RESEARCH PROJECT : DR JON PATRICIOS (Concussion epidemiology)
Search for: limit 14 to yr="2005 -Current"
Results: 1-58
Database: Ovid MEDLINE(R) <1950 to November Week 3 2009>
Search Strategy:
-------------------------------------------------------------------------------1
exp Brain Concussion/ep [Epidemiology] (235)
2
symptoms.mp. (437204)
3
exp brain concussion/ (3689)
4
concuss$.tw. or 3 (4806)
5
2 and 4 (628)
6
1 or 5 (809)
7
limit 6 to (english language and ("child (6 to 12 years)" or "adolescent (13 to 18 years)")) (297)
8
concuss$.ti. and 7 (103)
9
south africa/ and 1 (2)
10
limit 9 to english language (2)
11
exp *brain concussion/ and 7 (185)
12
8 and 11 (100)
13
9 or 12 (101)
14
from 13 keep 1-82 (82)
15
limit 14 to yr="2005 -Current" (58)
16
from 15 keep 1-58 (58)
***************************
Result <1>
Unique Identifier
16816151
Status
MEDLINE
Authors
Van Kampen DA. Lovell MR. Pardini JE. Collins MW. Fu FH.
Authors Full Name
Van Kampen, Derk A. Lovell, Mark R. Pardini, Jamie E. Collins, Michael W. Fu, Freddie H.
Institution
Department of Orthopaedic Surgery, University Medical Center Groningen, Groningen, the Netherlands.
Title
The "value added" of neurocognitive testing after sports-related concussion.[see comment].
Comments
Comment in: Clin J Sport Med. 2007 Sep;17(5):435-6; PMID: 17873562
Source
American Journal of Sports Medicine. 34(10):1630-5, 2006 Oct.
Abstract
BACKGROUND: Neurocognitive testing has been endorsed as a "cornerstone" of concussion management by recent Vienna and
Prague meetings of the Concussion in Sport Group. Neurocognitive testing is important given the potential unreliability of athlete
self-report after injury. Relying only on athletes' reports of symptoms may result in premature return of athletes to contact sport,
potentially exposing them to additional injury. HYPOTHESIS: Use of computer-based neurocognitive testing results in an increased
capacity to detect postconcussive abnormalities after injury. STUDY DESIGN: Case control study; Level of evidence, 3. METHODS:
High school and college athletes with a diagnosed concussion were tested 2 days after injury. Postinjury neurocognitive
performance (Immediate Postconcussion Assessment and Cognitive Testing) and symptom (postconcussion symptom) scores were
compared with preinjury (baseline) scores and with those of an age- and education-matched noninjured athlete!
control group. "Abnormal" test performance was determined statistically with Reliable Change Index scores. RESULTS: Sixty-four
percent of concussed athletes reported a significant increase in symptoms, as judged by postconcussion symptom scores, compared
with preinjury baseline at 2 days after injury. Eighty-three percent of the concussed sample demonstrated significantly poorer
neurocognitive test results relative to their own baseline performance. The addition of neurocognitive testing resulted in a net
increase in sensitivity of 19%. Ninety-three percent of the sample had either abnormal neurocognitive test results or a significant
increase in symptoms, relative to their own baseline; 30% of a control group demonstrated either abnormalities in neurocognitive
testing or elevated symptoms, as judged by postconcussion symptom scores. For the concussed group, use of symptom and
neurocognitive test results resulted in an increased yield of 29% overreliance on symptoms alone.!
In contrast, 0% of the control group had both symptoms and abnormal n
eurocognitive testing. CONCLUSION: Reliance on patients' self-reported symptoms after concussion is likely to result in
underdiagnosis of concussion and may result in premature return to play. Neurocognitive testing increases diagnostic accuracy
when used in conjunction with self-reported symptoms.
Publication Type
Controlled Clinical Trial. Journal Article.
Result <2>
Unique Identifier
17361669
Status
MEDLINE
Authors
Lovell MR. Iverson GL. Collins MW. Podell K. Johnston KM. Pardini D. Pardini J. Norwig J. Maroon JC.
Authors Full Name
Lovell, Mark R. Iverson, Grant L. Collins, Michael W. Podell, Kenneth. Johnston, Karen M. Pardini, Dustin. Pardini, Jamie.
Norwig, John. Maroon, Joseph C.
Institution
UPMC Center for Sports Medicine; 3200 South Water Street, Pittsburgh, PA 15203, USA. lovellmr@upmc.edu
Title
Measurement of symptoms following sports-related concussion: reliability and normative data for the post-concussion scale.
Source
Applied Neuropsychology. 13(3):166-74, 2006.
Abstract
It is important to carefully evaluate self-reported symptoms in athletes with known or suspected concussions. This article presents
data on the psychometric and clinical properties of a commonly used concussion symptom inventory-the Post-Concussion Scale.
Normative and psychometric data are presented for large samples of young men (N = 1,391) and young women (N = 355). In
addition, data gathered from a concussed sample of athletes (N = 260) seen within 5 days of injury are presented. These groups
represent samples of both high school and collegiate athletes. Data from a subsample of 52 concussed athletes seen 3 times postinjury are presented to illustrate symptom reporting patterns during the initial recovery period. General guidelines for the clinical
use of the scale are provided.
Publication Type
Journal Article.
Result <3>
Unique Identifier
18585890
Status
MEDLINE
Authors
Shuttleworth-Rdwards AB. Radloff SE.
Authors Full Name
Shuttleworth-Rdwards, Ann B. Radloff, Sarah E.
Institution
Department of Psychology, Rhodes University, Grahamstown, South Africa. a.edwards@ru.ac.za
Title
Compromised visuomotor processing speed in players of Rugby Union from school through to the national adult level.
Source
Archives of Clinical Neuropsychology. 23(5):511-20, 2008 Sep.
Abstract
The aim of this study was to investigate the residual effects of concussion amongst players of Rugby Union from school through to
the national adult level, with pre-season testing on tests of visuomotor processing speed (Digit Symbol; Trail Making Test A and B).
Comparison groups included 124 male rugby players versus 102 non-contact sport controls; 71 forward versus 53 backline players.
Across groups there was equivalence for age, education, estimated IQ, and hand motor dexterity. There was a significantly higher
percentage of rugby players with 2+ concussions than controls. Poorer performance was in evidence for rugby players compared
with controls on all tests of visuomotor speed, and for forward versus backline players on Digit Symbol, with clinically relevant
medium effect sizes. The results implicate vulnerability amongst rugby players on the prototypically sensitive function of visuomotor
processing in association with years of exposure to repetitive concussive and !
subconcussive injury.
Publication Type
Comparative Study. Journal Article. Research Support, Non-U.S. Gov't.
Result <4>
Unique Identifier
16682158
Status
MEDLINE
Authors
Nacajauskaite O. Endziniene M. Jureniene K. Schrader H.
Authors Full Name
Nacajauskaite, Olga. Endziniene, Milda. Jureniene, Kristina. Schrader, Harald.
Institution
Center of Pediatric Surgery, Vilnius University Children's Hospital, Santariskiu 7, Vilnius, Lithuania. olgutene@takas.lt
Title
The validity of post-concussion syndrome in children: a controlled historical cohort study.
Source
Brain & Development. 28(8):507-14, 2006 Sep.
Abstract
The aim of this controlled historical cohort study was to assess the validity of post-concussion syndrome in children. We identified
301 children aged 4-15 years who had sustained an isolated brain concussion, and another group of 301 children who sustained
any other mild body injury excluding the head. Parents from both groups filled in standardized questionnaires containing questions
about the health condition of the children: headache, neck pain, dizziness, malaise, fatigability, exercise or noise intolerance,
irritability, weepiness, sadness, anxiety, nocturnal enuresis, tics, sleep disorders, memory or learning difficulties, hyperactivity,
seizures, attention disorder, buzzing in the ears, subjective parental concerns about the child's health condition, and parental
concerns about their child having a brain disorder. The severity of the complaints was rated on the Visual Analogue Scale. After the
final exclusion, 102 pairs strictly matched by sex, age, and the date of!
trauma were analyzed. The differences of parental complaints about the health condition of their children between case and
control groups were statistically insignificant for all symptoms, except parental concerns about their child having brain damage
which were significantly higher in the case group. The likelihood of parental concerns about the possibility of their child having brain
damage was 2.7 times higher in the case group. Headache, learning difficulties, and sleep disorders were significant variables
predicting the concerns. These results question the validity of the post-concussion syndrome in children.
Publication Type
Comparative Study. Journal Article. Research Support, Non-U.S. Gov't. Validation Studies.
Result <5>
Unique Identifier
16537266
Status
MEDLINE
Authors
Iverson GL. Brooks BL. Collins MW. Lovell MR.
Authors Full Name
Iverson, Grant L. Brooks, Brian L. Collins, Michael W. Lovell, Mark R.
Institution
University of British Columbia & Riverview Hospital, Vancouver, BC, Canada. giverson@interchange.ubc.ca
Title
Tracking neuropsychological recovery following concussion in sport.
Source
Brain Injury. 20(3):245-52, 2006 Mar.
Abstract
PRIMARY OBJECTIVE: The purpose of this study was to illustrate the serial use of computerized neuropsychological screening with
ImPACT to monitor recovery in a clinical case series of injured athletes. METHODS AND PROCEDURES: Amateur athletes with
concussions (n= 30, average age= 16.1, SD= 2.1 years) underwent pre-season testing and three post-concussion evaluations
within the following intervals: 1-2 days, 3-7 days (M= 5.2 days) and 1-3 weeks (M= 10.3 days). The study selection criteria
increased the probability of including athletes with slow recovery. RESULTS: Repeated measures ANOVAs revealed significant main
effects for all five composite scores (verbal memory, visual memory, reaction time, processing speed and total symptoms). In group
analyses, performance decrements and symptoms relating to concussion appeared to largely resolve by 5 days post-injury and fully
resolve by 10 days. Athletes' scores were examined individually using the reliable change methodology. At !
1 day post-injury, 90% had two or more reliable declines in performance or increases in symptom reporting. At 10 days, 37% were
still showing two or more reliable changes from pre-season levels. CONCLUSIONS: This study illustrates the importance of analysing
individual athletes' test data because group analyses can obscure slow recovery in a substantial minority of athletes.
Publication Type
Journal Article.
Result <6>
Unique Identifier
16421067
Status
MEDLINE
Authors
Hynes LM. Dickey JP.
Authors Full Name
Hynes, Loriann M. Dickey, James P.
Institution
Human Biology and Nutritional Sciences, University of Guelph, Ontario, Canada.
Title
Is there a relationship between whiplash-associated disorders and concussion in hockey? A preliminary study.
Source
Brain Injury. 20(2):179-88, 2006 Feb.
Abstract
PRIMARY OBJECTIVE: To examine the relationship between the occurrence of whiplash-associated disorders and concussion
symptoms in hockey players. RESEARCH DESIGN: Prospective cohort observational study to examine the relationship between
whiplash associated disorders and concussion in actual hockey play. METHODS AND PROCEDURES: Twenty hockey teams were
followed prospectively for one season. Team therapists completed acute and 7-10 day follow-up evaluation questionnaires for all of
the players who received either a whiplash mechanism or a concussion. MAIN OUTCOMES AND RESULTS: 183 players were
registered for this study; 13 received either a whiplash mechanistic injury or a concussion injury. Initial injuries ranged from WAD I
to WAD III and all subjects reported concussion symptoms. Only three subjects reported full resolution of both WAD and concussion
symptoms at the 7-10 day follow-up evaluation. CONCLUSIONS: There is a strong association between whiplash induced neck in!
juries and the symptoms of concussion in hockey injuries. Both should be evaluated when dealing with athletes/patients suffering
from either injury.
Publication Type
Journal Article.
Result <7>
Unique Identifier
18216159
Status
MEDLINE
Authors
Yang J. Phillips G. Xiang H. Allareddy V. Heiden E. Peek-Asa C.
Authors Full Name
Yang, J. Phillips, G. Xiang, H. Allareddy, V. Heiden, E. Peek-Asa, C.
Institution
Department of Community and Behavioral Health, College of Public Health, The University of Iowa, 200 Hawkins Drive, E236 GH,
Iowa City, Iowa 52242, USA. jingzhen-yang@uiowa.edu
Title
Hospitalisations for sport-related concussions in US children aged 5 to 18 years during 2000-2004.
Source
British Journal of Sports Medicine. 42(8):664-9, 2008 Aug.
Abstract
OBJECTIVES: To describe patient and hospital characteristics associated with hospitalisation for a diagnosis of non-fatal sportrelated concussion, and to determine factors associated with these hospitalisations. METHODS: Children aged 5-18 years with a
primary diagnosis of a sport-related concussion in the Nationwide Inpatient Sample (2000-2004) were identified. Length of stay and
hospital charges for sport-related concussions were documented. Logistic regression was used to assess the association of patient
or hospital characteristics with hospitalisations for sport-related concussion. RESULTS: Between 2000 and 2004, a total of 755 nonfatal paediatric sport-related hospitalisations for concussion were identified. Nationwide, this represents 3712 hospitalisations and
over US$29 million total hospital charges, with nearly US$6 million in total hospital charges per year. Over half (52.3%) of patients
with concussion experienced loss of consciousness. Over 80% of the patien!
ts hospitalised for concussion received no procedures during their average 1.1 day (median 0.8 day) of hospital stay. Older age,
but not gender, was associated with increased odds of sport-related hospitalisations for concussion. Non-teaching hospitals or
hospitals in rural areas had significantly greater odds of admitting sport-related concussions versus other sport-related traumatic
brain injuries compared with teaching or urban hospitals. CONCLUSIONS: Management of paediatric sport-related concussions
varied, depending on the patient and the hospital. Better guidelines are needed for the identification and management of sportrelated concussions. Standardised procedures for hospitals treating concussive injuries may also be warranted.
