age = 15.0 years; evaluated median = 9 days postinjury) reported experiencing current neck or shoulder pain at initial evaluation, and 268 did not (31% female; median age = 14.7 years; evaluated median = 8 days postinjury). Neck or shoulder pain was associated with longer symptom resolution time (β = 6.38, 95% confidence interval [CI] = 2.44, 10.31; P = .002), more severe symptoms (β = 7.06, 95% CI = 4.91, 9.21; P < .001), and greater odds of missing >5 days of school (adjusted odds ratio [aOR] = 1.89, 95% CI = 1.23, 2.93; P = .004), and postinjury sleep problems (aOR = 2.20, 95% CI = 1.51, 3.21; P < .001). Experiencing neck or shoulder pain during the initial postinjury clinical evaluation was associated with worsened clinical outcomes. Clinicians may consider referral to early rehabilitation following concussion among those who report neck or shoulder pain.
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Affiliation(s)
- Aaron J Provance
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.,Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA
| | - David R Howell
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.,Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA
| | - Morgan N Potter
- School of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Pamela E Wilson
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA
| | - Allison M D'Lauro
- Department of Physical Therapy, Children's Hospital Colorado, Aurora, CO, USA
| | - Julie C Wilson
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.,Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
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24
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Salmon DM, Mcgowan J, Sullivan SJ, Murphy I, Walters S, Whatman C, Keung S, Clacy A, Romanchuk J. What they know and who they are telling: Concussion knowledge and disclosure behaviour in New Zealand adolescent rugby union players. J Sports Sci 2020; 38:1585-1594. [PMID: 32264762 DOI: 10.1080/02640414.2020.1749409] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to survey high school rugby players from a range of ethnic, geographic and socioeconomic backgrounds in New Zealand (NZ) to gain an understanding of concussion knowledge, awareness of NZ Rugby's (NZR) guidelines and attitudes towards reporting behaviours. Male and female high school rugby players (n= 416) from across NZ were surveyed. The findings indicated that 69% of players had sustained a suspected concussion, and 31% had received a medical diagnosis of concussion. 63% of players indicated they were aware of NZR's guidelines. Māori and Pasifika players were less likely to be aware of the guidelines compared to NZ European, Adjusted OR 0.5, p = 0.03. Guideline awareness was significantly higher for those from high decile schools when compared to low (Unadjusted OR 1.63, p = 0.04); however, when ethnicity and school locations were controlled for this became non-significant (Adjusted OR= 1.3, p=0.37). The coach was the key individual for the provision of concussion information and disclosure of symptoms for players. The findings of this study will inform the development and delivery of NZR's community concussion initiative and how these examined factors influence a high school player's concussion knowledge and reporting behaviour.
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Affiliation(s)
- Danielle M Salmon
- Health Safety and Welfare, New Zealand Rugby , Wellington, New Zealand
| | - Jody Mcgowan
- Health Safety and Welfare, New Zealand Rugby , Wellington, New Zealand
| | - S John Sullivan
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago , Dunedin, New Zealand
| | - Ian Murphy
- Health Safety and Welfare, New Zealand Rugby , Wellington, New Zealand
| | - Simon Walters
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology , Auckland, New Zealand
| | - Chris Whatman
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology , Auckland, New Zealand
| | - Sierra Keung
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology , Auckland, New Zealand
| | - Amanda Clacy
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast , Birtinya, Australia
| | - Janelle Romanchuk
- Health Safety and Welfare, New Zealand Rugby , Wellington, New Zealand
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25
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Ernst W, Kneavel ME. Development of a Peer Education Program to Improve Concussion Knowledge and Reporting in Collegiate Athletes. J Athl Train 2020; 55:448-455. [PMID: 32250640 DOI: 10.4085/1062-6050-212-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT A novel peer concussion-education program (PCEP) was developed to enhance concussion knowledge and reporting among collegiate student-athletes. OBJECTIVE To describe the PCEP and its development and implementation. DESIGN Program development consisting of a literature review, focus group, and pilot implementation. SETTING Athletics department at a college participating at the National Collegiate Athletic Association Division II-sanctioned competition level. PATIENTS OR OTHER PARTICIPANTS Fifteen student-athletes from the women's soccer and men's lacrosse teams participated in the focus group. Four peer concussion educators (PCEs) were debriefed after the pilot implementation of the PCEP with the women's soccer and men's lacrosse teams. DATA COLLECTION AND ANALYSIS Focus-group data were analyzed qualitatively. The PCEs were debriefed, and responses were organized into recommendation types. RESULTS The literature review contributed information that supported the development of the PCEP's conceptual model. Focus-group results provided information used to train the PCEs and refine the PCEP's education modules. The pilot implementation and PCE debriefing supplied information used to further revise the education modules, PCE training, and PCEP implementation procedure. CONCLUSIONS The PCEP was developed based on the Theory of Reasoned Action and Planned Behavior and uses a peer-mediated, cognitive-behavioral, and interdisciplinary model to enhance concussion knowledge of and reporting by collegiate student-athletes. After a focus-group discussion and pilot implementation, we revised the PCEP and its education modules and developed an online manual to facilitate broad dissemination.
