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Concussion return to play

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https://www.readbyqxmd.com/read/28521519/improving-primary-care-provider-practices-in-youth-concussion-management
#1
Kristy B Arbogast, Allison E Curry, Kristina B Metzger, Ronni S Kessler, Jeneita M Bell, Juliet Haarbauer-Krupa, Mark R Zonfrillo, Matthew J Breiding, Christina L Master
Primary care providers are increasingly providing youth concussion care but report insufficient time and training, limiting adoption of best practices. We implemented a primary care-based intervention including an electronic health record-based clinical decision support tool ("SmartSet") and in-person training. We evaluated consequent improvement in 2 key concussion management practices: (1) performance of a vestibular oculomotor examination and (2) discussion of return-to-learn/return-to-play (RTL/RTP) guidelines...
May 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28520677/the-use-of-an-electrophysiological-brain-function-index-in-the-evaluation-of-concussed-athletes
#2
M Alison Brooks, Jeffrey J Bazarian, Leslie S Prichep, Samanwoy Ghosh Dastidar, Thomas M Talavage, William Barr
OBJECTIVE: To evaluate the effectiveness of the electroencephalographic (EEG) Brain Function Index (BFI) for characterizing sports-related concussive injury and recovery. PARTICIPANTS: Three hundred fifty-four (354) male contact sport high school and college athletes were prospectively recruited from multiple locations over 6 academic years of play (244 control baseline athletes and 110 athletes with a concussion). METHODS: Using 5 to 10 minutes of eyes closed resting EEG collected from frontal and frontotemporal regions, a BFI was computed for all subjects and sessions...
May 17, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28515977/establishing-normative-change-values-in-visual-acuity-loss-during-the-dynamic-visual-acuity-test
#3
Chris Marquez, Monica Lininger, Scot Raab
BACKGROUND: Baseline visual acuity (VA) loss from static to dynamic head conditions assessed using the Dynamic Visual Acuity Testing (DVAT) have not been established in NCAA football players. DVAT assesses the Vestibulo-Ocular Reflex (VOR) which is measured in Logarithm of the Minimum Angle of Resolution (logMAR). Decreased VA beyond baseline measures may detect VOR impairment and impact treatment protocols and assist in return to play decisions post-concussion. HYPOTHESIS/PURPOSE: To establish normative VA mean scores during a static head posture as well as dynamically during the DVAT with a head speed of 150 deg/s in the pitch (vertical) and yaw (horizontal) planes rotating 20 degrees in each direction...
April 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/28506094/a-preliminary-study-of-youth-sport-concussions-parents-health-literacy-and-knowledge-of-return-to-play-protocol-criteria
#4
Robert W Turner, Jeffery W Lucas, Lewis H Margolis, Brian N Corwell
PRIMARY OBJECTIVE: To preliminarily explore parents' health literacy and knowledge of youth sport league rules involving concussion education and training, and return-to-play protocols. RESEARCH DESIGN AND METHODS: This study was guided by the Knowledge, Attitude and Practice (KAP) model of health knowledge to examine parents' concussion literacy, and understanding of concussion education and training, and return-to-play protocols in youth sports. The mixed-method design involved 119 participants; that included in-person (n=8) and telephone (n=4) interviews, and web-based surveys administered through Mechanical Turk via Qualtrics (n=98)...
May 16, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28480575/comprehensive-headache-experience-in-collegiate-student-athletes-an-initial-report-from-the-ncaa-headache-task-force
#5
Tad Seifert, Alicia Sufrinko, Robert Cowan, W Scott Black, Dave Watson, Bill Edwards, Scott Livingston, Keith Webster, David Akers, Mathew Lively, Anthony P Kontos
BACKGROUND: The prevalence of primary headache disorders in the general population provides a unique challenge in the evaluation of headache occurring in the context of sport. Despite a wealth of studies exploring the epidemiology of headache in the layperson, little is known about the prevalence and nature of headaches in collegiate student-athletes. These scenarios are challenging in the return to play context, as it is often unclear whether an athlete has an exacerbation of a primary headache disorder, new onset headache unrelated to trauma, or has suffered a concussive injury...
May 7, 2017: Headache
https://www.readbyqxmd.com/read/28476439/misunderstandings-of-concussion-within-a-youth-rugby-population
#6
Philip E Kearney, James See
OBJECTIVES: The recognition and management of concussion has become a major health concern within rugby union. Identifying misconceptions and attitudes regarding concussion is valuable for informing player education. Therefore, the purpose of this study was to explore the knowledge of, and attitudes towards, concussion in subgroups of youth rugby players. DESIGN: Cross-sectional survey. METHODS: Information sheets and consent forms were distributed at training sessions for multiple teams at each of three schools and three clubs...
