Concussion and the College Athlete

2015 ◽  
Author(s):  
Paul Comper ◽  
Mike Hutchison
Keyword(s):  
Recovery Process ◽  
Return To Play ◽  
Professional Athletes ◽  
College Level ◽  
Central Theme ◽  
College Athlete ◽  
University Level ◽  
Psychosocial Challenges ◽  
Concussion Recovery ◽  
Serious Injury

Concussion is a common and serious injury among college/university level athletes. Similar to professional athletes, a central theme for most college level athletes is to be able to quickly but safely return to play following concussion. However, unlike professional athletes who earn their living playing sports, most college level athletes will move into other careers or professions once their playing career ends. College athletes therefore have a dual role, with academics and “returning to learn” being a component equally important as return to play in the concussion recovery process. This article describes some of the issues in developing and implementing a university concussion program, as well as issues and common difficulties facing college level athletes as they encounter the acute physical, neuropsychological, and psychosocial challenges related to concussive injuries.

scholarly journals Concussion Recovery Phase Affects Vestibular and Oculomotor Symptom Provocation

2017 ◽  
Vol 39 (02) ◽  
pp. 141-147 ◽  
Author(s):  
Kelly Cheever ◽  
Jane McDevitt ◽  
Ryan Tierney ◽  
W. Wright
Keyword(s):  
Recovery Process ◽  
Recovery Phase ◽  
Return To Play ◽  
Initial Assessment ◽  
Valuable Insight ◽  
Gaze Stabilization ◽  
Symptom Provocation ◽  
Acute Group ◽  
Time Requirements ◽  
Concussion Recovery

AbstractVestibular and oculomotor testing is emerging as a valuable assessment in sport-related concussion (SRC). However, their usefulness for tracking recovery and guiding return-to-play decisions remains unclear. Therefore the purpose of this study was to evaluate their clinical usefulness for tracking SRC recovery. Vestibular and oculomotor assessments were used to measure symptom provocation in an acute group (n=21) concussed≤10 days, prolonged symptoms group (n=10) concussed ≥16 days (median=84 days), healthy group (n=58) no concussions in >6 months. Known-groups approach was used with three groups at three time points (initial, 2-week and 6-week follow-up). Provoked symptoms for Gaze-Stabilization (GST), Rapid Eye Horizontal (REH), Optokinetic Stimulation (OKS), Smooth-Pursuit Slow (SPS) and Fast (SPF) tests, total combined symptoms scores and near point convergence (NPC) distance were significantly greater at initial assessment in both injury groups compared to controls. Injury groups improved on the King-Devick test and combined symptom provocation scores across time. The acute group improved over time on REH and SPF tests, while the prolonged symptoms group improved on OKS. A regression model (REH, OKS, GST) was 90% accurate discriminating concussed from healthy. Vestibular and ocular motor tests give valuable insight during recovery. They can prove beneficial in concussion evaluation given the modest equipment, training and time requirements. The current study demonstrates that when combined, vestibular and oculomotor clinical tests aid in the detection of deficits following a SRC. Additionally, tests such as NPC, GST, REH, SPS, SPF OKS and KD provide valuable information to clinicians throughout the recovery process and may aid in return to play decisions.

scholarly journals Teaching strategies to promote imagination and creativity through student choice

2016 ◽  
Vol 8 ◽  
Author(s):  
Darlene A. Smucny ◽  
Courtney Baker ◽  
Monisha Tripathy
Keyword(s):  
Online Courses ◽  
Course Delivery ◽  
Learning Activities ◽  
Student Choice ◽  
College Level ◽  
Learner Engagement ◽  
Engagement Strategies ◽  
Instructional Content ◽  
University Level ◽  
K 12

High-agency learning activities empower students to take more active roles in their own learning, directed by their interests, curiosities, and choices. Educators, particularly K-12, have long asserted that student choice of learning activities encourages a greater degree of personal engagement with instructional content, leading to more confident, interested, imaginative, and creative students (e.g., Kohn, 1993; Ronan, 2015).  However, implementing these strategies at the college level often proves challenging as course instructors merge learner engagement strategies, such as student choice, while still sufficiently addressing course objectives and content. Additionally, creating  supportive classroom environments that promote “open-ended” assignments at times are met with student resistance. This session is designed to provide ideas and tips to instructors wishing to employ student choice to enhance active learning, imagination, and creativity in their courses.  Presenters will share best practices for implementing student choice in learning activities and assignments, primarily using examples from asynchronous and synchronous online courses across various disciplines at George Mason University. We also will encourage participants to reflect on how learning activities and assignments in their own courses might be adapted to include student choice to promote imagination and creativity in university-level learning across course delivery formats.ReferencesKohn, A. (1993). Choices for Children: Why and How to Let Students Decide. The Phi Delta Kappan, 75(1), 8–20. Retrieved from http://www.jstor.org/stable/20405017Ronan, A. (2015, March 20). 7 Ways to Hack Your Classroom to Include Student Choice. Retrieved March 16, 2016, from http://www.edudemic.com/7-ways-to-hack-your-classroom/