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Stuart S, Parrington L, Martini DN, Kreter N, Chesnutt JC, Fino PC, King LA. Analysis of Free-Living Mobility in People with Mild Traumatic Brain Injury and Healthy Controls: Quality over Quantity. J Neurotrauma 2020; 37:139-145. [DOI: 10.1089/neu.2019.6450] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Samuel Stuart
- Department of Neurology, Oregon Health and Science University, Portland, Oregon
- Veterans Affairs Portland Health Care System, Portland, Oregon
| | - Lucy Parrington
- Department of Neurology, Oregon Health and Science University, Portland, Oregon
- Veterans Affairs Portland Health Care System, Portland, Oregon
| | - Douglas N. Martini
- Department of Neurology, Oregon Health and Science University, Portland, Oregon
- Veterans Affairs Portland Health Care System, Portland, Oregon
| | - Nicholas Kreter
- Department of Neurology, Oregon Health and Science University, Portland, Oregon
- Veterans Affairs Portland Health Care System, Portland, Oregon
| | - James C. Chesnutt
- Department of Neurology, Oregon Health and Science University, Portland, Oregon
| | - Peter C. Fino
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, Utah
| | - Laurie A. King
- Department of Neurology, Oregon Health and Science University, Portland, Oregon
- Veterans Affairs Portland Health Care System, Portland, Oregon
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27
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Ramsay S, Dahinten S. Concussion Education in Children and Youth: A Scoping Review. SAGE Open Nurs 2020; 6:2377960820938498. [PMID: 33415292 PMCID: PMC7774435 DOI: 10.1177/2377960820938498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Sports-related concussions in children and youth are a significant health concern. There is increasing literature pertaining to levels of knowledge about concussion and the effects of educational interventions, but the literature has not yet been synthesized for the subpopulation of children and youth. Therefore, the purpose of this review was to identify and summarize the current state of the literature on concussion knowledge, and the effect of concussion education on the knowledge, attitudes, and behaviors of children and youth who engage in sports. METHODS A scoping review was conducted, guided by Joanna Briggs Institute methodology. Two databases, MEDLINE and CINAHL (Cumulative Index to Nursing and Allied Health Literature), and reference lists were searched to identify relevant studies that focused on children and youth less than 19 years of age who engage in sports. We also searched Google Scholar for gray literature. RESULTS Of the 21 articles that met inclusion criteria, 15 focused on levels of concussion knowledge, and 6 examined the effects of educational interventions. Children and youths' level of knowledge and exposure to prior concussion education varied, although more of the studies found a lack of concussion knowledge. Educational interventions of various types have been associated with short-term increases in knowledge and intention to report, but few of the studies found sustained effects. CONCLUSIONS Findings highlight the need for improved concussion education for children and youth engaged in sports. Findings also indicate a need for further research using more rigorous methods, and studies that examine subgroup differences in knowledge and factors that may moderate the effects of educational interventions.
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Affiliation(s)
- Scott Ramsay
- School of Nursing, University of British Columbia
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Mallory KD, Hickling A, Wilson KE, Reed N. Online concussion resources for Canadian high school aged youth: A systematic search strategy. Brain Inj 2019; 34:171-177. [PMID: 31760806 DOI: 10.1080/02699052.2019.1692369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To identify online concussion resources that are suitable for Canadian youth and accurate according to the current International Consensus Statement on Concussion in Sport.Methods: A five-phased systematic search strategy was used to identify concussion resources. This included 1. searching key Canadian stakeholder websites (sport organizations, injury prevention groups, children's hospitals, governments, public health agencies, and physical and health education associations), 2. pediatric concussion expert consultation, 3. applying inclusion and exclusion criteria, 4. reviewing content for accuracy according to the consensus statement and 5. evaluating resources for readability, usability and suitability.Results: A total of 456 resources were initially identified however, only 32 met the final criteria. Across all resources, 34.6% (n=109) were excluded as they were not designed primarily for youth. Among resources reviewed for content accuracy according to the consensus statement, 53.1% (n=51) were excluded. When evaluating resources for readability, usability and suitability, 28.5% (n=13) were excluded as they were not suitable for youth.Implications: Most concussion resources available online are not written for youth and do not contain accurate information on pediatric concussion. The identified evidence-based resources can ensure that accurate and suitable information is provided to youth in order to enhance their concussion knowledge.
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Affiliation(s)
- Kylie D Mallory
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Andrea Hickling
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Katherine E Wilson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Nick Reed
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
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Provvidenza CF, Hartman LR, Carmichael J, Reed N. Does a picture speak louder than words? The role of infographics as a concussion education strategy. J Vis Commun Med 2019; 42:102-113. [DOI: 10.1080/17453054.2019.1599683] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Christine F. Provvidenza
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Laura R. Hartman
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | | | - Nick Reed
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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Chen Y, Buggy C, Kelly S. Winning at all costs: a review of risk-taking behaviour and sporting injury from an occupational safety and health perspective. SPORTS MEDICINE - OPEN 2019; 5:15. [PMID: 31049736 PMCID: PMC6497707 DOI: 10.1186/s40798-019-0189-9#citeas] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/11/2019] [Indexed: 06/14/2023]
Abstract
Professional athletes involved in high-performance sport are at a high injury risk, which may lead to long-term health consequences. Professional athletes often expose themselves to risky behaviours, resulting in a higher acceptance level of occupational risk compared to other occupations. To date, many studies have focused on elite athletes' specific injury prevention techniques. The objective of this narrative review is to (1) summarise elite athletes' attitudes towards important occupational safety and health (OSH) practices, including injury reporting, medicine usage and personal protective equipment (PPE) usage, and (2) explore factors that may influence elite athletes' injury awareness. If injury awareness were given a similar weighting in elite sports as in any other highly physical occupation, the potential benefits to elite athletes and their long-term health could be highly significant. This review identifies that most elite athletes are not aware that sporting injuries are occupational injuries requiring behaviours determined by OSH rules. All the 39 studies identified met the moderate methodological quality criteria according to the Mixed Methods Appraisal Tool (MMAT). The factors impeding athletes' injury awareness from achieving occupational health standards are discussed from three safety management perspectives: organisational, societal and individual. This review contributes to a better understanding of how to build a positive safety culture, one that could reduce elite athletes' injury rate and improve their long-term wellbeing. Further research is required to develop a quantitative measurement instrument to evaluate occupational health awareness in the sport context. Based on the papers reviewed, the study population was categorised as elite, professional, high-performance amateur and student-athletes.