April 21, 2017: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/28431031/sandbagging-on-the-immediate-post-concussion-assessment-and-cognitive-testing-impact-in-a-high-school-athlete-population
#7
Kathryn L Higgins, Robert L Denney, Arthur Maerlender
The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a computerized neuropsychological test battery commonly used to assess cognitive functioning after a concussion. It is recommended that application of ImPACT utilizes a baseline administration so athletes have an individualized baseline with which to compare post-injury results should they sustain a concussion. It has been suggested that athletes may provide suboptimal effort, called "sandbagging," in order to return to their baseline cognitive scores, and thus to play, more quickly...
May 1, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28430553/sport-concussion-management-using-facebook-a-feasibility-study-of-an-innovative-adjunct-icon
#8
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
https://www.readbyqxmd.com/read/28417330/management-of-nasal-fractures-in-sports
#9
Yashika Patel, Peter Goljan, Todd P Pierce, Anthony Scillia, Kimona Issa, Vincent K McInerney, Anthony Festa
Nasal fractures represent approximately 60% of all maxillofacial injuries that occur in athletic activities; however, there are no current guidelines regarding immediate sideline management of these injuries. Therefore, the purpose of this article was to (1) summarize the anatomy, etiology, and incidence of nasal fractures, and (2) evaluate the current body of literature regarding immediate on-field and subsequent outpatient management. It is imperative to establish that the athlete's airway is not compromised and there are no other severe concomitant injuries, such as a concussion, ocular injury, or leakage of cerebrospinal fluid...
April 17, 2017: Sports Medicine
https://www.readbyqxmd.com/read/28404801/serum-neurofilament-light-as-a-biomarker-for-mild-traumatic-brain-injury-in-contact-sports
#10
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...
May 9, 2017: Neurology
https://www.readbyqxmd.com/read/28397546/measuring-cognitive-change-with-impact-the-aggregate-baseline-approach
#11
Jared M Bruce, Ruben J Echemendia, Willem Meeuwisse, Michael G Hutchison, Mark Aubry, Paul Comper
OBJECTIVE: The Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) is commonly used to assess baseline and post-injury cognition among athletes in North America. Despite this, several studies have questioned the reliability of ImPACT when given at intervals employed in clinical practice. Poor test-retest reliability reduces test sensitivity to cognitive decline, increasing the likelihood that concussed athletes will be returned to play prematurely. We recently showed that the reliability of ImPACT can be increased when using a new composite structure and the aggregate of two baselines to predict subsequent performance...
April 11, 2017: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/28387560/clinical-evaluation-of-the-concussed-athlete-a-view-from-the-sideline
#12
Margot Putukian
CONTEXT: The sideline assessment of concussion is challenging, given its variable presentations, the limited sensitivity and specificity of sideline assessment tools, and how the presentation of the injury evolves over time. In addition, the diagnostic process, as well as the tools used to assess and manage concussion, continue to progress as research and what we know about concussion advance. This paper focuses on the initial assessment on the sideline by reviewing the concussion-evaluation literature, drawing from clinical experience to emphasize a standardized approach, and underscoring the importance of both familiarity with the athlete and clinical judgment...
March 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28387555/epidemiology-of-sport-related-concussions-in-high-school-athletes-national-athletic-treatment-injury-and-outcomes-network-nation-2011-2012-through-2013-2014
#13
Kathryn L O'Connor, Melissa M Baker, Sara L Dalton, Thomas P Dompier, Steven P Broglio, Zachary Y Kerr
CONTEXT: Sports participation is one of the leading causes of concussions among nearly 8 million US high school student-athletes. OBJECTIVE: To describe the epidemiology of sport-related concussion (SRC) in 27 high school sports during the 2011-2012 through 2013-2014 academic years. DESIGN: Descriptive epidemiology study. SETTING: Aggregate injury and exposure data from 27 sports in 147 high schools in the National Athletic Treatment, Injury and Outcomes Network (NATION)...
March 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28387552/predicting-recovery-patterns-after-sport-related-concussion
#14
Elizabeth F Teel, Stephen W Marshall, Viswanathan Shankar, Michael McCrea, Kevin M Guskiewicz
CONTEXT: Clinicians sometimes treat concussed individuals who have amnesia, loss of consciousness (LOC), a concussion history, or certain symptom types more conservatively, but it is unclear whether recovery patterns differ in individuals with these characteristics. OBJECTIVE: To determine whether (1) amnesia, LOC, and concussion history influence the acute recovery of symptoms, cognition, and balance; and (2) cognition and balance are influenced by acute symptom type...