Publication Type
Journal Article. Multicenter Study.
Result <8>
Unique Identifier
17615173
Status
MEDLINE
Authors
Delaney JS. Al-Kashmiri A. Drummond R. Correa JA.
Authors Full Name
Delaney, J S. Al-Kashmiri, A. Drummond, R. Correa, J A.
Institution
McGill Sport Medicine Clinic, 475 Pine Ave. West, Montreal, Quebec, Canada. j.delaney@mcgill.ca
Title
The effect of protective headgear on head injuries and concussions in adolescent football (soccer) players.
Source
British Journal of Sports Medicine. 42(2):110-5; discussion 115, 2008 Feb.
Abstract
OBJECTIVE: To examine the effects of protective headgear in adolescent football (soccer) players. DESIGN: Cross-sectional study.
SETTING: Oakville Soccer Club, Oakville, Canada. PARTICIPANTS: Football players aged 12-17 years. INTERVENTION: A
questionnaire examining the 2006 football season using self-reported symptoms. MAIN OUTCOME MEASURES: The number of
concussions experienced during the current football season, the duration of symptoms, injuries to the head and face and any
associated risk factors for these injuries. RESULTS: In the population studied, 47.8% had experienced symptoms of a concussion
during the current football year. 26.9% of athletes who wore headgear (HG) and 52.8% of those who did not wear headgear (NoHG) had concussions. Approximately 4 out of 5 athletes in each group did not realize they had suffered a concussion. More than
one concussion was experienced by 50.0% of the concussed HG athletes and 69.3% of the concussed No-HG group. 23.9% of all
conc!
ussed players experienced symptoms for at least 1 day or longer. Variables that increased the risk of suffering a concussion during
the 2006 football year included being female and not wearing headgear. Being female and not wearing football headgear increased
the risk of suffering an abrasion, laceration or contusion on areas of the head covered by football headgear. CONCLUSION:
Adolescent football players experience a significant number of concussions. Being female may increase the risk of suffering a
concussion and injuries on the head and face, while the use of football headgear may decrease the risk of sustaining these injuries.
Publication Type
Journal Article.
Result <9>
Unique Identifier
16431999
Status
MEDLINE
Authors
Williamson IJ. Goodman D.
Authors Full Name
Williamson, I J S. Goodman, D.
Institution
Simon Fraser University, Burnaby, BC, Canada.
Title
Converging evidence for the under-reporting of concussions in youth ice hockey.
Source
British Journal of Sports Medicine. 40(2):128-32; discussion 128-32, 2006 Feb.
Abstract
BACKGROUND: Concussions are potentially serious injuries. The few investigations of prevalence or incidence in youth ice hockey
have typically relied on prospective reports from physicians or trainers and did not survey players, despite the knowledge that many
athletes do not report probable concussions. OBJECTIVE: This study sought to compare concussion rates in youth ice hockey that
were estimated from a variety of reporting strategies. METHODS: Rates were calculated from British Columbia Amateur Hockey
Association (BCAHA) official injury reports, from direct game observation by minor hockey volunteers (such as coaches and
managers), as well as from retrospective surveys of both elite and non-elite youth players. All research was conducted within the
BCAHA. RESULTS: Estimates from official injury reports for male players were between 0.25 and 0.61 concussions per 1000 player
game hours (PGH). Concussion estimates from volunteer reports were between 4.44 and 7.94 per 1000!
PGH. Player survey estimates were between 6.65 and 8.32 per 1000 PGH, and 9.72 and 24.30 per 1000 PGH for elite and nonelite male youth hockey, respectively. CONCLUSION: It was found that concussions are considerably under-reported to the BCAHA
by youth hockey players and team personnel.
Publication Type
Journal Article. Research Support, Non-U.S. Gov't.
Result <10>
Unique Identifier
16431999
Status
MEDLINE
Authors
Williamson IJ. Goodman D.
Authors Full Name
Williamson, I J S. Goodman, D.
Institution
Simon Fraser University, Burnaby, BC, Canada.
Title
Converging evidence for the under-reporting of concussions in youth ice hockey.
Source
British Journal of Sports Medicine. 40(2):128-32; discussion 128-32, 2006 Feb.
Other ID
Source: NLM. PMC2492052
Abstract
BACKGROUND: Concussions are potentially serious injuries. The few investigations of prevalence or incidence in youth ice hockey
have typically relied on prospective reports from physicians or trainers and did not survey players, despite the knowledge that many
athletes do not report probable concussions. OBJECTIVE: This study sought to compare concussion rates in youth ice hockey that
were estimated from a variety of reporting strategies. METHODS: Rates were calculated from British Columbia Amateur Hockey
Association (BCAHA) official injury reports, from direct game observation by minor hockey volunteers (such as coaches and
managers), as well as from retrospective surveys of both elite and non-elite youth players. All research was conducted within the
BCAHA. RESULTS: Estimates from official injury reports for male players were between 0.25 and 0.61 concussions per 1000 player
game hours (PGH). Concussion estimates from volunteer reports were between 4.44 and 7.94 per 1000!
PGH. Player survey estimates were between 6.65 and 8.32 per 1000 PGH, and 9.72 and 24.30 per 1000 PGH for elite and nonelite male youth hockey, respectively. CONCLUSION: It was found that concussions are considerably under-reported to the BCAHA
by youth hockey players and team personnel.
Publication Type
Journal Article. Research Support, Non-U.S. Gov't.
Result <11>
Unique Identifier
19534331
Status
MEDLINE
Authors
Cusimano MD.
Authors Full Name
Cusimano, Michael D.
Institution
Injury Prevention Research Office, Division of Neurosurgery, St. Michael's Hospital, Toronto, Ontario, Canada.
Title
Canadian minor hockey participants' knowledge about concussion.[see comment].
Comments
Comment in: Can J Neurol Sci. 2009 May;36(3):269-70; PMID: 19534322
Source
Canadian Journal of Neurological Sciences. 36(3):315-20, 2009 May.
Abstract
BACKGROUND AND OBJECTIVES: In Canada and the USA, ice hockey is a cause of traumatic brain injury. Post-concussive
symptoms are the most important feature of the diagnosis of concussion in sports and it is recommended that athletes not return to
play while still symptomatic. Lack of knowledge of concussions could therefore be one of the main detriments to concussion
prevention in hockey. The purpose of this research is to describe what minor league hockey players, coaches, parents and trainers
know about concussion and its management. METHODS: A questionnaire to assess concussion knowledge and return to play
guidelines was developed and administered to players at different competitive levels (n = 267), coaches, trainers and parents (total
adults n = 142) from the Greater Toronto Area. RESULTS: Although a majority of adults and players could identify mechanisms
responsible for concussion, about one-quarter of adults and about a quarter to a half of children could not recall!
any symptoms or recalled only one symptom of a concussion. A significant number of players and some adults did not know what
a concussion was or how it occurred. Almost half of the players and a fifth of the adults incorrectly stated that concussion was
treated with medication or physical therapy. Nearly one quarter of all players did not know if an athlete experiencing symptoms of
concussion should continue playing. CONCLUSIONS: This study demonstrated that a significant number of people held
misconceptions about concussion in hockey which could lead to serious health consequences and creates a need for better
preventive and educational strategies.
Publication Type
Journal Article.
Result <12>
Unique Identifier
17219233
Status
MEDLINE
Authors
Hayden MG. Jandial R. Duenas HA. Mahajan R. Levy M.
Authors Full Name
Hayden, M G. Jandial, R. Duenas, H A. Mahajan, R. Levy, M.
Institution
Division of Neurosurgery, Mailcode 8893200, University of California, San Diego, San Diego, CA 92103-8893, USA.
Title
Pediatric concussions in sports; a simple and rapid assessment tool for concussive injury in children and adults.
Source
Childs Nervous System. 23(4):431-5, 2007 Apr.
Abstract
BACKGROUND: We established a routine protocol for concussion evaluation in athletes for nonmedical personnel. The evaluation,
management guidelines, and return-to-play recommendations were summarized with a memorable mnemonic on a convenient
handheld card. MATERIALS AND METHODS: The ability to remember the return-to-play mnemonic and effectively apply it to
corresponding guidelines was evaluated in 194 sports personnel without medical training. The participants were given three clinical
scenarios, each including age, pertinent history, sporting event, description of an injury, symptoms, signs, and a brief neurological
exam. Subsequently, the subject's ability to recall the return-to-play mnemonic and the Standard Assessment of Concussion, to
describe the corresponding guidelines, and to advise return-to-play was evaluated. CONCLUSION: Our "return-to-play" mnemonic
was found to be simple and memorable, allowing for a high recall percentage and accurate evaluation of concuss!
ion cases. High intersubject agreement suggests that this method has both standardization and generalization potential.
Publication Type
Journal Article.
Result <13>
Unique Identifier
19423976
Status
MEDLINE
Authors
Sullivan SJ. Bourne L. Choie S. Eastwood B. Isbister S. McCrory P. Gray A.
Authors Full Name
Sullivan, S John. Bourne, Liam. Choie, Sharon. Eastwood, Brigitte. Isbister, Sarah. McCrory, Paul. Gray, Andrew.
Institution
Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
sjohn.sullivan@otago.ac.nz
Title
Understanding of sport concussion by the parents of young rugby players: a pilot study.
Source
Clinical Journal of Sport Medicine. 19(3):228-30, 2009 May.
Abstract
OBJECTIVE: Establish the knowledge and beliefs of the parents of high school rugby players about concussion. DESIGN:
Descriptive cross-sectional intercept style face-to-face pilot survey. SETTING: The survey was conducted during high school rugby
games. PARTICIPANTS: Two hundred parents of male high school rugby players who were attending their teenagers' games. MAIN
OUTCOME MEASURES: Exploratory analysis of the closed- and open-ended questionnaire. Concussion signs and symptoms were
subsequently mapped onto the framework of the Sport Concussion Assessment Tool. RESULTS: Most parents (83%; 165 of 198)
reported that they were able to recognize a concussion in their teenager and provide a list of well-accepted signs and symptoms.
Nearly all (96%; 188 of 196) were aware of the risks of continuing to play while concussed, and approximately half (51%; 99 of
196) were aware of return-to-play guidelines/recommendations after a concussion. CONCLUSIONS: Parents of male high school !
rugby players reported having basic knowledge of concussion symptoms and the seriousness of concussion. Parents are potentially
key figures in the detection of a possible concussion in the postgame/practice home environment.
Publication Type
Journal Article.
Result <14>
Unique Identifier
18806547
Status
MEDLINE
Authors
Shuttleworth-Edwards AB. Noakes TD. Radloff SE. Whitefield VJ. Clark SB. Roberts CO. Essack FB. Zoccola D. Boulind MJ.
Case SE. Smith IP. Mitchell JL.
Authors Full Name
Shuttleworth-Edwards, Ann B. Noakes, Timothy D. Radloff, Sarah E. Whitefield, Victoria J. Clark, Susan B. Roberts, Craig O.
Essack, Fathima B. Zoccola, Diana. Boulind, Melissa J. Case, Stephanie E. Smith, Ian P. Mitchell, Julia L G.
Institution
Department of Psychology, Rhodes University, Grahamstown, South Africa. a.edwards@ru.ac.za
Title
The comparative incidence of reported concussions presenting for follow-up management in South African Rugby Union.
Source
Clinical Journal of Sport Medicine. 18(5):403-9, 2008 Sep.
Abstract
OBJECTIVE: The objective of this study was to compare the seasonal concussion incidence for school, university, club and
provincial level Rugby Union players in South Africa. DESIGN: The study presents a retrospective statistical analysis of the number
of reported concussions documented annually for groups of Rugby Union players as a proportion of those who received preseason
neurocognitive assessment. SETTING: Between 2002 and 2006, concussion management programs using computerized
neuropsychological assessment were implemented for clinical and research purposes by psychologists in selected South African
institutions involved in Rugby Union from school through to the professional level. PARTICIPANTS: The incidence figures were
based on 175 concussive episodes reported for 165 athletes who were referred for neurocognitive assessment from a population of
1366 athletes who received preseason baseline testing. INTERVENTIONS: Concussion management routines varied according to !
the protocols adopted by the different psychologists and rugby organizations. MAIN OUTCOME MEASUREMENTS: It was expected
that the incidence of concussion would vary significantly due to level of play and different management protocols. RESULT: There
was wide disparity in the manner in which concussion follow-up was managed by the various organizations. Within broadly
comparable cohorts, tighter control was associated with a relatively higher concussion incidence for athletes per rugby playing
season, with average institutional figures ranging from 4% to 14% at school level and 3% to 23% at adult level. CONCLUSIONS:
This analysis suggests that concussion goes unrecognized and therefore incorrectly managed in a number of instances.
Recommendations for optimal identification of concussed athletes for follow-up management are presented.
Publication Type
Journal Article. Research Support, Non-U.S. Gov't.
Result <15>
Unique Identifier
18469564
Status
MEDLINE
Authors
Valovich McLeod TC. Bay RC. Heil J. McVeigh SD.
Authors Full Name
Valovich McLeod, Tamara C. Bay, R Curtis. Heil, John. McVeigh, Scott D.
Institution
Athletic Training Program, Arizona School of Health Sciences, A. T. Still University, Mesa, AZ 85206, USA. tmcleod@atsu.edu
Title
Identification of sport and recreational activity concussion history through the preparticipation screening and a symptom survey in
young athletes.
