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Do Sideline Concussion Assessments Predict Subsequent Neurocognitive Impairment After Sport-Related Concussion?

Do Sideline Concussion Assessments Predict Subsequent Neurocognitive Impairment After Sport-Related Concussion?

J Athl Train. 2017 May 23;:

Authors: Sufrinko A, McAllister-Deitrick J, Womble M, Kontos A

Abstract
CONTEXT:   Comprehensive, multi-domain assessment is the standard of care after sport-related concussion. However, the relationship between performance on sideline concussion-assessment tools and in-office computerized neurocognitive testing has received little attention, and the prognostic utility of sideline measures is unknown.
OBJECTIVE:   To evaluate concurrent impairment on commonly used concussion measures 24 to 48 hours postinjury while also determining the predictive utility of sideline measures on computerized neurocognitive testing in the acute to subacute recovery periods postinjury.
DESIGN:   Case-control study.
SETTING:   High school and collegiate athletics.
PATIENTS OR OTHER PARTICIPANTS:   A total of 125 high school and college-aged athletes (85 males, 40 females) 14 to 23 (16.8 ± 2.21) years old.
MAIN OUTCOME MEASURE(S):   Participants were administered sideline concussion-assessment measures (ie, Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT], Standardized Assessment of Concussion [SAC], and Balance Error Scoring System [BESS]) 24 to 48 hours postinjury and completed ImPACT and the Post-Concussion Symptom Scale 5 to 7 and 10 to 14 days postinjury. Outcome measures were the ImPACT composite (verbal memory, visual memory, reaction time, visual-motor speed), SAC, and BESS scores and total symptom score on the Post-Concussion Symptom Scale.
RESULTS:   Participants demonstrated heterogeneous patterns of impairment on measures 24 to 48 hours postinjury, with the most common pattern being impairment on ImPACT and the SAC. Performance on the SAC and BESS at 24 to 48 hours after injury did not distinguish between those with and those without impairment on ImPACT at 5 to 7 days postinjury (χ(2) = 5.076, P = .079) or 10 to 14 days postinjury (χ(2) = 2.04, P = .361).
CONCLUSIONS:   More than 90% of athletes were impaired on at least 1 sideline or neurocognitive measure 24 to 48 hours after sport-related concussion. Although sideline measures are useful for concussion diagnosis, they are not suitable for prognostication of impairment or the presence of symptoms 1 to 2 weeks postinjury.

PMID: 28535099 [PubMed - as supplied by publisher]




Ball-Contact Injuries in 11 National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2009-2010 Through 2014-2015.

Ball-Contact Injuries in 11 National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2009-2010 Through 2014-2015.

J Athl Train. 2017 May 23;:

Authors: Fraser MA, Grooms DR, Guskiewicz KM, Kerr ZY

Abstract
CONTEXT:   Surveillance data regarding injuries caused by ball contact in collegiate athletes have not been well examined and are mostly limited to discussions of concussions and catastrophic injuries.
OBJECTIVE:   To describe the epidemiology of ball-contact injuries in 11 National Collegiate Athletic Association (NCAA) sports during the 2009-2010 through 2014-2015 academic years.
DESIGN:   Descriptive epidemiology study.
SETTING:   Convenience sample of NCAA programs in 11 sports (men's football, women's field hockey, women's volleyball, men's baseball, women's softball, men's and women's basketball, men's and women's lacrosse, and men's and women's soccer) during the 2009-2010 through 2014-2015 academic years.
PATIENTS OR OTHER PARTICIPANTS:   Collegiate student-athletes participating in 11 sports.
MAIN OUTCOME MEASURE(S):   Ball-contact injury rates, proportions, rate ratios, and proportion ratios with 95% confidence intervals were based on data from the NCAA Injury Surveillance Program during the 2009-2010 through 2014-2015 academic years.
RESULTS:   During the 2009-2010 through 2014-2015 academic years, 1123 ball-contact injuries were reported, for an overall rate of 3.54/10 000 AEs. The sports with the highest rates were women's softball (8.82/10 000 AEs), women's field hockey (7.71/10 000 AEs), and men's baseball (7.20/10 000 AEs). Most ball-contact injuries were to the hand/wrist (32.7%) and head/face (27.0%) and were diagnosed as contusions (30.5%), sprains (23.1%), and concussions (16.1%). Among sex-comparable sports (ie, baseball/softball, basketball, and soccer), women had a larger proportion of ball-contact injuries diagnosed as concussions than men (injury proportion ratio = 2.33; 95% confidence interval = 1.63, 3.33). More than half (51.0%) of ball-contact injuries were nontime loss (ie, participation-restriction time <24 hours), and 6.6% were severe (ie, participation-restriction time ≥21 days). The most common severe ball-contact injuries were concussions (n = 18) and finger fractures (n = 10).
CONCLUSION:   Ball-contact injury rates were the highest in women's softball, women's field hockey, and men's baseball. Although more than half were non-time-loss injuries, severe injuries such as concussions and fractures were reported.

