Removal From Activity After Sports- Related Concussion in Sex-Comparable Sports From the Michigan High School Athletic Association

2021 ◽  
pp. 036354652110200
Author(s):  
Aaron J. Zynda ◽  
Kyle M. Petit ◽  
Morgan Anderson ◽  
Christopher P. Tomczyk ◽  
Tracey Covassin
Keyword(s):  
High School ◽  
Student Athletes ◽  
Female Athletes ◽  
Student Athlete ◽  
Male Athletes ◽  
Certified Athletic Trainers ◽  
Reporting Behaviors ◽  
Injury Event ◽  
Injury Reporting ◽  
High School Athletic

Background: Research has demonstrated that female athletes are more likely to report their sports-related concussion (SRC) symptoms compared with male athletes; however, it is unknown if these reporting behaviors correspond to immediate removal from activity in sex-comparable sports. Purpose: To compare the incidence of high school student-athletes removed and not removed from activity after SRC in sex-comparable sports in Michigan. Study Design: Descriptive epidemiology study. Methods: Participants included student-athletes diagnosed with SRC participating in Michigan High School Athletic Association–sponsored athletic activities (22 sex-comparable sports) between 2016 and 2019. All SRCs were recorded in the association’s Head Injury Reporting System (HIRS) by certified athletic trainers, administrators, or coaches. Removal from activity indicated that the student-athlete was removed from play at the time of an injury event. If the student-athlete reported that his or her suspected injury event occurred earlier during activity or if symptom onset was delayed, “not removed from activity” was entered into the HIRS. Incidence proportions were calculated by dividing SRCs not removed by total SRCs in each sport. Risk ratios were calculated by dividing the incidence proportions of girls not removed by boys not removed in each sport. Results: A total of 4418 (2773 female, 1645 male) SRCs were reported, with the most occurring in female soccer players (n = 1023). Overall, 515 girls and 243 boys were not removed from activity, resulting in incidences of 0.19 (95% CI, 0.17-0.20) and 0.15 (95% CI, 0.13-0.17), respectively. Across all sports, girls were 1.26 (95% CI, 1.09-1.45) times as likely to not be removed from activity compared with boys. Of the sports with the most SRCs—soccer, basketball, baseball/softball, and lacrosse—girls had 1.37 (95% CI, 1.09-1.72), 1.15 (95% CI, 0.89-1.47), 1.19 (95% CI, 0.77-1.84), and 1.35 (95% CI, 0.94-1.95) times the risk of not being removed, respectively. Conclusion: Girls were at greater risk of not being removed from activity compared with boys in sex-comparable sports. Results from this study should be incorporated into SRC education in Michigan and potentially elsewhere to inform affiliated personnel of potential sex differences and protect female student-athletes from further harm.

Sports-Related Concussion Occurrence at Various Time Points During High School Athletic Events: Part 2

2018 ◽  
Vol 46 (9) ◽  
pp. 2270-2276 ◽  
Author(s):  
Tracey Covassin ◽  
Kyle M. Petit ◽  
Jennifer L. Savage ◽  
Abigail C. Bretzin ◽  
Meghan E. Fox ◽  
...  
Keyword(s):  
High School ◽  
Student Athletes ◽  
Female Athletes ◽  
Medical Professional ◽  
Medical Attention ◽  
Certified Athletic Trainers ◽  
Common Time ◽  
Injury Reporting ◽  
High School Athletic ◽  
Time Point

Background: Sports-related concussion (SRC) injury rates, and identifying those athletes at the highest risk, have been a primary research focus. However, no studies have evaluated at which time point during an athletic event athletes are most susceptible to SRCs. Purpose: To determine the clinical incidence of SRCs during the start, middle, and end of practice and competition among high school male and female athletes in the state of Michigan. Study Design: Descriptive epidemiological study. Methods: There were 110,774 male and 71,945 female student-athletes in grades 9 through 12 (mean time in high school, 2.32 ± 1.1 years) who participated in sponsored athletic activities (13 sports) during the 2015-2016 academic year. An SRC was diagnosed and managed by a medical professional (ie, MD, DO, PA, NP). SRC injuries were reported by certified athletic trainers, athletic administrators, and coaches using the Michigan High School Athletic Association Head Injury Reporting System. Time of SRC was defined as the beginning, middle, or end of practice/competition. Clinical incidence was calculated by dividing the number of SRCs in a time point (eg, beginning) by the total number of participants in a sport per 100 student-athletes (95% CI). Risk ratios were calculated by dividing one time point by another time point. Results: There were 4314 SRCs reported, with the highest in football, women’s basketball, and women’s soccer. The total clinical incidence for all sports was 2.36 (95% CI, 2.29-2.43) per 100 student-athletes. The most common time for SRCs was the middle, followed by the end of all events. Athletes had a 4.90 (95% CI, 4.44-5.41) and 1.50 (95% CI, 1.40-1.60) times greater risk during the middle of all events when compared with the beginning and end, respectively. There was a 3.28 (95% CI, 2.96-3.63) times greater risk at the end of all events when compared with the beginning. Conclusion: Athletes were at the greatest risk for SRCs at the middle of practice and competition when compared with the beginning and end. Clinical Relevance: The current study suggests that medical attention is particularly important during the middle of all athletic events. Intervention measures to limit SRCs may be most beneficial during the middle of athletic events.

