scholarly journals On-Field Signs and Symptoms Associated With Recovery Duration After Concussion in High School and College Athletes: A Critically Appraised Topic

2015 ◽  
Vol 24 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Jaebin Shim ◽  
Deanna H. Smith ◽  
Bonnie L. Van Lunen
Keyword(s):  
High School ◽  
College Athletes ◽  
Signs And Symptoms ◽  
Recovery Process ◽  
Return To Play ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Duration Of Symptoms ◽  
Wide Range ◽  
Recovery Times

Clinical Scenario:Over the past decade, sport-related concussions have received increased attention due to their frequency and severity over a wide range of athletics. Clinicians have developed return-to-play protocols to better manage concussions in young athletes; however, a standardized process projecting the length of recovery time after concussion has remained an elusive piece of the puzzle. The recovery times associated with such an injury once diagnosed can last anywhere from 1 wk to several months. Risk factors that could lead to protracted recovery times include a history of 1 or multiple concussions and a greater number, severity, and duration of symptoms after the injury. Examining the possible relationship between on-field or sideline signs and symptoms and recovery times would give clinicians the confident ability to properly treat and manage an athlete’s recovery process in a more systematic manner. Furthermore, identifying factors after a head injury that may be predictive of protracted recovery times would be useful for athletes, parents, and coaches alike.Focused Clinical Question:Which on-field and sideline signs and symptoms affect length of recovery after concussion in high school and college athletes?

Sport-Related Concussion Knowledge and Occurrence: A Survey of High School and College Athletes in South Korea

2016 ◽  
Vol 21 (2) ◽  
pp. 53-60 ◽  
Author(s):  
Hyung Rock Lee ◽  
Jacob E. Resch ◽  
Tae Kyung Han ◽  
Jessica D. Miles ◽  
Michael S. Ferrara
Keyword(s):  
High School ◽  
South Korea ◽  
Student Athletes ◽  
College Athletes ◽  
Signs And Symptoms ◽  
Return To Play ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
South Korean ◽  
History Of

Few studies have been conducted on individuals’ knowledge of sport-related concussions (SRCs) in South Korea. The purpose of this study was to examine South Korean athletes’ knowledge and recognition of SRC. A cross-sectional survey assessing (a) the recognition of specific signs and symptoms associated with SRC; (b) history of SRC; and (c) knowledge of the return-to-play decision (RTP) process after SRC was distributed to 410 high school and collegiate student-athletes from a variety of sports. No participants correctly identified all 9 items on the checklist of SRC signs and symptoms. While 8.9% reported a history of SRC, approximately 50% of those never reported their postconcussion signs and symptoms. Furthermore, 63.9% of the athletes who reported SRC made RTP decisions on their own. These results reflect the lack of knowledge in South Korean athletics of common signs, symptoms, and appropriate RTP decisions following concussion.

Diagnosis and Treatment of Cervical Pathology Following a Sport-Related Concussion: A Critically Appraised Topic

2020 ◽  
pp. 1-5
Author(s):  
Kelly M. Cheever ◽  
Jane McDevitt ◽  
Jacqueline Phillips
Keyword(s):  
Signs And Symptoms ◽  
Diagnosis And Treatment ◽  
Return To Play ◽  
Clinical Question ◽  
Bottom Line ◽  
Symptom Resolution ◽  
Delayed Recovery

Focused Clinical Question: In concussed patients, are signs and symptoms of cervical dysfunction a cause for delayed symptom resolution and return to play? Clinical Bottom Line: Based on the results of this Critically Appraised Topic, there is some evidence to suggest that the presence of cervical symptoms and cervical dysfunction following sport-related concussion elevates a patient’s risk of delayed recovery and return to play.

scholarly journals Epidemiology of Shoulder Dislocations in High School and Collegiate Athletics in the United States: 2004/2005 Through 2013/2014

2017 ◽  
Vol 10 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Matthew J. Kraeutler ◽  
Dustin W. Currie ◽  
Zachary Y. Kerr ◽  
Karen G. Roos ◽  
Eric C. McCarty ◽  
...  
Keyword(s):  
High School ◽  
Shoulder Dislocation ◽  
College Athletes ◽  
Age Groups ◽  
Injury Rate ◽  
The United States ◽  
Collegiate Athletics ◽  
Return To Play ◽  
High School Athletes ◽  
Injury Rates