Source
Clinical Journal of Sport Medicine. 18(3):235-40, 2008 May.
Abstract
OBJECTIVE: To evaluate the concussion history of young athletes using three questions on the preparticipation screening (PPS)
and a concussion symptom survey (CSS). DESIGN: Descriptive survey. SETTING: Mass high school PPS. PATIENTS OR OTHER
PARTICIPANTS: Five hundred twenty young athletes. INTERVENTIONS: Athletes were asked about their concussion history using
three different questions on the PPS. The CSS, a list of concussion-related symptoms, was also given to assess the history of
concussion-related symptoms associated with a previous injury to the head. MAIN OUTCOME MEASURES: Positive concussion
history was determined as a positive response on one of the three PPS questions or any one of the CSS responses and reported as
frequencies and percentages. Kappa coefficients were used to evaluate the agreement between the responses on the three PPS
questions. RESULTS: There was little agreement among the three PPS questions, with kappa coefficients ranging from kappa = 0.01!
8 to 0.342. Analysis of the CSS revealed that 286 athletes (55.0%) reported having at least one concussion symptom after a head
injury. Of those reporting symptoms, 86.4% did not report a concussion history in sport, and 92.7% did not report a concussion
history in recreational activities. CONCLUSIONS: The identification of concussion history may depend on the phrasing of questions
on the PPS. Simply asking an athlete whether they had a concussion may not adequately identify athletes with concussion histories.
Although recommendations have been made to avoid the terminology of ding and bell rung, it seems these terms may be needed to
ensure adequate reporting of previous concussions in young athletes.
Publication Type
Journal Article.
Result <16>
Unique Identifier
17304003
Status
MEDLINE
Authors
Iverson G.
Authors Full Name
Iverson, Grant.
Institution
University of British Columbia and Riverview Hospital, 2255 Wesbrook Mall, Vancouver, British Columbia, Canada.
giverson@interchange.ubc.ca
Title
Predicting slow recovery from sport-related concussion: the new simple-complex distinction.[see comment].
Comments
Comment in: Clin J Sport Med. 2007 Jul;17(4):330; author reply 330-1; discussion 331; PMID: 17620795
Source
Clinical Journal of Sport Medicine. 17(1):31-7, 2007 Jan.
Abstract
OBJECTIVE: Following the Second International Conference on Concussion in Sport in 2005, a summary agreement statement was
published that introduced new terminology for sport-related concussions. This new classification system is binary (ie, "simple"
versus "complex" concussions). Athletes who are slow to recover (ie, >10 days) are classified as having complex concussions. The
purpose of this study was to determine if high school football players, retrospectively classified as having a simple or a complex
concussion, could be differentiated in the first 48 after injury on the basis of symptom reporting or neuropsychological testing.
DESIGN: Case-control study. SETTING: Pennsylvania high school football programs. PARTICIPANTS: The total sample consisted of
114 concussed high school football players who were identified through a 3 year prospective cohort study. INTERVENTIONS: All
completed a computerized neuropsychological screening evaluation within 72 hours of injury. They!
were followed clinically until they recovered and were cleared to return to play. They were classified retrospectively as having a
simple (n = 55) or complex (n = 59) concussion based on their recovery times. MAIN OUTCOME MEASUREMENTS: Neurocognitive
test performance and symptom ratings. RESULTS: Within 72 hours after injury, athletes with complex concussions performed more
poorly on neuropsychological testing and reported more symptoms than those with simple concussions. Athletes with complex
concussions who were slow to recover were 18 times more likely to have 3 unusually low neuropsychological test scores than those
with simple concussions (95% CI = 2.3-144.9). Athletes with previous concussions did not recover more slowly. CONCLUSIONS:
This study provides evidence that supports and refutes the clinical usefulness of the new simple-complex concussion classification
system.
Publication Type
Journal Article. Research Support, Non-U.S. Gov't.
Result <17>
Unique Identifier
16162986
Status
MEDLINE
Authors
Barbic D. Pater J. Brison RJ.
Authors Full Name
Barbic, David. Pater, Joseph. Brison, Robert J.
Institution
Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada. 8db@qlink.queensu.ca
Title
Comparison of mouth guard designs and concussion prevention in contact sports: a multicenter randomized controlled trial.
Source
Clinical Journal of Sport Medicine. 15(5):294-8, 2005 Sep.
Abstract
OBJECTIVES: To compare the effectiveness of the WIPSS mouth guard to other currently used mouth guards in the prevention of
concussion injuries in athletes participating in varsity football and rugby. DESIGN:: Multicenter, cluster-randomized, controlled trial
comparing the WIPSS Brain-Pad mouth guard against the standard use mouth guard of choice. Teams were monitored by their
respective athletic therapist, trainer, or sports physician for 1 playing season to diagnose and record incident concussion injuries
and dental trauma. Concussion symptoms were also recorded at the time of injury. SETTING: Five Ontario universities.
PARTICIPANTS: University male football (394) and university male (129) and female (123) rugby athletes reporting to 2003 fall
training camps. MAIN OUTCOME MEASUREMENTS: The primary end point was the incidence of any diagnosed concussion events
during the 2003 playing season as defined by the American Academy of Neurology Concussion Guidelines. Secondary e!
ndpoints included the incidence of dental trauma events and observed concussion symptoms. RESULTS: There was no significant
difference in the number of concussions observed between the intervention and control arms of this trial (P = 0.79; odds ratio,
1.06, in favor of controls; 95% CI, 0.51, <<1.61). No dental trauma events occurred. The 5 most common symptoms experienced
by concussed athletes were dizziness, general headache, nausea, loss of visual focus, and personality changes. CONCLUSIONS: In
this study, concussion rates were not significantly different for varsity football and rugby players who wore the WIPSS Brain-Pad
mouth guard compared with other types of mouth guards.
Publication Type
Comparative Study. Journal Article. Multicenter Study. Randomized Controlled Trial. Research Support, Non-U.S. Gov't.
Result <18>
Unique Identifier
15782050
Status
MEDLINE
Authors
LaBotz M. Martin MR. Kimura IF. Hetzler RK. Nichols AW.
Authors Full Name
LaBotz, Michele. Martin, Mersadies R. Kimura, Iris F. Hetzler, Ronald K. Nichols, Andrew W.
Institution
University of Hawaii Sports Medicine Research Group, Honolulu, HI 96822, USA. labotz@hawaii.edu
Title
A comparison of a preparticipation evaluation history form and a symptom-based concussion survey in the identification of
previous head injury in collegiate athletes.
Source
Clinical Journal of Sport Medicine. 15(2):73-8, 2005 Mar.
Abstract
OBJECTIVE: The purpose of this study was to compare the incidence of prior head injury reported on preparticipation physical
evaluation (PPE) history forms with a retrospective symptom-based survey. DESIGN: A comparison of 2 retrospective survey
instruments. SETTING: NCAA Division I varsity athletic program. PARTICIPANTS: A total of 93 male and 79 female athletes
participating in intercollegiate contact/collision sports. MAIN OUTCOME MEASURES: Athletes were administered a concussion
symptom survey (CSS) with questions about symptom incidence after head injury. These responses were compared with answers
given about previous concussion/head injury on the university's PPE history form. The numbers of positive responses were analyzed
using descriptive statistics, and differences between the PPE medical history form and the concussion symptom survey were
assessed using chi analysis. Factor analysis was performed to assess for possible variance structure between reported symptom!
s. RESULTS: Seventy-one percent of athletes reporting symptoms consistent with concussion were not identified as having a
history of head injury on the PPE medical history form. The most common symptom on the CSS was headache, which accounted for
46 (56.1%) positive responses. CONCLUSIONS: The CSS revealed greater numbers of athletes experiencing symptomatic head
injuries than the screening questions on the PPE history form. Screening for signs and symptoms of concussion may enhance the
sensitivity of the PPE in detecting a prior history of concussion.
Publication Type
Comparative Study. Journal Article.
Result <19>
Unique Identifier
18068428
Status
MEDLINE
Authors
Slobounov S. Cao C. Sebastianelli W. Slobounov E. Newell K.
Authors Full Name
Slobounov, Semyon. Cao, Cheng. Sebastianelli, Wayne. Slobounov, Elena. Newell, Karl.
Institution
Department of Kinesiology, The Pennsylvania State University, 19 Recreation Building, University Park, PA 16802, USA.
sms18@psu.edu
Title
Residual deficits from concussion as revealed by virtual time-to-contact measures of postural stability.
Source
Clinical Neurophysiology. 119(2):281-9, 2008 Feb.
Abstract
OBJECTIVE: Traumatic brain injury (TBI), including mild traumatic brain injury (MTBI), commonly known as a "concussion", is still
one of the most puzzling neurological disorders and least understood injuries facing sport medicine and the scientific community
[Cantu R. Concussion assessment Ongoing controversy. In: Slobounov S, Sebastianelli W, editors. Foundations of sport-related
brain injuries. New York: Springer Press; 2006. p. 87-111.]. It was our primary objective to assess the dynamic properties of
postural control in subjects prior to and after sport-related MTBI using the traditional center of pressure (COP) and virtual time-tocontact (VTC) measures. METHODS: We assessed 12 student-athletes prior to and 30 days after they suffered sport-related MTBI
on a number of standing still and dynamic postural tasks. All subjects were clinically asymptomatic at day 30 of testing and were
cleared for full sport participation based upon neurological and neuropsychological asse!
ssments, as well as clinical symptoms resolution. RESULTS: The findings showed: (1) no significant differences for any of the
standard COP-based measures of postural control (i.e., 90% ellipse COP area, COP velocity and Stability Index) as a function of
testing day (prior to and 30 days post-injury, p>.05); (2) no differences in terms of VTC shape, distribution and nominal values
before and after concussion during standing still postural tasks regardless of vision conditions, p>.05; and (3) there were significant
alterations in VTC in terms of absolute values, range of VTC at the deflection points and mode at the day 30 post-injury.
CONCLUSIONS: The deficits in VTC control are indicative of residual postural abnormality in subjects suffering from mild traumatic
brain injuries and provide further evidence that VTC is used to regulate dynamic postural movement. SIGNIFICANCE: The results
show that residual postural abnormalities in concussed individuals may be undetected using!
conventional research methods and the implications of this for clinic
al practice are discussed.
Publication Type
Journal Article.
Result <20>
Unique Identifier
16323387
Status
MEDLINE
Authors
Eyres S. Carey A. Gilworth G. Neumann V. Tennant A.
Authors Full Name
Eyres, Sophie. Carey, Amy. Gilworth, Gill. Neumann, Vera. Tennant, Alan.
Institution
Academic Unit of Musculoskeletal and Rehabilitation Medicine, The University of Leeds, 36 Clarendon Road, Leeds LS2 9NZ, UK.
Title
Construct validity and reliability of the Rivermead Post-Concussion Symptoms Questionnaire.
Source
Clinical Rehabilitation. 19(8):878-87, 2005 Dec.
Abstract
OBJECTIVES: To provide further evidence of reliability and internal and external construct validity of the Rivermead PostConcussion Symptoms Questionnaire (RPQ), which measures severity of postconcussion symptoms following head injury. DESIGN
AND SETTING: A cross-sectional study of consecutive patients presenting with a head injury in two urban teaching hospitals and a
community trust. PATIENTS: Three hundred and sixty-nine patients returned a questionnaire from 1689 consecutive adult patients
(18 years and above) referred to radiology for a skull X-ray following a head injury, and those who were currently under the care of
a community-based multidisciplinary head injury team. METHOD: Internal construct validity tested by fit to the Rasch Measurement
model; external construct validity tested by correlations with Rivermead Head Injury Follow-up Questionnaire (RHFUQ); test-retest
reliability tested by correlations at two-week intervals. OUTCOME MEASURES: Rivermead Post-Conc!
ussion Symptoms Questionnaire and Rivermead Head Injury Follow-up Questionnaire. MAIN RESULTS: RPQ scores ranged from 0
to 64 (17.3% floor, 0.3% ceiling). Overall fit to the Rasch model was poor (item fit mean -0.416, SD = 1.989, chi-squared=
172.486, p<0.01) suggesting a lack of unidimensionality. The items headaches, dizziness and forgetful displayed misfitting residuals
and the first two items also displayed significant item trait fit statistics (p < 0.0006). After removing the items headaches, dizziness
and subsequently nausea the RPQ demonstrated good fit at overall and individual item levels, both for the remaining 13 items
(RPQ-13) and the three items (RPQ-3) which now formed a subsidiary scale. All items functioned consistently across age and
gender. The RPQ-13 and RPQ-3 scales showed test-retest reliability coefficients of 0.89 and 0.72 (both p-values < 0.01) and
positive correlations with RHFUQ scores (0.83 for RPQ-13, 0.62 for RPQ-3, both p-values < 0.01). CONCLU!
SIONS: As currently used, the RPQ does not meet modern psychometric st
andards. Its 16 items do not tap into the same underlying construct and should not be summated in a single score. When the RPQ
is split into two separate scales, the RPQ-13 and the RPQ-3, each set of items forms a unidimensional construct for people with
head injury at three months post injury. These scales show good test-retest reliability and adequate external construct validity.
Publication Type
Journal Article. Research Support, Non-U.S. Gov't. Validation Studies.
Result <21>
Unique Identifier
17606933
Status
MEDLINE
Authors
Moulton D.
Authors Full Name
Moulton, Donalee.
Title
Secret locker room game causing concussions.
Source
CMAJ Canadian Medical Association Journal. 177(1):25, 2007 Jul 3.
Other ID
Source: NLM. PMC1896045
Publication Type
News.