Performance-Based Outcomes After Anterior Cruciate Ligament Reconstruction in Professional Athletes Differ Between Sports

2017 ◽  
Vol 45 (10) ◽  
pp. 2226-2232 ◽  
Author(s):  
Harry T. Mai ◽  
Danielle S. Chun ◽  
Andrew D. Schneider ◽  
Brandon J. Erickson ◽  
Ryan D. Freshman ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
National Football League ◽  
Cruciate Ligament ◽  
Survival Rates ◽  
The Other ◽  
Return To Play ◽  
Professional Athletes ◽  
Level Of Evidence ◽  
Performance Statistics ◽  
Anterior Cruciate

Background: Excellent outcomes have been reported for anterior cruciate ligament (ACL) reconstruction (ACLR) in professional athletes in a number of different sports. However, no study has directly compared these outcomes between sports. Purpose: To determine if differences in performance-based outcomes exist after ACLR between professional athletes of each sport. Study Design: Cohort study; Level of evidence, 3. Methods: National Football League (NFL), National Basketball Association (NBA), National Hockey League (NHL), and Major League Baseball (MLB) athletes undergoing primary ACLR for an acute rupture were identified through an established protocol of injury reports and public archives. Sport-specific performance statistics were collected before and after surgery for each athlete. Return to play (RTP) was defined as a successful return to the active roster for at least 1 regular-season game after ACLR. Results: Of 344 professional athletes who met the inclusion criteria, a total of 298 (86.6%) returned to play. NHL players had a significantly higher rate of RTP (95.8% vs 83.4%, respectively; P = .04) and a shorter recovery time (258 ± 110 days vs 367 ± 268 days, respectively; P < .001) than athletes in all the other sports. NFL athletes experienced significantly shorter careers postoperatively than players in all the other sports (2.1 vs 3.2 years, respectively; P < .001). All athletes played fewer games ( P ≤ .02) 1 season postoperatively, while those in the NFL had the lowest rate of active players 2 and 3 seasons postoperatively (60%; P = .002). NBA and NFL players showed decreased performance at season 1 after ACLR ( P ≤ .001). NFL players continued to have lower performance at seasons 2 and 3 ( P = .002), while NBA players recovered to baseline performance. Conclusion: The data indicate that NFL athletes fare the worst after ACLR with the lowest survival rate, shortest postoperative career length, and sustained decreases in performance. NHL athletes fare the best with the highest rates of RTP, highest survival rates, longest postoperative career lengths, and no significant changes in performance. The unique physical demand that each sport requires is likely one of the explanations for these differences in outcomes.

scholarly journals Preliminary Evidence-Based Recommendations for Return to Learn: a novel pilot study tracking concussion recovery in college students

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S33.3-S34
Author(s):  
Zachary Bevilacqua ◽  
Mary Kerby ◽  
David Fletcher ◽  
Zhongxue Chen ◽  
Becca Merritt ◽  
...  
Keyword(s):  
Physical Activity ◽  
Longitudinal Design ◽  
Text Messages ◽  
Return To Play ◽  
Evidence Based ◽  
Full Time ◽  
Symptom Resolution ◽  
Phone Calls ◽  
Return To Learn ◽  
Concussion Recovery

ObjectiveInvestigate the potential factors influencing resolution of chief concussion symptoms in a longitudinal design. Second, assess subjects’ perception of their concussion recovery and what types of activities and accommodations appeared beneficial.BackgroundAthletes re-entering the academic setting after a concussion is commonly referred as return-to-learn (RTL), which has appeared secondary to the abundantly researched return-to-play protocols implemented ubiquitously. Importantly, every concussed collegiate, adolescent, and pediatric athlete is first and foremost a student-athlete, with “student” holding the emphasis. To date, very few studies have examined the RTL aspect of concussion recovery, and the effects premature classroom attendance may cause.Design/MethodsNine concussed, college aged (18-26 years), full-time students were monitored longitudinally throughout their recovery from diagnosis to full symptom-free academic participation. Symptom severity for five prevalent symptoms were recorded 4 times per day, along with a daily phone call to report participant’s diet, duration of screen-time usage and music listened to, physical activity participation, and types of classes attended.ResultsResponse rates to text messages and phone calls yielded a mean 92% and 93% respectively across the nine subjects. Additionally, five variables were significantly associated with symptom resolution (music, sleep, physical activity, water, and time) (p = 0.0004 to p = 0.036). Lastly, subjects reported math and computer-oriented courses as the most difficult (33% and 44% respectively). Additional time on assignments/exams and reducing screen brightness were the most beneficial accommodations (66% and 56% respectively).ConclusionsOur findings introduce a novel and robust approach to monitoring concussed students throughout their recovery. Furthermore, this methodology is the first to produce holistic evidence-based results concerning re-integrating students to the classroom. Lastly, it appears that dietary and social behaviors can indeed influence symptom resolution.

