scholarly journals Longer Neurophysiological vs. Clinical Recovery Following Sport Concussion

2021 ◽  
Vol 3 ◽  
Author(s):  
Michail Ntikas ◽  
Angus M. Hunter ◽  
Iain J. Gallagher ◽  
Thomas G. Di Virgilio
Keyword(s):  
Assessment Tool ◽  
Recovery Period ◽  
Silent Period ◽  
Intracortical Inhibition ◽  
Small Sample ◽  
The Other ◽  
American Football ◽  
Return To Play ◽  
Sport Concussion ◽  
Concussion Recovery

Objectives: The objective of this study was to assess if injury-related alterations in the Sport Concussion Assessment Tool-5 (SCAT5) are matched by changes in transcranial magnetic stimulation-derived intracortical inhibition. We hypothesised that neurophysiological measures would take longer to return to normal than recovery assessed by the SCAT5 following sport related concussion (SRC).Methods: Thirteen male contact sport athletes (20.5 ± 4.5 years), who reported a concussion were recruited from local Rugby and American football clubs. Participants were tested at 4 timepoints throughout the concussion recovery period: within 24 h of concussion (day 0), and at 7, 9, and 11 days after concussion. All participants completed the SCAT5 and underwent TMS to assess cortical silent period duration (CSp), a measure of intracortical inhibition.Results: After concussion CSp significantly declined from day 0 (122 ± 28 ms) to day 11 (106 ± 15 ms) [F(3, 33) = 7.80, p < 0.001]. SCAT5 measures of symptom number and severity were significantly decreased [symptom number: χ(3)2 = 30.44, p < 0.01; symptom severity: χ(3)2 = 25.75, p < 0.001] between the day 0 timepoint and each of the other timepoints. SCAT5 balance errors (mBESS) decreased significantly [F(3, 33) = 19.55, p < 0.001] between the day 0 timepoint and each of the other timepoints. CSp and SCAT5 recovery patterns were different. SCAT5 domains recovered faster showing no further significant changes after day 7, whilst CSp was still decreasing between days 7 and 9. Due to the small sample size we also used a Bayesian linear model to investigate the recovery of CSp and mBESS. The posterior distribution of our Bayesian model provided evidence that CSp decreased at day 7 and it continued to decrease at day 9, unlike mBESS which decreased at day 7 and then reached a plateau.Conclusion: There are clinically important discrepancies between clinical and neurophysiological measures of concussion recovery. This finding has important implications for return to play (RTP) protocols and the prevention of complications after sport concussion.

scholarly journals Post-traumatic headache: the use of the sport concussion assessment tool (SCAT-3) as a predictor of post-concussion recovery

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Olivia Begasse de Dhaem ◽  
William B. Barr ◽  
Laura J. Balcer ◽  
Steven L. Galetta ◽  
Mia T. Minen
Keyword(s):  
Assessment Tool ◽  
Sport Concussion ◽  
Post Traumatic ◽  
Concussion Recovery

scholarly journals Symptoms and Vestibular Screening in Pediatric Concussion

2019 ◽  
Vol 34 (5) ◽  
pp. 763-763
Author(s):  
V Fazio Sumrok ◽  
N Kegel ◽  
N Blaney ◽  
A Colorito ◽  
K Viggiano ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Assessment Tool ◽  
Descriptive Statistics ◽  
Population Characteristics ◽  
Return To Play ◽  
Ocular Motor ◽  
Clinical Assessments ◽  
Pediatric Concussion ◽  
Sport Concussion ◽  
Symptom Ratings