Result <22>
Unique Identifier
19390439
Status
MEDLINE
Authors
Cohen JS. Gioia G. Atabaki S. Teach SJ.
Authors Full Name
Cohen, Joanna S. Gioia, Gerard. Atabaki, Shireen. Teach, Stephen J.
Institution
Division of Emergency Medicine, Children's National Medical Center, Washington, DC 20010, USA. jcohen@cnmc.org
Title
Sports-related concussions in pediatrics. [Review] [59 refs]
Source
Current Opinion in Pediatrics. 21(3):288-93, 2009 Jun.
Abstract
PURPOSE OF REVIEW: Mild traumatic brain injury (mTBI) accompanied by concussion is a common presenting complaint among
children presenting to emergency departments (EDs). There is wide practice variation regarding diagnosis and management of
sports-related concussions in children. Our aim is to review the most recent evidence and expert recommendations regarding initial
diagnosis and management of sports-related concussions in children. RECENT FINDINGS: Previous classifications and return-to-play
guidelines for sports-related concussions in children were inadequate and have been abandoned. The most recent
recommendations, from the Third International Conference on Concussion in Sport (CIS), reinforce an individualized evaluation of
the athlete's neurocognitive functioning, symptoms and balance. They further reinforce a step-wise approach in the return-to-play
process once neurocognitive function has returned to baseline and all symptoms have resolved. The need for a standa!
rdized and objective tool to aid in the initial evaluation and diagnosis of mTBI in the clinical setting led to the development of the
Acute Concussion Evaluation (ACE) protocol, which is currently being modified for specific use in the ED. Computed tomography
(CT) in the acute setting is not likely to be useful for children with mTBI. Newer functional imaging techniques may prove relevant
in the future. SUMMARY: Further research on both the incidence of sports-related concussions in children and management
paradigms is needed. The role of novel imaging modalities in clinical assessment also needs to be elucidated. An individualized
approach to evaluation and management of sports-related concussions is recommended. It should incorporate standard symptom
assessment, neuropsychological testing and postural stability testing. [References: 59]
Publication Type
Journal Article. Review.
Result <23>
Unique Identifier
16914990
Status
MEDLINE
Authors
Buzzini SR. Guskiewicz KM.
Authors Full Name
Buzzini, Sergio R Russo. Guskiewicz, Kevin M.
Institution
Department of Pediatrics and Orthopaedic Surgery, Division of Adolescent Medicine, Medical University of South Carolina,
Charleston, South Carolina, USA. buzzini@musc.edu
Title
Sport-related concussion in the young athlete. [Review] [52 refs]
Source
Current Opinion in Pediatrics. 18(4):376-82, 2006 Aug.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to present an overview of sport-related concussion in the young athlete and
review recent publications of clinical and scientific importance. RECENT FINDINGS: Recent findings show that young athletes are
more susceptible to concussions than older athletes and more likely to develop second impact syndrome, as well as long-term
negative cumulative consequences. Further, ongoing research suggests a more prolonged disturbance of brain function following a
concussion than previously believed. SUMMARY: Given the increased vulnerability of the young athlete, current research suggests
conservative management of concussion and return-to-play decisions. A decision tree diagram to assist the practitioner in making
return-to-play recommendations for the young athlete is included in this review. [References: 52]
Publication Type
Journal Article. Review.
Result <24>
Unique Identifier
16640477
Status
MEDLINE
Authors
Slobounov S. Slobounov E. Newell K.
Authors Full Name
Slobounov, Semyon. Slobounov, Elena. Newell, Karl.
Institution
Department of Kinesiology, University, University Park, Pennsylvania, USA. sms18@psu.edu
Title
Application of virtual reality graphics in assessment of concussion.
Source
Cyberpsychology & Behavior. 9(2):188-91, 2006 Apr.
Abstract
Abnormal balance in individuals suffering from traumatic brain injury (TBI) has been documented in numerous recent studies.
However, specific mechanisms causing balance deficits have not been systematically examined. This paper demonstrated the
destabilizing effect of visual field motion, induced by virtual reality graphics in concussed individuals but not in normal controls. Fifty
five student-athletes at risk for concussion participated in this study prior to injury and 10 of these subjects who suffered MTBI
were tested again on day 3, day 10, and day 30 after the incident. Postural responses to visual field motion were recorded using a
virtual reality (VR) environment in conjunction with balance (AMTI force plate) and motion tracking (Flock of Birds) technologies.
Two experimental conditions were introduced where subjects passively viewed VR scenes or actively manipulated the visual field
motion. Long-lasting destabilizing effects of visual field motion were revealed, a!
lthough subjects were asymptomatic when standard balance tests were introduced. The findings demonstrate that advanced VR
technology may detect residual symptoms of concussion at least 30 days post-injury.
Publication Type
Comparative Study. Evaluation Studies. Journal Article.
Result <25>
Unique Identifier
17227375
Status
MEDLINE
Authors
Mihalik JP. McCaffrey MA. Rivera EM. Pardini JE. Guskiewicz KM. Collins MW. Lovell MR.
Authors Full Name
Mihalik, Jason P. McCaffrey, Meghan A. Rivera, Eric M. Pardini, Jamie E. Guskiewicz, Kevin M. Collins, Michael W. Lovell, Mark
R.
Institution
Sports Medicine Research Laboratory, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill,
Chapel Hill, NC 27599, USA. jasonm@unc.edu
Title
Effectiveness of mouthguards in reducing neurocognitive deficits following sports-related cerebral concussion.[see comment].
Comments
Comment in: Dent Traumatol. 2007 Aug;23(4):262; author reply 262-3; PMID: 17635364
Source
Dental Traumatology. 23(1):14-20, 2007 Feb.
Abstract
Although it is widely accepted that mouthguards decrease the incidence of dental injuries, there is a controversy among sports
medicine professionals as to the effectiveness of mouthguards in decreasing the incidence or severity of sports-related cerebral
concussion (SRCC). While some experimental data suggest that this may be the case, there exist a number of reports suggesting
that mouthguards do not serve this purpose. These conclusions have been drawn, however, without actually measuring the extent
of neurocognitive dysfunction in athletes following sports-related concussion. The purpose of this study was to determine whether
mouthguard use reduces the neurocognitive and symptomatic impairments that follow an injurious episode of SRCC. Preseason
baseline data were collected as part of an ongoing clinical program that uses a computerized neurocognitive test to assess various
faculties of brain function and symptoms reported at the time of testing. Follow-up testing from!
180 student-athletes who had sustained an SRCC was analyzed for the purpose of this study. These athletes were separated into
one of two groups: those who reported using mouthguards and those who did not. Neurocognitive testing was accomplished using
the Immediate Post-Concussion and Assessment Test (ImPACT). Results suggest that neurocognitive deficits at the time of the
athletes' first follow-up assessment did not differ between mouthguard users and non-users, suggesting that mouthguard use does
little to reduce the severity of neurocognitive dysfunction and onset of symptoms following sports-related head trauma. However,
an interesting finding in this study was that athletes experienced significantly lower neurocognitive test scores and reported higher
symptom scores following SRCC regardless of mouthguard use. This emphasizes a thorough clinical evaluation of athletes that have
sustained an SRCC. Although it was found in this study that mouthguard use does not decrease!
the severity of concussion, it is important to note that the use of m
outhguards is paramount in reducing maxillofacial and dental trauma and their use should continue to be mandated by athletic
associations and supported by all dental and sports medicine professionals.
Publication Type
Evaluation Studies. Journal Article.
Result <26>
Unique Identifier
19116810
Status
MEDLINE
Authors
Roe C. Sveen U. Alvsaker K. Bautz-Holter E.
Authors Full Name
Roe, Cecilie. Sveen, Unni. Alvsaker, Kristin. Bautz-Holter, Erik.
Institution
Department of Physical Medicine and Rehabilitation, Ulleval University Hospital, Oslo, Norway. cecilie.roe@ulleval.no
Title
Post-concussion symptoms after mild traumatic brain injury: influence of demographic factors and injury severity in a 1-year
cohort study.
Source
Disability & Rehabilitation. 31(15):1235-43, 2009.
Abstract
PURPOSE: To assess the prevalence and variation of post-concussion symptoms within the first year after mild traumatic brain
injury (TBI), and explore the association between injury severity, demographic factors and symptoms. METHODS: Prospective study
of patients with mild TBI followed up at 3, 6 and 12 months (N= 96 included, n = 52 attending all follow-ups). Sociodemographic
factors, injury mechanisms and impact of injury (Glasgow Coma Scale score, Abbreviated Injury Severity Score (AIS), Injury
Severity Score) were recorded at inclusion. Symptoms were reported in the Rivermead Post-Concussion Symptoms Questionnaire
(RPQ) at the follow-ups. The sumscore of all symptoms in RPQ was calculated for each subject. Scores were also calculated
separately for the cognitive, physical and behavioural symptoms. RESULTS: Twenty-nine subjects met the post-concussion
syndrome criteria at 3 months, and 22 patients at 6 and 12 months. The cognitive symptoms were more prominent than the !
physical and behavioural symptoms. The cognitive and physical symptoms were associated with AIS for the head injury at 3
months, but not at 12 months. Considerable individual variability in the symptom pattern was found, and the subjects who attended
only the 3-months follow-up reported a lower level of symptoms than those attending all follow-ups. CONCLUSIONS: Persistence of
symptoms was a considerable problem even 1 year after the injury, with cognitive symptoms dominating. More severe AIS scores
were associated with a higher level of cognitive and physical symptoms at 3 months, but not at later follow-ups. Strategies to
prevent and treat these symptoms should be focussed in clinical practice.
Publication Type
Journal Article.
Result <27>
Unique Identifier
16958503
Status
MEDLINE
Authors
Valentine V. Curl WW.
Authors Full Name
Valentine, Verle. Curl, Walton W.
Institution
Department of Orthopedic Surgery, Medical College of Georgia, Augusta, Georgia, USA.
Title
Concussions in adolescent athletes. [Review] [34 refs]
Source
Instructional Course Lectures. 55:703-9, 2006.
Abstract
A concussion is defined as a complex pathophysiologic process affecting the brain that is induced by traumatic biomechanical
forces. Concussions are caused by a direct or indirect blow that leads to a graded set of syndromes characterized by functional
rather than structural disturbances to the brain. Concussions are characterized by a wide variety of presenting symptoms, including
loss of consciousness, amnesia, confusion, headache, and nausea. Concussions occur in patients participating in all levels of athletic
activities, with most occurring in younger athletes. The evaluation of a patient with a concussion should include assessment of the
airway, breathing, circulation, level of consciousness, orientation, memory, concentration, and neurologic function. Multiple grading
scales and return to play guidelines have been published to assist the clinician in the treatment of patients with concussions.
Diagnostic and treatment concerns include spinal cord injury, intracrania!
l pathology, second impact syndrome, and long-term impairment of cognitive function. Computerized neuropsychologic testing is a
new tool in the treatment of concussions. These tests measure memory, new learning, attention, and reaction time and should be
used as an adjunct to other tools for clinical decision making. Published guidelines will assist in treatment decisions; however, it
should be kept in mind that all concussions are unique injuries. [References: 34]
Publication Type
Journal Article. Review.
Result <28>
Unique Identifier
16169584
Status
MEDLINE
Authors
Goodman D. Bradley NL. Paras B. Williamson IJ. Bizzochi J.
Authors Full Name
Goodman, David. Bradley, Nori L. Paras, Bradley. Williamson, Ian J. Bizzochi, James.
Institution
Faculty of Applied Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6. goodman@sfu.ca
Title
Video gaming promotes concussion knowledge acquisition in youth hockey players.
Source
Journal of Adolescence. 29(3):351-60, 2006 Jun.
Abstract
While the positive uses for video games in an educational setting have also been established, the educational aim is usually made
explicit. The goal of this research was to develop a video game wherein the educational aspect was implicitly embedded in the video
game, such that the gaming activity remained interesting and relevant. Following a pilot study to confirm the usability of an inhouse developed game, two studies were conducted with 11-17 year old hockey players (N(1)=130, N(2)=39). Results
demonstrated that participants playing the experimental version of the video game scored significantly higher on a concussion
symptoms questionnaire, in a significantly faster time, than participants playing the control version of the game. Most participants
indicated that they enjoyed the game and would play it again. These results suggest that educational material can be conveyed
successfully and in an appealing manner via video game play.
Publication Type
Journal Article. Research Support, Non-U.S. Gov't.
Result <29>
Unique Identifier
18523563
Status
MEDLINE
Authors
Majerske CW. Mihalik JP. Ren D. Collins MW. Reddy CC. Lovell MR. Wagner AK.
Authors Full Name
Majerske, Cynthia W. Mihalik, Jason P. Ren, Dianxu. Collins, Michael W. Reddy, Cara Camiolo. Lovell, Mark R. Wagner, Amy K.
Institution
University of Pittsburgh, Pittsburgh, PA, USA.
Title
Concussion in sports: postconcussive activity levels, symptoms, and neurocognitive performance.
Source
Journal of Athletic Training. 43(3):265-74, 2008 May-Jun.
