scholarly journals Post-concussion return to boxing protocol

2016 ◽  
Vol 28 (2) ◽  
pp. 61-62
Author(s):  
N Sethi
Keyword(s):  
National Football League ◽  
Return To Play ◽  
Medical Community ◽  
Decision Making Process ◽  
Cognitive Rest ◽  
Biomechanical Forces ◽  
Evidence Based Guidelines ◽  
Professional Boxing ◽  
The Brain ◽  
Impact Syndrome

Background: Concussion is a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. Immediately following a concussion, an athlete is usually advised physical and cognitive rest until post-concussion symptoms abate. The athlete then enters a stepwise return-to-play protocol. Premature return to play risks a second concussion, second impact syndrome, exacerbation and persistence of post-concussive symptoms. Various sports governing organisations such as the National Football League have developed post-concussion return to play protocols.Discussion: Professional boxing is a popular contact sport in which concussions are common. Professional boxing currently lacks a standardised post-concussion return to boxing protocol. Professional boxers are arbitrarily suspended for periods ranging from 30 to 90 days after suffering a technical knockout (TKO) due to multiple head and body shots or after a knockout (KO). For some boxers a neurology clearance is requested prior to their return to boxing.Conclusion: Developing and implementing a post-concussion return to the boxing protocol will standardise a return to boxing decision-making process and help to protect a boxer’s health. This paper proposes a post-concussion return to boxing protocol with the recommendation that the proposed protocol be debated vigorously by the scientific community and evidence-based guidelines be developed by the medical community in conjunction with the professional boxing governing bodies.

scholarly journals Good versus bad medical stoppages in boxing: Stopping a fight in time

2017 ◽  
Vol 28 (3) ◽  
Author(s):  
N Sethi
Keyword(s):  
Causes Of Death ◽  
Good Practice ◽  
Health And Safety ◽  
The United States ◽  
Medical Community ◽  
Contact Sport ◽  
Common Causes ◽  
Evidence Based Guidelines ◽  
Professional Boxing ◽  
Impact Syndrome

Background: Professional boxing is a popular contact sport with a high risk for both acute and chronic traumatic brain injury (TBI). Although rare, many boxers have died in the ring or soon after the completion of a bout. The most common causes of death in these cases are usually acute subdural hematomas, acute epidural hematomas, a subarachnoid haemorrhage, an intracranial haemorrhage or Second Impact Syndrome (SIS). Ringside physicians are entrusted with the health and safety of boxers in the ring and in the immediate aftermath of a bout.Discussion: As per the Uniform Boxing Rules (approved August 25, 2001, Amended August 2, 2002, Amended July 3, 2008, Amended July 24, 2012, Amended July 29, 2014), the referee is the sole arbiter of a bout and is the only individual authorised to stop a contest. [1]In some states in the United States and in other countries around the world, the referee and the ringside physician are the sole arbiters of a fight and the only individuals authorised to enter the fighting area at any time during the competition and also authorised to stop a fight. This raises the important question of when should a fight be stopped on medical grounds.Conclusion: Standardising medical stoppage decisions in boxing will help to protect a boxer’s health and safety in the ring. Good practice guidelines for medical stoppage due to suspected TBI are suggested. It is recommended that the medical community debate the proposed guidelines vigorously, in order that evidence-based guidelines can be developed in conjunction with professional boxing governing bodies.

scholarly journals Concussion in National Football League Athletes Is Not Associated With Increased Risk of Acute, Noncontact Lower Extremity Musculoskeletal Injury

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110034
Author(s):  
Toufic R. Jildeh ◽  
Fabien Meta ◽  
Jacob Young ◽  
Brendan Page ◽  
Kelechi R. Okoroha
Keyword(s):  
Lower Extremity ◽  
National Football League ◽  
Field Performance ◽  
Return To Play ◽  
Lower Extremity Injury ◽  
Extremity Injury ◽  
Lower Extremity Injuries ◽  
Increased Risk ◽  
Extremity Injuries ◽  
And Control

