Impact of Playing Surface on Concussion Symptoms in Young American Football Players

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S12.2-S12
Author(s):  
Morgan Michelle Heinzelmann ◽  
Mathew Stokes ◽  
Stephen Bunt ◽  
Nyaz Didehbani ◽  
Shane Miller ◽  
...  
Keyword(s):  
American Football ◽  
Prior History ◽  
Football Players ◽  
Symptom Checklist ◽  
North Texas ◽  
Blurred Vision ◽  
The North ◽  
History Of ◽  
Modifiable Factor ◽  
Time Since Injury

ObjectiveTo identify differences in symptoms following sports-related concussion (SRC) on natural grass vs artificial turf in youth and adolescent football players.BackgroundThere is continued interest in reducing risk of SRC in football, with playing surface being one potentially modifiable factor. It is estimated that 15–30% of concussions result from helmet-to-ground contact, and some studies have suggested a higher incidence of SRC on grass in competitive contact sports compared to turf. To our knowledge, our study is the first to investigate reported post-concussive symptoms after SRC as they relate to playing surface.Design/MethodsData were prospectively collected from the North Texas Concussion Registry (ConTex), a longitudinal multi-institutional concussion database. We selected male football players between the ages of 10 and 24 who sustained a helmet-to-ground SRC (GCS 13–15) on either grass or turf. Pre-injury information and post-concussive symptoms (Graded Symptom Checklist from the SCAT-5) were collected at an initial in-person visit within 2 weeks of injury and via electronic follow up at 3 months.ResultsFifty-eight participants were included (grass = 32, turf = 26), and groups were similar in age (p = 0.089), time since injury (p = 0.500), history of headache (χ2 = 0.167), and prior history of concussion (χ2 = 0.868). Athletes who sustained SRC on grass reported significantly higher scores on the Graded Symptom Checklist (p = 0.018, mean 26.0 vs 11.4) and higher numbers of distinct symptoms (p = 0.013, mean 10.2 vs 5.5) compared to those who sustained SRC on turf. Symptoms that were rated significantly higher after SRC on grass included headache (p = 0.010), phonophobia (p = 0.014), dizziness (p = 0.001), fatigue (p = 0.021), blurred vision (p = 0.001), feeling “in a fog” (p = 0.014), difficulty remembering (p = 0.004), and feeling emotional (p = 0.041).ConclusionsYouth and adolescent football players who sustain SRC on grass report higher post-concussive symptom severity and burden. Elucidating differential effects of SRC on grass vs turf is important, as competitive playing surface is a modifiable risk factor.

Do Learning Disorders Impact Clinical Measures Following Concussion?

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S16.3-S17
Author(s):  
Mathew Stokes ◽  
Aaron J. Zynda ◽  
Jane Chung ◽  
Cheryl Silver ◽  
Munro Cullum ◽  
...  
Keyword(s):  
Impulse Control ◽  
Clinical Findings ◽  
Learning Disorders ◽  
Adhd Group ◽  
North Texas ◽  
The North ◽  
Patient Health ◽  
History Of ◽  
Clinical Measures ◽  
Time Since Injury