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Affiliation(s)
- Yanbing Chen
- Institute of Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Conor Buggy
- Centre for Safety and Health at Work, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Seamus Kelly
- Institute of Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Chen Y, Buggy C, Kelly S. Winning at all costs: a review of risk-taking behaviour and sporting injury from an occupational safety and health perspective. SPORTS MEDICINE - OPEN 2019; 5:15. [PMID: 31049736 PMCID: PMC6497707 DOI: 10.1186/s40798-019-0189-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/11/2019] [Indexed: 01/19/2023]
Abstract
Professional athletes involved in high-performance sport are at a high injury risk, which may lead to long-term health consequences. Professional athletes often expose themselves to risky behaviours, resulting in a higher acceptance level of occupational risk compared to other occupations. To date, many studies have focused on elite athletes' specific injury prevention techniques. The objective of this narrative review is to (1) summarise elite athletes' attitudes towards important occupational safety and health (OSH) practices, including injury reporting, medicine usage and personal protective equipment (PPE) usage, and (2) explore factors that may influence elite athletes' injury awareness. If injury awareness were given a similar weighting in elite sports as in any other highly physical occupation, the potential benefits to elite athletes and their long-term health could be highly significant. This review identifies that most elite athletes are not aware that sporting injuries are occupational injuries requiring behaviours determined by OSH rules. All the 39 studies identified met the moderate methodological quality criteria according to the Mixed Methods Appraisal Tool (MMAT). The factors impeding athletes' injury awareness from achieving occupational health standards are discussed from three safety management perspectives: organisational, societal and individual. This review contributes to a better understanding of how to build a positive safety culture, one that could reduce elite athletes' injury rate and improve their long-term wellbeing. Further research is required to develop a quantitative measurement instrument to evaluate occupational health awareness in the sport context. Based on the papers reviewed, the study population was categorised as elite, professional, high-performance amateur and student-athletes.
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Affiliation(s)
- Yanbing Chen
- Institute of Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Conor Buggy
- Centre for Safety and Health at Work, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Seamus Kelly
- Institute of Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Craig DI, Lininger MR, Wayment HA, Huffman AH. Investigation of strategies to improve concussion reporting in American football. Res Sports Med 2019; 28:181-193. [PMID: 30859851 DOI: 10.1080/15438627.2019.1586706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
While research on sport-related concussion has increased dramatically over the past decade, research investigating concussion reporting is in its early stages. The purpose of this project was to assess concussion reporting and work with stakeholders to develop and assess strategies to improve reporting. We used a multi-site, repeated measures design with three NCAA Division I football programs, including 223 athlete participants. A modified community-based participatory research (CBPR) approach was used to develop intervention strategies (Fall 2017 season) with stakeholders designed to increase concussion reporting intentions. Preseason and postseason surveys were administered to determine effectiveness. Main outcome measures included concussion knowledge, intervention effectiveness, and reporting intention measures. For all three programs, concussion knowledge was unrelated to reporting intentions. Two of the three programs implemented the intervention strategies and for these programs there was evidence that the interventions were effective. Specifically, athletes from these two programs perceived more support from coaches about reporting (P< 0.05; t= 2.83), received education more frequently (P< 0.05; t= 2.67), and reported being more likely to report concussion symptoms (P< 0.05; t= 2.14). Our study demonstrates that working with stakeholders to develop site-specific strategies to improve concussion reporting is an effective approach to help improve reporting behaviours.
