Epidemiology of Concussion in the National Football League, 2015-2019

2021 ◽  
pp. 194173812110114
Author(s):  
Christina D. Mack ◽  
Gary Solomon ◽  
Tracey Covassin ◽  
Nicholas Theodore ◽  
Javier Cárdenas ◽  
...  
Keyword(s):  
National Football League ◽  
Average Rate ◽  
American Football ◽  
Descriptive Epidemiology ◽  
Level Of Evidence ◽  
Injury Reduction ◽  
Area Of Interest ◽  
Average Annual Incidence ◽  
Reduction Strategies

Background: Concussion in American football, and specifically the National Football League (NFL) is a major area of interest and key focus for injury prevention. Complete and accurate characterization of when, how, and to whom these injuries occur can facilitate injury reduction efforts. Existing studies of concussion in the NFL use publicly available data, potentially limiting data quality and the inferences that can be made. Hypothesis: Concussion incidence in the NFL decreased across the 2015-2019 seasons. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: Concussion incidence, including counts, one-season risk, and rates per game and player-plays, among active NFL players from 2015 to 2019 is described by year, season, play type, and roster position. Results: A total 1302 concussions were identified from 2015 to 2019 among 1004 players. Of these, 80% occurred in NFL games. The average annual incidence of in-season game concussions changed over the study period, from 230.7 per season (2015-2017) to 177.0 per season (2018-2019); this represented a 23% decrease in game settings ( P < 0.01). Practice concussions fluctuated across the years of the study from 38 to 67 per season (average = 50.8/season). There were 70.6 concussions per 100 preseason games, which was slightly higher than the regular season rate per game of 61.7. Overall, there were 790 regular season game concussions across 4,657,243 player-plays and 114,428 player-games during the 5-year study. In regular season games, the majority of concussions were sustained on running and passing plays (n = 119/season), and the highest average rate per play occurred on kickoffs (0.69/100 plays). Defensive secondary (cornerbacks, safeties, and generic defensive backs) and offensive line incurred the most concussions, and the highest rates of concussion were among tight ends and wide receivers. Conclusion and Relevance: Concussions in the NFL are a key focus for player safety. Concussion reduction strategies were implemented before 2018, after which there was a sustained 2-year decrease in concussion incidence, providing a new benchmark from which to work toward further injury reduction.

scholarly journals Prevalence and Impact of Hip Arthroscopic Surgery on Future Participation in Elite American Football Athletes

2018 ◽  
Vol 6 (2) ◽  
pp. 232596711775230 ◽  
Author(s):  
Derrick M. Knapik ◽  
Joe Sheehan ◽  
Shane J. Nho ◽  
James E. Voos ◽  
Michael J. Salata
Keyword(s):  
National Football League ◽  
Arthroscopic Surgery ◽  
American Football ◽  
Current Status ◽  
Level Of Evidence ◽  
Labral Tears ◽  
Significant Difference ◽  
History Of ◽  
Not At Risk ◽  
The Impact

Background: Intra-articular injuries to the hip in elite athletes represent a source of significant pain and disability. Hip arthroscopic surgery has become the gold standard for the treatment of disorders involving the hip joint. Purpose: To examine the incidence of and abnormalities treated with hip arthroscopic surgery as well as the impact on future participation in American football athletes invited to the National Football League (NFL) Scouting Combine with a history of hip arthroscopic surgery. Study Design: Cohort study; Level of evidence, 3. Methods: Athletes invited to the NFL Combine from 2012 to 2015 were evaluated for a history of hip arthroscopic surgery. Athlete demographics, imaging findings, and physical examination results were gathered using the NFL Combine database. Information on prospective participation in the NFL with regard to draft status, games played, games started, and current status was gathered using publicly available databases and compared against all other athletes participating in the combine. Results: Fourteen athletes (15 hips) had a history of arthroscopic hip surgery. Acetabular labral tears were treated in 93% (14 hips), with femoroacetabular impingement decompression performed in 33% (5 hips). Compared with athletes who had no history of hip arthroscopic surgery, those undergoing arthroscopic surgery did not possess a lower likelihood of being drafted (66% vs 71%, respectively; P = .78) or of being on an active roster (52% vs 43%, respectively; P = .44) after their first season in the NFL. Moreover, there was no significant difference in the number of regular-season games played (10.9 ± 4.8 with arthroscopic surgery vs 11.0 ± 5.1 without; P = .96) or started (7.0 ± 3.6 with arthroscopic surgery vs 7.1 ± 5.3 without; P = .98). Conclusion: American football athletes invited to the NFL Combine with a history of hip arthroscopic surgery were not at risk for diminished participation when compared with all other athletes during their first season in the NFL.