March 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28387548/review-of-vestibular-and-oculomotor-screening-and-concussion-rehabilitation
#15
Anthony P Kontos, Jamie McAllister Deitrick, Michael W Collins, Anne Mucha
Vestibular and oculomotor impairment and symptoms may be associated with worse outcomes after sport-related concussion (SRC), including prolonged recovery. In this review, we evaluate current findings on vestibular and oculomotor impairments as well as treatment approaches after SRC, and we highlight areas in which investigation is needed. Clinical researchers have intimated that recovery from SRC may follow certain clinical profiles that affect the vestibular and oculomotor pathways. Identifying clinical profiles may help to inform better treatment and earlier intervention to reduce recovery time after SRC...
March 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28378627/evaluation-of-implementation-of-massachusetts-sports-concussion-regulations
#16
Jonathan Howland, Holly Hackman, Alyssa Taylor, Linda Brown, Mary Ann Gapinski, Julie Kautz Mills, Kathleen Thornton
In 2015, the Massachusetts Department of Public Health conducted focus groups with school nurses (SNs) and athletic trainers (ATs) from Massachusetts middle and high schools to assess implementation of legislated regulations relative to the management of students' head injuries incurred during extracurricular sports. Four tape-recorded focus groups were conducted by experienced facilitators. Lists of themes were synthesized by investigators for each focus group. Participating SNs and ATs supported the sports concussion legislation, felt that implementation had gone well, indicated that the law empowered them in managing return-to-school/play for students with concussion, and experienced support from their school administrators...
January 1, 2017: Journal of School Nursing: the Official Publication of the National Association of School Nurses
https://www.readbyqxmd.com/read/28326890/functional-and-molecular-correlates-following-single-and-repeated-rat-closed-head-concussion-indices-of-vulnerability-following-brain-injury
#17
Andrea Mountney, Angela Boutte, Casandra M Cartagena, William J Flerlage, David Johnson, Chanyang Rho, Xi-Chun M Lu, Angela M Yarnell, Sean R Marcsisin, Jason Sousa, Chau Vuong, Victor E Zottig, Lai Yee Leung, Ying Deng-Bryant, Janice Gilsdorf, Frank C Tortella, Deborah A Shear
Closed-head concussive injury is one of the most common causes of traumatic brain injury (TBI). Isolated concussions frequently produce acute neurological impairments; however, individuals typically recover spontaneously within a short time frame. In contrast, brain injuries resulting from multiple concussions can result in cumulative damage and elevated risk of developing chronic brain pathologies, including chronic traumatic encephalopathy (CTE). Increased attention has focused on identification of diagnostic markers that can prognostically serve as indices of brain health after injury, revealing the temporal profile of vulnerability to a second insult...
March 22, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28294629/sport-concussion-management-using-facebook-a-feasibility-study-of-an-innovative-adjunct-icon
#18
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
https://www.readbyqxmd.com/read/28287034/exploration-of-us-men-s-professional-sport-organization-concussion-policies
#19
Graham Dean Cochrane, Matthew Owen, Joseph D Ackerson, Matthew H Hale, Sara Gould
Concussion policies are increasingly being developed and adopted among professional sports organizations. We sought to compare the policies of the National Hockey League (NHL), the National Basketball Association (NBA), the National Football League (NFL), and Major League Baseball (MLB). Our objective was to summarize each policy and evaluate the extent to which each policy is organization-specific and/or consistent with medical guidelines. We visited websites for the NHL, NBA, NFL, and MLB. We searched media articles reporting concussion policy...
May 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28283595/astroglial-activation-and-altered-amyloid-metabolism-in-human-repetitive-concussion
#20
Pashtun Shahim, Yelverton Tegner, Niklas Marklund, Kina Höglund, Erik Portelius, David L Brody, Kaj Blennow, Henrik Zetterberg
OBJECTIVE: To determine whether postconcussion syndrome (PCS) due to repetitive concussive traumatic brain injury (rcTBI) is associated with CSF biomarker evidence of astroglial activation, amyloid deposition, and blood-brain barrier (BBB) impairment. METHODS: A total of 47 participants (28 professional athletes with PCS and 19 controls) were assessed with lumbar puncture (median 1.5 years, range 0.25-12 years after last concussion), standard MRI of the brain, and Rivermead Post-Concussion Symptoms Questionnaire (RPQ)...
April 11, 2017: Neurology
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