Abstract Purpose Purpose: Children under age 11 participate in sports with a risk of concussion. Tools are limited for assessment. Clinicians rely on exam for management and return to play. Researchers have started assessment adaptation: Sport Concussion Assessment Tool-5 Child (SCAT-5 Child) (Davis et al., 2017) and Vestibular/Ocular Motor Screening (VOMS) (Mucha et al., 2014). The purpose of this study was to compare scores on components of the SCAT-5 Child, Pediatric VOMS, and SCAT-5 Parent. Methods Method: Participants included 59 children (M-33/26-F) aged 5-10 (7.50±1.17) within 30 days from concussion. Participants completed the SCAT-5 Child, SCAT-5 parent, and Pediatric VOMS at all visits. Descriptive statistics were used to calculate population characteristics. Paired t-tests were used to compare measures. Results Results: 42.6% (n=25) reported symptoms on VOMS at first visit. Only 10.0% reported symptom on VOMS (p=.003) at second visit. VOMS scores were improved across visits (p=.003). Participants reported decreases in symptom severity (p<.001) and number (p<.001) on the SCAT-5 Child across visits. Parents reported decreases in symptom severity (p=.009) and number (p=.005). Both children (p=.001) and parents (p=.001) reported significant increases in BTN% across visits. Participants and parent reported similar scores in number of symptoms, severity, and BTN% on the SCAT-5 at both visits. Conclusion Conclusions: Results demonstrate the Pediatric VOMS assessment is useful to evaluate vestibular/ocular impairment. The SCAT-5 Child and Parent do not evaluate these areas. Symptom ratings decrease and are similar between parent and child, indicating this measure remains consistent across reporters. Findings highlight needed expansion of clinical assessments and research in pediatrics.

scholarly journals Examining Changes in Sleep Between Concussed and Healthy Individuals Across Recovery

2019 ◽  
Vol 34 (5) ◽  
pp. 746-746
Author(s):  
M Anderson ◽  
A C Bretzin ◽  
K M Petit ◽  
C P Tomczyk ◽  
J L Savage ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Pittsburgh Sleep Quality Index ◽  
Assessment Tool ◽  
Return To Play ◽  
Healthy Individuals ◽  
Concussion Management ◽  
Main Effect ◽  
Sport Concussion ◽  
Within Subjects ◽  
The Relationship

Abstract Purpose To examine changes and the relationship between Pittsburgh Sleep Quality Index (PSQI) scores and the Sport Concussion Assessment Tool–5th Edition (SCAT5) sleep symptom across recovery between concussed and healthy individuals. Methods Sixty-eight (18.12±2.6 years; male:n=47, female:n=21; concussed:n=38, healthy:n=30) individuals completed the PSQI and SCAT5 at three times across recovery (≤72 hours of injury, return-to-play (RTP), >one-month after RTP). Two mixed between-within subjects analysis of variance (ANOVAs) evaluated changes in PSQI scores and SCAT5 sleep symptom across recovery between concussed and healthy individuals. Spearman’s rho correlations were used to examine the relationships between the two sleep measures. Significance was set at p≤.05. Results There was no significant groupXtime interaction for PSQI scores (Wilks λ=.96, F(2,65)=1.50, p=.23, η2=.04) or SCAT5 sleep symptom (Wilks λ=.93, F(2,65)=2.42, p=.10, η2=.07). There was a significant main effect for time for PSQI scores (Wilks λ=.65, F(2,65)=17.2, p<.001, η2=.35) and SCAT5 sleep symptom (Wilks λ=.88, F(2,65)=4.25, p=.02, η2=.12) with PSQI scores and SCAT5 sleep symptom improving over time. For the SCAT5 sleep symptom there was a significant main effect for group (F(1,66)=13.41, p<.001, η2=.17), with concussed individuals reporting higher SCAT5 sleep symptom (M=0.59, SE=0.1) than healthy controls (M=0.09, SE=0.1). There was no significant correlation between PSQI scores and SCAT5 sleep symptom ≤72 hours (r=.15, p=.36), but there were significant correlations at RTP (r=.38, p=.02) and >one-month (r=.43, p=.01). Conclusion Global sleep quality changes throughout recovery and may influence post-concussion outcomes. Utilizing a specialized sleep measure along with sleep-related symptoms may be beneficial to healthcare professionals, specifically during acute concussion management.