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Affiliation(s)
- Debbie I Craig
- Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, Arizona
| | - Monica R Lininger
- Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, Arizona
| | - Heidi A Wayment
- Psychological Sciences, W.A. Franke College of Business, Northern Arizona University
| | - Ann H Huffman
- Psychological Sciences, W.A. Franke College of Business, Northern Arizona University
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Sutton M, Chan V, Escobar M, Mollayeva T, Hu Z, Colantonio A. Neck Injury Comorbidity in Concussion-Related Emergency Department Visits: A Population-Based Study of Sex Differences Across the Life Span. J Womens Health (Larchmt) 2018; 28:473-482. [PMID: 30592685 PMCID: PMC6482894 DOI: 10.1089/jwh.2018.7282] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: The cervical spine region can be especially vulnerable to concurrent injury in concussion, with research suggesting that females may be at greater risk due to their weaker and anatomically distinct necks. The main objective of our research was to study sex differences in the rate of neck injury comorbidity across the life span among patients with a concussion diagnosis in the emergency department (ED) setting, by cause of injury (motor vehicle collisions [MVC] and sports). Materials and Methods: All patients with a first concussion-related ED visit between fiscal years 2002/2003 and 2011/2012 (inclusive) in Ontario were identified in population-based health administrative data using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada (ICD-10-CA) codes. Age-dependent odds ratios of comorbid neck injury for sex were estimated using polynomial multivariable logistic regression models, adjusting for sociodemographic characteristics. Results: Females with a concussion had significantly higher odds of sustaining a comorbid neck injury between the ages of 5–49 years for all concussion-related ED visits, 15–49 years for MVC-related concussion ED visits, and 10–39 years for sports-related concussion ED visits, holding all other covariates in the model constant. Conclusions: These results support the consideration of increased screening for comorbid neck injuries, particularly for females, to allow for early intervention. Furthermore, the increased risk of comorbid neck injury in females with a concussion-related ED visit was age-dependent, with the interaction between sex and age following a nonlinear trend. As such, future studies on concussions should consider linear and nonlinear sex and age interactions.
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Affiliation(s)
- Mitchell Sutton
- Toronto Rehabilitation Institute–University Health Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Vincy Chan
- Toronto Rehabilitation Institute–University Health Network, Toronto, Canada
| | - Michael Escobar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Tatyana Mollayeva
- Toronto Rehabilitation Institute–University Health Network, Toronto, Canada
- Department of Occupational Sciences and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Zheng Hu
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Angela Colantonio
- Toronto Rehabilitation Institute–University Health Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Occupational Sciences and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Institute for Clinical and Evaluative Sciences, Toronto, Canada
- Address correspondence to: Angela Colantonio, PhD, Rehabilitation Sciences Building, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON M5G 1V7, Canada
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The evolving landscape of policies, rules, and law in sport-related concussion. HANDBOOK OF CLINICAL NEUROLOGY 2018; 158:257-267. [PMID: 30482354 DOI: 10.1016/b978-0-444-63954-7.00025-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Beginning in 2009 with the passage of the Zackery Lystedt law in the state of Washington, all 50 states have passed concussion laws that implement a mandatory framework of care for high school and youth athletes. The structure of these laws generally shares the three primary components of the Lystedt law: (1) preseason concussion education; (2) mandatory removal from play with suspected concussion; and (3) clearance from a healthcare professional prior to return to play. These same three policy components are also found at the collegiate and professional levels of sport, either through established policy or labor contracts. This chapter explores concussion-specific legal and policy developments that currently inform concussion management practices across multiple levels of the US athletic system.
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Knollman-Porter K, Brown J, Flynn M. A Preliminary Examination of Concussion Knowledge by Collegiate Athletes and Non-Athletes. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:778-795. [PMID: 29625433 DOI: 10.1044/2018_ajslp-17-0108] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 01/03/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Concussions affect various populations, including collegiate athletes and non-athletes. The purpose of this study was to compare collegiate varsity athletes, recreational athletes, and non-athletes' knowledge of concussion definition, symptoms, and support services available following injury. Preferred method of concussion education delivery was also examined. METHOD We surveyed 306 current college students using an online survey system. The survey included free recall and forced-choice question formats. Quantitative analyses were used to analyze results and compare responses among groups. RESULTS Collegiate athletes and non-athletes demonstrate incomplete knowledge of concussion definition, related symptoms, and professionals involved in postinjury management. Varsity athletes rated self-knowledge of concussion parameters significantly higher than the other groups (p < .001), though few significant differences in actual knowledge levels were observed. Overall, respondents reported having the highest preference for concussion education delivered by medical professionals. CONCLUSION Knowledge concerning concussion is incomplete in the collegiate population. Varsity athletes' exposure to formal education did not result in higher knowledge levels compared with other groups. Further examination of concussion educational delivery models' effect on change in concussion-related behavior in this population is warranted.
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Affiliation(s)
| | - Jessica Brown
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | - Madelaine Flynn
- Department of Speech Pathology & Audiology, Miami University, Oxford, OH
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Waltzman D, Daugherty J. Concussion knowledge and experience among a sample of American adults. JOURNAL OF CONCUSSION 2018; 2:1-11. [PMID: 30370060 PMCID: PMC6198821 DOI: 10.1177/2059700218769218] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Recently, there has been a strong emphasis on educating athletes, parents, coaches, and health care providers about concussions. However, not much is known about whether these efforts are affecting the general public’s level of concussion knowledge. Purpose: To determine what is currently known among the public about concussions and where education campaigns may be targeted in order to fill in the gaps. Methods: In order to achieve the project’s objective, CDC analyzed self-reported data from Porter Novelli’s 2017 SummerStyles survey, an annual survey of American adults aged 18 and older across the United States. The questions focused on personal concussion experiences, basic concussion knowledge, knowledge of prevention strategies, and perceived best sources of information about concussion. Results: Analysis of the data showed that approximately 18% of respondents reported that they had personally experienced a concussion in their lifetime, and about two-thirds of these respondents were evaluated by a health care provider after their injury. In terms of concussion knowledge, the majority were aware of common causes of concussion. While 94% knew that headache was a symptom of concussion, just over half were aware that sleep problems were as well. Most respondents (>78%) correctly identified that wearing seat-belts, preventing falls, and reducing participation in contact sports were ways to prevent a concussion, while installing baby-gates across stairs was less frequently known (65.5%) as a prevention technique. Nearly all of the respondents believed that a doctor or other health professional was a good source of information about concussions. These results varied by age, sex, race/ethnicity, and education. Conclusion: The results demonstrate that even though the public has a relatively high knowledge level of concussion, targeted education is needed to teach American adults about the symptoms and ways of getting a concussion.
