scholarly journals Concussion Management, Education, and Return-to-Play Policies in High Schools

2013 ◽  
Vol 5 (3) ◽  
pp. 258-262 ◽  
Author(s):  
Amanda Esquivel ◽  
Sadiq Haque ◽  
Patrick Keating ◽  
Stephanie Marsh ◽  
Stephen Lemos
Keyword(s):  
High Schools ◽  
Management Education ◽  
Return To Play ◽  
Concussion Management

scholarly journals Medical Supervision of High School Athletics in Chicago: A Follow-up Study

2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986250
Author(s):  
Nathaniel S. Jones ◽  
Kyle Wieschhaus ◽  
Brendan Martin ◽  
Pietro M. Tonino
Keyword(s):  
High School ◽  
High Schools ◽  
The United States ◽  
Return To Play ◽  
Athletic Trainer ◽  
Public High Schools ◽  
High School Sports ◽  
Medical Supervision ◽  
Concussion Management ◽  
School Sports

Background: High school sports participation in the United States has increased dramatically over the past 25 years. A corresponding increase in the number of injuries has been noted, particularly in contact sports such as football. This has led medical and sports organizations nationwide to advocate for proper medical supervision of athletes at games and practices. Purpose: To gather information from Chicago public high schools to gauge how medical supervision for high school sports has changed in 2017 compared with 2003. Study Design: Cross-sectional study. Methods: Survey questionnaires were sent to the athletic directors of all 99 Chicago public high schools to complete via email. The questionnaire survey contained the same questions as in a survey conducted in 2003 by Tonino and Bollier, with the addition of 4 novel questions relating to emergency action plans (EAPs), automated external defibrillators, concussion management policy, and tackling progression drills. Results: The response rate was 66.67% (66/99 schools). Of the 66 responding schools, all with football programs, no school had a physician on the sideline at home games (decrease from 10.6% in 2003), 37.9% had an athletic trainer present (increase from 8.5% in 2003), and 63.6% had a paramedic available (decrease from 89.4% in 2003). In 2017, 65.6% of responding schools had a coach certified in cardiopulmonary resuscitation (CPR) available at practice to handle medical problems, compared with 89.4% in 2003 ( P < .001). Regarding the 4 novel questions, 93.9% of the responding schools had proper tackling progression drills in place, followed by 89.1% who had appropriate EAPs and 93.9% with concussion management protocols, including return-to-play and return-to-learn protocols. Conclusion: Although significant improvement was found in athletic trainer coverage, especially at games, physician coverage was lacking and fewer coaches were certified in CPR in 2017 compared with 2003. EAPs and concussion management protocols were present in most Chicago public high schools. Overall, greater medical supervision is needed, which we believe should come in the form of increased athletic training and physician involvement and coverage, given that expert, expedited medical care saves lives.

scholarly journals Qualitative Evaluation of High School Implementation Strategies for Youth Sports Concussion Laws

2018 ◽  
Vol 53 (9) ◽  
pp. 873-879 ◽  
Author(s):  
Susan Davies ◽  
Kathryn Coxe ◽  
Hosea H. Harvey ◽  
Bhavna Singichetti ◽  
Jinhong Guo ◽  
...  
Keyword(s):  
High School ◽  
Public Schools ◽  
High Schools ◽  
Implementation Strategies ◽  
Qualitative Evaluation ◽  
Return To Play ◽  
Certified Athletic Trainers ◽  
Team Members ◽  
Concussion Management ◽  
Concussion Education

Context:  All 50 states and the District of Columbia have enacted laws governing concussion management and education. These concussion laws, featuring common tenets regarding removal from play, return to play, and concussion education, have shaped school and district policies. Objective:  To evaluate the strategies commonly used to implement concussion laws at the school and district levels, as reported by certified athletic trainers (ATs). Design:  Qualitative study. Setting:  High schools. Patients or Other Participants:  We interviewed 64 ATs from high schools (1 per school) participating in High School Reporting Information Online. Data Collection and Analysis:  Interviews were conducted with participants between April and October 2015 regarding implementation of the 3 core tenets of concussion laws. Research team members independently evaluated the interview transcripts and field notes to identify common themes in implementation strategies. Results:  Of the 64 schools represented, 90.6% were public schools, 89.1% sponsored more than 15 sports, and all schools employed at least 1 AT and had a written concussion policy. Four commonly used strategies to implement removal from play were reliance on coaches, immediate response, referral and guidance after injury, and notification of key individuals. Use of assessment or baseline tests, communication among parties involved, reliance on AT assessments, and return-to-learn policies were 4 frequent strategies to implement return to play. Finally, 3 major implementation strategies to effectuate concussion education were use of existing educational tools, timing of education, and concussion training for school professionals. Conclusions:  Although concussion laws were passed at different times and varied in content across states, common themes in implementation strategies emerged across jurisdictions. The identification of strategic approaches to implementation will help ensure proper concussion management and education, reducing negative health outcomes among youths with concussions.