scholarly journals Correspondence regarding: Post-traumatic headache: the use of the sport concussion assessment tool (SCAT-3) as a predictor of post-concussion recovery

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Salman Khazaei ◽  
Shiva Mansouri Hanis ◽  
Kamyar Mansori ◽  
Olivia Begasse de Dhaem ◽  
William B. Barr ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Sport Concussion ◽  
Post Traumatic ◽  
Concussion Recovery

scholarly journals Concussion in cricket: Clinical findings using Sport Concussion Assessment Tool and recovery timeframes

2021 ◽  
Vol 5 ◽  
pp. 205970022199332
Author(s):  
Laura M Lallenec ◽  
Anna E Saw ◽  
Alex Kountouris ◽  
Richard Saw ◽  
John Orchard
Keyword(s):  
Clinical Utility ◽  
Assessment Tool ◽  
Clinical Findings ◽  
Head Impact ◽  
Return To Play ◽  
Clinical Tool ◽  
Female Cricket ◽  
Sport Concussion ◽  
Recovery Times ◽  
Clinical Records

Objectives To retrospectively review data of concussed and non-concussed elite cricket athletes following head impact to describe which clinical features on the day of injury are associated with concussion diagnosis. A secondary aim was to describe the recovery time of concussed athletes. Design Retrospective cohort study. Methods This study reviewed five seasons of Sport Concussion Assessment Tool (SCAT) data and clinical records for elite male and female cricket athletes who sustained a head impact during a cricket match or training. Results Data from 30 concussed and 37 non-concussed athletes were compared. Symptoms of ‘don’t feel right’ and ‘feeling slowed down’ had the strongest clinical utility for a concussion diagnosis post head impact. Concussed athletes reported a significantly lower ‘percent of normal’ (median 60%, IQR 60–90%) compared to athletes who sustained a non-concussive head impact (median 99%, IQR 95–100%, p = 0.003). No other component of the SCAT distinguished concussed from non-concussed athletes on day of injury. Concussed athletes typically experienced symptom resolution within 2–8 days and completed a graded return to play protocol within 4–14 days. No differences in SCAT findings or recovery times were observed between genders. Conclusion The SCAT may be used as a clinical tool to assist in diagnosis of concussionin elite cricket athletes. The components of the SCAT with the greatest clinical utility on day of injury were athlete-reported symptoms and ‘percent of normal’. Concussed cricket athletes typically complete their graded return to play protocol within 14 days however individualised management is paramount.

Information about Sports Related Concussion and Return to Play Rules in Youth Soccer, Rugby and Handball on Websites of German Sports Clubs (Preprint)

2020 ◽  
Author(s):  
Laura Rihani ◽  
Jennifer Usinger ◽  
Nicola Jungbäck ◽  
Gabriele Stumm ◽  
Thorsten Schulz ◽  
...  
Keyword(s):  
Brain Injuries ◽  
Return To Play ◽  
Online Information ◽  
Lower Saxony ◽  
Systematic Analysis ◽  
Youth Soccer ◽  
Sports Clubs ◽  
Sport Concussion ◽  
The Usa ◽  
Sports Activities

BACKGROUND Sports-related mild traumatic brain injuries (sports related concussion, SRC) have received increasing attention since neurodegenerative processes have been linked to repetitive SRCs. Return-to-Play (RTP) rules have been established for medical advised return into sports activities after concussion, but it is not clear if these rules also reach the sports clubs and its young athletes. OBJECTIVE In youth sports, athletes and their parents search the internet for advice after SRC. We therefore investigated which websites of German sports associations and clubs in football (soccer), handball and rugby offer information on SRC and RTP rules. METHODS The systematic analysis included websites of local football, handball and rugby clubs in two comparable regions in Southern Bavaria and Lower Saxony. The websites of the regional and the German umbrella associations were also included into the study. Eight criteria of the revised Sport Concussion Consensus Statement served as standard for the evaluation according to the protocol published by Swallow et al. (J Neurosurg Pediatr, 2018). RESULTS No information on RTP rules or the topic “sports-related brain injuries” could be found on any of the clubs’ websites. Only the Bavarian Football Association and the Rugby Association sporadically provided information on the topic. The German umbrella associations in football and rugby take up international documents and regulations of the European and the world associations. No information could be found at the German Handball Association. CONCLUSIONS The topics of sports-related brain injuries and RTP rules are mostly neglected on the analysed Websites. This is remarkable, as there are clearly defined consensus guidelines which are widely accepted in international comparison. Especially in the USA, online information on this topic has become standard.