ObjectiveEvaluate differences in clinical testing following concussion between adolescents with no history of learning disorder (LD) and those with a history of dyslexia and/or ADD/ADHD.BackgroundLearning disorders, such as ADHD, can affect ImPACT® baseline neurocognitive testing. The effect that ADHD has on other clinical measures is less well understood. Additionally, limited data exists on the effect of dyslexia on these measures.Design/MethodsData were prospectively collected from participants enrolled in the North Texas Concussion Registry (ConTex). Participants ages 10–18 years old, diagnosed with a concussion sustained within 30 days of enrollment were included and assessed for self-reported history of LD type (dyslexia and/or ADD/ADHD). Clinical findings examined included symptom scores (derived from SCAT5™), ImPACT®, King-Devick (KD) test, patient health questionnaire 8(PHQ-8) scores, and generalized anxiety disorder 7(GAD-7) scores. Mann-Whitney tests were used to compare groups.ResultsIn total, 1,298 participants were included: 58 with dyslexia, 158 with ADD/ADHD, 35 with both (dyslexia and ADD/ADHD), and 1,047 with no LD. There was no difference in age, sex, time since injury, or history of concussion apart from the ADD/ADHD group, which had more males (p < 0.001). The dyslexia group had slower mean KD time (p = 0.011) and increased error scores (p = 0.028). In those with ADD/ADHD, impulse control scores on ImPACT® were significantly higher (p = 0.007), but no other ImPACT® score differences reached significance. PHQ-8 and GAD-7 scores were significantly higher in those with ADD/ADHD (p < 0.001). Participants with both dyslexia and ADHD demonstrated slower KD times (p = 0.009) and had higher PHQ-8 (p < 0.001) and GAD-7 (p = 0.001) scores.ConclusionsParticipants with dyslexia and/or ADD/ADHD had worse scores on commonly used concussion clinical measures including ImPACT® impulse control, KD testing, and depression and anxiety screenings. Understanding the differences in these groups will aid providers in their evaluation and assist in counseling families regarding the injury.

scholarly journals Pediatric headache incidence and outcomes after sports-related concussion: Findings from the North Texas ConcussionRegistry (ConTex)

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S11.3-S12
Author(s):  
Bert B. Vargas ◽  
Elida Godbey ◽  
Stephen Bunt ◽  
Ali Shah Tejani ◽  
Munro Cullum
Keyword(s):  
Common Symptom ◽  
North Texas ◽  
Recurrent Headache ◽  
Symptom Resolution ◽  
The North ◽  
Pediatric Headache ◽  
History Of ◽  
Time Since Injury ◽  
Mean Time

IntroductionHeadache is the most common symptom reported after concussion; however, little is known about the incidence of headache and the clinical course over 3 months in pediatric patients with sports-related concussion (SRC) presenting within 30 days of injury.MethodsFour hundred twenty-five patients met inclusion criteria (patients under 18 years old limited to SRC within 30 days of injury and who also completed a 3 months follow up evaluation) and were enrolled from any 1 of 5 ConTex clinic sites.ResultsMean age was 14.3 years (range = 7–18, SD 2.2) and mean time since injury at presentation to clinic was 8.1 days (range = 0–30, SD = 6.7). Only 13.7% (n = 56) had a history of headache before their concussion. 96.5% (n = 410) of patients recalled having headache at time of injury. At initial presentation, 77.3% (n = 317) reported headache; 38.2% (n = 121) mild, 48.6% (n = 154) moderate, 13.2% (n = 42) severe (on a scale from 0-6). At 3 months follow up, 19.8% (n = 81) reported headache; 76.6% (n = 62) mild, 18.5% (n = 15) moderate, 4.9% (n = 4) severe. Among 264 that were treated with headache abortive medications, 97.7% (n = 258) used simple analgesics (NSAIDs or acetaminophen); 0.8% (n = 2) used opioids; 10.2% (n = 27) used triptans; and 5.7% (n = 15) used other non-specified treatments. 66.5% of children reported symptom resolution within 29 days (range 0–90 days, mode 17–29, n = 71, 20.2%).ConclusionsThe incidence of headache at the time of concussion is high and remains high within 30 days after injury, the majority of which were moderate in severity. By 3 months, only a minority of patients report headache, the majority of which were mild. For 86.3% of children, their first experience with recurrent headache occurred in the context of SRC. Outcomes were generally good at 3 months despite an overwhelming majority of children being treated with non-specific, simple analgesics. Most children reported symptom resolution within 29 days of injury.