scholarly journals A Profile of Injuries Sustained by Firefighters: A Critical Review

2019 ◽  
Vol 16 (20) ◽  
pp. 3931 ◽  
Author(s):  
Robin Orr ◽  
Vinicius Simas ◽  
Elisa Canetti ◽  
Ben Schram
Keyword(s):  
Recent Literature ◽  
Methodological Approach ◽  
Level Of Evidence ◽  
Injury Rates ◽  
Injury Reduction ◽  
Work Related ◽  
Search Terms ◽  
Reduction Strategies ◽  
Meta Analyses

Firefighters, along with other tactical personnel, are at a high risk of work-related physical injury above that of the private sector. The aim of this critical narrative review was to identify, critically appraise and synthesise key findings from recent literature investigating firefighting musculoskeletal injuries to inform injury reduction programs. The methodological approach (search terms, databases, etc.) was registered with PROSPERO and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the Downs and Black checklist with scores graded according to the Kennelly grading system. Levels of evidence were ranked according to the Australian National Health and Medical Research Council. Of the 8231 studies identified, 17 met the criteria for inclusion. The methodological quality of the studies was ‘fair’ with a level of evidence of III-2. Reported injury rates ranged from 9% to 74% with the lower extremities and back the leading aggregated bodily sites of injury. Sprains and strains were the leading nature of musculoskeletal injury, often caused by slips, trips and falls, although muscle bending, lifting and squatting or muscle stressing were also prevalent. This review may inform injury reduction strategies and given that injuries reported in firefighters are similar to those of other tactical populations, safety processes to mitigate injuries may be of benefit across the tactical spectrum.

scholarly journals Descriptive Epidemiology of Rescue-Related Fatal Drowning in Turkey

2021 ◽  
Vol 18 (12) ◽  
pp. 6613
Author(s):  
Ali Işın ◽  
Adnan Turgut ◽  
Amy E. Peden
Keyword(s):  
Public Health ◽  
Retrospective Study ◽  
Relative Risk ◽  
Confidence Interval ◽  
Descriptive Epidemiology ◽  
Death Registry ◽  
Public Health Threat ◽  
Reduction Strategies ◽  
Media Reports ◽  
Risk Reduction Strategies

Drowning is a public-health threat and a leading cause of injury-related death. In Turkey, drowning results in 900 fatalities annually, and the rate is rising. As data on rescue-related drowning are scarce, this retrospective study explores the epidemiology of fatal drowning among rescuers in Turkey. As there are no routinely collected death registry data on drowning in Turkey, data were sourced from media reports of incidents between 2015 and 2019. Rescuer fatalities were analysed by age, sex, activity prior to rescue, location, incident day of week and season, and place of death. Statistical analyses comprised X2 tests of significance (p < 0.05) and calculation of relative risk (95% confidence interval) using fatality rates. In total, 237 bystander rescuers drowned (90% male; 35% 15–24 years). In 33% of cases, the primary drowning victim (PDV) was successfully rescued, while in 46% of cases the rescue resulted in multiple drowning fatalities (mean = 2.29; range 1–5 rescuers). Rescues were more likely to be successful in saving the PDV if undertaken at the beach/sea (X2 = 29.147; p < 0.001), while swimming (X2 = 12.504; p = 0.001), or during summer (X2 = 8.223; p = 0.029). Risk of bystander rescue-related fatal drowning was twice as high on weekdays compared to on weekends (RR = 2.04; 95%CI: 1.56–2.67). While bystanders play an important role in reducing drowning, undertaking a rescue is not without risk and can lead to multiple drowning incidents. Training in rescue and resuscitation skills (especially the prioritization of non-contact rescues) coupled with increasing awareness of drowning risk, are risk-reduction strategies which should be explored in Turkey.

scholarly journals Jones Fractures Identified at the National Football League Scouting Combine: Assessment of Prognostic Factors, Computed Tomography Findings, and Initial Career Performance