Background: Shoulder dislocations occur frequently in athletes across a variety of sports. This study provides an updated descriptive epidemiological analysis of shoulder dislocations among high school and college athletes and compares injury rates and patterns across these age groups. Hypothesis: There would be no difference in injury rates/patterns between high school and college athletes. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: Shoulder dislocation data from the High School Reporting Information Online (RIO) and the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) databases were analyzed from the 2004/2005 through 2013/2014 (NCAA) or 2005/2006 through 2013/2014 (RIO) academic years in 11 different sports. Rate ratios (RRs) and injury proportion ratios (IPRs) were calculated to make comparisons between age groups. Results: During the study period, 598 shoulder dislocations were reported during 29,249,482 athlete-exposures (AEs) among high school athletes, for an overall shoulder dislocation rate of 2.04 per 100,000 AEs; 352 shoulder dislocations were reported during 13,629,533 AEs among college athletes, for an overall injury rate of 2.58 per 100,000 AEs. College athletes had a higher rate of shoulder dislocation than high school athletes (RR, 1.26; 95% CI, 1.11-1.44). However, the injury rate in football was lower in collegiate than high school athletes (RR, 0.52; 95% CI, 0.43-0.62). Surgery was performed to correct 28.0% of high school and 29.6% of college shoulder dislocations. Shoulder dislocations resulted in longer return-to-play times than other shoulder injuries. Conclusion: Overall, shoulder dislocation rates were higher among collegiate than high school athletes. This may be due to greater contact forces involved in sports at higher levels of play, although the increased rate in high school football warrants additional research. Clinical Relevance: Higher shoulder dislocation rates within collegiate athletics are likely due to the higher level of intensity at this level of play, with stronger and faster athletes resulting in more forceful collisions.

scholarly journals Trends in Concussion Return-to-Play Timelines Among High School Athletes From 2007 Through 2009

2013 ◽  
Vol 48 (6) ◽  
pp. 836-843 ◽  
Author(s):  
Jennifer M. Medina McKeon ◽  
Scott C. Livingston ◽  
Ashley Reed ◽  
Robert G. Hosey ◽  
Williams S. Black ◽  
...  
Keyword(s):  
High School ◽  
Confidence Interval ◽  
Censored Data ◽  
Return To Play ◽  
Prognostic Indicators ◽  
High School Athletes ◽  
Time To Event ◽  
Interscholastic Sports ◽  
Probability Estimates ◽  
Recovery Times

Context: Whereas guidelines about return-to-play (RTP) after concussion have been published, actual prognoses remain elusive. Objective: To develop probability estimates for time until RTP after sport-related concussion. Design: Descriptive epidemiology study. Setting: High school. Patients or Other Participants: Injured high school varsity, junior varsity, or freshman athletes who participated in 1 of 13 interscholastic sports at 7 area high schools during the 2007–2009 academic years. Intervention(s): Athletic trainers employed at each school collected concussion data. The athletic trainer or physician on site determined the presence of a concussion. Athlete-exposures for practices and games also were captured. Main Outcome Measure(s): Documented concussions were categorized by time missed from participation using severity outcome intervals (same-day return, 1- to 2-day return, 3- to 6-day return, 7- to 9-day return, 10- to 21-day return, >21-day return, no return [censored data]). We calculated Kaplan-Meier time-to-event probabilities that included censored data to determine the probability of RTP at each of these time intervals. Results: A total of 81 new concussions were documented in 478 775 athlete-exposures during the study period. After a new concussion, the probability of RTP (95% confidence interval) was 2.5% (95% confidence interval = 0.3, 6.9) for a 1- to 2-day return, 71.3% (95% confidence interval = 59.0, 82.9) for a 7- to 9-day return, and 88.8% (95% confidence interval = 72.0, 97.2) for a 10- to 21-day return. Conclusions: For high school athletes, RTP within the first 2 days after concussion was unlikely. After 1 week, the probability of return rose substantially (approximately 71%). Prognostic indicators are used to educate patients about the likely course of disease. Whereas individual symptoms and recovery times vary, prognostic time-to-event probabilities allow clinicians to provide coaches, parents, and athletes with a prediction of the likelihood of RTP within certain timeframes after a concussion.