Other ID
Source: NLM. PMC2386420
Abstract
CONTEXT: Evidence suggests that athletes engaging in high-intensity activities after concussion have more difficulties with
cognitive recovery. OBJECTIVE: To examine the role postinjury activity level plays in postconcussive symptoms and performance on
neurocognitive tests in a population of student-athletes. DESIGN: Retrospective cohort study with repeated measures of
neurocognitive performance and symptom reporting. SETTING: University-based sports concussion clinic. PATIENTS OR OTHER
PARTICIPANTS: Ninety-five student-athletes (80 males, 15 females: age = 15.88 +/- 1.35 years) were retrospectively assigned to 1
of 5 groups based on a postinjury activity intensity scale. MAIN OUTCOME MEASURE(S): We employed a regression analysis for
repeated measures to evaluate the relationship of activity intensity to symptoms and neurocognitive outcome up to 33 days after
concussion. Postconcussion symptom scores and neurocognitive (verbal memory, visual memory, visual motor speed, and!
reaction time) scores served as the primary outcome measures. RESULTS: Level of exertion was significantly related to all
outcome variables (P < .02 for all comparisons). With multivariate analysis, activity intensity remained significant with respect to
visual memory (P = .003) and reaction time (P < .001). CONCLUSIONS: Activity level after concussion affected symptoms and
neurocognitive recovery. Athletes engaging in high levels of activity after concussion demonstrated worse neurocognitive
performance. For these tasks, those engaging in moderate levels of activity demonstrated the best performance.
Publication Type
Journal Article. Research Support, N.I.H., Extramural.
Result <30>
Unique Identifier
18174937
Status
MEDLINE
Authors
Gessel LM. Fields SK. Collins CL. Dick RW. Comstock RD.
Authors Full Name
Gessel, Luke M. Fields, Sarah K. Collins, Christy L. Dick, Randall W. Comstock, R Dawn.
Institution
The Ohio State University, Columbus, OH, USA.
Title
Concussions among United States high school and collegiate athletes.
Source
Journal of Athletic Training. 42(4):495-503, 2007 Oct-Dec.
Other ID
Source: NLM. PMC2140075
Abstract
CONTEXT: An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United
States. Sports are second only to motor vehicle crashes as the leading cause of traumatic brain injury among people aged 15 to 24
years. OBJECTIVE: To investigate the epidemiology of concussions in a nationally representative sample of high school athletes and
to compare rates of concussion among high school and collegiate athletes. DESIGN: Descriptive epidemiologic study. SETTING: 100
United States high schools and 180 US colleges. PATIENTS OR OTHER PARTICIPANTS: United States high school and collegiate
athletes. MAIN OUTCOME MEASURE(S): Data from 2 injury surveillance systems, High School Reporting Information Online (RIO)
and the National Collegiate Athletic Association Injury Surveillance System, were analyzed to calculate rates, describe patterns, and
evaluate potential risk factors for sport-related concussion. RESULTS: Concussions represented!
8.9% (n = 396) of all high school athletic injuries and 5.8% (n = 482) of all collegiate athletic injuries. Among both groups, rates
of concussions were highest in the sports of football and soccer. In high school sports played by both sexes, girls sustained a higher
rate of concussions, and concussions represented a greater proportion of total injuries than in boys. In all sports, collegiate athletes
had higher rates of concussion than high school athletes, but concussions represented a greater proportion of all injuries among
high school athletes. CONCLUSIONS: Sport-related injury surveillance systems can provide scientific data to drive targeted injuryprevention projects. Developing effective sport-related concussion preventive measures depends upon increasing our knowledge of
concussion rates, patterns, and risk factors.
Publication Type
Journal Article. Research Support, U.S. Gov't, P.H.S..
Result <31>
Unique Identifier
18060001
Status
MEDLINE
Authors
Ives JC. Alderman M. Stred SE.
Authors Full Name
Ives, Jeffrey C. Alderman, Mark. Stred, Susan E.
Institution
Department of Exercise & Sport Sciences, Ithaca College, Ithaca, NY 14850, USA. emailto jives@ithaca.edu
Title
Hypopituitarism after multiple concussions: a retrospective case study in an adolescent male.
Source
Journal of Athletic Training. 42(3):431-9, 2007 Jul-Sep.
Other ID
Source: NLM. PMC1978466
Abstract
OBJECTIVE: To describe the development of hypopituitarism in an adolescent athlete after multiple concussions and to raise
awareness among sports medicine clinicians concerning the growing concern of hypopituitarism in concussion injury surveillance
and management. BACKGROUND: A 14-year-old, previously healthy male athlete suffered 4 head traumas over a 4-month period.
The first 3 traumas were considered by the athlete to be minor and were not reported to medical personnel. The fourth trauma was
a medically diagnosed concussion suffered during soccer play. Over the next year, the patient noted a decline in strength and
conditioning and a failure to grow. DIFFERENTIAL DIAGNOSIS: After physical examination and a full battery of endocrine tests, the
patient, then 16.5 years old, was diagnosed with hypopituitarism. Follow-up interviews provided evidence that at least 2 of the 3
head injuries suffered before the last concussion could also be considered concussions, which may ha!
ve contributed to the severity of the last head injury. TREATMENT: The patient is currently being treated with physiologic
replacement hormones (growth hormone, cortisol, and thyroxine), with resumption of linear growth and strength. He is progressing
well. UNIQUENESS: In the past few years in the medical literature, increased attention has been drawn to the occult occurrence of
hypopituitarism after traumatic brain injury in adults. Initial reports indicate that children are also at risk. To our knowledge, this is
the first reported case of hypopituitarism after mild traumatic brain injury in the sports medicine literature. CONCLUSIONS:
Symptoms of hypopituitarism are often masked by trauma and postconcussion symptoms and may not appear until months or years
after the trauma incident, which can lead to significant delay in proper diagnosis and treatment. We urge greater vigilance by, and
training of, sports medicine clinicians toward the goal of recognizing the possibility!
of pituitary disorders after sports concussion.
Publication Type
Case Reports. Journal Article.
Result <32>
Unique Identifier
18523563
Status
MEDLINE
Authors
Majerske CW. Mihalik JP. Ren D. Collins MW. Reddy CC. Lovell MR. Wagner AK.
Authors Full Name
Majerske, Cynthia W. Mihalik, Jason P. Ren, Dianxu. Collins, Michael W. Reddy, Cara Camiolo. Lovell, Mark R. Wagner, Amy K.
Institution
University of Pittsburgh, Pittsburgh, PA, USA.
Title
Concussion in sports: postconcussive activity levels, symptoms, and neurocognitive performance.
Source
Journal of Athletic Training. 43(3):265-74, 2008 May-Jun.
Other ID
Source: NLM. PMC2386420
Abstract
CONTEXT: Evidence suggests that athletes engaging in high-intensity activities after concussion have more difficulties with
cognitive recovery. OBJECTIVE: To examine the role postinjury activity level plays in postconcussive symptoms and performance on
neurocognitive tests in a population of student-athletes. DESIGN: Retrospective cohort study with repeated measures of
neurocognitive performance and symptom reporting. SETTING: University-based sports concussion clinic. PATIENTS OR OTHER
PARTICIPANTS: Ninety-five student-athletes (80 males, 15 females: age = 15.88 +/- 1.35 years) were retrospectively assigned to 1
of 5 groups based on a postinjury activity intensity scale. MAIN OUTCOME MEASURE(S): We employed a regression analysis for
repeated measures to evaluate the relationship of activity intensity to symptoms and neurocognitive outcome up to 33 days after
concussion. Postconcussion symptom scores and neurocognitive (verbal memory, visual memory, visual motor speed, and!
reaction time) scores served as the primary outcome measures. RESULTS: Level of exertion was significantly related to all
outcome variables (P < .02 for all comparisons). With multivariate analysis, activity intensity remained significant with respect to
visual memory (P = .003) and reaction time (P < .001). CONCLUSIONS: Activity level after concussion affected symptoms and
neurocognitive recovery. Athletes engaging in high levels of activity after concussion demonstrated worse neurocognitive
performance. For these tasks, those engaging in moderate levels of activity demonstrated the best performance.
Publication Type
Journal Article. Research Support, N.I.H., Extramural.
Result <33>
Unique Identifier
18174937
Status
MEDLINE
Authors
Gessel LM. Fields SK. Collins CL. Dick RW. Comstock RD.
Authors Full Name
Gessel, Luke M. Fields, Sarah K. Collins, Christy L. Dick, Randall W. Comstock, R Dawn.
Institution
The Ohio State University, Columbus, OH, USA.
Title
Concussions among United States high school and collegiate athletes.
Source
Journal of Athletic Training. 42(4):495-503, 2007 Oct-Dec.
Other ID
Source: NLM. PMC2140075
Abstract
CONTEXT: An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United
States. Sports are second only to motor vehicle crashes as the leading cause of traumatic brain injury among people aged 15 to 24
years. OBJECTIVE: To investigate the epidemiology of concussions in a nationally representative sample of high school athletes and
to compare rates of concussion among high school and collegiate athletes. DESIGN: Descriptive epidemiologic study. SETTING: 100
United States high schools and 180 US colleges. PATIENTS OR OTHER PARTICIPANTS: United States high school and collegiate
athletes. MAIN OUTCOME MEASURE(S): Data from 2 injury surveillance systems, High School Reporting Information Online (RIO)
and the National Collegiate Athletic Association Injury Surveillance System, were analyzed to calculate rates, describe patterns, and
evaluate potential risk factors for sport-related concussion. RESULTS: Concussions represented!
8.9% (n = 396) of all high school athletic injuries and 5.8% (n = 482) of all collegiate athletic injuries. Among both groups, rates
of concussions were highest in the sports of football and soccer. In high school sports played by both sexes, girls sustained a higher
rate of concussions, and concussions represented a greater proportion of total injuries than in boys. In all sports, collegiate athletes
had higher rates of concussion than high school athletes, but concussions represented a greater proportion of all injuries among
high school athletes. CONCLUSIONS: Sport-related injury surveillance systems can provide scientific data to drive targeted injuryprevention projects. Developing effective sport-related concussion preventive measures depends upon increasing our knowledge of
concussion rates, patterns, and risk factors.
Publication Type
Journal Article. Research Support, U.S. Gov't, P.H.S..
Result <34>
Unique Identifier
18060001
Status
MEDLINE
Authors
Ives JC. Alderman M. Stred SE.
Authors Full Name
Ives, Jeffrey C. Alderman, Mark. Stred, Susan E.
Institution
Department of Exercise & Sport Sciences, Ithaca College, Ithaca, NY 14850, USA. emailto jives@ithaca.edu
Title
Hypopituitarism after multiple concussions: a retrospective case study in an adolescent male.
Source
Journal of Athletic Training. 42(3):431-9, 2007 Jul-Sep.
Other ID
Source: NLM. PMC1978466
Abstract
OBJECTIVE: To describe the development of hypopituitarism in an adolescent athlete after multiple concussions and to raise
awareness among sports medicine clinicians concerning the growing concern of hypopituitarism in concussion injury surveillance
and management. BACKGROUND: A 14-year-old, previously healthy male athlete suffered 4 head traumas over a 4-month period.
The first 3 traumas were considered by the athlete to be minor and were not reported to medical personnel. The fourth trauma was
a medically diagnosed concussion suffered during soccer play. Over the next year, the patient noted a decline in strength and
conditioning and a failure to grow. DIFFERENTIAL DIAGNOSIS: After physical examination and a full battery of endocrine tests, the
patient, then 16.5 years old, was diagnosed with hypopituitarism. Follow-up interviews provided evidence that at least 2 of the 3
head injuries suffered before the last concussion could also be considered concussions, which may ha!
ve contributed to the severity of the last head injury. TREATMENT: The patient is currently being treated with physiologic
replacement hormones (growth hormone, cortisol, and thyroxine), with resumption of linear growth and strength. He is progressing
well. UNIQUENESS: In the past few years in the medical literature, increased attention has been drawn to the occult occurrence of
hypopituitarism after traumatic brain injury in adults. Initial reports indicate that children are also at risk. To our knowledge, this is
the first reported case of hypopituitarism after mild traumatic brain injury in the sports medicine literature. CONCLUSIONS:
Symptoms of hypopituitarism are often masked by trauma and postconcussion symptoms and may not appear until months or years
after the trauma incident, which can lead to significant delay in proper diagnosis and treatment. We urge greater vigilance by, and
training of, sports medicine clinicians toward the goal of recognizing the possibility!
of pituitary disorders after sports concussion.
Publication Type
Case Reports. Journal Article.
Result <35>
Unique Identifier
16029831
Status
MEDLINE
Authors
Delaney JS. Abuzeyad F. Correa JA. Foxford R.
Authors Full Name
Delaney, J Scott. Abuzeyad, Faras. Correa, Jose A. Foxford, Robert.
Institution
Department of Emergency Medicine, McGill University Health Centre; McGill Sport Medicine Clinic, McGill University, 687 Pine
Avenue West, Montreal, Quebec H3A 1A1, Canada.
Title
Recognition and characteristics of concussions in the emergency department population.
Source
Journal of Emergency Medicine. 29(2):189-97, 2005 Aug.
Abstract
An anonymous survey was conducted over a 6-month period of time using consenting Emergency Department (ED) patients in an
attempt to better understand concussions occurring in the ED population. Calculations were made using the respondents' history
and self-reported symptoms during the previous 12 months. Five hundred twenty-two of 700 approached patients responded to the
anonymous questionnaire. Of respondents, 20.1% (105/522) answered that they had experienced symptoms of a concussion after
being hit in the head during the previous 12 months. Of the 105 respondents who experienced a concussion, 88.6% (93/105) did
not recognize that they had suffered a concussion. There were 28.2% (147/522) of all respondents who were actively engaging in
at least one activity that was considered to be at high risk for concussions. Headache was the most common symptom for both
recognized and unrecognized concussions. Respondents who experienced nausea after being hit in the head were the !
most likely to seek some form of medical attention, followed by people who suffered a loss of consciousness. Those patients who
suffered a loss of consciousness were the most likely to visit an ED. Many patients have a poor understanding of concussions and
these patients may be actively participating in high-risk activities while still suffering symptoms from a concussion. Therefore, these
patients may be at risk for further concussions and Second Impact Syndrome.
