scholarly journals Top Ten Reasons Why All Athletes Need to have Neuropsychological Testing

2019 ◽  
pp. 1-2
Author(s):  
Michael F Shaughnessy ◽  
Keyword(s):  
Chronic Traumatic Encephalopathy ◽  
Neuropsychological Testing ◽  
Head Injuries ◽  
Return To Play ◽  
Research Journal ◽  
Post Test ◽  
Control And Prevention ◽  
History Of ◽  
Tackle Football

Currently, we are more and more aware of head injuries, concussion and the risks and dangers of athletes being exposed to long term risk and injury.Twenty years or so ago, coaches relied on side line assessment to decide as to whether an athlete who“has had his/her bells rung” should return to play. Currently however, there is much more sophisticated sideline assessment (such as Impact) and other laptop instruments. There are many, many reasons why athletes should undergo pre-and post-test assessment as well as sideline assessment. These will be summarily discussed. These issues have also been discussed by:Arginteanu (2019) and others have clearly specified the need to be concerned and observant regardingthe concept of return to play and even return to the classroom. Hernandez, Giordano, Goubran, Parivash, Grant, Zeineh and Camarillo (2019) have discussed sports related concussions and Corman, Adame, Tsa, Ruston, Beaumont, Kamrath, Liu, Posteher, Tremblayand van Raalt, (2019) have published on sports related concussions. Rose, Yeates, Nguyen, McCarthy, Ercole, Pizzimenti, (2019)have written on youth tackle football. Engleman (2013) writing in The Rotarian pp 27-30 suggests that “youth football leagues should require coaches and encourage all parents, to take the “Heads IUP” training course available at www.cdc.gov. The web site of the U.S. Centers for Disease Control and Prevention” There is much concern about CTE (Chronic traumatic encephalopathy- which is a progressive degenerative disease of the brain. This is usually discerned in individuals who have some type of history of repetitive brain trauma or injury. This could include soccer, basketball, baseball, softball (at least many players DO wear helmets) and wrestling (in terms of wrestling, players do wear protective devices for their ears, but still may suffer concussions and head injuries. Shaughnessy and Laman (2012) have provided an excellent review of evidence based intervention and treatment/rehabilitation of traumatic brain injury. This was published in the Research Journal in Organizational Psychology and Educational Studies and is a serious review of the literature in this realm.

scholarly journals A Qualitative Study of Youth Football Coaches’ Perception of Concussion Safety in American Youth Football and Their Experiences With Implementing Tackling Interventions

2020 ◽  
pp. 1-9
Author(s):  
Kelly Sarmiento ◽  
Dana Waltzman ◽  
Kelley Borradaile ◽  
Andrew Hurwitz ◽  
Kara Conroy ◽  
...  
Keyword(s):  
Head Injuries ◽  
Young Age ◽  
Long Term Effects ◽  
Head Impacts ◽  
Football Coaches ◽  
Youth Athletes ◽  
Risks And Benefits ◽  
Youth Football ◽  
Tackle Football

Due in part to concern about the potential long-term effects of concussion and repetitive head injuries in football, some programs have implemented tackling interventions. This paper explores youth football coaches’ perception of football safety and their experiences implementing these interventions aimed at athlete safety. Using a qualitative approach, coaches were interviewed by means of a semi-structured protocol that covered: (a) demographics; (b) background and experiences with contact sports; (c) perceived concussion risks and benefits of youth football; (d) experiences with tackling technique; (e) experiences with mouth guard sensors; and (f) personal sources of training related to football safety. Most coaches felt that learning tackling at a young age helped prepare them for their playing later in life and believed that youth should begin playing tackle football at a young age. Coaches were mixed regarding their concerns about the risk for concussion and subconcussive head impacts. Still, most were receptive to changes in rules and policies aimed at making football safer. Findings from this study demonstrate that youth football coaches are important stakeholders to consider when implementing changes to youth football. Understanding coach perceptions and experiences may inform future efforts aimed to educate coaches on rules and policies to make the game safer for youth athletes.

