scholarly journals Sports-related concussion (SRC) assessment in road cycling: a systematic review and call to action

2019 ◽  
Vol 5 (1) ◽  
pp. e000525 ◽  
Author(s):  
Jonathan Elliott ◽  
Richard Anderson ◽  
Stephen Collins ◽  
Neil Heron

BackgroundSports-related concussion (SRC) is a recognised risk in road cycling and can have serious health consequences. Recent high-profile cases of professional road cyclists continuing to participate in races despite suffering obvious SRC have highlighted the difficulties in assessing SRC within road cycling.PurposeTo undertake a systematic review of the literature on SRC assessment in road cycling.Study designSystematic review.MethodsLiterature describing SRC assessment in road cycling was identified by searching MEDLINE, EMBASE, PsycINFO and Web of Science. Two reviewers independently screened titles and abstracts for eligibility and a qualitative analysis was undertaken of included studies.ResultsFrom 94 studies identified, two were included for review. Gordonet aldescribe the presentation of a single case of paediatric concussion following a cycling crash. They highlight the utility of SRC evaluation using the Sport Concussion Assessment Tool (SCAT) as well as the importance of a stepwise return-to-play protocol. Greve and Modabber discuss a number of traumatic brain injuries that occurred during the 2011 road cycling season and, as a minimum, call for riders to be withdrawn from competition following loss of consciousness or amnesia. Both studies are at high risk of bias and of low quality.ConclusionRoad cycling poses unique challenges for the assessment of SRC. This review illustrates the lack of published evidence to advise effective means of SRC assessment within road cycling. The Union Cycliste Internationale (UCI) regulations advise the use of SCAT-5 for concussion assessment but this tool is impractical, requiring modification for use in road cycling. We would like to call on the UCI to hold a consensus meeting to establish an evidence-based SRC assessment protocol and return-to-riding protocol for road cycling.

2010 ◽  
Vol 29 (5) ◽  
pp. E4 ◽  
Author(s):  
Paul Sean Echlin ◽  
Charles H. Tator ◽  
Michael D. Cusimano ◽  
Robert C. Cantu ◽  
Jack E. Taunton ◽  
...  

Object The objective of this study was to measure the incidence of concussion (scaled relative to number of athlete exposures) and recurrent concussion within 2 teams of fourth-tier junior ice hockey players (16–21 years old) during 1 regular season. Methods A prospective cohort study called the Hockey Concussion Education Project was conducted during 1 junior ice hockey regular season (2009–2010) involving 67 male fourth-tier ice hockey players (mean age 18.2 ± 1.2 years, range 16–21 years) from 2 teams. Prior to the start of the season, every player underwent baseline assessments using the Sideline Concussion Assessment Tool 2 (SCAT2) and the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). The study protocol also required players who entered the study during the season to complete baseline SCAT2 and ImPACT testing. If the protocol was not followed, the postinjury test results of a player without true baseline test results would be compared against previously established age and gender group normative levels. Each regular season game was observed by a qualified physician and at least 1 other neutral nonphysician observer. Players who suffered a suspected concussion were evaluated at the game. If a concussion diagnosis was made, the player was subsequently examined in the physician's office for a full clinical evaluation and the SCAT2 and ImPACT were repeated. Based on these evaluations, players were counseled on the decision of when to return to play. Athlete exposure was defined as 1 game played by 1 athlete. Results Twenty-one concussions occurred during the 52 physician-observed games (incidence 21.5 concussions per 1000 athlete exposures). Five players experienced repeat concussions. No concussions were reported during practice sessions. A concussion was diagnosed by the physician in 19 (36.5%) of the 52 observed games. One of the 5 individuals who suffered a repeat concussion sustained his initial concussion in a regular season game that was not observed by a physician, and as a result this single case was not included in the total of 21 total concussions. This initial concussion of the player was identified during baseline testing 2 days after the injury and was subsequently medically diagnosed and treated. Conclusions The incidence of game-related concussions (per 100 athlete exposures) in these fourth-tier junior ice hockey players was 7 times higher than the highest rate previously reported in the literature. This difference may be the result of the use of standardized direct physician observation, diagnosis, and subsequent treatment. The results of this study demonstrate the need for follow-up studies involving larger and more diverse sample groups to reflect generalizability of the findings. These follow-up studies should involve other contact sports (for example football and rugby) and also include the full spectrum of gender, age, and skill levels.