PMID: 28535098 [PubMed - as supplied by publisher]




Comparative Effectiveness of Plantar-Massage Techniques on Postural Control in Those With Chronic Ankle Instability.

Comparative Effectiveness of Plantar-Massage Techniques on Postural Control in Those With Chronic Ankle Instability.

J Athl Train. 2017 May 23;:

Authors: Wikstrom EA, Song K, Lea A, Brown N

Abstract
CONTEXT:   One of the major concerns after an acute lateral ankle sprain is the potential for development of chronic ankle instability (CAI). The existing research has determined that clinician-delivered plantar massage improves postural control in those with CAI. However, the effectiveness of self-administered treatments and the underlying cause of any improvements remain unclear.
OBJECTIVES:   To determine (1) the effectiveness of a self-administered plantar-massage treatment in those with CAI as well and (2) whether the postural-control improvements were due to the stimulation of the plantar cutaneous receptors.
DESIGN:   Crossover study.
SETTING:   University setting.
PATIENTS OR OTHER PARTICIPANTS:   A total of 20 physically active individuals (6 men and 14 women) with self-reported CAI.
INTERVENTION(S):   All participants completed 3 test sessions involving 3 treatments: a clinician-delivered manual plantar massage, a patient-delivered self-massage with a ball, and a clinician-delivered sensory brush massage.
MAIN OUTCOME MEASURE(S):   Postural control was assessed using single-legged balance with eyes open and the Star Excursion Balance Test.
RESULTS:   Static postural control improved (P ≤ .014) after each of the interventions. However, no changes in dynamic postural control after any of the interventions were observed (P > .05). No differences were observed between a clinician-delivered manual plantar massage and either a patient-delivered self-massage with a ball or a clinician-delivered sensory brush massage in any postural-control outcome.
CONCLUSIONS:   In those with CAI, single 5-minute sessions of traditional plantar massage, self-administered massage, and sensory brush massage each resulted in comparable static postural-control improvements. The results also provide empirical evidence suggesting that the mechanism for the postural-control improvements is the stimulation of the plantar cutaneous receptors.

PMID: 28535097 [PubMed - as supplied by publisher]




Mandated High School Concussion Education and Collegiate Athletes' Understanding of Concussion.

Mandated High School Concussion Education and Collegiate Athletes' Understanding of Concussion.

J Athl Train. 2017 May 23;:

Authors: Carroll-Alfano M

Abstract
CONTEXT:   Concussions in student-athletes are a serious problem. Most states have enacted legislation mandating concussion education for student-athletes, under the assumption that education leads to better self-reporting of concussions and improved knowledge of symptoms.
OBJECTIVE:   (1) To determine the effect of state-based concussion legislation on the proportion of student-athletes receiving concussion education and to assess the moderation of this effect by gender and sport and (2) to assess the effect of concussion education on student-athletes' knowledge of concussion symptoms and likelihood of seeking treatment after a concussion.
DESIGN:   Cross-sectional study.
SETTING:   Private university.
PATIENTS OR OTHER PARTICIPANTS:   A total of 249 National Association of Intercollegiate Athletics collegiate athletes attending St Xavier University; 160 were surveyed prelegislation and 89 were surveyed postlegislation.
MAIN OUTCOME MEASURE(S):   Participants completed an anonymous survey that assessed previous involvement in concussion-education programs, degree of self-reporting after a concussion, and ability to enumerate symptoms.
RESULTS:   The number of athletes who reported having received education increased after the implementation of concussion legislation; however, almost 25% still reported not having received education. Athletes who played football were more likely to report having received education than those who played volleyball. The student-athletes' ability to name a diversity of concussion symptoms or to report seeking medical attention after a concussion did not improve in the postlegislation period relative to the prelegislation period.
CONCLUSIONS:   Legislation has been passed in all 50 states to address concussions in student-athletes; however, improvements are still needed. Concussion education must be delivered in a uniform, effective manner to all student-athletes across sports and genders. Concussion education should emphasize the diversity of symptoms, especially cognitive and behavioral symptoms. We must develop and disseminate evidence-based educational programs that are clinically proven to be effective in improving athletes' knowledge and behaviors.

PMID: 28535096 [PubMed - as supplied by publisher]




Journal Update: 2017.

Journal Update: 2017.

J Athl Train. 2017 May;52(5):410

Authors: Denegar CR

PMID: 28535090 [PubMed - in process]




2016 Outstanding Manuscript Awards.

2016 Outstanding Manuscript Awards.

J Athl Train. 2017 May;52(5):409

Authors:

Abstract
Congratulations to the winners of the 2016 Outstanding Manuscript Awards, as determined by the Editorial Board and the Editors of the Journal of Athletic Training.

PMID: 28535089 [PubMed - in process]