Consideration of the Federal Guidelines for Academic Services for Student-Athletes with Sports-Related Concussion

2012 ◽  
Vol 13 (3) ◽  
pp. 70-78 ◽  
Author(s):  
Bess Sirmon-Taylor ◽  
Anthony P. Salvatore
Keyword(s):  
Student Athletes ◽  
Section 504 ◽  
Return To Play ◽  
Behavioral Deficits ◽  
Prevention Education ◽  
Concussion Management ◽  
School Settings ◽  
Definition Of ◽  
Federal Guidelines ◽  
Academic Services

Abstract Purpose: Federal regulations should be implemented to provide appropriate services for student-athletes who have sustained a concussion, which can result in impaired function in the academic setting. Eligibility guidelines for special education services do not specifically address the significant, but sometimes transient, impairments that can manifest after concussion, which occur in up to 10% of student-athletes. Method: We provide a definition of the word concussion and discuss the eligibility guidelines for traumatic brain injury and other health-impaired under IDEA, as is the use of Section 504. Results: The cognitive-linguistic and behavioral deficits that can occur after concussion can have a significant impact on academic function. We draw comparisons between the clinical presentation of concussion and the eligibility indicators in IDEA and Section 504. Conclusion: Speech-language pathologists are well-positioned to serve on concussion management teams in school settings, providing services including collection of baseline data, intervention and reassessment after a concussion has occurred, prevention education, and legislative advocacy. Until the cultural perception of concussion changes, with increased recognition of the potential consequences, student-athletes are at risk and appropriate implementation of the existing guidelines can assist in preservation of brain function, return to the classroom, and safe return to play.

scholarly journals Effects of stricter management guidelines on return-to-play timeframes following concussion in professional Australian Rules football

2021 ◽  
Author(s):  
Alan J Pearce ◽  
Doug A King ◽  
Adam J White ◽  
Catherine M Suter
Keyword(s):  
Policy Change ◽  
Subjective Assessment ◽  
Return To Play ◽  
Primary Concern ◽  
Concussion Management ◽  
Australian Football League ◽  
Australian Rules Football ◽  
Australian Football ◽  
Policy Objectives ◽  
The Impact

AbstractBackgroundManagement of concussion remains a serious issue for professional sports, particularly with the growing knowledge on the consequences of repetitive concussion. One primary concern is the subjective assessment of recovery that dictates the time until a concussed athlete is returned to competition. In response to this concern, the Australian Football League (AFL) changed its policy in 2020 such that clearance for return-to-play was extended from one day, to a minimum of five days, prior to the next scheduled match.ObjectiveWe sought to examine the impact of the AFL policy change by asking whether the time to return-to-play after concussion was increased in the 2020 season relative to previous years.MethodsRetrospective data on injury and return-to-play were sourced from publicly available tables published on the AFL website. We compared the number of matches missed and the number of days missed in concussed players across 2017 to 2020 inclusive.ResultsAnalysis of data from 166 concussed players revealed no increase in the number of matches missed in 2020 relative to previous years as would have been expected from an extend recovery protocol. Considering the number of days missed in 2020 relative to 2017-19 we found, paradoxically, that there was an overall reduction in the average time to return-to-play in 2020 (11.2 vs 16.2 days).ConclusionThis study demonstrates that any policy change around concussion management requires ongoing auditing to ensure clearance meets policy objectives and highlights the need for objective measures for return-to-play after concussion.

scholarly journals Disparities in baseline neurocognitive testing for student concussion management in Massachusetts high schools

2020 ◽  
Vol 6 (1) ◽  
pp. e000752
Author(s):  
Julia Campbell ◽  
Jonathan Howland ◽  
Courtney Hess ◽  
Kerrie Nelson ◽  
Robert A Stern ◽  
...  
Keyword(s):  
High Schools ◽  
Low Income ◽  
Economic Status ◽  
Secondary Analysis ◽  
Neurocognitive Testing ◽  
Student Body ◽  
Cross Sectional ◽  
Concussion Management ◽  
Health Related ◽  
Baseline Testing