Long-Term Anesthetic-Dependent Hypoactivity after Repetitive Mild Traumatic Brain Injuries in Adolescent Mice

2016 ◽  
Vol 38 (3) ◽  
pp. 220-238 ◽  
Author(s):  
Bridgette D. Semple ◽  
Raha Sadjadi ◽  
Jaclyn Carlson ◽  
Yiran Chen ◽  
Duan Xu ◽  
...  
Keyword(s):  
Brain Injuries ◽  
Injury Severity ◽  
Vasogenic Edema ◽  
Head Injuries ◽  
Traumatic Brain Injuries ◽  
Return To Play ◽  
Brain Maturation ◽  
Long Term Outcomes ◽  
Mild Traumatic Brain Injuries

Recent evidence supports the hypothesis that repetitive mild traumatic brain injuries (rmTBIs) culminate in neurological impairments and chronic neurodegeneration, which have wide-ranging implications for patient management and return-to-play decisions for athletes. Adolescents show a high prevalence of sports-related head injuries and may be particularly vulnerable to rmTBIs due to ongoing brain maturation. However, it remains unclear whether rmTBIs, below the threshold for acute neuronal injury or symptomology, influence long-term outcomes. To address this issue, we first defined a very mild injury in adolescent mice (postnatal day 35) as evidenced by an increase in Iba-1- labeled microglia in white matter in the acutely injured brain, in the absence of indices of cell death, axonal injury, and vasogenic edema. Using this level of injury severity and Avertin (2,2,2-tribromoethanol) as the anesthetic, we compared mice subjected to either a single mTBI or 2 rmTBIs, each separated by 48 h. Neurobehavioral assessments were conducted at 1 week and at 1 and 3 months postimpact. Mice subjected to rmTBIs showed transient anxiety and persistent and pronounced hypoactivity compared to sham control mice, alongside normal sensorimotor, cognitive, social, and emotional function. As isoflurane is more commonly used than Avertin in animal models of TBI, we next examined long-term outcomes after rmTBIs in mice that were anesthetized with this agent. However, there was no evidence of abnormal behaviors even with the addition of a third rmTBI. To determine whether isoflurane may be neuroprotective, we compared the acute pathology after a single mTBI in mice anesthetized with either Avertin or isoflurane. Pathological findings were more pronounced in the group exposed to Avertin compared to the isoflurane group. These collective findings reveal distinct behavioral phenotypes (transient anxiety and prolonged hypoactivity) that emerge in response to rmTBIs. Our findings further suggest that selected anesthetics may confer early neuroprotection after rmTBIs, and as such mask long-term abnormal phenotypes that may otherwise emerge as a consequence of acute pathogenesis.

scholarly journals Concussion in Hockey: Compliance with Return to Play Advice and Follow-up Status

2009 ◽  
Vol 36 (2) ◽  
pp. 207-212 ◽  
Author(s):  
Alun Ackery ◽  
Christine Provvidenza ◽  
Charles H. Tutor
Keyword(s):  
Head Injuries ◽  
Compliance Rate ◽  
Retrospective Chart Review ◽  
Participation Rate ◽  
Clinic Visit ◽  
Return To Play ◽  
Hockey Players ◽  
Professional Aspirations

Objectives:To determine the compliance rate among hockey players with concussion or other head injuries who were advised by a physician about return to play. To assess compliance of hockey players with return to play advice and to assess the incidence of long-term post-concussion symptoms.Methods:A retrospective chart review, telephone questionnaire and follow-up analysis of income, level of education and professional aspirations. The study examined 40 hockey players with concussion or other head injury treated at a neurosurgical ambulatory clinic, who had initial visits between 1995 and 2003, and had been seen at least two years prior to completing the questionnaire.Results:There was a 58% (23 of 40) participation rate in the study. Fifteen (65%) of the 23 participants were advised to never return to play, and 5 (33%) were non-compliant and returned to play. Four (80%) of the five non-compliant players continued to suffer from post concussion symptoms. Overall, 15 (65%) of the 23 players participating in the study continued to suffer post concussion symptoms at least two years after the clinic visit.Conclusions:Five (33%) of 15 hockey players advised to never return to play were non-compliant and returned to play, and four continued to suffer from post concussion symptoms two or more years later. After repeated concussions, 65% of hockey players had long-term sequelae that prevented return to play and produced long-term post-concussion symptoms.