Publication Type
Journal Article.
Result <36>
Unique Identifier
19679020
Status
MEDLINE
Authors
McConnell A. Shubrook J.
Authors Full Name
McConnell, Amanda. Shubrook, Jay.
Institution
Department of Neurology, Ohio University College of Osteopathic Medicine, Athens, OH, USA. Am427597@ohio.edu
Title
Concussion care: simple strategies, big payoffs. [Review] [21 refs]
Source
Journal of Family Practice. 58(8):410-4, 2009 Aug.
Abstract
Consider any alteration of mental status that follows a trauma to be a concussion, whether or not there is also a loss of
consciousness. Don't order neuroimaging routinely; it is not necessary for diagnosing concussion. Neuroimaging is important,
however, for patients who exhibit prolonged unconsciousness, focal neurologic deficits, or worsening symptoms. Treat postconcussive headache, a common complaint, with acetaminophen or ibuprofen. [References: 21]
Publication Type
Case Reports. Journal Article. Review.
Result <37>
Unique Identifier
19679020
Status
MEDLINE
Authors
McConnell A. Shubrook J.
Authors Full Name
McConnell, Amanda. Shubrook, Jay.
Institution
Department of Neurology, Ohio University College of Osteopathic Medicine, Athens, OH, USA. Am427597@ohio.edu
Title
Concussion care: simple strategies, big payoffs.[see comment]. [Review] [21 refs]
Comments
Comment in: J Fam Pract. 2009 Oct;58(10):512, Comment in: J Fam Pract. 2009 Oct;58(10):512-3; author reply 513
Source
Journal of Family Practice. 58(8):410-4, 2009 Aug.
Abstract
Consider any alteration of mental status that follows a trauma to be a concussion, whether or not there is also a loss of
consciousness. Don't order neuroimaging routinely; it is not necessary for diagnosing concussion. Neuroimaging is important,
however, for patients who exhibit prolonged unconsciousness, focal neurologic deficits, or worsening symptoms. Treat postconcussive headache, a common complaint, with acetaminophen or ibuprofen. [References: 21]
Publication Type
Case Reports. Journal Article. Review.
Result <38>
Unique Identifier
18362765
Status
MEDLINE
Authors
Naunheim RS. Matero D. Fucetola R.
Authors Full Name
Naunheim, Rosanne S. Matero, David. Fucetola, Robert.
Institution
Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO 63110, USA.
naunheir@msnotes.wustl.edu
Title
Assessment of patients with mild concussion in the emergency department.
Source
Journal of Head Trauma Rehabilitation. 23(2):116-22, 2008 Mar-Apr.
Abstract
OBJECTIVES: (1) To test the validity of the Standardized Assessment of Concussion (SAC) in characterizing the early evolution of
concussion-related symptoms and mental status changes in the emergency department (ED) setting and (2) to compare it to the
Conner's Continuous Performance Test 2nd Edition (CPT-II). DESIGN: Prospective within-subject (repeated measures) design.
PARTICIPANTS: Sixty-two persons with concussion (Glasgow Coma Scale = 15) and negative head computed tomographic scan
results were examined on arrival in the ED and 3 and 6 hours later. SETTING: A large urban, tertiary medical center ED. MAIN
OUTCOME MEASURES: SAC; CPT-II; Post-Concussion Symptom Scale-Revised (PCS-R). RESULTS: SAC and CPT-II scores improved
significantly over the time course in the ED. Symptoms did not correlate with improvement, with many subjects complaining of
headache or nausea after their scores improved. The average initial score on the SAC was 21 +/- 5.4/30. Conclusion: The SAC ap!
pears sensitive to the acute changes following concussion. It may be a useful tool for clinicians in detecting mental status changes
after a concussion, when Glasgow Coma Scale and radiologic findings are normal.
Publication Type
Journal Article. Validation Studies.
Result <39>
Unique Identifier
17063314
Status
MEDLINE
Authors
Potter S. Leigh E. Wade D. Fleminger S.
Authors Full Name
Potter, Seb. Leigh, Eleanor. Wade, Derick. Fleminger, Simon.
Institution
Lishman Brain Injury Unit, The Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK. s.potter@iop.kcl.ac.uk
Title
The Rivermead Post Concussion Symptoms Questionnaire: a confirmatory factor analysis.
Source
Journal of Neurology. 253(12):1603-14, 2006 Dec.
Abstract
OBJECTIVE: To investigate the factor structure of the Rivermead Post Concussion Symptoms Questionnaire (RPQ) among
individuals seen as part of routine follow-up following traumatic brain injury. METHODS: RPQ data from 168 participants was
examined (mean age 35.2, SD 14.3; 89% with post traumatic amnesia duration<24 hours) six months after admission to an
Accident & Emergency Department following TBI. Structural equation modelling was carried out to evaluate proposed models of the
underlying structure of post-concussion symptoms (PCS). RESULTS: The results support the existence of separate cognitive,
emotional and somatic factors, although there was a high degree of covariation between the three factors. A two-factor model that
collapsed the emotional and somatic factors together showed a similar goodness-of-fit to the data, whilst a one-factor model proved
a poor fit. CONCLUSION: The results support the notion of post-concussion symptoms as a collection of associated but a!
t least partially separable cognitive, emotional and somatic symptoms, although questions persist regarding symptom specificity.
The use of the RPQ is discussed, and classification bands for use in clinical practice are suggested.
Publication Type
Journal Article.
Result <40>
Unique Identifier
16543534
Status
MEDLINE
Authors
Wall SE. Williams WH. Cartwright-Hatton S. Kelly TP. Murray J. Murray M. Owen A. Turner M.
Authors Full Name
Wall, S E. Williams, W H. Cartwright-Hatton, S. Kelly, T P. Murray, J. Murray, M. Owen, A. Turner, M.
Institution
School of Psychology and Centre for Cognitive Neuroscience, Washington Singer Laboratories, University of Exeter, Exeter EX4
4QG, UK.
Title
Neuropsychological dysfunction following repeat concussions in jockeys.[see comment].
Comments
Comment in: J Neurol Neurosurg Psychiatry. 2006 Apr;77(4):428; PMID: 16543517
Source
Journal of Neurology, Neurosurgery & Psychiatry. 77(4):518-20, 2006 Apr.
Abstract
BACKGROUND: Single and repeat concussions have a high prevalence in sport. However, there is limited research into longterm
risks associated with single and repeat concussions. OBJECTIVES: To determine the effects of single and repeat historical
concussions on the neuropsychological functioning and neurological reports of licensed jockeys. METHODS: Six hundred and ninety
eight licensed jockeys in the UK were assessed for neurological and neuropsychological symptoms of concussion at least three
months after potential episodes. RESULTS: Jockeys reporting multiple historical injuries versus a single injury showed reliable
decrements on a measure of response inhibition and, to a less robust degree, on divided attention. Younger adults showed greater
vulnerability. CONCLUSIONS: Repeated concussion is associated with reliable decrements in cognitive performance--even after a
three month window for recent recovery.
Publication Type
Journal Article.
Result <41>
Unique Identifier
16543534
Status
MEDLINE
Authors
Wall SE. Williams WH. Cartwright-Hatton S. Kelly TP. Murray J. Murray M. Owen A. Turner M.
Authors Full Name
Wall, S E. Williams, W H. Cartwright-Hatton, S. Kelly, T P. Murray, J. Murray, M. Owen, A. Turner, M.
Institution
School of Psychology and Centre for Cognitive Neuroscience, Washington Singer Laboratories, University of Exeter, Exeter EX4
4QG, UK.
Title
Neuropsychological dysfunction following repeat concussions in jockeys.[see comment].
Comments
Comment in: J Neurol Neurosurg Psychiatry. 2006 Apr;77(4):428; PMID: 16543517
Source
Journal of Neurology, Neurosurgery & Psychiatry. 77(4):518-20, 2006 Apr.
Other ID
Source: NLM. PMC2077488
Abstract
BACKGROUND: Single and repeat concussions have a high prevalence in sport. However, there is limited research into longterm
risks associated with single and repeat concussions. OBJECTIVES: To determine the effects of single and repeat historical
concussions on the neuropsychological functioning and neurological reports of licensed jockeys. METHODS: Six hundred and ninety
eight licensed jockeys in the UK were assessed for neurological and neuropsychological symptoms of concussion at least three
months after potential episodes. RESULTS: Jockeys reporting multiple historical injuries versus a single injury showed reliable
decrements on a measure of response inhibition and, to a less robust degree, on divided attention. Younger adults showed greater
vulnerability. CONCLUSIONS: Repeated concussion is associated with reliable decrements in cognitive performance--even after a
three month window for recent recovery.
Publication Type
Journal Article.
Result <42>
Unique Identifier
15926710
Status
MEDLINE
Authors
Broshek DK. Kaushik T. Freeman JR. Erlanger D. Webbe F. Barth JT.
Authors Full Name
Broshek, Donna K. Kaushik, Tanya. Freeman, Jason R. Erlanger, David. Webbe, Frank. Barth, Jeffrey T.
Institution
Department of Psychiatric Medicine, University of Virginia Health System, Charlottesville, Virginia 22908-0203, USA.
broshek@virginia.edu
Title
Sex differences in outcome following sports-related concussion.
Source
Journal of Neurosurgery. 102(5):856-63, 2005 May.
Abstract
OBJECT: Females comprise an increasing percentage of the athlete population across all age groups, and analysis of recent
literature reveals that they sustain more concussions in collegiate sports. Results of human and animal studies indicate that females
may have poorer outcomes after traumatic brain injury; however, no return-to-play guideline takes sex or other individual
differences into account. In the present study the authors evaluated the influence of patient sex on objective neurocognitive
performance and subjective reporting of symptoms following sports-related concussion. METHODS: According to preseason baseline
neurocognitive computerized testing in 2340 male and female high school and collegiate athletes, individuals who sustained sportsrelated concussions (155 persons) were reevaluated using an alternate form of the cognitive test. Sex differences in the magnitude
of cognitive change from baseline levels and the subjective experience of symptoms were analyze!
d. To account for the possible protective effects of helmets, comparisons were performed among females, males with helmets, and
males without helmets; none of the female athletes wore helmets. Female athletes had significantly greater declines in simple and
complex reaction times relative to preseason baseline levels, and they reported more postconcussion symptoms compared with
males. As a group, females were cognitively impaired approximately 1.7 times more frequently than males following concussions.
Furthermore, females experienced more objective and subjective adverse effects from concussion even after adjusting for the use
of helmets by some groups of male athletes (for example, in football). CONCLUSIONS: Return-to-play decisions and concussion
management must be objective and made on an individual basis, including consideration of factors such as patient sex rather than
relying on a one-size-fits-all guideline.
Publication Type
Comparative Study. Journal Article. Research Support, Non-U.S. Gov't. Research Support, U.S. Gov't, Non-P.H.S.. Research
Support, U.S. Gov't, P.H.S..
Result <43>
Unique Identifier
18227110
Status
MEDLINE
Authors
Ganesalingam K. Yeates KO. Ginn MS. Taylor HG. Dietrich A. Nuss K. Wright M.
Authors Full Name
Ganesalingam, Kalaichelvi. Yeates, Keith Owen. Ginn, Melissa Susan. Taylor, H Gerry. Dietrich, Ann. Nuss, Kathy. Wright,
Martha.
Institution
The Research Institute at Nationwide Children's Hospital, Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio
43205, USA. Kalaichelvi.Ganesalingam@nationwidechildrens.org
Title
Family burden and parental distress following mild traumatic brain injury in children and its relationship to post-concussive
symptoms.
Source
Journal of Pediatric Psychology. 33(6):621-9, 2008 Jul.
Abstract
OBJECTIVE: To examine the relationship of mild traumatic brain injuries (TBI) and post-concussive symptoms (PCS) to post injury
family burden and parental distress, using data from a prospective, longitudinal study. METHODS: Participants included 71 children
with mild TBI with loss of consciousness (LOC), 110 with mild TBI without LOC, and 97 controls with orthopedic injuries not
involving the head (OI), and their parents. Shortly after injury, parents and children completed a PCS interview and questionnaire,
and parents rated premorbid family functioning. Parents also rated family burden and parental distress shortly after injury and at 3
months post injury. RESULTS: Mild TBI with LOC was associated with greater family burden at 3 months than OI, independent of
socioeconomic status and premorbid family functioning. Higher PCS shortly after injury was related to higher ratings of family
burden and distress at 3 months. CONCLUSIONS: Mild TBI are associated with family burde!
n and distress more than mild injuries not involving the head, although PCS may influence post injury family burden and distress
more than the injury per se. Clinical implications of the current findings are noted in the Discussion section.
Publication Type
Journal Article. Research Support, N.I.H., Extramural.
Result <44>
Unique Identifier
16548083
Status
MEDLINE
Authors
Elgmark Andersson E. Emanuelson I. Olsson M. Stalhammar D. Starmark JE.
Authors Full Name
Elgmark Andersson, Elisabeth. Emanuelson, Ingrid. Olsson, Margareta. Stalhammar, Daniel. Starmark, Jan-Erik.
Institution
Rehabilitation Medicine, From the Institute of Clinical Neuroscience, Goteborg, Sweden. elisabeth.elgmark@hhj.hj.se
Title
The new Swedish Post-Concussion Symptoms questionnaire: a measure of symptoms after mild traumatic brain injury and its
concurrent validity and inter-rater reliability.
Source
Journal of Rehabilitation Medicine. 38(1):26-31, 2006 Jan.
Abstract
OBJECTIVE: To study the concurrent validity and the inter-rater reliability of the Post-Concussion Symptoms Questionnaire.