Comparison of Pregaming Alcohol Use and Consequences by Season Status and Sex in College Student Athletes

2020 ◽  
pp. 004723792097665
Author(s):  
Callon M. Williams ◽  
Linda M. Reynolds ◽  
Nadine R. Mastroleo
Keyword(s):  
Alcohol Use ◽  
Student Athletes ◽  
Female Athletes ◽  
Student Athlete ◽  
Blood Alcohol ◽  
Negative Outcomes ◽  
Male Athletes ◽  
Biological Sex ◽  
Use Patterns ◽  
College Student Athletes

As student athletes exhibit unique alcohol use patterns based on being in- versus out-of-season and biological sex, we aimed to explore student athlete ( N = 442) alcohol use, pregaming behaviors, and associated negative outcomes. Results suggest being out-of-season and male are positively associated with negative alcohol-related consequences, and male athletes report greater numbers of pregame specific alcohol-related consequences than female athletes ( p <  .05). Female athletes indicated significantly higher estimated blood alcohol concentrations than male athletes on pregaming nights. No differences emerged between in- and out-of-season athletes on pregame consequences. Results suggest that further emphasis on the role season status and sex has on pregaming behaviors and experiencing negative outcomes may be an important next step toward enhancing prevention and intervention approaches.

Time-to-Event Analyses: Return to Unrestricted Participation Following Sport-Related Concussion in a Cohort of High School Athletes

2020 ◽  
Author(s):  
Tracey Covassin ◽  
Abigail C. Bretzin ◽  
Erica Beidler ◽  
Jessica Wallace
Keyword(s):  
High School ◽  
High School Student ◽  
Student Athletes ◽  
Event Analysis ◽  
Time To Event ◽  
Injury Surveillance System ◽  
Kaplan Meier ◽  
Injury Reporting ◽  
Recovery Trajectory ◽  
High School Athletic

Abstract Context: Understanding time-loss resulting from sport-related concussion (SRC) within individual sports allows high school athletic trainers to provide accurate and clinically evidence-based information. Currently there is a lack of research regarding patterns of clinical recovery outcomes in high school student-athletes across sports. Objective: To describe the time to authorized unrestricted RTP following SRC in a large cohort of high school student-athletes in variety of sports using a time-to-event analysis. Design: Descriptive Epidemiology Study. Setting: Aggregate injury and player exposure data from the STATE-XXX High School Athletic Association (XHSAA) Head Injury Reporting System (HIRS). Patients or Other Participants: High school student-athletes. Main Outcome Measure(s): Dates for SRC injury events and authorized unrestricted RTP were entered into the HIRS for each case, and were used to calculate time to unrestricted RTP. Survival analysis determined time to authorized RTP for males and females in weekly increments across sports and academic years. Separate Kaplan-Meier analyses adjusted for SRC cases with a history of concussion also identified the proportions of student-athletes that obtained authorized medical clearance in weekly increments. Results: There was a total of 15,821 SRC cases, 10,375 (65.6%) male and 5,446 (34.4%) female, reported during the 2015–16 through 2018–19 academic years. The median time to authorized unrestricted RTP was 11 days for all cases. Approximately, 30% of concussed student-athletes were not cleared for unrestricted RTP by 14 days following their SRC diagnosis, with 13% taking longer than 21 days to unrestricted RTP after SRC. Conclusions: The results from this multi-site, State-based injury surveillance system indicate that it is not abnormal for high school student-athletes to take longer than 14 days to fully recovery from a SRC. This information may be useful for educating high school student-athletes and sport stakeholders, normalizing SRC recovery trajectory perceptions, and establishing realistic RTP timeline expectations.