2018 ◽  
Vol 6 (8) ◽  
pp. 232596711879074 ◽  
Author(s):  
Robert C. Spang ◽  
Daniel B. Haber ◽  
Brendin R. Beaulieu-Jones ◽  
Kristen L. Stupay ◽  
George Sanchez ◽  
...  
Keyword(s):  
Computed Tomography ◽  
National Football League ◽  
Treatment Method ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Specific Performance ◽  
Incomplete Healing ◽  
Bony Healing ◽  
The Mean ◽  
Career Performance

Background: Jones fractures result in subsequent dysfunction and remain an issue for athletes. Purpose: To (1) describe the epidemiology, treatment, and impact of Jones fractures identified at the National Football League (NFL) Scouting Combine on players’ early careers and (2) establish the value of computed tomography (CT) to determine bony healing after a fracture in prospective players. Study Design: Cohort study; Level of evidence, 3. Methods: All players who attended the combine between 2009 and 2015 were retrospectively reviewed to identify their history of Jones fractures. The playing position, treatment method, and number of missed collegiate games were recorded. The mean overall draft pick number, number of games started and played, snap percentage, and position-specific performance scores (fantasy score) over the first 2 years in the NFL were compared between players with fractures and controls. An imaging classification system was applied based on grading of each quadrant of the fifth metatarsal (plantar, dorsal, medial, lateral), with a score of 0 for not healed or 1 for healed. Results: Overall, the number of Jones fractures identified was 72 in 2285 athletes (3.2%), with all treated via intramedullary screw fixation. The mean overall draft pick number for players with fractures was 111.2 ± 67.9 compared with 99.0 ± 65.9 for controls ( P = .12). Performance scores for players with fractures were lower than those for controls across all positions, with a significant difference in running backs (2.6 vs 4.0, respectively; P < .001) and defensive linemen (1.4 vs 2.3, respectively; P = .02). The mean CT score was 2.5 ± 1.3. Of the 32 athletes who underwent imaging, 16 Jones fractures (50.0%) were healed or nearly healed, 12 (37.5%) were partially healed, and 4 (12.5%) showed little or no healing. The plantar cortex demonstrated the least healing (18/32; 56.3%), followed by the lateral cortex (15/32; 46.9%). Players with a mean score <1 were found to have fewer games started (2.7 ± 2.5) than those with 1 to 3 cortices healed (17.4 ± 10.4) or all cortices healed (8.7 ± 11.2). Conclusion: Based on CT, 50% of all players with a previous Jones fracture demonstrated incomplete healing. Moreover, position-specific performance scores over the first 2 years of a player’s career were lower across all positions for those with fractures compared with controls. Players with CT scores <1 were found to start fewer games and were drafted later than controls.

Effect of Turf Toe on Foot Contact Pressures in Professional American Football Players

2009 ◽  
Vol 30 (5) ◽  
pp. 405-409 ◽  
Author(s):  
Robert H. Brophy ◽  
Seth C. Gamradt ◽  
Scott J. Ellis ◽  
Ronnie P. Barnes ◽  
Scott A. Rodeo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
National Football League ◽  
Peak Pressure ◽  
American Football ◽  
Football Players ◽  
Plantar Pressures ◽  
History Of ◽  
Turf Toe ◽  
The Relationship ◽  
Contact Pressures

Background: The relationship between turf toe and plantar foot pressures has not been extensively studied. Two hypotheses were tested in a cohort of professional American football players: first, that a history of turf toe is associated with increased peak hallucal and first metatarsophalangeal (MTP) plantar pressures; second, that decreased range of motion (ROM) of the first MTP correlates with increased peak hallucal and first MTP plantar pressures. Materials and Methods: Forty-four athletes from one National Football League (NFL) team were screened for a history of turf toe during preseason training. Dorsal passive MTP ROM and dynamic plantar pressures were measured in both feet of each player. Anatomical masking was used to assess peak pressure at the first MTP and hallux. Results: First MTP dorsiflexion was significantly lower in halluces with a history of turf toe (40.6 ± 15.1 degrees versus 48.4 ± 12.8 degrees, p = 0.04). Peak hallucal pressures were higher in athletes with turf toe (535 ± 288 kPa versus 414 ± 202 kPa, p = 0.05) even after normalizing for athlete body mass index ( p = 0.0003). Peak MTP pressure was not significantly different between the two groups tested. First MTP dorsiflexion did not correlate with peak hallucal or first MTP pressures. Conclusion: This study showed that turf toe is associated with decreased MTP motion. In addition, increased peak hallucal pressures were found. Further study is warranted to determine whether these pressures correlate with the severity of symptoms or progression of turf toe to first MTP arthritis.

