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Concussion technology

Osman Hassan Ahmed, Anthony G Schneiders, Paul R McCrory, S John Sullivan
CONTEXT:   Sport concussion is currently the focus of much international attention. Innovative methods to assist athletic trainers in facilitating management after this injury need to be investigated. OBJECTIVE:   To investigate the feasibility of using a Facebook concussion-management program termed iCon (interactive concussion management) to facilitate the safe return to play (RTP) of young persons after sport concussion. DESIGN:   Observational study...
April 2017: Journal of Athletic Training
Pashtun Shahim, Henrik Zetterberg, Yelverton Tegner, Kaj Blennow
OBJECTIVE: To evaluate whether the axonal protein neurofilament light (NFL) in serum is a sensitive biomarker to detect subtle brain injury or concussion in contact sports athletes. METHODS: Two prospective cohort studies involving (1) 14 Swedish amateur boxers who underwent fluid biomarker assessments at 7-10 days after bout and after 3 months of rest from boxing and (2) 35 Swedish professional hockey players who underwent blood biomarker assessment at 1, 12, 36, and 144 hours after concussion and when the players returned to play were performed...
April 12, 2017: Neurology
Andrew J Gardner, Shirley L Shih, Elizabeth V Adamov, Ross D Zafonte
With the continued advancement in technology, such as increasingly sophisticated neuroimaging parameters, and the ongoing development of various scientific fields, like serum and blood biomarkers, genetics, and physiology, traumatic brain injury (TBI) research is a dynamic field of study. TBI remains a significant public health concern and research has continued to grow exponentially over the past decade. This review provides an overview of the frontiers of TBI research, from sports concussion to severe TBI, from acute and subacute injury to long-term/chronic outcomes, from assessment and management to prognosis, specifically examining recent neuroimaging, biomarkers, genetics, and physiologic studies...
May 2017: Physical Medicine and Rehabilitation Clinics of North America
Thomas McAllister, Michael McCrea
Initially, interest in sport-related concussion arose from the premise that the study of athletes engaged in sports associated with high rates of concussion could provide insight into the mechanisms, phenomenology, and recovery from mild traumatic brain injury. Over the last decade, concerns have focused on the possibility that, for some athletes, repetitive concussions may raise the long-term risk for cognitive decline, neurobehavioral changes, and neurodegenerative disease. First conceptualized as a discrete event with variable recovery trajectories, concussion is now viewed by some as a trigger of neurobiological events that may influence neurobehavioral function over the course of the life span...
March 2017: Journal of Athletic Training
Osman Hassan Ahmed, Anthony G Schneiders, Paul R McCrory, S John Sullivan
CONTEXT:   Sport concussion is currently the focus of much international attention. Innovative methods to assist athletic trainers in facilitating management after this injury need to be investigated. OBJECTIVE:   To investigate the feasibility of using a Facebook concussion-management program termed iCon (interactive concussion management) to facilitate the safe return to play (RTP) of young persons after sport concussion. DESIGN:   Observational study...
March 15, 2017: Journal of Athletic Training
Jon Patricios, Gordon Ward Fuller, Richard Ellenbogen, Stanley Herring, Jeffrey S Kutcher, Mike Loosemore, Michael Makdissi, Michael McCrea, Margot Putukian, Kathryn J Schneider
BACKGROUND: Sideline detection is the first and most significant step in recognising a potential concussion and removing an athlete from harm. This systematic review aims to evaluate the critical elements aiding sideline recognition of potential concussions including screening tools, technologies and integrated assessment protocols. DATA SOURCES: Bibliographic databases, grey literature repositories and relevant websites were searched from 1 January 2000 to 30 September 2016...
March 7, 2017: British Journal of Sports Medicine
William Johnston, Garrett F Coughlan, Brian Caulfield
The assessment and management of sports-related concussion has become a contentious issue in the field of sports medicine. The current consensus in concussion evaluation involves the use of a subjective examination, supported by multifactorial assessment batteries designed to target the various components of cerebral function. Balance assessment forms an important component of this multifactorial assessment, as it can provide an insight into the function of the sensorimotor subsystems post-concussion. In recent times, there has been a call to develop objective clinical assessments that can aid in the assessment and monitoring of concussion...