Sex-Specific Differences in Perceived Injury Management and Prevention in High School Student-Athletes

2021 ◽  
Vol 1 (1) ◽  
pp. 30-37
Author(s):  
Eve Kantaros ◽  
Haylee Borgstrom
Keyword(s):  
High School ◽  
Injury Prevention ◽  
High School Student ◽  
Student Athletes ◽  
Female Athletes ◽  
Return To Sport ◽  
Male Athletes ◽  
Injury Management ◽  
Sex Disparities ◽  
Prevention Training

BACKGROUND: Sport-related injuries are common among high school student-athletes with specific sex disparities in injury risk. Many of these injuries may be avoidable with the use of injury prevention programs (IPPs). Sex differences in injury management and return to sport are not well understood. PURPOSE: To determine sex-specific differences in self-reported injury management and prevention strategies in high school student-athletes. DESIGN: Cross-sectional, survey-based study. METHODS: An anonymous 13-item electronic survey was distributed to all students in a private high school in December 2019 with responses recorded over a one-month study period. Primary outcomes were sex-specific differences in self-reported outcome measures assessing student-athlete experience during injury recovery and familiarity with IPPs. Groups were evaluated via descriptive statistics and differences between groups were compared. RESULTS: From a total of 190 responses, 106 were included in the analysis (63F, 43M, mean age 16.7 years). Female athletes reported decreased exposure to injury prevention training (44.4% vs 69.8%, p=0.01) and practice-based utilization of IPPs (23.8% vs 55.8%, p=0.001) compared to male athletes. Overall, reported utilization of IPPs was low regardless of sex at less than 40% for all athletes. Nearly 85% of female athletes compared to 51% of male athletes felt they could benefit from IPPs (p=0.001), yet fewer than half of female athletes reported ever having training in injury prevention. There were no statistically significant differences in measures of injury management or return to sport between sexes. Females reported similar major impact of injury on life and future plans compared to male athletes. CONCLUSIONS: Male athletes were 1.6x more likely to report injury prevention training and 2.4x more likely to report practice-based utilization of IPPs compared to female athletes. Sex-specific differences in injury management and return to sport were not identified. Better incorporation of IPPs, specifically at the high-school level, may help to address sex disparities in preventable sport-related injuries and allow student-athletes to maximize the myriad benefits of sport participation.

scholarly journals Time-to-Event Analyses: Return to Unrestricted Participation After Sport-Related Concussion in a Cohort of High School Athletes

2021 ◽  
Author(s):  
Tracey Covassin ◽  
Abigail C. Bretzin ◽  
Erica Beidler ◽  
Jessica Wallace
Keyword(s):  
High School ◽  
Head Injury ◽  
High School Student ◽  
Student Athletes ◽  
Reporting System ◽  
Event Analysis ◽  
Time To Event ◽  
Injury Surveillance System ◽  
Injury Reporting ◽  
High School Athletic

Context Understanding time loss resulting from sport-related concussion (SRC) within individual sports allows high school athletic trainers to provide accurate and evidence-based clinical information. Currently, research regarding patterns of clinical recovery outcomes in high school student-athletes across sports is lacking. Objective To describe the time to authorized unrestricted return to participation (RTP) after SRC in a large cohort of high school student-athletes in a variety of sports using a time-to-event analysis. Design Descriptive epidemiology study. Setting Aggregate injury and player exposure data from the Michigan High School Athletic Association Head Injury Reporting System. Patients or Other Participants High school student-athletes. Main Outcome Measure(s) Dates for SRC injury events and authorized unrestricted RTP were entered into the Head Injury Reporting System for each case and were used to calculate time to unrestricted RTP. Survival analysis indicated the time to authorized RTP for males and females in weekly increments across sports and academic years. Separate Kaplan-Meier analyses adjusted for SRC cases with a history of concussion also identified the proportions of student-athletes who obtained authorized medical clearance in weekly increments. Results A total of 15 821 SRCs, 10 375 (65.6%) in males and 5446 (34.4%) in females, were reported during the 2015–2016 through 2018–2019 academic years. The median time to authorized unrestricted RTP was 11 days for all patients. Approximately 30% of concussed student-athletes were not cleared for unrestricted RTP by 14 days after their SRC diagnosis, with 13% taking longer than 21 days to return to unrestricted RTP after SRC. Conclusions The results from this multisite, state-based injury surveillance system indicated that it is not abnormal for high school student-athletes to take longer than 14 days to fully recover from an SRC. This information may be useful for educating high school student-athletes and sport stakeholders, normalizing SRC recovery trajectory perceptions, and establishing realistic RTP timeline expectations.