scholarly journals Mitigating the Consequences of Subconcussive Head Injuries

2020 ◽  
Vol 22 (1) ◽  
pp. 387-407
Author(s):  
Eric A. Nauman ◽  
Thomas M. Talavage ◽  
Paul S. Auerbach
Keyword(s):  
Head Injury ◽  
Clinical Diagnosis ◽  
Head Injuries ◽  
Tissue Level ◽  
Clinical Neurology ◽  
Subconcussive Injury ◽  
History Of ◽  
Tissue Alteration ◽  
The Brain

Subconcussive head injury represents a pathophysiology that spans the expertise of both clinical neurology and biomechanical engineering. From both viewpoints, the terms injury and damage, presented without qualifiers, are synonymously taken to mean a tissue alteration that may be recoverable. For clinicians, concussion is evolving from a purely clinical diagnosis to one that requires objective measurement, to be achieved by biomedical engineers. Subconcussive injury is defined as subclinical pathophysiology in which underlying cellular- or tissue-level damage (here, to the brain) is not severe enough to present readily observable symptoms. Our concern is not whether an individual has a (clinically diagnosed) concussion, but rather, how much accumulative damage an individual can tolerate before they will experience long-term deficit(s) in neurological health. This concern leads us to look for the history of damage-inducing events, while evaluating multiple approaches for avoiding injury through reduction or prevention of the associated mechanically induced damage.

scholarly journals Prevalence of Concussion in Quidditch

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S21.1-S21
Author(s):  
Michael Pepper ◽  
Jeff Wayland ◽  
Adam Elwood ◽  
Spencer Walser ◽  
Vi Tran ◽  
...  
Keyword(s):  
Head Injury ◽  
Health Effects ◽  
Head Injuries ◽  
Return To Play ◽  
Long Term Effects ◽  
Basic Care ◽  
Significant Burden ◽  
Traditional Sports ◽  
Repetitive Injury

ObjectiveThe aim of our study is to assess the rate of concussion occurring while engaging in nontraditional sports such as Quidditch, and the effects that injury during a novelty sport may have on concussion detection when compared to more traditional sports.BackgroundConcussions, once dismissed as nonconsequential, are rapidly attracting notice for acute and long-term health effects. Rates of recovery with repeated trauma is known to decrease with each occurrence. In novelty sports, regulation of concussions and proper return-to-play(RTP) protocol are not routinely enforced, resulting in repetitive injury to the detriment of players.Design/MethodsIRB approval was obtained prior to survey distribution to all players associated with Major League Quidditch (MLQ). Responses were recorded and analyzed.Results157 responses were received. 63% were male and 37% female with mean age 22.9. 146 (93%) respondents confirmed or denied quidditch-related head injury. 22 (15%) denied head injury and 124 (85%) indicated hitting their heads while participating in the sport. 19% of respondents indicated >10 head injuries. 67 (54%) reported suspected concussion with an additional 41 (33%) reporting formal diagnosis with at least one concussion. EMS reported 18 injuries at MLQ matches. 5 (27.8%) were preliminarily diagnosed with concussion. 3 had no further treatment, 1 RTP and 1 received basic care. 0 recieved formal neurologic evaluation. Players were also asked about head injuries sustained in non-quidditch activities for comparison. 43 (27%) reported having medically diagnosed concussions outside of quidditch. 53 (34%) reported at least one suspected concussion without formal diagnosis. 24 (15%) answered maybe.ConclusionsOur data supports that concussion is a significant burden in novelty sports such as quidditch. It is vital to recognize that with the rise of nontraditional sports, the prevalence of concussions in younger nontraditional athletes may be underreported and that concussion specialists must be cognizant of both traditional and novelty sports when evaluating long term effects of head trauma.

scholarly journals Effectiveness of the US Centers for Disease Control and Prevention HEADS UP coaches’ online training as an educational intervention

2019 ◽  
Vol 78 (7) ◽  
pp. 784-797 ◽  
Author(s):  
Jill Daugherty ◽  
Lara DePadilla ◽  
Kelly Sarmiento
Keyword(s):  
Disease Control ◽  
Online Training ◽  
Return To Play ◽  
Rank Test ◽  
The Us ◽  
Post Test ◽  
Control And Prevention ◽  
Signed Rank Test ◽  
Centers For Disease Control ◽  
High Level