Lost in Translation or a Work in Progress? Developing Desistance-Informed Youth Justice Practice in the Welsh Context

2020 ◽  
Author(s):  
John Deering ◽  
Jonathan Evans
Keyword(s):  
Assessment Tool ◽  
Work Practice ◽  
Social Work Practice ◽  
Small Sample ◽  
Structured Interviews ◽  
Youth Justice ◽  
Practice Model ◽  
Case File ◽  
Justice Practice ◽  
Lost In Translation

Abstract This article draws upon empirical research conducted within a Welsh Youth Offending Service (YOS) in 2017–2018. It captured staff responses to the introduction of AssetPlus, an assessment tool intended to complement a corresponding move to desistance-informed practice. Given that YOSs are now expected to develop practice underpinned by desistance theories, the article focuses on how desistance theories were interpreted and translated into one YOS. It was concluded that the introduction of the new practice model suffered from inadequate planning and AssetPlus assessment did little to enhance this shift. In an exercise in Utopianism, the views of practitioners and managers were sought on what constituted ‘ideal’ practice with children in conflict with the law. The researchers found some evidence of support for holistic child-centred social work practice that addressed contextual factors. The study was conducted with a small sample of practitioners and operational managers, involving seven semi-structured interviews, two focus groups (a total of eighteen respondents), case file analysis, document reading and observation. Given the size of the sample, the findings are not regarded as generalisable, but rather as raising important issues and pointers for further research.

scholarly journals Long-Term Clinical Outcomes of Osteochondritis Dissecans Lesions of the Elbow Treated with Arthroscopy

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0020
Author(s):  
Michael Ryan ◽  
Benton Emblom ◽  
E. Lyle Cain ◽  
Jeffrey Dugas ◽  
Marcus Rothermich
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Failure Rate ◽  
Osteochondritis Dissecans ◽  
Surgical Techniques ◽  
The Other ◽  
Return To Play ◽  
Exclusion Criteria