scholarly journals Objective Functional Assessment After a Head Injury Using Movement and Activity in Physical Space Scores: A Case Report

2014 ◽  
Vol 49 (4) ◽  
pp. 568-575 ◽  
Author(s):  
James L. Farnsworth ◽  
Danielle McElhiney ◽  
Shannon David ◽  
Gaurav Sinha ◽  
Brian G. Ragan
Keyword(s):  
Athletic Training ◽  
Objective Measure ◽  
Physical Space ◽  
Recovery Process ◽  
Living Environment ◽  
Return To Play ◽  
Functional Score ◽  
Gps Receiver ◽  
Novel Approach ◽  
Objective Functional

Objective: To describe the potential benefit of using a global positioning system (GPS) and accelerometry as an objective functional-activity measure after concussion by creating Movement and Activity in Physical Space (MAPS) scores. Background: A 21-year-old female soccer player suffered a blow to the back of the head from an opponent's shoulder during an away match. No athletic trainer was present. She played the remainder of the match and reported to the athletic training facility the next day for evaluation. Differential Diagnosis: Concussion. Treatment: The athlete was removed from all athletic activities. Her symptoms were monitored based on the Zurich guidelines. She was also instructed to wear an accelerometer on her hip and to carry an on-person GPS receiver at all times for 10 days. Her total symptom scores for the 4 symptomatic days were 82, 39, 49, and 36. Her mean MAPS functional score for symptomatic days 3 through 5 was 900.9 and for asymptomatic days 6 through 11 was 2734.9. Uniqueness: We monitored the patient's function during the concussion-recovery process using an on-person GPS receiver and accelerometer to calculate personalized MAPS scores. This novel approach to measuring function after injury may provide a useful complementary tool to help with return-to-play decisions. Conclusions: An on-person GPS receiver and accelerometer were used to observe the patient's physical activity in a free-living environment, allowing for an objective measure of function during recovery. Her MAPS scores were low while she was symptomatic and increased as she became asymptomatic. We saw the expected inverse relationship between symptoms and function. In situations where accuracy of reported symptoms may be a concern, this measure may provide a way to verify the validity of, or raise doubts about, self-reported symptoms.

Return-to-Play Outcomes After Microscopic Lumbar Diskectomy in Professional Athletes

2012 ◽  
Vol 40 (11) ◽  
pp. 2530-2535 ◽  
Author(s):  
Robert G. Watkins ◽  
Robert Hanna ◽  
David Chang ◽  
Robert G. Watkins
Keyword(s):  
Primary Outcome ◽  
Case Series ◽  
Return Time ◽  
Return To Play ◽  
Professional Athletes ◽  
Level Of Evidence ◽  
Average Return ◽  
Progressive Return ◽  
Postoperative Time ◽  
Herniated Nucleus Pulposus

Background: It has been shown a microscopic lumbar diskectomy (MLD) is effective in getting professional athletes back to their sport after a herniated nucleus pulposus (HNP). There is a need for more information on the time it takes professional athletes to return after surgery. Purpose: To determine average time for return to play and success in returning to play for professional athletes undergoing MLD. Study Design: Case series; Level of evidence, 4. Methods: Between 1996 and 2010, the senior authors treated 171 professional athletes for lumbar HNP. A retrospective review was performed using patient charts, operative reports, team medical records, and internet search. Eighty-five patients were treated with MLD, and 86 patients were treated nonoperatively. This study focused on the return to play of the operatively treated patients. Primary outcome measures were return rate and average return time, considering only patients whose sport is in season at specific postoperative time points. Results: Of surgically treated patients, 89.3% returned to sport. The average time it took operative patients to return to their sport (return time) was 5.8 months. Progressive return data for surgically treated patients showed the percentage of athletes who returned increased from 50% at 3 months to 72% at 6 months to 77% at 9 months and 84% at 12 months. Conclusion: The chance a player returns to play after MLD is 50% at 3 months, 72% at 6 months, 77% at 9 months, and 84% at 12 months. The overall chance of returning to play at any point is 89%.