scholarly journals Transmission Risk of COVID-19 in High School and College Water Polo

2021 ◽  
Author(s):  
Raymond J. Kreienkamp ◽  
Christopher J. Kreienkamp ◽  
Cindy Terrill ◽  
Mark E. Halstead ◽  
Jason G. Newland
Keyword(s):  
High School ◽  
Prospective Observational Study ◽  
College Athletes ◽  
The United States ◽  
Transmission Risk ◽  
Return To Play ◽  
Contact Tracing ◽  
High School Athletes ◽  
School Environments ◽  
Water Polo

Abstract Background: Concerns that athletes may be at a higher risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has led to reduced participation in sports during the COVID-19 pandemic. We aimed to assess COVID-19 incidence and transmission during the spring 2021 high school and college water polo seasons across the United States. Methods: This prospective observational study enrolled 1,825 water polo athletes from 54 high schools and 36 colleges. Surveys were sent to coaches throughout the season, and survey data were collected and analyzed. Results: We identified 17 COVID-19 cases among 1,223 high school water polo athletes (1.4%) and 66 cases among 602 college athletes (11.0%). Of these cases, contact tracing suggested that 3 were water polo–associated in high school, and 0 were water polo–associated in college. Quarantine data suggest low transmission during water polo play as only 3 out of 232 (1.3%) high school athletes quarantined for a water polo–related exposure developed COVID-19. In college, 0 out of 54 athletes quarantined for exposure with an infected opponent contracted COVID-19. However, in both high school and college, despite the physical condition of water polo athletes, both high school (47%) and college athletes (21%) had prolonged return to play after contracting COVID-19, indicating the danger of COVID-19, even to athletes. Conclusions: While COVID-19 spread can occur during water polo play, few instances of spread occurred during the spring 2021 season, and transmission rates appear similar to those in other settings, such as school environments.

Positive and Negative Factors That Influence Concussion Reporting Among Secondary-School Athletes

2015 ◽  
Vol 24 (2) ◽  
pp. 210-213 ◽  
Author(s):  
Melissa C. Kay ◽  
Cailee E. Welch ◽  
Tamara C. Valovich McLeod
Keyword(s):  
Secondary School ◽  
District Of Columbia ◽  
Signs And Symptoms ◽  
Behavior Changes ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Us States ◽  
Reporting Practices ◽  
Negative Factors ◽  
The Brain

Clinical Scenario:Concussions are one of the most common sport-related injuries affecting athletes participating at all levels across a variety of sports. It has been reported that up to 3.8 million concussive events occur per year that are sports-related. One significant issue with identifying concussions is that a clinical diagnosis is based on the presence of signs and symptoms, which are self-reported by the patient. In the adolescent population, injury to the brain is possible with even the slightest insult, which can affect recovery and predispose them to subsequent concussions. Recent legislative efforts have included athlete education as a means to improve concussion reporting. More specifically, all 50 US states and the District of Columbia have implemented concussion legislation that includes some type of concussion education protocol, but there is still little evidence to suggest that enhanced knowledge levels result in behavior changes, including improved concussion-reporting practices. It is unclear what factors make an adolescent athlete more or less likely to report the symptoms of a concussion.Focused Clinical Question:What factors positively or negatively influence secondary school athletes’ likelihood of reporting symptoms of sport-related concussions?

Which Outcome Measures Should Be Used to Determine Readiness to Play After ACL Reconstruction?

2014 ◽  
Vol 23 (2) ◽  
pp. 158-164 ◽  
Author(s):  
Luke M. Mueller ◽  
Ben A. Bloomer ◽  
Chris J. Durall
Keyword(s):  
Acl Reconstruction ◽  
Outcome Measures ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Surgical Reconstruction ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Acl Injuries ◽  
Anterior Cruciate ◽  
Injured Knee

Clinical Scenario:Anterior cruciate ligament (ACL) injuries are associated with a lengthy recovery time, decreased performance, and an increased rate of reinjury. To improve performance of the injured knee, affected athletes often undergo surgical reconstruction and rehabilitation. Determining when an athlete is ready to safely return to play (RTP), however, can be challenging for clinicians. Although various outcome measures have been recommended, their ability to predict a safe RTP is questionable.Focused Clinical Question:Which outcome measures should be used to determine readiness to return to play after ACL reconstruction?