Background: Impaired neuromuscular function after concussion has recently been linked to increased risk of lower extremity injuries in athletes. Purpose: To determine if National Football League (NFL) athletes have an increased risk of sustaining an acute, noncontact lower extremity injury in the 90-day period after return to play (RTP) and whether on-field performance differs pre- and postconcussion. Study Design: Cohort study, Level of evidence, 3. Methods: NFL concussions in offensive players from the 2012-2013 to the 2016-2017 seasons were studied. Age, position, injury location/type, RTP, and athlete factors were noted. A 90-day RTP postconcussive period was analyzed for lower extremity injuries. Concussion and injury data were obtained from publicly available sources. Nonconcussed, offensive skill position NFL athletes from the same period were used as a control cohort, with the 2014 season as the reference season. Power rating performance metrics were calculated for ±1, ±2, and ±3 seasons pre- and postconcussion. Conditional logistic regression was used to determine associations between concussion and lower extremity injury as well as the relationship of concussions to on-field performance. Results: In total, 116 concussions were recorded in 108 NFL athletes during the study period. There was no statistically significant difference in the incidence of an acute, noncontact lower extremity injury between concussed and control athletes (8.5% vs 12.8%; P = .143), which correlates with an odds ratio of 0.573 (95% CI, 0.270-1.217). Days (66.4 ± 81.9 days vs 45.1 ± 69.2 days; P = .423) and games missed (3.67 ± 3.0 vs 2.9 ± 2.7 games; P = .470) were similar in concussed athletes and control athletes after a lower extremity injury. No significant changes in power ratings were noted in concussed athletes in the acute period (±1 season to injury) when comparing pre- and postconcussion. Conclusion: Concussed, NFL offensive athletes did not demonstrate increased odds of acute, noncontact, lower extremity injury in a 90-day RTP period when compared with nonconcussed controls. Immediate on-field performance of skill position players did not appear to be affected by concussion.

scholarly journals Acute Gastrocnemius-Soleus Complex Injuries in National Football League Athletes

2017 ◽  
Vol 5 (1) ◽  
pp. 232596711668034 ◽  
Author(s):  
Brian C. Werner ◽  
Nicole S. Belkin ◽  
Steve Kennelly ◽  
Leigh Weiss ◽  
Ronnie P. Barnes ◽  
...  
Keyword(s):  
Relative Frequency ◽  
National Football League ◽  
Fluid Collection ◽  
Magnetic Resonance Images ◽  
Calf Muscle ◽  
Return To Play ◽  
Imaging Findings ◽  
Muscle Injuries ◽  
Lower Extremity Muscle ◽  
Imaging Characteristics

Background: Lower extremity muscle injuries are common in professional football. Although less common than hamstring or quadriceps injuries in National Football League (NFL) athletes, calf injuries occur with relative frequency and have not previously been studied. Purpose: To evaluate gastrocnemius-soleus complex muscle injuries over the past 13 years from a single NFL team to determine the incidence of such injuries, their imaging characteristics, and return to play after such injuries and any correlation between imaging findings and prolonged return to play. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of all acute calf muscle injuries on a single NFL team from 2003 to 2015 was performed. Player demographics and return-to-play data were obtained from the medical records. All available magnetic resonance images (MRIs) were reviewed by a musculoskeletal radiologist for specific imaging findings that correlated with return to play. Results: A total of 27 calf injuries in 24 NFL players were reviewed, yielding an incidence of 2.3 acute calf injuries per year on a single NFL team. Of these 27 injuries, 20 (74%) were isolated injuries to the gastrocnemius muscle, 4 (15%) were isolated injuries to the soleus muscle, and the remaining 3 injuries (11%) involved both. Defensive players were more likely to sustain injuries ( P = .043). The mean time to return to play for all 27 players was 17.4 ± 14.6 days (range, 3-62 days). MRIs were available in 14 of the 27 injuries. The average size of the fascial defect ( P = .032) and the presence of a fluid collection ( P = .031) both correlated with return to play of longer than 2 weeks. Conclusion: Although less common than hamstring or quadriceps muscle injuries, calf muscle injuries occur with relative frequency in the NFL, and more so in defensive players. The majority of these injuries occur in the gastrocnemius and result in significant disability, with at least 2 weeks of missed playing time on average. MRI may have an important role in the evaluation of calf injuries in NFL players, as certain injury imaging characteristics, including the anteroposterior size of any fascial tear and the presence of a fluid collection, are associated with longer return-to-play times after injury.