Background: Concussions are common among youth athletes. Responsibility for the recognition and management of concussion is often put on coaches. To equip coaches with appropriate knowledge and skills, the US Centers for Disease Control and Prevention (CDC) launched the HEADS UP: Concussion in Youth Sports online training. Objectives: To determine whether HEADS UP coaches’ training improves knowledge, attitudes and behavioural intentions. Methods: Knowledge questions were grouped into scales by level of difficulty. Differences between pre- and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score and effect sizes were interpreted. Results: Coaches displayed a high level of knowledge in the pre-test. While lower difficulty questions did not show improvement from pre- to post-test, moderate and high difficulty questions did. Use of the training was associated with improved knowledge about symptom resolution, return-to-play recommendations and under-reporting of incidents of concussion. Coaches demonstrated improvement in five of the seven concussion-related attitude and behavioural intention items post training. Conclusion: HEADS UP training improved coaches’ knowledge on select topics and helped them feel more comfortable about responding to concussion among their athletes. This study provides insight into how to better focus future HEADS UP concussion health education efforts to fit coaches’ informational needs.

Statement of the American Society of Clinical Oncology: genetic testing for cancer susceptibility, Adopted on February 20, 1996.

1996 ◽  
Vol 14 (5) ◽  
pp. 1730-1736 ◽  
Keyword(s):  
Genetic Testing ◽  
Early Detection ◽  
Cancer Risk ◽  
Cancer Susceptibility ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Post Test ◽  
History Of ◽  
American Society

As the leading organization of physicians who treat people with cancer, the American Society of Clinical Oncology (ASCO) recognizes that cancer specialists must be fully informed of the range of issues involved in genetic testing for cancer risk. The newly discovered and still developing ability to identify individuals at highest risk for cancer holds the promise of improved prevention and early detection of cancers. It also poses potential medical, psychological, and other personal risks that must be addressed in the context of informed consent for genetic testing. ASCO firmly believes that any physician who offers genetic testing should be aware of, and able to communicate, the benefits and limits of current testing procedures, and the range of prevention and treatment options available to patients and their families. For these reasons, ASCO endorses the following principles: ASCO affirms the role of clinical oncologists in documenting a family history of cancer in their patients, providing counseling regarding familial cancer risk and options for prevention and early detection, and recognizing those families for which genetic testing may serve as an aid in counseling. To the greatest extent possible, genetic testing for cancer susceptibility should be performed in the setting of long-term outcome studies. ASCO endorses the formulation and implementation of a national cooperative study/registry with appropriate confidentiality to define the clinical significance of mutations in known cancer susceptibility genes. ASCO is committed to providing educational opportunities for physicians concerning methods of quantitative cancer risk assessment, genetic testing, and pre- and post-test genetic counseling so that oncologists may more responsibly integrate genetic counseling and testing into the practice of clinical and preventive oncology. Oncologists must assure that informed consent has been given by the patient as an integral part of the process of genetic predisposition testing, whether such testing is offered on a clinical or research basis. ASCO recommends that cancer predisposition testing be offered only when: 1) the person has a strong family history of cancer or very early age of onset of disease; 2) the test can be adequately interpreted; and 3) the results will influence the medical management of the patient or family member. As clinical testing becomes more widely available, the Society encourages oncologists to utilize laboratories committed to the validation of testing methodologies, and to facilitate families' participation in long-term outcome studies. ASCO recommends that oncologists include in pre- and post-test counseling discussion of possible risks and benefits of cancer early detection and prevention modalities, which have presumed but unproven efficacy for individuals at the highest hereditary risk for cancer. ASCO endorses efforts to strengthen regulatory authority over laboratories that provide cancer predisposition tests that will be utilized to inform clinical decisions. These regulatory requirements should include appropriate oversight of the products used in genetic testing, interlaboratory comparisons of reference samples, as well as quality control mechanisms. ASCO endorses all efforts including legislation to prohibit discrimination by insurance companies or employers based on an individual's inherited susceptibility to cancer. All individuals at hereditary risk for cancer should have access to appropriate genetic testing and associated medical care, which should be covered by public and private third-party payers. ASCO endorses continued support of patient-oriented research to analyze the psychological impact of genetic testing of at-risk populations.