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Affiliation(s)
- Dana Waltzman
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jill Daugherty
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
OBJECTIVE The purpose of this study is to determine whether the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) is an appropriate outcome measure to assess knowledge and attitudes toward concussion in collegiate student-athletes as determined through validity and reliability testing. STUDY DESIGN Convenience study. SETTING The researcher recruited all athletic teams at a Division III National Collegiate Athletic Association institution. PARTICIPANTS Four hundred thirty-three collegiate student-athletes, 18 years of age or older, from a variety of sports took part in this study. As the validity of RoCKAS has never been established for the target population, this study randomly split respondents into 2 studies. INTERVENTIONS Participants in this study completed the RoCKAS during preseason meetings before concussion education. The primary researcher was not present during the completion of the survey to allow participants to answer honestly without concern of coercion. MAIN OUTCOME MEASURES A paper-based Rosenbaum Concussion Knowledge and Attitudes Survey. RESULTS The Concussion Knowledge Index (CKI) was distributed in 2 cluster constructs and identified variables of low and high difficulty. Multivariate statistical analysis of the Concussion Attitude Index (CAI) explains 68.79% of the total variance. The Confirmatory Factor Analysis did not confirm the hypothesis that similar constructs can be found between data sets ((Equation is included in full-text article.)= 207.902; consistent akaike information criterion = 391.550; root mean square error of approximation = 0.125, and goodness of fit index = 0.868). CONCLUSIONS The CKI is a valid and reliable measure in collegiate student-athletes. However, the results of the Confirmatory Factor Analysis indicated a poor model fit and improper correlations between attitude items. Therefore, the CAI may not be a sound outcome measure of collegiate student-athlete's attitudes toward concussions.
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Kearney PE, See J. Misunderstandings of concussion within a youth rugby population. J Sci Med Sport 2017; 20:981-985. [DOI: 10.1016/j.jsams.2017.04.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 03/13/2017] [Accepted: 04/16/2017] [Indexed: 11/12/2022]
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Sarmiento K, Donnell Z, Hoffman R. A Scoping Review to Address the Culture of Concussion in Youth and High School Sports. THE JOURNAL OF SCHOOL HEALTH 2017; 87:790-804. [PMID: 28876477 PMCID: PMC6211168 DOI: 10.1111/josh.12552] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 02/02/2017] [Accepted: 04/10/2017] [Indexed: 05/28/2023]
Abstract
BACKGROUND In 2013, the National Academy of Sciences emphasized the need to develop, implement, and evaluate effective large-scale educational strategies to improve the culture of concussion in youth and high school sports. In support of this recommendation, in this article we summarize research on factors that contribute to the culture of concussion. METHODS We conducted the literature search using 7 electronic databases. We used a scoping review method to identify studies that addressed knowledge, attitudes, behaviors, use of educational resources, and interventions related to concussion among young athletes, coaches, and parents. RESULTS Of the 33 articles identified, most focused on concussion education (N = 15), followed by knowledge (N = 13), behaviors (N = 13), and attitudes (N = 5). Three studies addressed multiple study populations. CONCLUSIONS The rapid spread of concussion education and awareness efforts has outpaced research on effective strategies to improve knowledge, attitudes, and behaviors that contribute to the culture of concussion. Further research is critical to inform the development and implementation of large-scale educational efforts. This research should incorporate rigorous study designs; be inclusive of diverse ages, socioeconomic status, and racial/ethnic groups; and examine opportunities to improve behavioral outcomes around concussion prevention, reporting, and management.
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Affiliation(s)
- Kelly Sarmiento
- Health Communications Specialist, (), US Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 4770 Buford Hwy NE, Building 106,8th floor, Atlanta, GA30341
| | - Zoe Donnell
- Manager, (), Health Communications Team, ICF, 100 Cambridgepark Drive, Suite 501, Cambridge, MA 02140
| | - Rosanne Hoffman
- Senior Manager, (), Health Communications Team, ICF, 530 Gaither Road, Rockville, MD 20895
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Liller KD, Morris B, Fillion J, Yang Y, Bubu OM. Analysis of Baseline Computerized Neurocognitive Testing Results among 5-11-Year-Old Male and Female Children Playing Sports in Recreational Leagues in Florida. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14091028. [PMID: 28880237 PMCID: PMC5615565 DOI: 10.3390/ijerph14091028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/14/2017] [Accepted: 09/05/2017] [Indexed: 06/07/2023]
Abstract
There is a paucity of data related to sports injuries, concussions, and computerized neurocognitive testing (CNT) among very young athletes playing sports in recreational settings. The purpose of this study was to report baseline CNT results among male and female children, ages 5-11, playing sports in Hillsborough County, Florida using ImPACT Pediatric, which is specifically designed for this population. Data were collected from 2016 to 2017. The results show that 657 baseline tests were conducted and t-tests and linear regression were used to assess mean significant differences in composite scores with sex and age. Results showed that females scored better on visual memory and in general as age increased, baseline scores improved. The results can be used to build further studies on the use of CNT in recreational settings and their role in concussion treatment, management, and interventions.