scholarly journals Sport-related concussions

2014 ◽  
Vol 8 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Jéssica Natuline Ianof ◽  
Fabio Rios Freire ◽  
Vanessa Tomé Gonçalves Calado ◽  
Juliana Rhein Lacerda ◽  
Fernanda Coelho ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Behavioral Changes ◽  
American Football ◽  
Health Concern ◽  
Public Health Concern ◽  
Increased Risk ◽  
High Prevalence ◽  
Biomechanical Forces ◽  
The Brain

ABSTRACT Traumatic brain injury (TBI) is a major cause of lifelong disability and death worldwide. Sport-related traumatic brain injury is an important public health concern. The purpose of this review was to highlight the importance of sport-related concussions. Concussion refers to a transient alteration in consciousness induced by external biomechanical forces transmitted directly or indirectly to the brain. It is a common, although most likely underreported, condition. Contact sports such as American football, rugby, soccer, boxing, basketball and hockey are associated with a relatively high prevalence of concussion. Various factors may be associated with a greater risk of sport-related concussion, such as age, sex, sport played, level of sport played and equipment used. Physical complaints (headache, fatigue, dizziness), behavioral changes (depression, anxiety, irritability) and cognitive impairment are very common after a concussion. The risk of premature return to activities includes the prolongation of post-concussive symptoms and increased risk of concussion recurrence.

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.

Return to Play Following Achilles Tendon Rupture in NFL Players Based on Position

2021 ◽  
pp. 193864002110403
Author(s):  
Dane Barton ◽  
Aditya Manoharan ◽  
Ansab Khwaja ◽  
Jacob Sorenson ◽  
Michel Taylor
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
National Football League ◽  
Achilles Tendon Rupture ◽  
Epidemiologic Study ◽  
Return To Play ◽  
Control Group ◽  
Study Cohort ◽  
History Of ◽  
Level 3

Background: The purpose of this study was to determine the return-to-play (RTP) rate and postinjury performance after Achilles tendon (AT) ruptures in National Football League (NFL) skill position players. Methods: The study included NFL skill positions with an AT rupture between the 2009-2010 and 2015-2016 seasons. Performance data were collected and compared against a matched control group. RTP was defined as playing in at least 1 game after repair. Results: RTP rate was 57% for the study cohort. The tight ends (TEs) had the highest RTP rate at 71% while the wide receivers (WRs) had the lowest RTP rate at 38%. Compared with the control group, WRs with successful RTP had significantly less receptions per game ( P = .01). For defensive players with RTP there were significant decreases in postrepair performance in tackles, passes defended, and fumbles forced/recovered compared with the control group. Conclusion: A total of 57% of players achieved RTP with WRs and running backs (RBs) having the lowest RTP rates and TEs and linebackers (LBs) having the highest RTP rates. RBs, defensive backs (DBs), and LBs with successful RTP had decreased performance in all categories. This updated information may be helpful for athletes, physicians, scouts, and coaches in evaluating players with a history of AT rupture. Levels of Evidence: Analytic, level 3, retrospective cohort study, Epidemiologic study

Central Language Hypothesis in the Decision-Making Process

2016 ◽  
pp. 66-83 ◽  
Author(s):  
Duygu Buğa
Keyword(s):  
Decision Making ◽  
Theoretical Framework ◽  
Future Research ◽  
Limbic Cortex ◽  
Decision Making Process ◽  
Discussion Section ◽  
Research Directions ◽  
Additional Information ◽  
Future Research Directions ◽  
The Brain

The purpose of this chapter is to explore the potential connection between neuroeconomics and the Central Language Hypothesis (CLH) which refers to the language placed within the subconscious mind of an individual. The CLH forwards that in the brains of bilingual and multilingual people, one language is more suppressive as it dominates reflexes, emotions, and senses. This central language (CL) is located at the centre of the limbic cortex of the brain. Therefore, when there is a stimulus on the limbic cortex (e.g., fear, anxiety, sadness), the brain produces the central language. The chapter begins with an Introduction followed by a Theoretical Framework. The next section discusses the neurolinguistic projection of the central language and includes the survey and the results used in this study. The Discussion section provides additional information regarding the questionnaire and the CLH, followed by Future Research Directions, Implications, and finally the Conclusion.

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