Outcomes After Anterior Cervical Discectomy and Fusion in Professional Athletes

Neurosurgery ◽  
2013 ◽  
Vol 73 (1) ◽  
pp. 103-112 ◽  
Author(s):  
Joseph C. Maroon ◽  
Jeffrey W. Bost ◽  
Anthony L. Petraglia ◽  
Darren B. LePere ◽  
John Norwig ◽  
...  
Keyword(s):  
Neurological Examination ◽  
Full Range ◽  
Anterior Cervical Discectomy ◽  
Return To Play ◽  
Professional Athletes ◽  
Adjacent Segment ◽  
Contact Sports ◽  
Cervical Discectomy ◽  
Imaging Results ◽  
Increased Risk

Abstract BACKGROUND: Significant controversy exists regarding when an athlete may return to contact sports after anterior cervical discectomy and fusion (ACDF). Return-to-play (RTP) recommendations are complicated due to a mix of medical factors, social pressures, and limited outcome data. OBJECTIVE: The aim of this study was to characterize our diagnostic and surgical criteria, intervention, postoperative imaging results, and rehabilitation and report RTP decisions and outcomes for professional athletes with cervical spine injuries. METHODS: Fifteen professional athletes who had undergone a 1-level ACDF by a single neurosurgeon were identified after a retrospective chart and radiographic review from 2003 to 2012. Patient records and imaging studies were recorded. RESULTS: Seven of the 15 athletes presented with neurapraxia, 8 with cervical radiculopathy, and 2 with hyperintensity of the spinal cord. Cervical stenosis with effacement of the cerebrospinal fluid signal was noted in 14 subjects. The operative level included C3-4 (4 patients), C4-5 (1 patient), C5-6 (8 patients), and C6-7 (2 patients). All athletes were cleared for RTP after a neurological examination with normal findings, and radiographic criteria for early fusion were confirmed. Thirteen of the 15 players returned to their sport between 2 and 12 months postoperatively (mean, 6 months), with 8 still participating. The RTP duration of the 5 who retired after full participation ranged from 1 to 3 years. All athletes remain asymptomatic for radicular or myelopathic symptoms or signs. CONCLUSION: After a single-level ACDF, an athlete may return to contact sports if there are normal findings on a neurological examination, full range of neck movement, and solid arthrodesis. There may be an increased risk of the development of adjacent segment disease above or below the level of fusion. Cord hyperintensity may not necessarily preclude RTP.

scholarly journals Potential factors influencing recovery from concussion in collegiate student-athletes

2017 ◽  
Vol 1 ◽  
pp. 205970021770708 ◽  
Author(s):  
Kayla P Harvey ◽  
Eric E Hall ◽  
Kirtida Patel ◽  
Kenneth P Barnes ◽  
Caroline J Ketcham
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Student Athletes ◽  
Return To Play ◽  
Hyperactivity Disorder ◽  
Previous Diagnosis ◽  
History Of ◽  
Concussion Recovery ◽  
Potential Factors

Background Factors including sex, previous diagnosis of migraines, previous diagnosis of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder, and a history of concussion may influence the length of recovery from concussion in collegiate student-athletes. Purpose To better understand factors that may influence recovery from concussion in collegiate-student athletes. Methods A total of 91 student-athletes from a Division I NCAA University who sustained concussions from the fall of 2011 to the spring of 2015 were evaluated. They were considered recovered from their concussion when neurocognitive and symptom scores returned to baseline and they were cleared by their physician. Analyses of variance were conducted to determine if potential factors influenced concussion recovery ( p < .0125). Results No significant differences were found for sex (males = 7.4 ± 5.9; females = 8.3 ± 4.8 days; p = 0.417), previous diagnosis of migraines (diagnosis = 8.0 ± 5.7; no diagnosis = 7.8 ± 5.4 days; p = 0.926), or history of concussion (history = 8.3 ± 5.7; no history = 5.6 ± 3.4 days; p = 0.088). However, a significant difference in the length of recovery was found between those with a previous diagnosis of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and those without (diagnosis = 13.3 ± 7.3; no diagnosis = 7.3 ± 4.9 days; p = 0.002). Conclusion Student-athletes with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder show significantly longer recovery from concussions than those without. Further investigation of this and other factors that influence recovery from concussion may help in concussion recovery and return-to-play guidelines that improve student-athlete well-being.

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