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Concussion clinic

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By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
https://www.readbyqxmd.com/read/29239280/perceived-injustice-and-its-correlates-after-mild-traumatic-brain-injury
#1
Grant L Iverson, Douglas P Terry, Justin E Karr, William Panenka, Noah D Silverberg
Perceived injustice is a belief that one has been treated unfairly, disrespectfully, and is suffering unnecessarily as a result of another person's actions. Perceived injustice predicts chronic disability after musculoskeletal injury, but to our knowledge, has not been empirically studied in people with mild traumatic brain injuries (MTBIs). We examined perceived injustice and its correlates in patients who were slow to recover from MTBI. Patients (N=102) were recruited from four concussion clinics. The sample was on average 41...
December 14, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29197811/physical-examination-of-dizziness-in-athletes-after-a-concussion-a-descriptive-study
#2
Jennifer C Reneker, Vinay K Cheruvu, Jingzhen Yang, Mark A James, Chad E Cook
BACKGROUND: Dizziness is commonly reported after concussion. With the forces experienced at the time of the injury, several anatomical locations may have been altered, causing dizziness. OBJECTIVE: Describe an objective examination and the types of impairment/dysfunction implicated by the results of clinical examination tests in subjects with dizziness after a concussion. DESIGN: Cross-Sectional. METHODS: Athletes between ages 10-23 were enrolled with a diagnosis of concussion...
November 26, 2017: Musculoskeletal Science & Practice
https://www.readbyqxmd.com/read/29198023/the-use-of-stimulant-medication-to-treat-attention-deficit-hyperactivity-disorder-in-elite-athletes-a-performance-and-health-perspective
#3
Annie A Garner, Ashley A Hansen, Catherine Baxley, Michael J Ross
The use of stimulants as a treatment for attention-deficit/hyperactivity disorder (ADHD) among elite athletes is a controversial area with some arguing that stimulant use should not be permitted because it offers an advantage to athletes (fair play perspective). Guided by an integrated model of athletic performance, we address common concerns raised about stimulant use in sports from our perspective, which we coined the "performance and health perspective," highlighting relevant research and pointing to gaps in empirical research that should be addressed before bans on use of stimulants for athletes with ADHD are considered...
December 2, 2017: Sports Medicine
https://www.readbyqxmd.com/read/29198541/returning-adolescents-to-driving-after-sports-related-concussions-what-influences-physician-decision-making
#4
James MacDonald, Neha Patel, Julie Young, Emily Stuart
OBJECTIVE: To determine which data collected on an initial patient clinic visit for a sports-related concussion (SRC) might influence physicians to clear an adolescent to return to drive (RTD) after injury. STUDY DESIGN: Retrospective cohort study of 189 adolescents with a SRC referred to a hospital-based concussion clinic between June 1, 2015, and May 31, 2016. Subjects were ≥16 years with a valid driver's license (median age = 16, IQR [16, 17]). Concussion evaluations included Post-Concussion Symptom Scale, modified Balance Error Scoring System, and postinjury computerized neurocognitive testing (CNT)...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29194058/gait-deviations-associated-with-concussion-a-systematic-review
#5
Thaer S Manaseer, Douglas P Gross, Liz Dennett, Kathryn Schneider, Jackie L Whittaker
BACKGROUND: Gait deviations resulting from concussion are important to consider in the diagnosis, treatment progression, and return to activity after a concussion. OBJECTIVE: To identify quantifiable gait deviations associated with concussion across populations and time since injury. METHODS AND MATERIALS: Six electronic databases were systematically searched from January 1974 to September 2016. Studies selected included original data, had an analytic design, and reported a quantifiable gait parameter in individuals who had sustained a concussion as defined by the American Congress of Rehabilitation Medicine or related definitions...
November 21, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29189334/considerations-in-the-care-of-athletes-with-attention-deficit-hyperactivity-disorder
#6
George G A Pujalte, Jennifer R Maynard, McKennan J Thurston, Walter C Taylor, Mohit Chauhan
OBJECTIVES: Uncover literature pertaining to: (1) attention deficit hyperactivity disorder (ADHD) and how it impacts athletes; (2) ADHD medication effects; (3) regulations regarding ADHD medications; (4) approaches to conditions similar to, and occurring with, ADHD; and (5) use of stimulants. DATA SOURCES: MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Ovid interface. MAIN RESULTS: ADHD can have many effects on athletes and sports participation...
November 20, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29189336/history-of-high-motion-sickness-susceptibility-predicts-vestibular-dysfunction-following-sport-recreation-related-concussion
#7
Alicia M Sufrinko, Nathan E Kegel, Anne Mucha, Michael W Collins, Anthony P Kontos
OBJECTIVE: To compare vestibular dysfunction at 1 to 10 and 11 to 20 days following sport/recreation-related concussion (SRC) in athletes with and without history of motion sickness susceptibility. Secondary aims of this study were to investigate differences in neurocognitive performance and affective symptoms in these groups. DESIGN: Cross-sectional. SETTING: Concussion Specialty Clinic. PARTICIPANTS: One hundred twenty-four adolescents and adults (82 males, 42 females) aged 14 to 26 (16...