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Affiliation(s)
- Karen D Liller
- College of Public Health, University of South Florida, Tampa, FL 33612, USA.
| | - Barbara Morris
- Florida Hospital Wesley Chapel, Wesley Chapel, FL 33544, USA.
| | - Jessica Fillion
- College of Public Health, University of South Florida, Tampa, FL 33612, USA.
| | - Yingwei Yang
- College of Public Health, University of South Florida, Tampa, FL 33612, USA.
| | - Omonigho M Bubu
- College of Public Health, University of South Florida, Tampa, FL 33612, USA.
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Wallace J, Covassin T, Nogle S, Gould D, Kovan J. Concussion Knowledge and Reporting Behavior Differences Between High School Athletes at Urban and Suburban High Schools. THE JOURNAL OF SCHOOL HEALTH 2017; 87:665-674. [PMID: 28766322 DOI: 10.1111/josh.12543] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 12/21/2016] [Accepted: 02/13/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND We determined differences in knowledge of concussion and reporting behaviors of high school athletes attending urban and suburban high schools, and whether a relationship exists between underreporting and access to an athletic trainer in urban schools. METHODS High school athletes (N = 715) from 14 high schools completed a validated knowledge of concussion survey consisting of 83 questions. The independent variable was school type (urban/suburban). We examined the proportion of athletes who correctly identified signs and symptoms of concussion, knowledge of concussion and reasons why high school athletes would not disclose a potential concussive injury across school classification. Data were analyzed using descriptive, non-parametric, and inferential statistics. RESULTS Athletes attending urban schools have less concussion knowledge than athletes attending suburban schools (p < .01). Athletes attending urban schools without an athletic trainer have less knowledge than urban athletes at schools with an athletic trainer (p < .01) There was no significant relationship between reporting percentage and school type (p = .73); however, significant relationships exist between AT access at urban schools and 10 reasons for not reporting. CONCLUSION Concussion education efforts cannot be homogeneous in all communities. Education interventions must reflect the needs of each community.
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Affiliation(s)
- Jessica Wallace
- Kinesiology & Sport Science Department, Youngstown State University, 1 University Plaza, 307 L Beeghly Center, Youngstown, OH 44555
| | - Tracey Covassin
- Department of Kinesiology, Michigan State University, 105 IM Circle, East Lansing, MI 48824
| | - Sally Nogle
- Department of Athletics, Michigan State University, 105 IM Circle, East Lansing, MI 48824
| | - Daniel Gould
- Department of Kinesiology, Michigan State University, 308 W. Circle Drive, East Lansing, MI 48824
| | - Jeffrey Kovan
- Department of Radiology, Michigan State University, 4660 South Hagadorn Road, Suite 420, East Lansing, MI 48824
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Hecimovich M, Marais I. Examining the psychometric properties of a sport-related concussion survey: a Rasch measurement approach. BMC Res Notes 2017; 10:228. [PMID: 28651641 PMCID: PMC5485600 DOI: 10.1186/s13104-017-2559-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 06/19/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Awareness of sport-related concussion (SRC) is an essential step in increasing the number of athletes or parents who report on SRC. This awareness is important, as there is no established data on medical care at youth-level sports and may be limited to individuals with only first aid training. In this circumstance, aside from the coach, it is the players and their parents who need to be aware of possible signs and symptoms. The aim of this study was to examine the psychometric properties of a parent and player concussion survey intended for use before and after an education campaign regarding SRC. METHODS 1441 questionnaires were received from parents and 284 questionnaires from players. The responses to the sixteen-item section of the questionnaire's 'recognition of signs and symptoms' were submitted to psychometric analysis using the dichotomous and polytomous Rasch model via the Rasch Unidimensional Measurement Model software RUMM2030. The Rasch model of Modern Test Theory can be considered a refinement of, or advance on, traditional analyses of an instrument's psychometric properties. RESULTS The main finding is that these sixteen items measure two factors: items that are symptoms of concussion and items that are not symptoms of concussion. Parents and athletes were able to identify most or all of the symptoms, but were not as good at distinguishing symptoms that are not symptoms of concussion. Analyzing these responses revealed differential item functioning for parents and athletes on non-symptom items. When the DIF was resolved a significant difference was found between parents and athletes. CONCLUSIONS The main finding is that the items measure two 'dimensions' in concussion symptom recognition. The first dimension consists of those items that are symptoms of concussion and the second dimension of those items that are not symptoms of concussion. Parents and players were able to identify most or all of the symptoms of concussion, so one would not expect to pick up any positive change on these items after an education campaign. Parents and players were not as good at distinguishing symptoms that are not symptoms of concussion. It is on these items that one may possibly expect improvement to manifest, so to evaluate the effectiveness of an education campaign it would pay to look for improvement in distinguishing symptoms that are not symptoms of concussion.