PurposeThere is evidence of socioeconomic disparities with respect to the implementation of student-sports concussion laws nationally. The purpose of this study was to examine school sociodemographic characteristics associated with the provision of computerised baseline neurocognitive testing (BNT) in Massachusetts (MA) high schools, and to assess whether the scope of testing is associated with the economic status of student populations in MA.MethodsA cross-sectional secondary analysis of surveys conducted with MA athletic directors (n=270) was employed to investigate school characteristics associated with the provision of BNT. Correlation and regression analyses were used to assess whether the scope of testing is associated with the economic status of student populations in MA.ResultsThe scope of BNT was independently associated with the economic disadvantage rate (EDR) of the student population (β=−0.02, p=0.01); whether or not the school employs an athletic trainer (AT) (β=0.43, p=0.03); and school size (β=−0.54, p=0.03). In a multivariable regression model, EDR was significantly associated with the scope of baseline testing, while controlling for AT and size (β=−0.01, p=0.03, adj-R2=0.1135).ConclusionAmong public high schools in MA, disparities in the provision of BNT for students are associated with the economic characteristics of the student body. Schools that have a greater proportion of low-income students are less likely to provide comprehensive BNT. The clinical implications of not receiving BNT prior to concussion may include diminished quality of postconcussive care, which can have short-term and long-term social, health-related and educational impacts.

A-96 Stability of ImPACT’s Latent Structure from Baseline to Post Concussion Assessment

2021 ◽  
Vol 36 (6) ◽  
pp. 1143-1144
Author(s):  
Grace J Goodwin ◽  
Julia E Maietta ◽  
Anthony O Ahmed ◽  
Nia A Hopkins ◽  
Sara A Moore ◽  
...  
Keyword(s):  
Decision Making ◽  
Factor Structure ◽  
Factor Model ◽  
Cognitive Change ◽  
Return To Play ◽  
Cognitive Constructs ◽  
Concussion Management ◽  
Bifactor Models ◽  
Matched Design ◽  
Injury Status

Abstract Objective ImPACT is commonly used for sport-concussion management. Baseline and post-concussion tests serve as within-athlete comparisons for return-to-play decision-making. Previous literature has questioned whether ImPACT’s five composites accurately represent the internal structure of its cognitive scores. A recent alternative four-factor structure has strong confirmatory evidence for baseline scores (Maietta et al., doi:10.1037/pas0001014). The present study examined the stability of these constructs post-concussion. Method The current study utilized a case-matched design (age, sex, sport category) to select a sample of 3560 high school athletes’ baseline (n = 1780) and post-concussion (n = 1780) assessments. Multi-group CFA of first-order, hierarchical, and bifactor models was conducted to assess measurement invariance (configural, metric, scalar, and residual invariance) between baseline and post-concussion samples. Change in comparative fit indices was interpreted as the primary indicator of model invariance. Results ImPACT’s five composite structure, as well as the hierarchical and bifactor models, exhibited inadequate fit to the baseline and post-concussion data. The four-factor model demonstrated superior fit in the baseline sample and good fit in the post-concussion sample. The four-factor structure demonstrated invariance across injury status (baseline to post-concussion). Conclusion Given that ImPACT’s scores are used for return-to-play decision-making, it is important that they are psychometrically sound. Recent literature suggests that ImPACT’s five composites are not an adequate representation of the cognitive constructs. Findings support validity of the four-factor structure despite injury status, suggesting these cognitive constructs are assessable at both pre- and post-concussion. Additional research is needed to determine implications of these findings for tracking cognitive change following sport-related concussion and making return-to-play decisions.

scholarly journals The Influence of Athletic Trainers on the Incidence and Management of Concussions in High School Athletes

2018 ◽  
Vol 53 (11) ◽  
pp. 1017-1024 ◽  
Author(s):  
Timothy A. McGuine ◽  
Adam Y. Pfaller ◽  
Eric G. Post ◽  
Scott J. Hetzel ◽  
Alison Brooks ◽  
...  
Keyword(s):  
High Schools ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Athletic Trainers ◽  
Return To Sport ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Cox Proportional Hazards Model ◽  
Return To Play ◽  
Post Hoc

Context In many US high schools, the athletic trainer (AT) has the responsibility to identify and manage athletes with concussions. Although the availability of ATs varies a great deal among schools, how the level of AT availability in high schools affects the reported incidence and management of sport-related concussions (SRCs) is unknown. Objective To determine how the presence of an AT affects the reporting and management of SRCs. Design Prospective cohort study. Patients or Other Participants A total of 2459 (female = 37.5%, age = 16.1 ± 1.2 years) athletes from 31 Wisconsin high schools were categorized as having low availability (LoAT), mid availability (MidAT), or high availability (HiAT) of ATs. Athletic trainers recorded the incidence, days lost from sport, and postconcussion management through return to sport. The incidence of SRC reporting among categories was examined using a multivariate Cox proportional hazards model. Fisher exact tests were used to determine if postconcussion management differed based on AT availability. Results The incidence of reported SRCs was lower for the LoAT schools (2.4%) compared with the MidAT (5.6%, hazard ratio = 2.59, P = .043) and HiAT (7.0%, hazard ratio = 3.33, P = .002) schools. The median time before the first AT interaction was longer for LoAT schools (24.0 hours) than for MidAT (0.5 hours, post hoc P = .012) and HiAT (0.2 hours, post hoc P = .023) schools. The number of post-SRC interactions was different in all groups (LoAT = 2 interactions, MidAT = 3, and HiAT = 4; all post hoc P values &lt; .05). Days lost were greater for MidAT and HiAT (both 14 days lost) schools compared with LoAT schools (11.5 days lost, post hoc P = .231 and P = .029, respectively). Athletes at LoAT schools were less likely to undergo a return-to-play protocol (9/18 SRCs, 50.0%) than athletes at MidAT (44/47 SRCs, 93.6%; post hoc P = .001) or HiAT (64/64 SRCs, 100%; post hoc P &lt; .001) schools. Conclusions The level of AT availability positively influenced the reported incidence of SRCs as well as postconcussion management activities in this sample of high schools.