scholarly journals Chronic Traumatic Encephalopathy: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Michael Saulle ◽  
Brian D. Greenwald
Keyword(s):  
Military Service ◽  
Clinical Presentation ◽  
Chronic Traumatic Encephalopathy ◽  
Head Injuries ◽  
Emotional Disturbances ◽  
American Football ◽  
Closed Head Injuries ◽  
Apoe4 Allele ◽  
Closed Head

Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that is a long-term consequence of single or repetitive closed head injuries for which there is no treatment and no definitive pre-mortem diagnosis. It has been closely tied to athletes who participate in contact sports like boxing, American football, soccer, professional wrestling and hockey. Risk factors include head trauma, presence of ApoE3 or ApoE4 allele, military service, and old age. It is histologically identified by the presence of tau-immunoreactive NFTs and NTs with some cases having a TDP-43 proteinopathy or beta-amyloid plaques. It has an insidious clinical presentation that begins with cognitive and emotional disturbances and can progress to Parkinsonian symptoms. The exact mechanism for CTE has not been precisely defined however, research suggest it is due to an ongoing metabolic and immunologic cascade called immunoexcitiotoxicity. Prevention and education are currently the most compelling way to combat CTE and will be an emphasis of both physicians and athletes. Further research is needed to aid in pre-mortem diagnosis, therapies, and support for individuals and their families living with CTE.

Subconcussive Head Impacts and Neurocognitive Function Over 3 Seasons of Youth Football

2021 ◽  
pp. 088307382110044
Author(s):  
Sean C. Rose ◽  
Keith Owen Yeates ◽  
Joseph T. Nguyen ◽  
Patrick M. Ercole ◽  
Natalie M. Pizzimenti ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Social Adjustment ◽  
Neuropsychological Testing ◽  
Football Players ◽  
Cumulative Impact ◽  
Head Impacts ◽  
Before And After ◽  
History Of ◽  
Tackle Football ◽  
Neurobehavioral Outcomes

Objective: To determine the association between repetitive subconcussive head impacts and neurobehavioral outcomes in youth tackle football players. Methods: Using helmet-based sensors, we measured head impacts for 3 consecutive seasons of play in 29 male players age 9-11. Cumulative impact g’s were calculated. Players completed a battery of outcome measures before and after each season, including neuropsychological testing, vestibular-ocular sensitivity, and self- and parent-reported measures of symptoms and attention-deficit hyperactivity disorder (ADHD). Results: Average cumulative impact over 3 seasons was 13 900 g. High-intensity hits predicted worse change for self-reported social adjustment ( P = .001). Cumulative impact did not predict change in any of the outcome measures. History of ADHD, anxiety, and depression predicted worse change for self-reported symptoms and social adjustment, independent of head impacts. When players were stratified into 3 groups based on cumulative impact across all 3 seasons, differences in outcome measures existed prior to the start of the first season. These differences did not further increase over the course of the 3 seasons. Conclusion: Over 3 consecutive seasons of youth tackle football, we found no association between cumulative head impacts and neurobehavioral outcomes. Larger sample sizes and longer follow-up times would further assist in characterizing this relationship.

scholarly journals Professional Action Sport Athletes’ Experiences with and Attitudes Toward Concussion: A Phenomenological Study

2016 ◽  
Author(s):  
Caroline Faure ◽  
John Fitzpatrick
Keyword(s):  
Lived Experiences ◽  
Phenomenological Study ◽  
Head Injuries ◽  
Personal History ◽  
Long Term Effects ◽  
Extrinsic Factors ◽  
History Of ◽  
Personal Accounts ◽  
Intrinsic And Extrinsic Factors

This study examined the lived experiences and subsequent attitudes of freestyle BMX and motocross athletes relative to suffering concussions. Eleven professional athletes were interviewed using a semi-structured protocol. All cited a significant personal history with concussion and those personal accounts, along with their observations of others who experienced similar head injuries, shaped the athletes’ attitudes towards concussion. Both intrinsic and extrinsic factors contributed to each athlete’s acceptance of concussion risk inherent in their respective sport. Generally, athletes accepted concussion risk as part of their sport, but were largely unfamiliar with what concussion was and what long-term effects could result from a history of concussion. Additionally, athletes knew of no concussion protocols or guidelines in their sport and cited an overall lack of organized medical care accessible to them on an ongoing basis, as is the case with mainstream sports.

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