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Affiliation(s)
- Mark Hecimovich
- Division of Athletic Training, University of Northern Iowa, 003C Human Performance Center, Cedar Falls, IA USA
- School of Psychology and Exercise Science, Murdoch University, South Street, Murdoch, WA Australia
| | - Ida Marais
- University of Western Australia, Graduate School of Education, M428, 35 Stirling Highway, Crawley, WA Australia
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Tsushima WT, Ahn HJ, Siu AM, Fukuyama T, Murata NM. Computerized neuropsychological test performance of youth football players at different positions: A comparison of high and low contact players. APPLIED NEUROPSYCHOLOGY-CHILD 2017. [PMID: 28631970 DOI: 10.1080/21622965.2017.1290530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to examine the effects of head impact frequency on the neuropsychological test results of football players who participate in different positions on the team. Based on the biomechanical measures of head impact frequency reported in high school football, a High Contact group (n = 480) consisting of offensive and defensive linemen was compared with a Low Contact group (n = 640) comprised of receivers and defensive backs. The results revealed that the High Contact group obtained poorer performances on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) on three Composite scores (Verbal Memory, Visual Motor Speed, Impulse Control) and the Total Symptom score compared to the Low Contact group. The present study is the first, to date, to report differences in the neuropsychological test performances of athletes who participate in high and low contact football positions. The findings raise tentative concerns that youth football players exposed to repetitive head trauma, including subconcussive impacts, may be at risk for lowered neuropsychological functioning and increased symptoms.
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Affiliation(s)
- William T Tsushima
- a Psychiatry and Psychology Department , Straub Medical Center , Honolulu , Hawaii , USA
| | - Hyeong Jun Ahn
- b Office of Biostatistics & Quantitative Health Sciences , University of Hawaii John A. Burns School of Medicine , Honolulu , Hawaii , USA
| | - Andrea M Siu
- c Research Institute, Hawaii Pacific Health , Honolulu , Hawaii , USA
| | - Tama Fukuyama
- d Department of Human Biology , Scripps College , Claremont , California , USA
| | - Nathan M Murata
- e Department of Kinesiology and Rehabilitation Science , University of Hawaii at Manoa , Honolulu , Hawaii , USA
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Bernstein J, Calamia M. Characteristics of a Mild Traumatic Brain Injury Sample Recruited Using Amazon's Mechanical Turk. PM R 2017. [DOI: 10.1016/j.pmrj.2017.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Leddy J, Baker JG, Haider MN, Hinds A, Willer B. A Physiological Approach to Prolonged Recovery From Sport-Related Concussion. J Athl Train 2017; 52:299-308. [PMID: 28387557 DOI: 10.4085/1062-6050-51.11.08] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Management of the athlete with postconcussion syndrome (PCS) is challenging because of the nonspecificity of PCS symptoms. Ongoing symptoms reflect prolonged concussion pathophysiology or conditions such as migraine headaches, depression or anxiety, chronic pain, cervical injury, visual dysfunction, vestibular dysfunction, or some combination of these. In this paper, we focus on the physiological signs of concussion to help narrow the differential diagnosis of PCS in athletes. The physiological effects of exercise on concussion are especially important for athletes. Some athletes with PCS have exercise intolerance that may result from altered control of cerebral blood flow. Systematic evaluation of exercise tolerance combined with a physical examination of the neurologic, visual, cervical, and vestibular systems can in many cases identify one or more treatable postconcussion disorders.
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Affiliation(s)
- John Leddy
- UBMD Department of Orthopaedics and Sports Medicine
| | - John G Baker
- UBMD Department of Orthopaedics and Sports Medicine.,Department of Nuclear Medicine, and
| | - Mohammad Nadir Haider
- Jacobs School of Medicine and Biomedical Sciences, The State University of New York at Buffalo
| | - Andrea Hinds
- UBMD Department of Orthopaedics and Sports Medicine
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Wallace J, Covassin T, Beidler E. Sex Differences in High School Athletes' Knowledge of Sport-Related Concussion Symptoms and Reporting Behaviors. J Athl Train 2017; 52:682-688. [PMID: 28561626 DOI: 10.4085/1062-6050-52.3.06] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Recent researchers have reported that athletes' knowledge of sport-related concussion (SRC) has increased but that athletes still lack knowledge of all the signs and symptoms of SRC. Understanding the signs and symptoms of SRC and the dangers of playing while symptomatic are critical to reporting behaviors in high school athletes. OBJECTIVE To examine sex differences in knowledge of SRC symptoms and reasons for not reporting a suspected SRC to an authoritative figure in high school athletes. DESIGN Cross-sectional study. SETTING Survey. PATIENTS OR OTHER PARTICIPANTS A total of 288 athletes across 7 sports (198 males [68.8%] and 90 females [31.2%]). MAIN OUTCOME MEASURE(S) A validated knowledge-of-SRC survey consisted of demographic questions, a list of 21 signs and symptoms of SRC, and reasons why athletes would not report their SRC. The independent variable was sex. Athlete knowledge of SRC symptoms was assessed by having participants identify the signs and symptoms of SRC from a list of 21 symptoms. Knowledge scores were calculated by summing the number of correct answers; scores ranged from 0 to 21, with a score closer to 21 representing greater knowledge. Reporting-behavior questions asked athletes to choose reasons why they decided not to report any possible SRC signs and symptoms to an authoritative figure. RESULTS A sex difference in total SRC symptom knowledge was found (F286 = 4.97, P = .03, d = 0.26). Female high school athletes had more total SRC symptom knowledge (mean ± standard deviation = 15.06 ± 2.63; 95% confidence interval = 14.54, 15.57) than males (14.36 ± 2.76; 95% confidence interval = 13.97, 14.74). Chi-square tests identified significant relationships between sex and 8 different reasons for not reporting an SRC. CONCLUSIONS High school males and females had similar SRC symptom knowledge; however, female athletes were more likely to report their concussive symptoms to an authoritative figure.