scholarly journals The Effectiveness of Prophylactic Ankle Braces in Reducing the Incidence of Acute Ankle Injuries in Adolescent Athletes: A Critically Appraised Topic

2013 ◽  
Vol 22 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Kelley E. Farwell ◽  
Cameron J. Powden ◽  
Meaghan R. Powell ◽  
Cailee W. McCarty ◽  
Matthew C. Hoch
Keyword(s):  
High School ◽  
Secondary School ◽  
School Setting ◽  
Ankle Injuries ◽  
Clinical Scenario ◽  
Clinical Question ◽  
High School Athletics ◽  
Adolescent Athletes ◽  
Bottom Line ◽  
Ankle Bracing

Clinical Scenario:Ankle injuries constitute a large number of injuries sustained by adolescent athletes participating in high school athletics. Prophylactic ankle bracing may be an effective and efficient method to reduce the incidence of ankle injuries in adolescent athletes in the secondary-school setting.Clinical Question:Do prophylactic ankle braces reduce the incidence of acute ankle injuries in adolescent athletes?Summary of Key Findings:Two of the three included studies reported that prophylactic ankle braces reduced the incidence of ankle injuries compared with no ankle bracing.Clinical Bottom Line:There is moderate evidence to support the use of prophylactic ankle braces in adolescent athletes, particularly those who participate in football and basketball, to reduce the incidence of acute ankle injuries.Strength of Recommendation:Grade B evidence exists that prophylactic ankle braces reduce the incidence of acute ankle injuries in adolescent athletes.

Differentiating Concussion From Intracranial Pathology in Athletes

2017 ◽  
Vol 26 (1) ◽  
pp. 101-108 ◽  
Author(s):  
Andrea Cripps ◽  
Scott C. Livingston
Keyword(s):  
Head Injury ◽  
Medical Management ◽  
Closed Head Injury ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Closed Head ◽  
Intracranial Lesions ◽  
Clinical Signs And Symptoms

Clinical Scenario:A cerebral concussion is a traumatically induced transient disturbance of brain function characterized by a complex pathophysiologic process and is classified as a subset of mild traumatic brain injury. The occurrence of intracranial lesions after sport-related head injury is relatively uncommon, but the possibility of serious intracranial injury (ICI) should be included in the differential diagnosis. ICIs are potentially life threatening and necessitate urgent medical management; therefore, prompt recognition and evaluation are critical to proper medical management. One of the primary objectives of the initial evaluation is to determine if the concussed athlete has an acute traumatic ICI. Athletic trainers must be able promptly recognize clinical signs and symptoms that will enable them to accurately differentiate between a concussion (ie, a closed head injury not associated with significant ICI) and an ICI. The identification of predictors of intracranial lesions is, however, relatively broad.Focused Clinical Question:Which clinical examination findings (ie, clinical signs and symptoms) indicate possible intracranial pathology in individuals with acute closed head injuries?

The Value of Balance-Assessment Measurements in Identifying and Monitoring Acute Postural Instability Among Concussed Athletes

2013 ◽  
Vol 22 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Andrea Cripps ◽  
Scott C. Livingston
Keyword(s):  
Postural Instability ◽  
Assessment Tools ◽  
Return To Play ◽  
Measurement Tool ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Balance Assessment ◽  
Primary Measurement ◽  
High Incidence ◽  
Significant Health

Clinical Scenario:Sport-related concussions are a significant health issue due to the high incidence of concussions sustained each sports season. Current approaches to the evaluation of acutely concussed athletes include the use of balance assessments to identify and monitor underlying postural instability arising from concussion. Balance assessment has been recommended as a primary measurement tool for monitoring recovery and for making return-to-play decisions. Balance impairments have been shown to occur in the initial postconcussion period (ie, 1–10 d). Numerous clinical and laboratory measures have been used in the assessment of balance immediately after concussion, and clinicians are faced with deciding which measures to use.Focused Clinical Question:How do clinical or field-based balance-assessment tools compare to laboratory-based balance measures in identifying deficits in postural stability among acutely concussed athletes?

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