Dataset Information

The Epidemiology of Sports-Related Head Injury and Concussion in Water Polo.

ABSTRACT:

Purpose

Water polo is a sport with a high degree of physicality and aggressive play. Unlike most contact sports, epidemiological data on the incidence or prevalence of head trauma in water polo have not been gathered, reported, or made publicly available. The purpose of this study was to begin a systematic characterization of the risks of head impact and concussion in men and women who play water polo at various levels.

Design

We sent an electronic survey to the 44,000+ members of USA Water Polo, asking questions about concussions, head impacts, and symptoms commonly associated with prior concussion. From over 1500 complete responses, we report summary information on the prevalence of concussions and major head impacts in water polo.

Results

We found that 36% of respondents report sustaining a concussion while playing water polo, with an average of two concussions reported. The prevalence and number of concussions reported varied across positions, levels, and gender. Most strikingly, we found that goalies are at significantly higher risk for concussion, report a significantly more concussions, and appear to experience a qualitatively different type of head impact compared to other positions. Additionally, we found that competition level, gender, and field position are robust predictors of concussion risk.

Conclusion

Our findings demonstrate that concussions are not uncommon in water polo players. We conclude that there is need for systematic concussion reporting in water polo and suggest that understanding the risk factors of concussion in water polo will require fully considering differences in the head impact exposure between different field positions, competition levels, sexes, and differences in exposure between competition and practice.

SUBMITTER: Blumenfeld RS

PROVIDER: S-EPMC4919321 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

The Epidemiology of Sports-Related Head Injury and Concussion in Water Polo.

Blumenfeld Robert S RS Winsell Jessica C JC Hicks James W JW Small Steven L SL

Frontiers in neurology 20160624

<h4>Purpose</h4>Water polo is a sport with a high degree of physicality and aggressive play. Unlike most contact sports, epidemiological data on the incidence or prevalence of head trauma in water polo have not been gathered, reported, or made publicly available. The purpose of this study was to begin a systematic characterization of the risks of head impact and concussion in men and women who play water polo at various levels.<h4>Design</h4>We sent an electronic survey to the 44,000+ members of ...[more]

PMID: 27445965

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Project description:Background and purposeQuantitative susceptibility mapping using MR imaging can assess changes in brain tissue structure and composition. This report presents preliminary results demonstrating changes in tissue magnetic susceptibility after sports-related concussion.Materials and methodsLongitudinal quantitative susceptibility mapping metrics were produced from imaging data acquired from cohorts of concussed and control football athletes. One hundred thirty-six quantitative susceptibility mapping datasets were analyzed across 3 separate visits (24 hours after injury, 8 days postinjury, and 6 months postinjury). Longitudinal quantitative susceptibility mapping group analyses were performed on stability-thresholded brain tissue compartments and selected subregions. Clinical concussion metrics were also measured longitudinally in both cohorts and compared with the measured quantitative susceptibility mapping.ResultsStatistically significant increases in white matter susceptibility were identified in the concussed athlete group during the acute (24 hour) and subacute (day 8) period. These effects were most prominent at the 8-day visit but recovered and showed no significant difference from controls at the 6-month visit. The subcortical gray matter showed no statistically significant group differences. Observed susceptibility changes after concussion appeared to outlast self-reported clinical recovery metrics at a group level. At an individual subject level, susceptibility increases within the white matter showed statistically significant correlations with return-to-play durations.ConclusionsThe results of this preliminary investigation suggest that sports-related concussion can induce physiologic changes to brain tissue that can be detected using MR imaging-based magnetic susceptibility estimates. In group analyses, the observed tissue changes appear to persist beyond those detected on clinical outcome assessments and were associated with return-to-play duration after sports-related concussion.