“Detrimental to the Team Dynamic”: Exploring College Student-Athlete Dissent

2021 ◽  
pp. 216747952110019
Author(s):  
Rikishi T. Rey ◽  
Zac D. Johnson
Keyword(s):  
High School ◽  
College Student ◽  
Thematic Analysis ◽  
Student Athletes ◽  
Athletic Trainers ◽  
School Level ◽  
Student Athlete ◽  
College Level ◽  
High School Level ◽  
College Student Athletes

To properly manage college student-athlete dissent, stakeholders (e.g., coaches, teammates, administration, athletic trainers, etc.) must first recognize the situations that cause athletes to dissent. Although athletic dissent is not a new concept, to date, it has only been examined at the high school level. To fill this gap, this study begins to explore this issue at the college level by examining the triggering agents that cause college student-athletes to communicate dissent. Participants ( N = 72) from 11 different sports were asked to complete multiple narratives in response to open ended questions after reflecting on a time where they communicated dissent. Results of a thematic analysis indicate that there are eight triggering agents of dissent, demonstrating distinct differences between high school and college student-athlete dissent due to various contextual factors. These findings highlight the needs and desires of college student-athletes which can help coaches, administration, and other stakeholders to promote positive college student-athlete experiences.

scholarly journals Concussion Epidemiology in Youth Sports: Sports Study of a Statewide High School Sports Program

2020 ◽  
Vol 13 (1) ◽  
pp. 18-24
Author(s):  
Benjamin J. Chun ◽  
Troy Furutani ◽  
Ross Oshiro ◽  
Casey Young ◽  
Gale Prentiss ◽  
...  
Keyword(s):  
High School ◽  
Student Athletes ◽  
Sports Participation ◽  
Management Program ◽  
Level Of Evidence ◽  
High School Sports ◽  
School Sports ◽  
Relative Risks ◽  
Injury Reporting ◽  
The Impact

Background: Current research on concussion incidence in youth athletes (age <18 years) is small and limited by variability in injury reporting and diagnostic methodology. Hypothesis: Concussion injuries commonly occur in high school sports programs. The likelihood of concussion among student-athletes (aged 13-18 years) depends on the sport they are participating in as well as the sex of the athlete. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: A retrospective analysis of all Hawaii high school athletes aged 13 to 18 years participating in 14 sports from 2011 through 2017 was performed as part of a statewide standardized concussion assessment and management program. Results: A total of 5993 concussions were identified among 92,966 athletes. The overall concussion rate was 0.96 (95% CI, 0.94-0.99). Girls’ judo had the highest concussion rate (1.92; 95% CI, 1.68-2.17) followed by football (1.60; 95% CI, 1.53-1.66). The concussion rate for boys (1.0; 95% CI, 0.97-1.03) was higher than that for girls (0.91; 95% CI, 0.87-0.95); however, in 4 of the 5 sports in which both girls and boys participated, girls had a higher rate of concussion injury. Conclusion: The likelihood of concussion among student-athletes aged 13 to 18 years may be higher than previously thought and varies depending on sport and sex. Clinical Relevance: Epidemiologic data on concussion injury in children and adolescents are useful in accurately determining the relative risks of high school sports participation and may be valuable in determining the appropriate allocation of health care and scholastic resources for student-athletes, as well as the impact of rule and training modifications designed to improve participant safety.

scholarly journals ANTERIOR CRUCIATE LIGAMENT INJURIES IN HIGH SCHOOL FEMALE AND MALE SOCCER ATHLETES: ARE MATCH ACL RATES BEING UNDERESTIMATED?

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0000
Author(s):  
Aaron D. Gray ◽  
Scott M. Miller ◽  
Samuel Galloway ◽  
Seth Sherman ◽  
Emily Leary ◽  
...  
Keyword(s):  
High School ◽  
At Risk ◽  
Traditional Method ◽  
Female Athletes ◽  
Injury Rate ◽  
Acl Injury ◽  
Traditional Methods ◽  
Male Athletes ◽  
Acl Injuries ◽  
Injury Rates