scholarly journals Sport Concussion Management Using Facebook: A Feasibility Study of an Innovative Adjunct “iCon”

2017 ◽  
Vol 52 (4) ◽  
pp. 339-349 ◽  
Author(s):  
Osman Hassan Ahmed ◽  
Anthony G. Schneiders ◽  
Paul R. McCrory ◽  
S. John Sullivan
Keyword(s):  
Health Care Professionals ◽  
Athletic Trainers ◽  
Management Program ◽  
Return To Play ◽  
Concussion Management ◽  
Innovative Methods ◽  
Sport Concussion ◽  
Multimedia Technologies ◽  
Participant Group ◽  
Primary Focus

Context:  Sport concussion is currently the focus of much international attention. Innovative methods to assist athletic trainers in facilitating management after this injury need to be investigated. Objective:  To investigate the feasibility of using a Facebook concussion-management program termed iCon (interactive concussion management) to facilitate the safe return to play (RTP) of young persons after sport concussion. Design:  Observational study. Setting:  Facebook group containing interactive elements, with moderation and support from trained health care professionals. Patients or Other Participants:  Eleven participants (n = 9 men, n = 2 women; range, 18 to 28 years old) completed the study. Data Collection and Analysis:  The study was conducted over a 3-month period, with participant questionnaires administered preintervention and postintervention. The primary focus was on the qualitative experiences of the participants and the effect of iCon on their RTP. Usage data were also collected. Results:  At the completion of the study, all participants (100%) stated that they would recommend an intervention such as iCon to others. Their supporting quotes all indicated that iCon has the potential to improve the management of concussion among this cohort. Most participants (n = 9, 82%) stated they were better informed with regard to their RTP due to participating in iCon. Conclusions:  This interactive adjunct to traditional concussion management was appreciated among this participant group, which indicates the feasibility of a future, larger study of iCon. Athletic trainers should consider the role that multimedia technologies may play in assisting with the management of sport concussion.

scholarly journals A-30 Symptom Count Versus Symptom Severity: Which is a Better Predictor of Time to Recovery?

2020 ◽  
Vol 35 (5) ◽  
pp. 626-626
Author(s):  
J Pardini ◽  
D Pardini ◽  
J Sterling ◽  
M Docherty ◽  
J Mattis
Keyword(s):  
Regression Model ◽  
Test Performance ◽  
Symptom Severity ◽  
Clinic Visit ◽  
Return To Play ◽  
Prior History ◽  
Linear Regression Models ◽  
Symptom Scale ◽  
Concussion Management ◽  
The Impact

Abstract Objective Evaluation of self-reported symptoms is a key component of concussion management. This study examined whether symptom count, a more parsimonious method to gather symptom information, would predict recovery better than symptom severity. Method Participants were 1267 (39.3% female) adolescents ages 10–18 (M = 14.7, SD = 1.8) who were evaluated and diagnosed with a concussion by a physician within 10 days of injury. At their initial visit, participants completed the ImPACT computerized test and the included post-concussion symptom scale. The primary outcome was number of weeks (M = 3.2, SD = 1.8) until participants were cleared to return to play by the treating physician based on a standardized protocol. Results Symptom count and symptom severity were highly correlated (r = .89, p &lt; .001). When examined in separate linear regression models, both symptom count (β = .28, p &lt; .001) and symptom severity (β = .25, p &lt; .001) predicted weeks until return to play after controlling for age, gender, prior history of concussion, and neurocognitive test performance. However, when symptom count and severity were both included in the same regression model, symptom count continued to predict weeks to recovery (β = .31, p &lt; .001) and the effect of symptom severity was reduced to non-significance (β = −.03, p = .64). Conclusions Symptom count at initial clinic visit predicted recovery time, eliminating the predictive power of symptom severity when both were entered in the same regression model. Thus, symptom count may be a more robust and more parsimonious assessment than traditional severity ratings, which may save clinic time and allow for additional multimodal assessments.

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