Project description:BackgroundGaelic games are some of the most popular sports played by Irish adolescents, and the Gaelic Athletic Association has undertaken educational initiatives to improve awareness of a sports-related concussion (SRC). However, SRC underreporting is common among adolescent athletes internationally, potentially due to poor knowledge or attitudes toward SRC. This study aimed to examine previous experiences with, knowledge of, and attitudes toward reporting SRCs, as well as views on future education in adolescent Gaelic games players and their parents.HypothesesThe hypotheses were as follows: (1) A significant number of adolescent Gaelic games players will have experienced an SRC, (2) nondisclosure of SRCs will be common, and (3) adolescents will display poorer attitudes toward reporting than parents.Study designCross-sectional study.Level of evidenceLevel 3.MethodsAdolescent male and female Gaelic games players (n = 113) and parents (n = 151) completed an anonymous questionnaire examining previous experiences with, knowledge of, and attitudes toward reporting SRCs, as well as views on future SRC education initiatives.ResultsOverall, 57.5% of adolescent Gaelic games players suspected they had suffered an SRC previously, and a greater number of suspected SRCs were reported than were medically diagnosed. Adolescent players (mean score, 11.4/14) and their parents (mean score, 11.8) displayed good knowledge of SRC signs and symptoms. However, adolescents were less likely to report an SRC during an important game or if an important game was coming up. Both adolescents and their parents would like more SRC education, particularly in the format of online videos or medical professional-led workshops.ConclusionUnderreporting of SRC occurs in adolescent players, despite good knowledge of SRC signs and symptoms. Education is required to highlight the importance of completing a return-to-play program after an SRC regardless of match importance.Clinical relevanceA multifaceted educational strategy that targets the wider Gaelic games community in the preferred formats identified by key stakeholders is required.

Project description:BackgroundRecognizing sport-related concussion (SRC) is challenging and relies heavily on subjective symptom reports. An objective, biological marker could improve recognition and understanding of SRC. There is emerging evidence that salivary micro-ribonucleic acids (miRNAs) may serve as biomarkers of concussion; however, it remains unclear whether concussion-related miRNAs are impacted by exercise. We sought to determine whether 40 miRNAs previously implicated in concussion pathophysiology were affected by participation in a variety of contact and non-contact sports. Our goal was to refine a miRNA-based tool capable of identifying athletes with SRC without the confounding effects of exercise.MethodsThis case-control study harmonized data from concussed and non-concussed athletes recruited across 10 sites. Levels of salivary miRNAs within 455 samples from 314 individuals were measured with RNA sequencing. Within-subjects testing was used to identify and exclude miRNAs that changed with either (a) a single episode of exercise (166 samples from 83 individuals) or (b) season-long participation in contact sports (212 samples from 106 individuals). The miRNAs that were not impacted by exercise were interrogated for SRC diagnostic utility using logistic regression (172 samples from 75 concussed and 97 non-concussed individuals).ResultsTwo miRNAs (miR-532-5p and miR-182-5p) decreased (adjusted p < 0.05) after a single episode of exercise, and 1 miRNA (miR-4510) increased only after contact sports participation. Twenty-three miRNAs changed at the end of a contact sports season. Two of these miRNAs (miR-26b-3p and miR-29c-3p) were associated (R > 0.50; adjusted p < 0.05) with the number of head impacts sustained in a single football practice. Among the 15 miRNAs not confounded by exercise or season-long contact sports participation, 11 demonstrated a significant difference (adjusted p < 0.05) between concussed and non-concussed participants, and 6 displayed moderate ability (area under curve > 0.70) to identify concussion. A single ratio (miR-27a-5p/miR-30a-3p) displayed the highest accuracy (AUC = 0.810, sensitivity = 82.4%, specificity = 73.3%) for differentiating concussed and non-concussed participants. Accuracy did not differ between participants with SRC and non-SRC (z = 0.5, p = 0.60).ConclusionSalivary miRNA levels may accurately identify SRC when not confounded by exercise. Refinement of this approach in a large cohort of athletes could eventually lead to a non-invasive, sideline adjunct for SRC assessment.

Dataset Information

The Epidemiology of Sports-Related Head Injury and Concussion in Water Polo.

Purpose

Design

Results

Conclusion

Publications

The Epidemiology of Sports-Related Head Injury and Concussion in Water Polo.

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