December 30, 2016: QJM: Monthly Journal of the Association of Physicians
Cinthi Pillai, John W Gittinger
Traumatic brain injury results from an acute impact to the head causing brain dysfunction. Concussion is a form of mild traumatic brain injury. There are significant short- and long-term sequelae of concussion, and early diagnosis and management are key to recovery. Visual system symptoms and signs are common following concussion and have been shown to be a useful feature of concussion testing. Neuro-ophthalmic findings include abnormalities in the pupillary light reflex, accommodation, convergence, extraocular motility, steroacuity, as well as pursuit and saccades...
2017: Seminars in Ophthalmology
John Povlishock
This narrative provides a brief history of experimental animal model development for the study of traumatic brain injury. It draws upon a relatively rich history of early animal modeling that employed higher order animals to assess concussive brain injury while exploring the importance of head movement versus stabilization in evaluating the animal's response to injury. These themes are extended to the development of angular/rotational acceleration/deceleration models that also exploited brain movement to generate both the morbidity and pathology typically associated with human traumatic brain injury...
2016: Methods in Molecular Biology
Declan A Patton
Contact, collision, and combat sports have more head impacts as compared to noncontact sports; therefore, such sports are uniquely suited to the investigation of head impact biomechanics. Recent advances in technology have enabled the development of instrumented equipment, which can estimate the head impact kinematics of human subjects in vivo. Literature pertaining to head impact measurement devices was reviewed and usage, in terms of validation and field studies, of such devices was discussed. Over the past decade, instrumented equipment has recorded millions of impacts in the laboratory, on the field, in the ring, and on the ice...
2016: Applied Bionics and Biomechanics
Jason P Mihalik, Robert C Lynall, Erin B Wasserman, Kevin M Guskiewicz, Stephen W Marshall
PURPOSE: To determine the clinical utility of biomechanical head impact indicators by measuring the sensitivity, specificity, positive predictive value (PV+), and negative predictive value (PV-) of multiple thresholds. METHODS: Head impact biomechanics (n=283,348) from 185 football players in one Division I program were collected. A multidisciplinary clinical team independently made concussion diagnoses (n=24). We dichotomized each impact using diagnosis (yes=24/no=283,324), and across a range of plausible impact indicator thresholds (10g increments beginning with a resultant linear head acceleration of 50g and ending with 120g)...
August 30, 2016: Medicine and Science in Sports and Exercise
James H Brennan, Biswadev Mitra, Anneliese Synnot, Joanne McKenzie, Catherine Willmott, Andrew S McIntosh, Jerome J Maller, Jeffrey V Rosenfeld
BACKGROUND: Concussion is common in the sporting arena and is often challenging to diagnose. The development of wearable head impact measurement systems has enabled measurement of head kinematics in contact sports. OBJECTIVES: The objective of this systematic review was to determine the characteristics of head kinematics measured by an accelerometer system among male athletes diagnosed with concussion. METHODS: A systematic search was conducted in July 2015...
July 11, 2016: Sports Medicine
Kian Merchant-Borna, Patrick Asselin, Darren Narayan, Beau Abar, Courtney M C Jones, Jeffrey J Bazarian
One football season of sub-concussive head blows has been shown to be associated with subclinical white matter (WM) changes on diffusion tensor imaging (DTI). Prior research analyses of helmet-based impact metrics using mean and peak linear and rotational acceleration showed relatively weak correlations to these WM changes; however, these analyses failed to account for the emerging concept that neuronal vulnerability to successive hits is inversely related to the time between hits (TBH). To develop a novel method for quantifying the cumulative effects of sub-concussive head blows during a single season of collegiate football by weighting helmet-based impact measures for time between helmet impacts...
December 2016: Annals of Biomedical Engineering
McKay Moore Sohlberg, Alexander K Ledbetter
PURPOSE: This case review examines treatments speech-language pathologists at our clinic delivered to middle school, high school, and college students for the management of persistent cognitive symptoms after sport-related concussion. The goal is to examine a range of treatment options, describe clinical rationale for selecting those treatments, and report outcomes in order to identify feasible interventions for systematic evaluation through efficacy research. METHOD: Review of clinic intake data identified 63 cases referred for cognitive rehabilitation over a 36-month period...