DESIGN: The approach was to study the concurrent validity of the Post-Concussion Symptoms Questionnaire when used as an
interview questionnaire compared with a self-report questionnaire administered by the patients. The inter-rater reliability was also
studied when 2 different raters administered the Post-Concussion Symptoms Questionnaire interview. PATIENTS: Thirty-five
patients with mild traumatic brain injury were consecutively contacted by telephone and asked whether they would be willing to
participate in a follow-up intervention. METHODS: The Post-Concussion Symptoms Questionnaire was completed by the patients,
who answered "Yes" or "No" to the standardized questions. The patients were then interviewed to check the certain "Yes" or "No"
answers, 0-10 days after having completed the first Post-Concussion Symptoms Questionnaire. The raters filled i!
n their ratings independently. RESULTS: The concurrent validity of answers in the questionnaire compared with those in the
interview ranged from 82% to 100% agreement. The inter-rater reliability results ranged from 93% to 100% agreement between
the raters. CONCLUSION: The Post-Concussion Symptoms Questionnaire with answers of "Yes" or "No" is a valid instrument. High
reliability was found between the raters.
Publication Type
Comparative Study. Journal Article. Research Support, Non-U.S. Gov't.
Result <45>
Unique Identifier
16208863
Status
MEDLINE
Authors
Stalnacke BM. Bjornstig U. Karlsson K. Sojka P.
Authors Full Name
Stalnacke, Britt-Marie. Bjornstig, Ulf. Karlsson, Kurt. Sojka, Peter.
Institution
Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umea University Hospital, Umea, Sweden.
brittmarie.stalnacke@rehabmed.umu.se
Title
One-year follow-up of mild traumatic brain injury: post-concussion symptoms, disabilities and life satisfaction in relation to serum
levels of S-100B and neurone-specific enolase in acute phase.
Source
Journal of Rehabilitation Medicine. 37(5):300-5, 2005 Sep.
Abstract
OBJECTIVE: To investigate, in patients with mild traumatic brain injury, serum concentrations of S-100B and neurone-specific
enolase in acute phase and post-concussion symptoms, disabilities and life satisfaction 1 year after the trauma. DESIGN:
Prospective study. PATIENTS: Eighty-eight patients (age range 18-87 years). METHODS: Blood samples were taken on admission
and about 7 hours later. At follow-up 15 +/- 4 months later, the patients filled in questionnaires about symptoms (Rivermead Post
Concussion Symptoms), disability (Rivermead Head Injury Follow-up) and life satisfaction (LiSat-11). RESULTS: Concentrations of S100B and neurone-specific enolase were regularly increased in the first blood sample. Of the 69 patients participating in the follow-
up, 45% reported post-concussion symptom, 48% exhibited disability and 55% were satisfied with "life as a whole". In comparison
with the "sick-leave" situation on admission to hospital, 3 patients were on sick-leave at the ti!
me of follow-up because of the head trauma. Stepwise forward logistic regression analysis revealed a statistically significant
association (p<0.05) between disability and S-100B and dizziness. CONCLUSION: In spite of frequent persistent symptoms,
disabilities and low levels of life satisfaction, the sick-leave frequency was low at follow-up. The association between S-100B and
disability supports the notion that long-term consequences of a mild brain injury may partly be a result of brain tissue injury.
Publication Type
Journal Article. Research Support, Non-U.S. Gov't.
Result <46>
Unique Identifier
15998982
Status
MEDLINE
Authors
Necajauskaite O. Endziniene M. Jureniene K.
Authors Full Name
Necajauskaite, Olga. Endziniene, Milda. Jureniene, Kristina.
Institution
Center of Children Surgery, Vilnius University Children's Hospital, Santariskiu 7, 08406 Vilnius, Lithuania. olgutene@takas.lt
Title
The prevalence, course and clinical features of post-concussion syndrome in children.
Source
Medicina (Kaunas, Lithuania). 41(6):457-64, 2005.
Abstract
OBJECTIVE: To investigate the clinical features and the prevalence of symptoms of post-concussion syndrome in children with mild
traumatic brain injury, and to evaluate their changes over time. MATERIAL AND METHODS: The research involved two groups of 416 year-old children: the case group of 301 children who had experienced a single mild traumatic brain injury, and the control
group of 301 children who had sustained any other mild body injury without head trauma. Groups were matched according to
gender, age, and the date of admission to hospital. In total, 102 matched pairs were analyzed. The period between the date of the
trauma and the examination was one to five years (median-27 months). Standardized questionnaires were sent by post to parents
from both groups. Parents were asked about the health state as well as symptoms of post-concussion syndrome, their character
and frequency. The respondents were inquired about the presence of the symptoms prior to the trauma, sho!
rtly after the trauma, and during the last year and the last month before the inquiry. RESULTS: The prevalence of headache,
irritability, fears, sleep disorders, learning difficulties, as well as concentration and memory problems did not differ significantly
between children with mild traumatic brain injury and the control group when the results of the last year before examination and
the last month before the examination were compared. We have investigated how the period of time between the date of the
trauma and the date when the questionnaire was filled in influenced the results. The comparison of the questionnaires that were
filled a year (but less than two years) after the trauma to those that were filled in 2-5 years after the trauma revealed significant
differences in the prevalence of a number of symptoms of the post-concussion syndrome. In children with mild traumatic brain
injury, there was a significant decrease in the prevalence of learning difficulties soon aft!
er the trauma (p=0.032), headaches before (p=0.026) and soon after the
trauma (p=0.01), and irritability the last month before the examination (p=0.043). In children from the control group, there was a
significant decrease in the prevalence of concentration problems the last year before examination (p=0.023) and the last month
before examination (p=0.036). CONCLUSIONS: More than one year after the trauma, the prevalence of the symptoms of the postconcussion syndrome is not significant higher in children with mild traumatic brain injury, compared to children with other mild body
injuries, and is comparable by the changes over time.
Publication Type
Comparative Study. Journal Article. Research Support, Non-U.S. Gov't.
Result <47>
Unique Identifier
16394950
Status
MEDLINE
Authors
Piland SG. Motl RW. Guskiewicz KM. McCrea M. Ferrara MS.
Authors Full Name
Piland, Scott G. Motl, Robert W. Guskiewicz, Kevin M. McCrea, Michael. Ferrara, Michael S.
Institution
School of Human Performance and Recreation, University of Southern Mississippi, Hattiesburg, MS 39406-0001, USA.
scott.piland@usm.edu
Title
Structural validity of a self-report concussion-related symptom scale.
Source
Medicine & Science in Sports & Exercise. 38(1):27-32, 2006 Jan.
Abstract
PURPOSE: This study evaluated the factorial validity of a self-report measure of concussion-related symptom severity among a
large sample of male, high-school athletes. METHODS: Participants (N = 1089) were nonconcussed, male, high-school football
players. All participants completed a single baseline self-report measure of concussion-related symptom severity, namely the graded
symptom checklist (GSC). We tested the factorial validity of the measure with confirmatory factor analysis using LISREL 8.50.
RESULTS: The analysis indicated that a theoretically derived, three-factor model provided a good, but not excellent, fit for the 16item GSC. Excellent model-data fit was demonstrated for the three-factor model for a 9-item version of the GSC. In both instances,
the three factors were best described by a single second-order factor, namely concussion symptomatology. CONCLUSIONS: This
study provides additional evidence for the factorial validity of a summative self-reported meas!
ure of concussion-related symptoms. The factor structure represents a cohesive group of nine symptoms that can be explained by
three underlying latent variables, namely somatic symptoms, neurobehavioral symptoms, and "cognitive" symptoms, subsumed
under a single higher-order factor, namely concussion symptoms.
Publication Type
Journal Article. Validation Studies.
Result <48>
Unique Identifier
17917173
Status
MEDLINE
Authors
Rees RJ. Bellon ML.
Authors Full Name
Rees, Roger J. Bellon, Michelle L.
Institution
Disability Studies, School of Medicine, Flinders University, Adelaide, Australia. rees1@iinet.net.au
Title
Post concussion syndrome ebb and flow: longitudinal effects and management.
Source
Neurorehabilitation. 22(3):229-42, 2007.
Abstract
This research identified persistent post concussion symptoms (PCS) in a group of 20 adult subjects. PCS generally lasted for two
years with a mean of 3.35 years. Typical symptoms included physical and cognitive fatigue, depressive behaviors, sensitivity to
noise, social withdrawal, irritability, concentration and problem solving difficulties, loss of libido and much difficulty making decisions
at even the simplest strategic level. They represented a hard core group for whom the original symptoms persisted well beyond the
6~month period. Participants identified their PCS according to sensory, somatic affective and cognitive items immediately following
their trauma (01) and two years later (02). Counseling and psychotherapy intervention took place between 01 and 02. Items on the
PCS schedules and the Beck Depression Inventory (II) demonstrated significant decline in the presence of overall symptoms most
noticeably in reduction of agitation, irritability and suicidal wishes. !
However, subjects throughout generally experienced the feeling that they were being punished which equated with behaviors
comparable with learned helplessness. The PCS group considered themselves to be different people after trauma. They had
different goals, changing lifestyle, relationships and employment and were more often in a dependent state. Comparability with
other conditions such as PTSD and chronic fatigue syndrome (CFS) was demonstrated by individuals who experienced persistent
and invasive post concussion symptoms.
Publication Type
Journal Article.
Result <49>
Unique Identifier
17917171
Status
MEDLINE
Authors
Fazio VC. Lovell MR. Pardini JE. Collins MW.
Authors Full Name
Fazio, Vanessa C. Lovell, Mark R. Pardini, Jamie E. Collins, Michael W.
Institution
University of Pittsburgh Medical Center, Department of Orthopaedics, Pittsburgh, PA, USA.
Title
The relation between post concussion symptoms and neurocognitive performance in concussed athletes.
Source
Neurorehabilitation. 22(3):207-16, 2007.
Abstract
The objective of this study was to examine differences in neurocognitive performance between symptomatic concussed athletes, a
group of concussed athletes with no subjective symptoms, and a non-concussed control group of athletes. All concussed athletes
were evaluated within one week of injury using the ImPACT computerized test battery. Results indicate that concussed athletes who
denied subjective symptoms demonstrated poorer performance than control subjects on all four composite scores of the ImPACT
test batters (Verbal Memory, Visual Memory, Reaction Time and Processing Speed However, the concussed but asymptomatic group
demonstrated significantly better performance than did the concussed and symptomatic group. Thus, concussed athletes who did
not report subjective symptoms were not fully recovered based on neurocognitive testing. This study underscores the importance of
neurocognitive testing in the assessment of concussion sequelae and recovery.
Publication Type
Journal Article.
Result <50>
Unique Identifier
17917169
Status
MEDLINE
Authors
Kozlowski KF. Leddy JJ. Tomita M. Bergen A. Willer BS.
Authors Full Name
Kozlowski, Karl F. Leddy, John J. Tomita, Machiko. Bergen, Anne. Willer, Barry S.
Institution
Department of Exercise and Nutrition Sciences - Program in Athletic Training, State University of New York at Buffalo, Buffalo, NY,
USA. kfk@buffalo.edu
Title
Use of the ICECI and ICD-10 E-Coding structures to evaluate causes of head injury and concussion from sport and recreation
participation in a school population.
Source
Neurorehabilitation. 22(3):191-8, 2007.
Abstract
The purpose of this study was to identify the most common causes of head injury and associated symptoms of concussion in a
population of school children (n=1,372,979). Using standardized injury report forms, we identified the mechanisms of head injury
associated with various sports/recreation activities and assessed each injury for the presence of concussion symptoms. Head injury
reports (n=7,765) were coded using the WHO's ICECI and ICD-10 E-codes. 1,338 Cases reported symptoms of concussion. The
majority of head injuries occurred during School Free-Play/Recess (59.8%). Combative Sports and Wheeled Non-Motored Sports
were the activities most often associated with concussion symptoms (rate of concussion (RC): 48.3% and 44.4%, respectively,
p<0.001). School Free-Play/Recess and Physical Education Classes were significantly less likely to have head injuries associated with
concussion (RC: 16.0%, p<0.001, and 12.4%, p=0.034, respectively). The most common causes of head injur!
y were (1) Struck by an Object (24.9%) and (2) Falling on the Same Level (22.8%). Falling from a Transport was the only
etiological code significantly associated with concussion symptoms after head injury (RC: 28.7%, p<.001). Results were similar
when using the two coding structures in combination. Prevention efforts should focus on activities where children are moving at
high speeds since these are more likely to cause a concussion when a head injury occurs.
Publication Type
Journal Article.
Result <51>
Unique Identifier
17917167
Status
MEDLINE
Authors
Brooks DA.
Authors Full Name
Brooks, David A.
Institution
Performance Athletics Sportsmedicine Clinic, Summerland, BC V0H 1Z0, Canada. drdaveb@shaw.ca
Title
Use of computer based testing of youth hockey players with concussions. [Review] [47 refs]
Source
Neurorehabilitation. 22(3):169-79, 2007.
Abstract
Concussion is a potentially serious injury for athletes. Recent statistics suggest that approximately 300,000 sports-related
traumatic brain injuries occur annually in the United States. Soccer, rugby, football, and ice hockey are all considered high-risk team
sports for concussion. Hockey-related concussions are of particular concern in Canada, where over 500,000 players compete
annually in ice hockey. The United States is now registering similar numbers of players. Return to play issues are one of the most
difficult issues for physicians caring for concussed athletes. The advent of computerized neuropsychological testing adds another
tool to assist in this process. It also appears to enhance the education process for players, coaches, and parents on the potential
seriousness of concussion for these young athletes. [References: 47]
Publication Type
Case Reports. Journal Article. Review.