November 20, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29190849/concussion-recovery-phase-affects-vestibular-and-oculomotor-symptom-provocation
#8
Kelly M Cheever, Jane McDevitt, Ryan Tierney, W Geoffrey Wright
Vestibular and oculomotor testing is emerging as a valuable assessment in sport-related concussion (SRC). However, their usefulness for tracking recovery and guiding return-to-play decisions remains unclear. Therefore the purpose of this study was to evaluate their clinical usefulness for tracking SRC recovery. Vestibular and oculomotor assessments were used to measure symptom provocation in an acute group (n=21) concussed≤10 days, prolonged symptoms group (n=10) concussed ≥16 days (median=84 days), healthy group (n=58) no concussions in >6 months...
November 30, 2017: International Journal of Sports Medicine
https://www.readbyqxmd.com/read/29172647/clinical-utility-of-the-sport-concussion-assessment-tool-3-scat3-tandem-gait-test-in-high-school-athletes
#9
Ashley Santo, Robert C Lynall, Kevin M Guskiewicz, Jason P Mihalik
CONTEXT:   Dynamic balance during functional movement may provide important clinical information after concussion. The Sport Concussion Assessment Tool version 3 (SCAT3) includes a timed tandem-gait test (heel-to-toe walking) administered with a pass-fail scoring system. Minimal evidence supports inclusion of the tandem-gait test in the SCAT3, especially in high school athletes. OBJECTIVE:   To determine (1) the percentage of healthy high school athletes who passed (best trial ≤14 seconds) the tandem-gait test at baseline, (2) the association between sex and test performance (pass versus fail), and (3) the relationship among sex, age, height, and tandem-gait test score...
November 27, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/29159546/sport-related-concussion-and-mental-health-outcomes-in-elite-athletes-a-systematic-review
#10
REVIEW
Simon M Rice, Alexandra G Parker, Simon Rosenbaum, Alan Bailey, Daveena Mawren, Rosemary Purcell
BACKGROUND: Elite athletes can experience a diverse range of symptoms following post-concussive injury. The impact of sport-related concussion on specific mental health outcomes is unclear in this population. OBJECTIVE: The aim was to appraise the evidence base regarding the association between sport-related concussion and mental health outcomes in athletes competing at elite and professional levels. METHODS: A systematic search of PubMed, EMBASE, SPORTDiscus, PsycINFO, Cochrane, and Cinahl databases was conducted...
November 20, 2017: Sports Medicine
https://www.readbyqxmd.com/read/29149392/when-in-doubt-sit-it-out-pediatric-concussion-an-update
#11
Julia Morrow Kerrigan, Christopher C Giza
Concussion is a major public health issue that has received much publicity in recent years. Reported concussions are increasing across all ages, including the highest rates in pediatric age ranges. Due to the age-related physiological responses and differential recovery of symptoms after concussion, special consideration must be given to youth concussions. Concussion can affect each child differently and likely affects children differently than adults. Until the past decade, there has been a scarcity of scientifically rigorous studies examining concussions in children...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29147822/psychiatric-sequelae-of-concussions
#12
REVIEW
David A Brent, Jeffrey Max
PURPOSE OF REVIEW: The purpose of this study was to review the frequency, risk factors, phenomenology, and course of prolonged recovery from concussion and of psychiatric sequelae in pediatric populations. RECENT FINDINGS: Youth with prolonged recovery from concussions have higher initial symptoms, a history of multiple and/or recent concussions, and a tendency to somatization. Depression, post-traumatic stress disorder, behavioral disorders, and perhaps, suicidal behavior disorder are more common as both short- and longer-term sequelae of concussions...
November 17, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29138156/return-to-learn-after-concussion-in-children
#13
Andrew Irvine, Shelina Babul, Ran D Goldman
Question Despite recent interest in the pathophysiology and management of concussion in children, as well as the ongoing concern about return to activity, advice regarding the type and length of cognitive rest has been inconsistent. What should I recommend to the children and adolescents in my clinic regarding cognitive rest following mild concussion? Answer Strict cognitive rest is not needed in those with mild concussion. Evidence suggests a decrease in usual activity to a level that allows children to remain asymptomatic, followed by a gradual return to learning, is appropriate...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29138991/test-retest-reliability-and-interpretation-of-common-concussion-assessment-tools-findings-from-the-ncaa-dod-care-consortium
#14
Steven P Broglio, Barry P Katz, Shi Zhao, Michael McCrea, Thomas McAllister
BACKGROUND: Concussion diagnosis is typically made through clinical examination and supported by performance on clinical assessment tools. Performance on commonly implemented and emerging assessment tools is known to vary between administrations, in the absence of concussion. OBJECTIVE: To evaluate the test-retest reliability of commonly implemented and emerging concussion assessment tools across a large nationally representative sample of student-athletes. METHODS: Participants (n = 4874) from the Concussion Assessment, Research, and Education Consortium completed annual baseline assessments on two or three occasions...