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.

CLINICAL OUTCOMES OF PATIENTS UNDERGOING CORRECTION OF NEUROMUSCULAR SCOLIOSIS WITH A CONTROLLED HOSPITAL PROTOCOL – PRELIMINAR OUTCOMES

2021 ◽  
Vol 20 (4) ◽  
pp. 249-253
Author(s):  
Gabriela Alcalde Pereira ◽  
Caroline de Carvalho Garcia ◽  
Marcia Almeida Lima ◽  
José Carlos Baldocchi Pontin ◽  
Andrea Dias Lamas Mafra
Keyword(s):  
Retrospective Study ◽  
Surgical Correction ◽  
Neuromuscular Scoliosis ◽  
Complication Rates ◽  
Level Of Evidence ◽  
The Mean ◽  
Underlying Diseases ◽  
Level Hospital ◽  
Epidemiological Characterization

ABSTRACT Objectives: To identify the main hospital outcomes of patients undergoing surgical correction of neuromuscular scoliosis and to assess complication rates and achievement of mobility goals after the use of a managed protocol. Methods: This is a longitudinal, retrospective study, with data obtained six months after the application of a protocol in 103 patients of both sexes submitted to surgical correction of neuromuscular scoliosis, at a tertiary level hospital in São Paulo, between June and December 2018 (pre-protocol) and between May and September 2019 (post-protocol). Data from patients who had previously undergone other orthopedic spine surgeries were excluded. In addition to the data for epidemiological characterization of the underlying diseases, the clinical characteristics and complications were analyzed. Results: Of the 103 patients evaluated, there was a predominance of females (53.4%) and a mean age of 14.9 years. The most frequent diagnosis was cerebral palsy, the mean angle of curvature was 75°, and the most frequently observed comorbidities were lung diseases (25%). The protocol was partially adhered to by professionals and after its implementation, there was a significant decrease in pain and the systemic inflammatory response syndrome (SIRS), prevention of immobility and a low rate of infection. Conclusions: The use of a protocol focused on patients undergoing correction of neuromuscular scoliosis led to reduced complications of SIRS and reduced pain; kept the surgical site infection rate low, and prevented short-term immobility. Level of evidence III; Retrospective study.

scholarly journals Structure from Motion Multisource Application for Landslide Characterization and Monitoring: The Champlas du Col Case Study, Sestriere, North-Western Italy

Sensors ◽  
2019 ◽  
Vol 19 (10) ◽  
pp. 2364 ◽  
Author(s):  
Martina Cignetti ◽  
Danilo Godone ◽  
Aleksandra Wrzesniak ◽  
Daniele Giordan
Keyword(s):  
Structure From Motion ◽  
Winter Season ◽  
Cost Effective ◽  
Point Clouds ◽  
Slope Instability ◽  
Ski Resorts ◽  
Area Of Interest ◽  
3D Point Clouds ◽  
North Western

Structure from Motion (SfM) is a powerful tool to provide 3D point clouds from a sequence of images taken from different remote sensing technologies. The use of this approach for processing images captured from both Remotely Piloted Aerial Vehicles (RPAS), historical aerial photograms, and smartphones, constitutes a valuable solution for the identification and characterization of active landslides. We applied SfM to process all the acquired and available images for the study of the Champlas du Col landslide, a complex slope instability reactivated in spring 2018 in the Piemonte Region (north-western Italy). This last reactivation of the slide, principally due to snow melting at the end of the winter season, interrupted the main road used to reach Sestriere, one of the most famous ski resorts in north-western Italy. We tested how SfM can be applied to process high-resolution multisource datasets by processing: (i) historical aerial photograms collected from five diverse regional flights, (ii) RGB and multi-spectral images acquired by two RPAS, taken in different moments, and (iii) terrestrial sequences of the most representative kinematic elements due to the evolution of the landslide. In addition, we obtained an overall framework of the historical development of the area of interest, and distinguished several generations of landslides. Moreover, an in-depth geomorphological characterization of the Champlas du Col landslide reactivation was done, by testing a cost-effective and rapid methodology based on SfM principles, which is easily repeatable to characterize and investigate active landslides.