May 1, 2016: American Journal of Speech-language Pathology
Diana O Svaldi, Emily C McCuen, Chetas Joshi, Meghan E Robinson, Yeseul Nho, Robert Hannemann, Eric A Nauman, Larry J Leverenz, Thomas M Talavage
As participation in women's soccer continues to grow and the longevity of female athletes' careers continues to increase, prevention and care for mTBI in women's soccer has become a major concern for female athletes since the long-term risks associated with a history of mTBI are well documented. Among women's sports, soccer exhibits among the highest concussion rates, on par with those of men's football at the collegiate level. Head impact monitoring technology has revealed that "concussive hits" occurring directly before symptomatic injury are not predictive of mTBI, suggesting that the cumulative effect of repetitive head impacts experienced by collision sport athletes should be assessed...
January 26, 2016: Brain Imaging and Behavior
A Suleiman, B Lithgow, B Mansouri, Z Moussavi
Electrovestibulography (EVestG™) is a new technology that objectively measures the vestibular response. It has the potential to objectively, quickly and cost-effectively screen concussion. EVestG signals are recorded painlessly and non-invasively from the external ear in response to vestibular stimuli, and consist of brainstem and peripheral sensory oto-acoustic signals modulated by the cortical responses. In this study, we investigated the relationship between characteristic features of the extracted field potentials (FPs) of EVestG signals in people with side-impact concussion in comparison with those of control participants...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Thomas W Sawyer, Yushan Wang, David V Ritzel, Tyson Josey, Mercy Villanueva, Yimin Shei, Peggy Nelson, Grant Hennes, Tracy Weiss, Cory Vair, Changyang Fan, Julia Barnes
The role of primary blast in blast-induced traumatic brain injury (bTBI) is controversial in part due to the technical difficulties of generating free-field blast conditions in the laboratory. The use of traditional shock tubes often results in artifacts, particularly of dynamic pressure, whereas the forces affecting the head are dependent on where the animal is placed relative to the tube, whether the exposure is whole-body or head-only, and on how the head is actually exposed to the insult (restrained or not)...
July 1, 2016: Journal of Neurotrauma
Elizabeth F Teel, Michael R Gay, Peter A Arnett, Semyon M Slobounov
OBJECTIVE: Balance assessments are part of the recommended clinical concussion evaluation, along with computerized neuropsychological testing and self-reported symptoms checklists. New technology has allowed for the creation of virtual reality (VR) balance assessments to be used in concussion care, but there is little information on the sensitivity and specificity of these evaluations. The purpose of this study is to establish the sensitivity and specificity of a VR balance module for detecting lingering balance deficits clinical concussion care...
March 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
C Elaine Little, Carolyn Emery, Amanda Black, Stephen H Scott, Willem Meeuwisse, Alberto Nettel-Aguirre, Brian Benson, Sean Dukelow
BACKGROUND: Better diagnostic and prognostic tools are needed to address issues related to early diagnosis and management of concussion across the continuum of aging but particularly in children and adolescents. The purpose of the current study was to evaluate the reliability of robotic technology (KINARM robot) assessments of reaching, position sense, bimanual motor function, visuospatial skills, attention and decision making in youth ice hockey players (ages 10-14). METHODS: Thirty-four male children attended two testing days, one week apart...
2015: Journal of Neuroengineering and Rehabilitation
Tara D Rhine, Terri L Byczkowski, Ross A Clark, Lynn Babcock
OBJECTIVE: To examine postural instability in children acutely after concussion, using the Wii Balance Board (WBB). We hypothesized that children with traumatic brain injury would have significantly worse balance relative to children without brain injury. DESIGN: Prospective case-control pilot study. SETTING: Emergency department of a tertiary urban pediatric hospital. PARTICIPANTS: Cases were a convenience sample 11-16 years old who presented within 6 hours of sustaining concussion...
May 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
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