November 14, 2017: Sports Medicine
https://www.readbyqxmd.com/read/29132269/correlation-of-concussion-symptom-profile-with-head-impact-biomechanics-a-case-for-individual-specific-injury-tolerance
#15
Steven Rowson, Stefan M Duma, Brian D Stemper, Alok S Shah, Jason Mihalik, Jaroslaw Harezlak, Larry D Riggen, Christopher C Giza, John DiFiori, Alison Brooks, Kevin K Guskiewicz, Darren Campbell, Jerry McGinty, Steve Svoboda, Ken Cameron, Steven P Broglio, Thomas McAllister, Michael McCrea
Concussion is a brain injury induced by biomechanical forces that is broadly defined as a complex pathophysiological process affecting the brain. The intricate link between biomechanical input and concussion injury response is poorly understood. We aimed to test the hypothesis that greater biomechanical forces would result in the presentation of more concussion-related symptoms that would take longer to resolve. The objective of this study was to investigate the relationship between an array of biomechanical parameters measured for concussive impacts and the presentation and resolution of concussion symptoms...
November 13, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29135639/sleep-and-athletic-performance
#16
Andrew M Watson
Sleep is an essential component of health and well-being, with significant impacts on physical development, emotional regulation, cognitive performance, and quality of life. Along with being an integral part of the recovery and adaptive process between bouts of exercise, accumulating evidence suggests that increased sleep duration and improved sleep quality in athletes are associated with improved performance and competitive success. In addition, better sleep may reduce the risk of both injury and illness in athletes, not only optimizing health but also potentially enhancing performance through increased participation in training...
November 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/29135640/neuromechanical-considerations-for-postconcussion-musculoskeletal-injury-risk-management
#17
Gary B Wilkerson, Dustin R Grooms, Shellie N Acocello
Recent epidemiological studies have documented increased susceptibility to musculoskeletal injury after sport-related concussion, which raises questions about the adequacy of current clinical practices to ensure safe return to sport. A growing body of evidence derived from advanced neuroimaging and neurological assessment methods strongly suggests that mild traumatic brain injury has long-lasting adverse effects that persist beyond resolution of clinical symptoms. Plausible interrelationships among postconcussion changes in brain structure and function support the rationale for specific methods of clinical assessment and training to target the interaction of cognitive and motor function for reduction of musculoskeletal injury risk after concussion...
November 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/29130023/anxiety-and-mood-clinical-profile-following-sport-related-concussion-from-risk-factors-to-treatment
#18
Natalie Sandel, Erin Reynolds, Paul E Cohen, Brandon L Gillie, Anthony P Kontos
Conceptual models for assessing and treating sport-related concussion (SRC) have evolved from a homogenous approach to include different clinical profiles that reflect the heterogeneous nature of this injury and its effects. There are six identified clinical profiles, or subtypes from SRC, and one such clinical profile is the anxiety/mood profile. Athletes with this profile experience predominant emotional disturbance and anxiety following SRC. The purpose of this targeted review was to present an overview of the empirical evidence to support factors contributing to the anxiety/mood profile, along with methods of evaluation and treatment of this clinical profile following SRC...
August 2017: Sport, Exercise, and Performance Psychology
https://www.readbyqxmd.com/read/29084063/central-vertigo
#19
Jeong-Yoon Choi, Seung-Han Lee, Ji-Soo Kim
PURPOSE OF REVIEW: This review considers recent advances in central vertigo in terms of clinical and laboratory features and pathophysiology. RECENT FINDINGS: Strokes presenting dizziness-vertigo are more likely to be associated with a misdiagnosis in the emergency setting. The risk of future strokes after discharge is higher in patients diagnosed with peripheral vertigo than in control patients. Strokes and transient ischemic attacks account for one-quarter of acute transient vestibular syndrome...
October 27, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29117052/concussions-benefits-of-academic-reentry-plans
#20
Amy Coyle Connell
Purpose of this study was to identify whether children aged 12-14 years benefit from academic reentry plans when returning to school following a mild traumatic brain injury. An integrative review was carried out with data sourced from CINAHL, Medline, Education Full Text, Health Source: Nursing/Academic Edition, and hand searching of references. Abstracts were reviewed for inclusion/exclusion criteria, resulting with six articles appraised and analyzed for this article. The review shows the need for gradual return to physical and cognitive activity postconcussion to facilitate a quicker recovery with fewer postconcussive symptoms...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
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