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Affiliation(s)
- Jessica Wallace
- Youngstown State University, OH.,Michigan State University, East Lansing
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Wallace J, Covassin T, Nogle S, Gould D, Kovan J. Knowledge of Concussion and Reporting Behaviors in High School Athletes With or Without Access to an Athletic Trainer. J Athl Train 2017; 52:228-235. [PMID: 28387561 DOI: 10.4085/1062-6050-52.1.07] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Increased sport participation and sport-related concussion incidence has led to an emphasis on having an appropriate medical professional available to high school athletes. The medical professional best suited to provide medical care to high school athletes is a certified athletic trainer (AT). Access to an AT may influence the reporting of sport-related concussion in the high school athletic population; however, little is known about how the presence of an AT affects concussion knowledge, prevention, and recognition. OBJECTIVE To evaluate knowledge of concussion and reporting behaviors in high school athletes who did or did not have access to an AT. DESIGN Cross-sectional study. SETTING Survey. PATIENTS OR OTHER PARTICIPANTS A total of 438 athletes with access to an AT and 277 without access to an AT. INTERVENTION(S) A validated knowledge-of-concussion survey consisting of 83 items addressing concussion history, concussion knowledge, scenario questions, signs and symptoms of a concussion, and reasons why an athlete would not report a concussion. The independent variable was access to an AT. MAIN OUTCOME MEASURE(S) We examined the proportion of athletes who correctly identified knowledge of concussion, signs and symptoms of concussion, and reasons why high school student-athletes would not disclose a potential concussive injury by access to an AT. Frequency statistics, χ2 tests, independent t tests, and linear regression were conducted to analyze the data. RESULTS The underreporting of concussion among high school athletes was 55%. Athletes with access to an AT had more knowledge of concussion than did athletes without such access (P ≤ .001). Chi-square tests did not demonstrate a significant relationship between AT access and a higher percentage reporting concussions. CONCLUSIONS High school athletes with access to an AT had more concussion knowledge, but they did not report suspected concussions to an authority figure more frequently than athletes without access to an AT.
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Affiliation(s)
- Jessica Wallace
- Youngstown State University, OH.,Michigan State University, East Lansing
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Carroll-Alfano M. Mandated High School Concussion Education and Collegiate Athletes' Understanding of Concussion. J Athl Train 2017; 52:689-697. [PMID: 28535096 DOI: 10.4085/1062-6050-52.3.08] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Concussions in student-athletes are a serious problem. Most states have enacted legislation mandating concussion education for student-athletes, under the assumption that education leads to better self-reporting of concussions and improved knowledge of symptoms. OBJECTIVES (1) To determine the effect of state-based concussion legislation on the proportion of student-athletes receiving concussion education and to assess the moderation of this effect by gender and sport and (2) to assess the effect of concussion education on student-athletes' knowledge of concussion symptoms and likelihood of seeking treatment after a concussion. DESIGN Cross-sectional study. SETTING Private university. PATIENTS OR OTHER PARTICIPANTS A total of 249 National Association of Intercollegiate Athletics collegiate athletes attending St Xavier University; 160 were surveyed prelegislation and 89 were surveyed postlegislation. MAIN OUTCOME MEASURE(S) Participants completed an anonymous survey that assessed previous involvement in concussion-education programs, degree of self-reporting after a concussion, and ability to enumerate symptoms. RESULTS The number of athletes who reported having received education increased after the implementation of concussion legislation; however, almost 25% still reported not having received education. Athletes who played football were more likely to report having received education than those who played volleyball. The student-athletes' ability to name a diversity of concussion symptoms or to report seeking medical attention after a concussion did not improve in the postlegislation period relative to the prelegislation period. CONCLUSIONS Legislation has been passed in all 50 states to address concussions in student-athletes; however, improvements are still needed. Concussion education must be delivered in a uniform, effective manner to all student-athletes across sports and genders. Concussion education should emphasize the diversity of symptoms, especially cognitive and behavioral symptoms. We must develop and disseminate evidence-based educational programs that are clinically proven to be effective in improving athletes' knowledge and behaviors.
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Affiliation(s)
- Miriam Carroll-Alfano
- Department of Communication Sciences and Disorders, St Xavier University, Chicago, IL
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Patel SJ, Trowbridge CA. Caregivers of youth athletes: Developing a theory-based health communication intervention for concussion education. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/jabr.12098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wallace J, Covassin T, Moran R. Racial Disparities in Concussion Knowledge and Symptom Recognition in American Adolescent Athletes. J Racial Ethn Health Disparities 2017; 5:221-228. [DOI: 10.1007/s40615-017-0361-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/09/2017] [Accepted: 03/15/2017] [Indexed: 11/24/2022]
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