Background: The purpose of this study was to investigate the incidence of anterior cruciate ligament (ACL) injuries in Missouri high school female and male soccer players during the 2011-2013 seasons, using a single postseason survey sent to coaches. Our hypothesis is a single postseason survey be a feasible method to measure a large number of athletic exposures (AEs) and ACL injuries. We also hypothesize that “traditional” methods for calculating athletic exposures likely underestimate the actual burden of ACL injuries in high school soccer matches. Methods: The study was IRB approved through the University of Missouri. A web-based survey was developed and sent to every girls and boys high school soccer coach in Missouri using a Missouri State High School Activities Association (MSHSAA) database. In order to calculate AEs, questions were asked about the average number of athletes who participated in tryouts, practices, and matches along with the specific number of tryouts, practices, and matches for the 2011-2012 and 2012-2013 seasons. Coaches were also asked the number of ACL injuries their team suffered. No medical personnel were involved in filling out the surveys. Athletic exposures (AEs) were calculated using the formulas below. Match athletic exposures were calculated using a “traditional” method and also an “athlete at risk” method. The primary outcome measure was ACL injuries. Formulas for Calculation of Athletic Exposures (AEs) Tryouts & Practice= (a*A) + (b*B) Match (Traditional)= (c*C) Match (Athlete at Risk)= (11*C) a = average number of players participating in tryouts A = number of tryout sessions b = average number of players participating in practices B = number of practices in a season c = average number of players participating in matches C = number of matches in a season Results: In total, 885 coaches were sent surveys and 160 (18.1%) coaches responded, with 84 coaches representing girls soccer teams and 76 representing boys teams. A total of 323,010 AEs (160,756 female and 162,254 male) were reported of which 228,608 AEs (71%) took place in practices. 94,402 AEs occurred in matches using the “traditional” method and 61,963 AEs in matches using the “athlete at risk” method. 36 ACL injuries (28 female and 8 male) were reported. Of the 28 female ACL injuries, 25 happened during high school soccer activities (23 match, 2 practice). 3 ACL injuries occurred outside of high school soccer activities (1 club soccer, 1 volleyball, 1 unknown.) All 8 male ACL injuries were suffered during a high school match. Female athletes had an ACL injury rate of 0.16/1000 AEs compared to male athletes 0.05/1000 AEs (Table 1). Female athletes had a practice ACL injury rate of 0.02/1000 AEs and there were no ACL injuries suffered by male athletes in practice. Female athletes had a match ACL injury rate of 0.47/1000 AEs using “traditional” method and 0.70/1000 AEs by the “athlete at risk” method. Male athletes had a match ACL injury rate of 0.18/1000 AEs “traditional” method and 0.28/1000 AEs “athlete at risk” method (Figure 1). Female high school soccer athletes had a 3.2x greater risk of ACL tear than male high school soccer athletes. Female athletes were 26x more likely to tear their ACL in a match compared to practice. ACL match injury rates were 50-55% higher using the “athlete at risk” method compared to “traditional” methods for calculating match injury rates. Conclusion/Significance: A single postseason survey sent to coaches was successful in measuring AEs and ACL injury rates for a large population of high school soccer athletes. This represents an economical and feasible mechanism compared to previous studies (Table 2) to measure ACL injury rates for a high number of teams. It also allows ACL injury rates to be measured for schools and teams that do not have certified athletic trainers. “Traditional” methods for calculating match ACL injury rates greatly under represent ACL injuries compared to the “athlete at risk” method which is more representative of true injury risk exposure. A very high percentage of ACL injuries occurred during matches even though matches were responsible for only 29% of AEs. If future studies have limited resources, they should consider not recording practice AEs and ACL injuries since the likelihood of an ACL injury occurring during practice is very low compared to a match. [Table: see text][Table: see text][Figure: see text]

Using Repetitions to Fatigue to Predict One-Repetition Maximum Bench Press in Male High School Athletes

2004 ◽  
Vol 16 (3) ◽  
pp. 265-276 ◽  
Author(s):  
J. L. Mayhew ◽  
Chad D. Kerksick ◽  
Doug Lentz ◽  
John S. Ware ◽  
David L. Mayhew
Keyword(s):  
High School ◽  
Bench Press ◽  
Adolescent Male ◽  
High School Athletes ◽  
Male Athletes ◽  
Repetition Maximum ◽  
Male High School ◽  
Press Performance ◽  
New Equation ◽  
High School Athletic

The purpose of this study was to evaluate the effectiveness of repetitions to fatigue (RTF) for estimating one-repetition maximum (1-RM) bench press performance in male high school athletes. Members of high school athletic teams (N = 213, age = 16.3 ± 1.1 yrs, weight = 79.9 ± 16.7 kg) from four states were tested for 1-RM bench press and RTF after completing 4–6 weeks of resistance training. A new equation for use with male high school athletes was developed from a random sample of 180 participants; it appears to have excellent predictive potential (r = 0.96, SEE = 4.5 kg) and cross-validated well on a subsample (n = 33) from this population (r = 0.98, t = 0.64). Therefore, RTF can be used with acceptable accuracy to estimate maximal strength in the majority of adolescent male athletes who need to handle excessively heavy weights.

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