Objectives: While numerous studies exist evaluating the short-term clinical outcomes for patients who underwent arthroscopy for osteochondritis dissecans (OCD) of the capitellum, literature on long-term clinical outcomes for a relatively high number of this subset of patients from a single institution is limited. We performed a retrospective analysis on all patients treated surgically for OCD of the capitellum at our institution from January 2001 to August 2018. Our hypothesis was that clinical outcomes for patients treated arthroscopically for OCD of the capitellum would be favorable, with improved subjective pain scores and acceptable return to play for these patients. Methods: Inclusion criteria for this study included the diagnosis and surgical treatment of OCD of the capitellum treated arthroscopically with greater than 2-year follow-up. Exclusion criteria included any surgical treatment on the ipsilateral elbow prior to the first elbow arthroscopy for OCD at our institution, a missing operative report, and/or any portions of the arthroscopic procedure that were done open. Follow-up was achieved over the phone by a single author using three questionnaires: American Shoulder and Elbow Surgeons – Elbow (ASES-E), Andrews/Carson KJOC, and our institution-specific return-to-play questionnaire. Results: After the inclusion and exclusion criteria were applied to our surgical database, our institution identified 101 patients eligible for this study. Of these patients, 3 were then excluded for incomplete operative reports, leaving 98 patients. Of those 98 patients, 81 were successfully contacted over the phone for an 82.7% follow-up rate. The average age for this group at arthroscopy was 15.2 years old and average post-operative time at follow-up was 8.2 years. Of the 81 patients, 74 had abrasion chondroplasty of the capitellar OCD lesion (91.4%) while the other 7 had minor debridement (8.6%). Of the 74 abrasion chondroplasties, 29 of those had microfracture, (39.2% of that subgroup and 35.8% of the entire inclusion group). Of the microfracture group, 4 also had an intraarticular, iliac crest, mesenchymal stem-cell injection into the elbow (13.7% of capitellar microfractures, 5.4% of abrasion chondroplasties, and 4.9% of the inclusion group overall). Additional arthroscopic procedures included osteophyte debridement, minor synovectomies, capsular releases, manipulation under anesthesia, and plica excisions. Nine patients had subsequent revision arthroscopy (11.1% failure rate, 5 of which were at our institution and 4 of which were elsewhere). There were also 3 patients within the inclusion group that had ulnar collateral ligament reconstruction/repair (3.7%, 1 of which was done at our institution and the other 2 elsewhere). Lastly, 3 patients had shoulder operations on the ipsilateral extremity (3.7%, 1 operation done at our institution and the other 2 elsewhere). To control for confounding variables, scores for the questionnaires were assessed only for patients with no other surgeries on the operative arm following arthroscopy (66 patients). This group had an adjusted average follow-up of 7.9 years. For the ASES-E questionnaire, the difference between the average of the ASES-E function scores for the right and the left was 0.87 out of a maximum of 36. ASES-E pain was an average of 2.37 out of a max pain scale of 50 and surgical satisfaction was an average of 9.5 out of 10. The average Andrews/Carson score out of a 100 was 91.5 and the average KJOC score was 90.5 out of 100. Additionally, out of the 64 patients evaluated who played sports at the time of their arthroscopy, 3 ceased athletic participation due to limitations of the elbow. Conclusions: In conclusion, this study demonstrated an excellent return-to-play rate and comparable subjective long-term questionnaire scores with a 11.1% failure rate following arthroscopy for OCD of the capitellum. Further statistical analysis is needed for additional comparisons, including return-to-play between different sports, outcome comparisons between different surgical techniques performed during the arthroscopies, and to what degree the size of the lesion, number of loose bodies removed or other associated comorbidities can influence long-term clinical outcomes.

scholarly journals Cortical silent period reflects individual differences in action stopping performance

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mario Paci ◽  
Giulio Di Cosmo ◽  
Mauro Gianni Perrucci ◽  
Francesca Ferri ◽  
Marcello Costantini
Keyword(s):  
Individual Differences ◽  
Response Inhibition ◽  
Primary Motor Cortex ◽  
Silent Period ◽  
Intracortical Inhibition ◽  
Stop Signal ◽  
Stop Signal Task ◽  
Behavioral Differences ◽  
Cortical Silent Period ◽  
Stop Signal Reaction Time

AbstractInhibitory control is the ability to suppress inappropriate movements and unwanted actions, allowing to regulate impulses and responses. This ability can be measured via the Stop Signal Task, which provides a temporal index of response inhibition, namely the stop signal reaction time (SSRT). At the neural level, Transcranial Magnetic Stimulation (TMS) allows to investigate motor inhibition within the primary motor cortex (M1), such as the cortical silent period (CSP) which is an index of GABAB-mediated intracortical inhibition within M1. Although there is strong evidence that intracortical inhibition varies during action stopping, it is still not clear whether differences in the neurophysiological markers of intracortical inhibition contribute to behavioral differences in actual inhibitory capacities. Hence, here we explored the relationship between intracortical inhibition within M1 and behavioral response inhibition. GABABergic-mediated inhibition in M1 was determined by the duration of CSP, while behavioral inhibition was assessed by the SSRT. We found a significant positive correlation between CSP’s duration and SSRT, namely that individuals with greater levels of GABABergic-mediated inhibition seem to perform overall worse in inhibiting behavioral responses. These results support the assumption that individual differences in intracortical inhibition are mirrored by individual differences in action stopping abilities.

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