2016 ◽  
Vol 40 (6) ◽  
pp. 658-667 ◽  
Author(s):  
Masumeh Bagherzadeh Cham ◽  
Mohammad Ali Mohseni-Bandpei ◽  
Mahmood Bahramizadeh ◽  
Saeed Kalbasi ◽  
Akbar Biglarian

Background:Central nervous system receives information from foot mechanoreceptors in order to control balance and perform movement tasks. Subthreshold random noise seems to improve sensitivity of the cutaneous mechanoreceptor.Objectives:The purpose of this study was to systematically review published evidence conducted to evaluate the clinical and biomechanical effects of subthreshold random noise on the plantar surface of the foot in diabetic patients and elder people.Study design:Systematic review.Methods:A literature search was performed in PubMed, Scopus, ScienceDirect, Web of Knowledge, CINAHL, and EMBASE databases based on population, intervention, comparison, outcomes, and study method. Quality of studies was assessed using the methodological quality assessment tool, using Physiotherapy Evidence Database scale.Results:In all, 11 studies were selected for final evaluation based on inclusion criteria. Five studies evaluated the effects of subthreshold random noise in diabetic patients and six in elder people. In seven studies, biomechanical (balance and gait parameters) effects and in four studies clinical (pressure and vibration sensations) effects of subthreshold random noise were investigated. All reviewed studies were scored fair (2) to good (9) quality in terms of methodological quality assessment using Physiotherapy Evidence Database scale.Conclusion:The results indicated that subthreshold random noise improves balance and sensation in diabetic patients and elder people. Also gait variables can be improved in elder people with subthreshold random noise. However, further well-designed studies are needed.Clinical relevanceThe previous studies reported that subthreshold random noise may improve gait, balance, and sensation, but more studies are needed to evaluate the long-term effect of subthreshold random noise in shoe or insole for daily living tasks in diabetic patients and elder people.


2020 ◽  
Vol 63 (5) ◽  
pp. 1618-1635
Author(s):  
Céline Richard ◽  
Mary Lauren Neel ◽  
Arnaud Jeanvoine ◽  
Sharon Mc Connell ◽  
Alison Gehred ◽  
...  

Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.


2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.


2020 ◽  
Author(s):  
Laura Rihani ◽  
Jennifer Usinger ◽  
Nicola Jungbäck ◽  
Gabriele Stumm ◽  
Thorsten Schulz ◽  
...  

BACKGROUND Sports-related mild traumatic brain injuries (sports related concussion, SRC) have received increasing attention since neurodegenerative processes have been linked to repetitive SRCs. Return-to-Play (RTP) rules have been established for medical advised return into sports activities after concussion, but it is not clear if these rules also reach the sports clubs and its young athletes. OBJECTIVE In youth sports, athletes and their parents search the internet for advice after SRC. We therefore investigated which websites of German sports associations and clubs in football (soccer), handball and rugby offer information on SRC and RTP rules. METHODS The systematic analysis included websites of local football, handball and rugby clubs in two comparable regions in Southern Bavaria and Lower Saxony. The websites of the regional and the German umbrella associations were also included into the study. Eight criteria of the revised Sport Concussion Consensus Statement served as standard for the evaluation according to the protocol published by Swallow et al. (J Neurosurg Pediatr, 2018). RESULTS No information on RTP rules or the topic “sports-related brain injuries” could be found on any of the clubs’ websites. Only the Bavarian Football Association and the Rugby Association sporadically provided information on the topic. The German umbrella associations in football and rugby take up international documents and regulations of the European and the world associations. No information could be found at the German Handball Association. CONCLUSIONS The topics of sports-related brain injuries and RTP rules are mostly neglected on the analysed Websites. This is remarkable, as there are clearly defined consensus guidelines which are widely accepted in international comparison. Especially in the USA, online information on this topic has become standard.


Author(s):  
Tom Clifford ◽  
Jarred P. Acton ◽  
Stuart P. Cocksedge ◽  
Kelly A. Bowden Davies ◽  
Stephen J. Bailey

AbstractWe conducted a systematic review of human trials examining the effects of dietary phytochemicals on Nrf2 activation. In accordance with the PRISMA guidelines, Medline, Embase and CAB abstracts were searched for articles from inception until March 2020. Studies in adult humans that measured Nrf2 activation (gene or protein expression changes) following ingestion of a phytochemical, either alone or in combination were included. The study was pre-registered on the Prospero database (Registration Number: CRD42020176121). Twenty-nine full-texts were retrieved and reviewed for analysis; of these, eighteen were included in the systematic review. Most of the included participants were healthy, obese or type 2 diabetics. Study quality was assessed using the Cochrane Collaboration Risk of Bias Assessment tool. Twelve different compounds were examined in the included studies: curcumin, resveratrol and sulforaphane were the most common (n = 3 each). Approximately half of the studies reported increases in Nrf2 activation (n = 10); however, many were of poor quality and had an unclear or high risk of bias. There is currently limited evidence that phytochemicals activate Nrf2 in humans. Well controlled human intervention trials are needed to corroborate the findings from in vitro and animal studies.