scholarly journals Studies Examining the Efficacy of Ankle Foot Orthoses should Report Activity Level and Mechanical Evidence

2010 ◽  
Vol 34 (3) ◽  
pp. 327-335 ◽  
Author(s):  
Jaap Harlaar ◽  
Merel Brehm ◽  
Jules G. Becher ◽  
Daan J. J. Bregman ◽  
Jaap Buurke ◽  
...  
Keyword(s):  
Treatment Algorithm ◽  
Relevant Information ◽  
Current Treatment ◽  
Activity Level ◽  
Walking Ability ◽  
Foot Orthoses ◽  
Level Of Evidence ◽  
Levels Of Evidence ◽  
Ankle Foot Orthoses

Ankle Foot Orthoses (AFOs) to promote walking ability are a common treatment in patients with neurological or muscular diseases. However, guidelines on the prescription of AFOs are currently based on a low level of evidence regarding their efficacy. Recent studies aiming to demonstrate the efficacy of wearing an AFO in respect to walking ability are not always conclusive. In this paper it is argued to recognize two levels of evidence related to the ICF levels. Activity level evidence expresses the gain in walking ability for the patient, while mechanical evidence expresses the correct functioning of the AFO. Used in combination for the purpose of evaluating the efficacy of orthotic treatment, a conjunct improvement at both levels reinforces the treatment algorithm that is used. Conversely, conflicting outcomes will challenge current treatment algorithms and the supposed working mechanism of the AFO. A treatment algorithm must use relevant information as an input, derived from measurements with a high precision. Its result will be a specific AFO that matches the patient's needs, specified by the mechanical characterization of the AFO footwear combination. It is concluded that research on the efficacy of AFOs should use parameters from two levels of evidence, to prove the efficacy of a treatment algorithm, i.e., how to prescribe a well-matched AFO.

Examining Referral Patterns between Otolaryngology and Gastroenterology: A Window into Potential Inter-Specialty Knowledge Gaps

2020 ◽  
Vol 129 (8) ◽  
pp. 801-805 ◽  
Author(s):  
Adam Haines ◽  
Nikita Kohli ◽  
Benjamin A. Lerner ◽  
Michael Z. Lerner
Keyword(s):  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Data Extraction ◽  
Level Of Evidence ◽  
Referral Patterns ◽  
Record Data ◽  
Laryngopharyngeal Reflux Disease ◽  
Icd 10 ◽  
Looking Glass

Objective: The objective of this study was to examine referral patterns between otolaryngology and gastroenterology in order to delineate areas of clinical overlap, as well as to identify areas that might benefit from improved inter-specialty communication and collaboration. Methods: Montefiore’s Clinical Looking Glass tool was used to define parameters for electronic medical record data extraction from 2015 to 2018. Two cohorts were generated, one representing referrals placed by gastroenterology to otolaryngology and a second representing referrals placed by otolaryngology to gastroenterology. The ICD-10 codes in both cohorts were reviewed and 13 distinct “reason for referral” categories were defined. The rates of referral for each category were then calculated for each of the referral cohorts. Results: Otolaryngology referred to gastroenterology at a greater rate than gastroenterology referred to otolaryngology, despite seeing fewer total patients than gastroenterology. For referrals from gastroenterology to otolaryngology, the three most frequent referral reasons were oral cavity/oropharyngeal pathology (28.3%), dysphagia (28.3%), and gastroesophageal reflux disease/laryngopharyngeal reflux disease (GERD/LPRD) (11.3%). For referrals from otolaryngology to gastroenterology, the three most frequent referral reasons were GERD/LPRD (61.7%), dysphagia (18.6%), and esophageal pathology (5.3%). Conclusions: GERD/LPRD was more frequently referred out by otolaryngology than it was by gastroenterology, suggesting the need for further characterization of the discrepancy in management of a disease commonly treated by both specialties. The discrepant rates of referral for dysphagia also suggest a need to better understand what factors contribute to the differences in management of another clinical condition commonly assessed by both specialties. Level of Evidence: 4

Sign in / Sign up

Export Citation Format

Share Document