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.

scholarly journals Effects on intracranial cerebral blood flow by history of concussion

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S5.2-S5
Author(s):  
Yu Hiramoto ◽  
Haruo Nakayama ◽  
Satoshi Iwabuchi
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Flow Velocity ◽  
American Football ◽  
Average Score ◽  
Football Players ◽  
Mean Flow ◽  
Interpersonal Contact ◽  
Significant Difference ◽  
History Of

AimDecrease of intracranial cerebral blood flow is an important factor in pathophysiology of concussion. Transcranial Doppler (TCD) is simple and minimally invasive tool that can evaluate intracranial cerebral blood flow.MethodWe examined University American football players, number of 81 players. In the pre-season (before interpersonal contact), We evaluated their cerebral function with SCAT and evaluated intracranial cerebral blood flow with TCD by the same examiner. Forty-five players from which TCD waveforms could clearly be depicted were targeted. We divided them into concussion group (7 players with a history of concussion) and non-concussion group (38 players without a history of concussion). And we examined the score of SCAT and the parameter of TCD between the 2 groups.ResultThe average score of SCAT was 91.4 points, and there was no difference between the 2 groups due to the history of concussion. For parameter of TCD, the average of the depth is 64.9 mm, the average of Mean flow velocity is 37.4 cm/s (±9.2), the average of Peak flow velocity is 66.4 cm/s (±17.0). There was no difference between the 2 groups due to the history of concussion.ConclusionIn this study, there was no significant difference in the parameter of TCD or SCAT due to the presence or absence of concussion history.

Prevalence and Variance of Shoulder Injuries in Elite Collegiate Football Players

2005 ◽  
Vol 33 (8) ◽  
pp. 1142-1146 ◽  
Author(s):  
Lee D. Kaplan ◽  
David C. Flanigan ◽  
John Norwig ◽  
Patrick Jost ◽  
James Bradley
Keyword(s):  
Rotator Cuff ◽  
Surgical Procedures ◽  
American Football ◽  
Football Players ◽  
Shoulder Injuries ◽  
Anterior Instability ◽  
Posterior Instability ◽  
Rotator Cuff Injuries ◽  
History Of ◽  
Collegiate Football

Background Shoulder injuries are the fourth most common musculoskeletal injury encountered in American football players. There is little information in the literature on the role of playing position in the type of shoulder injuries seen. Hypothesis There is a high prevalence of shoulder injuries in elite collegiate American football players, with type of injury varying by playing position. Study Design Cohort study (prevalence); Level of evidence, 3. Methods A total of 336 elite collegiate American football players were invited to the National Football League Combine for physical testing and medical evaluation. Current and historical data were evaluated for the purpose of this study, and all players underwent radiographic examinations, including plain radiographs and/or magnetic resonance imaging when necessary. All shoulder pathological conditions and shoulder surgical procedures were recorded. Players were categorized by position for the analysis of position-specific trends. Results Of the players, 50% had a history of shoulder injuries, with a total of 226 shoulder injuries (1.3 injuries per player injured); 56 players (34%) had a total of 73 surgeries. The most common injuries were acromioclavicular separation (41%), anterior instability (20%), rotator cuff injury (12%), clavicle fracture (4%), and posterior instability (4%). The most common surgeries performed were anterior instability reconstruction (48%), Mumford/Weaver-Dunn surgery (15%), posterior instability surgery (10%), and rotator cuff surgery (10%). Shoulder injuries were more common in quarterbacks and defensive backs. Surgery was more common in linebackers or linemen. A history of anterior instability was more common in defensive players, with surgery required 76% of the time. Linemen had more rotator cuff injuries and posterior instability than players in other positions. Conclusion Shoulder injuries are common injuries in elite collegiate football players, with one-third undergoing surgical procedures. There are definitive trends in the types of injuries per player position.

scholarly journals Concussion related deficits in the general population predict impairments in varsity footballers

2019 ◽  
Author(s):  
Clara Alexandra Stafford ◽  
Bobby Stojanoski ◽  
Conor Wild ◽  
Danielle Brewer-Deluce ◽  
Timothy D. Wilson ◽  
...  
Keyword(s):  
General Population ◽  
Inhibitory Control ◽  
Population Level ◽  
American Football ◽  
Cognitive Tasks ◽  
Football Players ◽  
Head Impacts ◽  
Demographic Questionnaire ◽  
History Of