2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098207
Author(s):  
Sachin Allahabadi ◽  
Favian Su ◽  
Drew A. Lansdown

Background: Athletes in the Women’s National Basketball Association (WNBA) and National Basketball Association (NBA) are subject to high injury rates given the physical demands of the sport. Comprehensive data regarding injury patterns and rates in these athletes are limited. Purpose: To summarize available data on orthopaedic and sports medicine–related injuries through 2020 in professional female and male basketball players. Study Design: Systematic review; Level of evidence, 4. Methods: A search was conducted using PubMed and Embase through April 5, 2020, to identify injury studies regarding WNBA and NBA players. Studies were included if the injury or surgery was considered a direct consequence of game play including musculoskeletal/orthopaedic, concussion, ophthalmologic, and craniomaxillofacial injuries. Systematic reviews, screening studies, or studies without sufficient WNBA or NBA player subgroup analysis were excluded. Results: A total of 49 studies met inclusion criteria, 43 (87.8%) of which detailed musculoskeletal injuries. The lower extremity represented 63.3% of studies. A majority (59.2%) of studies were level 4 evidence. The source of data was primarily comprehensive online search (n = 33; 67.3%), followed by official databases (n = 11; 22.4%). Only 3 studies concerned WNBA athletes compared with 47 that concerned NBA athletes. The lowest return-to-play rates were cited for Achilles tendon repairs (61.0%-79.5%). Variability in return-to-play rates existed among studies even with similar seasons studied. Conclusion: The majority of literature available on orthopaedic and sports medicine–related injuries of NBA and WNBA athletes is on the lower extremity. The injuries that had the greatest effect on return to play and performance were Achilles tendon ruptures and knee cartilage injuries treated using microfracture. The reported outcomes are limited by heterogeneity and overlapping injury studies. There are limited available data on WNBA injuries specifically.


2021 ◽  
Vol 10 (15) ◽  
pp. 3345
Author(s):  
Martina Curtin ◽  
Evelien Dirks ◽  
Madeline Cruice ◽  
Rosalind Herman ◽  
Lauren Newman ◽  
...  

Background: Despite early identification and advancements in cochlear implant and hearing aid technology, delays in language skills in deaf children continue to exist. Good-quality parent–child interaction (PCI) is a key predictor for the successful development of deaf children’s signed and/or spoken language. Though professionals have standard assessments to monitor child language, a clinical tool to observe the quality of parental interaction is yet to be developed. Aims and methods: This systematic review with narrative synthesis aims to uncover which parent behaviours are assessed in PCI studies with deaf infants aged 0–3 years, how these behaviours are assessed, and which are correlated with higher scores in child language. Results: Sixty-one papers were included, spanning 40 years of research. Research included in the review assessed parents’ skills in gaining attention, joint engagement, emotional sensitivity, and language input. PCI was mostly assessed using coding systems and frame-by-frame video analysis. Some of the parent behaviours mentioned previously are associated with more words produced by deaf children. Conclusion: The results of the review provide the evidence base required to develop the content of a future clinical assessment tool for parent–child interaction in deafness.


Author(s):  
Julia Heffernan ◽  
Ewan McDonald ◽  
Elizabeth Hughes ◽  
Richard Gray

Police, ambulance and mental health tri-response services are a relatively new model of responding to people experiencing mental health crisis in the community, but limited evidence exists examining their efficacy. To date there have been no systematic reviews that have examined the association between the tri-response model and rates of involuntary detentions. A systematic review examining co-response models demonstrated possible reduction in involuntary detention, however, recommended further research. The aim of this protocol is to describe how we will systematically review the evidence base around the relationship of the police, ambulance mental health tri-response models in reducing involuntary detentions. We will search health, policing and grey literature databases and include clinical evaluations of any design. Risk of bias will be determined using the Effective Public Health Practice Project Quality Assessment Tool and a narrative synthesis will be undertaken to synthesis key themes. Risk of bias and extracted data will be summarized in tables and results synthesis tabulated to identify patterns within the included studies. The findings will inform future research into the effectiveness of tri-response police, ambulance, and mental health models in reducing involuntary detentions.


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