Result <52>
Unique Identifier
18162903
Status
MEDLINE
Authors
McCaffrey MA. Mihalik JP. Crowell DH. Shields EW. Guskiewicz KM.
Authors Full Name
McCaffrey, Meghan A. Mihalik, Jason P. Crowell, Dean H. Shields, Edgar W. Guskiewicz, Kevin M.
Institution
Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, North Carolina, USA.
Title
Measurement of head impacts in collegiate football players: clinical measures of concussion after high- and low-magnitude
impacts.
Source
Neurosurgery. 61(6):1236-43; discussion 1243, 2007 Dec.
Abstract
OBJECTIVE: It has been speculated that a theoretical injury threshold of 70 to 75 g may exist for concussions in football players.
We aimed to investigate acute balance and neurocognitive performance after head impacts exceeding a theoretical injury threshold
in the absence of both self-reported symptoms and a concussion diagnosis 24 hours before testing. METHODS: Forty-three Division
I collegiate football players participated in this double-blind, repeated-measures study. Subjects participated in three test sessions
(baseline, low impact, and high impact) separated by at least 2 weeks. The Head Impact Telemetry System (Simbex, Lebanon, NH)
recorded real-time head impacts sustained during practices and games. The Automated Neuropsychological Assessment Metrics
assessed neurocognitive performance. The NeuroCom Sensory Organization Test (NeuroCom International Inc., Clackamas, OR)
assessed postural stability. The Graded Symptom Checklist evaluated symptom presence and severi!
ty in our participants. RESULTS: After the low-impact test session (<60 g), we observed improvements in the Math Processing
(F(1, 26) = 9.797; P = 0.004), Matching to Sample (F(1, 26) = 6.504; P = 0.017), and Sternberg Procedure (F(1, 26) = 5.323; P =
0.030) Automated Neuropsychological Assessment Metrics test modules. Statistically significant differences were also observed after
the high-impact test session (>90 g) with improvements in Math Processing (F(1, 22) = 16.629; P < 0.001), Procedural Reaction
Time (F(1, 22) = 14.668; P < 0.001), and the total number of symptoms reported (F(1, 22) = 10.267; P = 0.004). Neurocognitive
improvements were likely attributed to a learning effect. CONCLUSION: Our findings suggest that sustaining an impact greater than
90 g does not result in acute observable balance and neurocognitive deficits within 24 hours of sustaining the impact. Although
previous studies have suggested a theoretical injury threshold, none have been founded on empi!
rical data collected on the playing field in real-time. Future studies
should consider the cumulative effects of impacts of varying magnitudes.
Publication Type
Journal Article. Research Support, U.S. Gov't, P.H.S..
Result <53>
Unique Identifier
17762746
Status
MEDLINE
Authors
Slobounov S. Slobounov E. Sebastianelli W. Cao C. Newell K.
Authors Full Name
Slobounov, Semyon. Slobounov, Elena. Sebastianelli, Wayne. Cao, Cheng. Newell, Karl.
Institution
Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania 16802, USA. sms18@psu.edu
Title
Differential rate of recovery in athletes after first and second concussion episodes.
Source
Neurosurgery. 61(2):338-44; discussion 344, 2007 Aug.
Abstract
OBJECTIVE: Clinical observations suggest that a history of previous concussions may cause a slower recovery of neurological
function after recurrent concussion episodes. However, direct examination of this notion has not been provided. This report
investigates the differential rate of restoring the visual-kinesthetic integration in collegiate athletes experiencing single versus
recurrent concussion episodes. METHODS: One hundred sixty collegiate athletes were tested preseason using multimodal research
methodology. Of these, 38 experienced mild traumatic brain injury (MTBI) and were tested on Days 10, 15, and 30 after injury.
Nine of these MTBI patients experienced a second MTBI within 1 year after the first brain injury and were retested. The
postconcussion symptoms checklist, neuropsychological evaluations, and postural responses to visual field motion were recorded
using a virtual reality environment. RESULTS: All patients were asymptomatic at Day 10 of testing and were !
cleared for sport participation based on clinical symptoms resolution. Balance deficits, as evident by incoherence with visual field
motion postural responses, were present at least 30 days after injury (P < 0.001). Most importantly, the rate of balance symptoms
restoration was significantly reduced after a recurrent, second concussion (P < 0.001) compared with those after the first
concussion. CONCLUSION: The findings of this study confirm our previous research indicating the presence of long-term residual
visual-motor disintegration in concussed individuals with normal neuropsychological measures. Most importantly, athletes with a
history of previous concussion demonstrate significantly slower rates of recovery of neurological functions after the second episode
of MTBI.
Publication Type
Journal Article.
Result <54>
Unique Identifier
16462481
Status
MEDLINE
Authors
Collins M. Lovell MR. Iverson GL. Ide T. Maroon J.
Authors Full Name
Collins, Micky. Lovell, Mark R. Iverson, Grant L. Ide, Thad. Maroon, Joseph.
Institution
University of Pittsburgh Medical Center Sports Concussion Program, Department of Orthopaedic Surgery/University of Pittsburgh
Medical Center for Sports Medicine, Pennsylvania 15206, USA. collinsmw@upmc.edu
Title
Examining concussion rates and return to play in high school football players wearing newer helmet technology: a three-year
prospective cohort study.
Source
Neurosurgery. 58(2):275-86; discussion 275-86, 2006 Feb.
Abstract
OBJECTIVE: The purpose of this study was to compare concussion rates and recovery times for athletes wearing newer helmet
technology compared to traditional helmet design. METHODS: This was a three-year, prospective, naturalistic, cohort study.
Participants were 2,141 high school athletes from Western Pennsylvania. Approximately half of the sample wore the Revolution
helmet manufactured by Riddell, Inc. (n = 1,173) and the remainder of the sample used standard helmets (n = 968). Athletes
underwent computerized neurocognitive testing through the use of ImPACT at the beginning of the study. Following a concussion,
players were reevaluated at various time intervals until recovery was complete. RESULTS: In the total sample, the concussion rate
in athletes wearing the Revolution was 5.3% and in athletes wearing standard helmets was 7.6% [chi (1, 2, 141) = 4.96, P <
0.027]. The relative risk estimate was 0.69 (95% confidence interval = 0.499- 0.958). Wearing the Revolution helme!
t was associated with approximately a 31% decreased relative risk and 2.3% decreased absolute risk for sustaining a concussion in
this cohort study. The athletes wearing the Revolution did not differ from athletes wearing standard helmets on the mechanism of
injury (e.g., head-to-head strike), on-field concussion markers (e.g., amnesia or loss of consciousness), or on-field presentation of
symptoms (e.g., headaches, dizziness, or balance problems). CONCLUSION: Recent sophisticated laboratory research has better
elucidated injury biomechanics associated with concussion in professional football players. This data has led to changes in helmet
design and new helmet technology, which appears to have beneficial effects in reducing the incidence of cerebral concussion in high
school football players.
Publication Type
Comparative Study. Journal Article. Research Support, Non-U.S. Gov't.
Result <55>
Unique Identifier
16094159
Status
MEDLINE
Authors
Moser RS. Schatz P. Jordan BD.
Authors Full Name
Moser, Rosemarie Scolaro. Schatz, Philip. Jordan, Barry D.
Institution
RSM Psychology Center, LLC, Lawrenceville, New Jersey 08648, USA. r.moser@rcn.com
Title
Prolonged effects of concussion in high school athletes.
Source
Neurosurgery. 57(2):300-6; discussion 300-6, 2005 Aug.
Abstract
OBJECTIVE: To identify enduring prolonged neuropsychological effects of cerebral concussion in high school youth athletes.
METHODS: High school athletes (n = 223) underwent baseline neuropsychological evaluation between 1999 and 2000, assigned to
independent groups on the basis of concussion history: athletes with no concussion history or present medical and/or
neuropsychological complaints (n = 82), symptom-free athletes who experienced one (n = 56) or two or more (n = 45) concussions
(not in the prior 6 mo), and those who experienced a concussion 1 week before testing (n = 40). Main outcome measures included
a structured clinical interview, demographic form, symptom checklist, the Repeatable Battery for the Assessment of
Neuropsychological Status, and the Trail Making Tests A and B. Analyses of variance were used to determine between-group
differences. RESULTS: Athletes with recent concussions performed significantly worse on measures of attention and concentration
than !
youth athletes with no concussion history. Symptom-free athletes with a history of two or more concussions performed similar on
testing to youth athletes who had just experienced a recent concussion. Similarly, cumulative academic grade point averages were
significantly lower not only for youth athletes with two or more previous concussion groups, but for youth athletes who experienced
recent concussions, suggesting that athletes with lower grade point averages may be more prone to concussion. CONCLUSION:
There seem to be subtle yet significant prolonged neuropsychological effects in youth athletes with a history of two or more
previous concussions.
Publication Type
Comparative Study. Evaluation Studies. Journal Article.
Result <56>
Unique Identifier
16647998
Status
MEDLINE
Authors
Gordon KE. Dooley JM. Wood EP.
Authors Full Name
Gordon, Kevin E. Dooley, Joseph M. Wood, Ellen P.
Institution
Division of Pediatric Neurology, Department of Pediatrics, Dalhousie University, and IWK Health Centre, Halifax, Nova Scotia,
Canada. KEGOR@DAL.CA
Title
Descriptive epidemiology of concussion.
Source
Pediatric Neurology. 34(5):376-8, 2006 May.
Abstract
To describe the epidemiology of reported concussion derived from a large, nationally representative health survey, the microdata
files of the Canadian National Population Health Survey (1996-1997) were analyzed. Respondents reported whether they had "any
injuries that were serious enough to limit their normal activities" in the preceding 12 months and the nature of the most serious
injury. A total of 99.8% of 81,804 eligible respondents, representing 28,606,100 Canadians, reported their injury experience within
the preceding year, with 89 reporting a concussion. The annual prevalence of Canadians reporting a concussion as their most
serious injury was 110 per 100,000 population (95% confidence interval: 80, 140). Those reporting concussion were more likely to
be younger (P < 0.001) and male (P = 0.02). Males were significantly overrepresented in the 16-34 year-old group (P = 0.004).
More than 54% of all concussions were sport-related (95% confidence interval: 39%, 67%), oc!
curring at a place for recreation or sport, with sport having a role in >85% of concussions in the 16-34 year-old group. This study
presents annual prevalence estimates of reported concussion, derived from a sizeable, nationally representative population survey.
Publication Type
Journal Article.
Result <57>
Unique Identifier
18395647
Status
MEDLINE
Authors
Reddy CC. Collins MW. Gioia GA.
Authors Full Name
Reddy, Cara Camiolo. Collins, Michael W. Gioia, Gerald A.
Institution
Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
camioloce1@upmc.edu
Title
Adolescent sports concussion. [Review] [60 refs]
Source
Physical Medicine & Rehabilitation Clinics of North America. 19(2):247-69, viii, 2008 May.
Abstract
Approximately 2 million sports and recreation concussive injuries occur per year in the United States, which may be an
underestimate because of inconsistent data reporting. The field of concussion management has evolved rapidly over the last 10
years, and with these advances comes new understanding of the significant symptomatic and cognitive impairments of concussion.
These sequelae are more fully realized and may last longer than previously thought. Data have emerged regarding pathophysiology
of concussion, risk factors, outcome, effects of repetitive injury, subtypes of concussive injury, and treatment protocols. This
evidence calls for more conservative management of concussion, particularly in younger athletes, and demonstrates the
shortcomings of concussion guidelines. [References: 60]
Publication Type
Journal Article. Review.
Result <58>
Unique Identifier
16048453
Status
MEDLINE
Authors
Kumar S. Rao SL. Nair RG. Pillai S. Chandramouli BA. Subbakrishna DK.
Authors Full Name
Kumar, Sanjay. Rao, Shobini L. Nair, Ragesh G. Pillai, Shibu. Chandramouli, Bangalore A. Subbakrishna, Dodbalapur K.
Institution
Department of Clinical Psychology, Division of Neuropsychology, National Institute of Mental Health and Neurosciences, Bangalore,
India.
Title
Sensory gating impairment in development of post-concussive symptoms in mild head injury.
Source
Psychiatry & Clinical Neurosciences. 59(4):466-72, 2005 Aug.
Abstract
Post-concussive symptoms reported by mild head injury (MHI) patients have been inadequately understood. Post-concussive
symptoms reported by patients with MHI have so far been explained in terms of impairment in neurocognitive functions or deficits
in modulation of flow of information. There are no studies that have looked into sensory gating impairment in MHI and its relation
to post-concussive symptoms. The purpose of the present paper was to investigate the role of sensory gating impairment in postconcussive symptoms in mild head injury patients. Thirty MHI patients were evaluated for their neuropsychological functions,
sensory gating deficits, and post-concussive symptoms. Neuropsychological functions were in the domain of attention, executive
functions, and learning and memory. Sensory gating was assessed by Structured Interview for Assessing Perceptual Anomalies and
post-concussive symptoms were assessed using the Neurobehavioral Rating Scale. Multiple regression me!
thod was used to identify predictors for post-concussive symptoms. Post-concussive symptoms were predicted by sensory gating
deficits when sensory gating deficit was one of the predictors along with neuropsychological functions. Post-concussive symptoms
were predicted by scores of Digit Vigilance and Digit Symbol Substitution Test, when predictors were restricted to
neuropsychological functions. Sensory gating deficits were correlated with performance on Digit Symbol Substitution test. Postconcussive symptoms reported by MHI patients are the result of poor modulation of incoming sensory information.
Publication Type
Journal Article.