ObjectiveWe investigated the long-term cognitive effects of concussion in 19,261 members of the general population and a cohort of varsity American football players with a history of frequent head impacts, using tests that are known to be sensitive to small changes in performance. MethodsWe asked 19,261 participants to complete a demographic questionnaire and 12 cognitive tests measuring aspects of executive function, including inhibitory control. We compared the performance of those reporting a history of concussion (post-concussion) to those reporting no history of concussion (non-concussed) on the cognitive battery and four non-cognitive variables. We used the results of this population-level study to predict the profile of cognitive performance in varsity American football players, who completed the same cognitive tasks. ResultsPost-concussion and non-concussed participants did not differ on 11 of the 12 cognitive tasks employed. However, on a test of inhibitory control based on the classic Stroop paradigm, post-concussion participants showed accuracy-related impairments specific to the incongruent conditions of the task. Post-concussion participants reported higher levels of anxiety, depression, and trouble concentrating. An entirely independent sample of 74 varsity American football players demonstrated the same pattern of impairment: compared to healthy controls, they scored significantly lower on the test of inhibitory control but were indistinguishable from controls on the 11 other tasks.InterpretationSelf-reported concussion is not associated with long-term general effects on cognitive function. Nevertheless, those who report at least one concussion and those who expose themselves to long-term frequent sport-related head impacts, do have a modest, but statistically robust, deficit of inhibitory control.

History of Chronic Traumatic Encephalopathy

2020 ◽  
Vol 40 (04) ◽  
pp. 353-358
Author(s):  
Robert C. Cantu ◽  
Charles Bernick
Keyword(s):  
Chronic Traumatic Encephalopathy ◽  
Neurological Impairment ◽  
American Football ◽  
Football Players ◽  
Long Term Effects ◽  
Public Attention ◽  
Head Impacts ◽  
Repetitive Head Impacts ◽  
History Of ◽  
Initial Description

AbstractThe long-term effects of repetitive head impacts have been recognized for close to a century. What is now referred to as chronic traumatic encephalopathy (CTE) was first described by Martland in 1928 in a series of boxers. Over the years, several important articles were published, including Critchley's 1957 report where he introduced the term “chronic traumatic encephalopathy,” Robert's study in 1969 which provided evidence of the prevalence of neurological impairment in retired fighters, and Corsellis' initial description of the pathology of CTE. However, what brought public attention to the issue of CTE in sports were the postmortem findings of CTE pathology in professional American football players, initially reported by Omalu and subsequently in a large series by McKee. There is now standardization of pathological criteria for CTE and recognition that it can be seen across all activities that involve repetitive head impacts.

An index predictive of cognitive outcome in retired professional American Football players with a history of sports concussion

2016 ◽  
Vol 38 (5) ◽  
pp. 561-571 ◽  
Author(s):  
Mathew J. Wright ◽  
Ellen Woo ◽  
J. Brandon Birath ◽  
Craig A. Siders ◽  
Daniel F. Kelly ◽  
...  
Keyword(s):  
Cognitive Outcome ◽  
American Football ◽  
Football Players ◽  
Sports Concussion ◽  
History Of

Ras al Khaimah: further archaeological discoveries

Antiquity ◽  
1976 ◽  
Vol 50 (200) ◽  
pp. 216-222
Author(s):  
Beatrice De Cardi
Keyword(s):  
United Arab Emirates ◽  
The State ◽  
Focused Attention ◽  
North East ◽  
The North ◽  
History Of ◽  
The City

Ras a1 Khaimah is the most northerly of the seven states comprising the United Arab Emirates and its Ruler, H. H. Sheikh Saqr bin Mohammad al-Qasimi, is keenly interested in the history of the state and its people. Survey carried out there jointly with Dr D. B. Doe in 1968 had focused attention on the site of JuIfar which lies just north of the present town of Ras a1 Khaimah (de Cardi, 1971, 230-2). Julfar was in existence in Abbasid times and its importance as an entrep6t during the sixteenth and seventeenth centuries-the Portuguese Period-is reflected by the quantity and variety of imported wares to be found among the ruins of the city. Most of the sites discovered during the survey dated from that period but a group of cairns near Ghalilah and some long gabled graves in the Shimal area to the north-east of the date-groves behind Ras a1 Khaimah (map, FIG. I) clearly represented a more distant past.

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