Incidence of Sports-Related Concussion Among NCAA Women's Ice Hockey Athletes.
Ontology highlight
ABSTRACT:
SUBMITTER: Brook EM
PROVIDER: S-EPMC5528947 | biostudies-other | 2017 Jul
REPOSITORIES: biostudies-other
Similar Datasets
Project description:ContextThe incidence of sports-related concussion in females has been increasing in recent years.ObjectiveTo conduct a meta-analysis on sex-based differences in concussion incidence in various sports and to determine the effects of study design (retrospective vs prospective), setting (competition vs practice), and population (university and above vs high school and below) via a meta-regression.Data sourcesPubMed (Medline), EMBASE, and Cochrane Library databases were searched from January 2000 to January 2018.Study selectionStudies reporting sports-related concussion incidence data for both males and females (age ≥10 years) were included.Study designSystematic review with meta-analysis and meta-regression.Level of evidenceLevel 4.MethodsThe rate ratio was calculated as the concussion rate in females/males. Data were pooled using the DerSimonian-Laird random-effects model.ResultsThirty-eight studies met the eligibility criteria and were included in the meta-analysis. Soccer and basketball demonstrated significantly higher incidence of concussions in females compared with males (rate ratio [95% CI], 1.76 [1.43-2.16] and 1.99 [1.56-2.54], respectively; P < 0.01). Sex-based differences in concussion incidence rates for baseball/softball, ice hockey, lacrosse, swimming/diving, and track and field were not statistically significant. In the meta-regression analysis, there were no significant effects on the rate ratio when evaluating study design, setting, and population.ConclusionConcussion incidence rates were significantly higher in females than in males for soccer and basketball.
| S-EPMC6822209 | biostudies-literature
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.
| S-EPMC6055518 | biostudies-literature
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.
| S-EPMC6822212 | biostudies-literature
Project description:Concussion among athletes is an issue of growing concern, with efforts underway to improve detection, diagnosis, and treatment. Success depends on communication by athletes, as brain-related symptoms are often not outwardly visible. Education programs to increase reporting behavior have not been successful to date. In accordance with the socioecological approach to health, we argue that multiple levels of influence on student athletes must be addressed, and report a multi-dimensional, mixed-methods research project conducted to identify possible points of intervention into changing the culture of concussion-injury reporting among collegiate athletes. Using quantitative, qualitative and interpretive methods, we examine the individual-level vested interests athletes have in reporting or not reporting concussion symptoms, and how these interests interact with community-level team culture and interpersonal relationships, and social-level cultural narratives to influence concussion-reporting behavior. Our findings confirm the viability of this approach, identifying immediacy, separation of responsibility and pain-enduring story systems as particularly salient elements. We conclude that competing performance versus safety value structures, reflected in cultural narratives and team culture, create mixed-messages for athletes, which are resolved in favor of performance because athletes perceive concussion injuries to be of low immediacy.
| S-EPMC6505740 | biostudies-literature
Project description:Studies suggest that a lack of standardized knowledge may lead to underreporting and undertreatment of sports-related concussion. However, there has been little work done to establish how this knowledge may affect athletes' behaviors toward reporting their concussions and removing themselves from play. We conducted an anonymous online survey to assess athletes' knowledge of signs and symptoms of concussion, and also sought to estimate the potential frequency of underreporting in a collegiate athlete cohort. Among 262 athletes who responded to the survey, 43% of those with a history of concussion reported that they had knowingly hidden symptoms of a concussion to stay in a game, and 22% of athletes overall indicated that they would be unlikely or very unlikely to report concussion symptoms to a coach or athletic trainer in the future. These data suggest that there may be a substantial degree of underreporting of concussion among collegiate athletes, despite most acknowledging that they have been formally educated about the risks of concussion.
| S-EPMC3787116 | biostudies-literature
Project description:ObjectivesThe pathophysiology of sports-related concussion (SRC) is incompletely understood. Human adult and experimental animal investigations have revealed structural axonal injuries, decreases in the neuronal metabolite N-acetyl aspartate, and reduced cerebral blood flow (CBF) after SRC and minor traumatic brain injury. The authors of this investigation explore these possibilities after pediatric SRC.Patients and methodsTwelve children, ages 11 to 15 years, who experienced SRC were evaluated by ImPACT neurocognitive testing, T1 and susceptibility weighted MRI, diffusion tensor imaging, proton magnetic resonance spectroscopy, and phase contrast angiography at <72 hours, 14 days, and 30 days or greater after concussion. A similar number of age- and gender-matched controls were evaluated at a single time point.ResultsImPACT results confirmed statistically significant differences in initial total symptom score and reaction time between the SRC and control groups, resolving by 14 days for total symptom score and 30 days for reaction time. No evidence of structural injury was found on qualitative review of MRI. No decreases in neuronal metabolite N-acetyl aspartate or elevation of lactic acid were detected by proton magnetic resonance spectroscopy. Statistically significant alterations in CBF were documented in the SRC group, with reduction in CBF predominating (38 vs 48 mL/100 g per minute; P = .027). Improvement toward control values occurred in only 27% of the participants at 14 days and 64% at >30 days after SRC.ConclusionsPediatric SRC is primarily a physiologic injury, affecting CBF significantly without evidence of measurable structural, metabolic neuronal or axonal injury. Further study of CBF mechanisms is needed to explain patterns of recovery.
| S-EPMC3255471 | biostudies-literature
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.
| S-EPMC10199136 | biostudies-literature
Project description:Traumatic brain injury (TBI) is associated with increased risk of later-life neurodegeneration and dementia. However, the underpinning mechanisms are poorly understood, and secondary injury resulting from perturbed physiological processes plays a significant role. Cerebral vasoreactivity (CVR), a measure of hemodynamic reserve, is known to be impaired in TBI. However, the temporal course of this physiological perturbation is not established. We examined CVR and clinical symptoms on day 3 (T1), day 21 (T2), and day 90 (T3) after concussion in collegiate athletes and cross-sectionally in non-injured controls. Changes in middle cerebral artery blood flow velocity (MCAV; transcranial Doppler ultrasonography) were measured during changes in end-tidal CO2 (PetCO2) at normocapnia, hypercapnia (inspiring 8% CO2), and hypocapnia (hyperventilation). CVR was determined as the slope of the linear relationship and expressed as percent change in MCAV per mmHg change in PetCO2. CVR was attenuated during the acute phase T1 (1.8?±?0.4U; p?=?0.0001), subacute phases T2 (2.0?±?0.4U; p?=?0.0017), and T3 (1.9?±?0.6U; p?=?0.023) post-concussion compared to the controls (2.3?±?0.3U). Concussed athletes exhibited higher symptom number (2.5?±?3.0 vs. 12.1?±?7.0; p?<?0.0001) and severity (4.2?±?6.0 vs. 29.5?±?23.0; p?<?0.0001), higher Patient Health Questionnaire-9 score (2.2?±?2.0 vs. 9.1?±?6.0; p?=?0.0003) at T1. However, by T2, symptoms had resolved. We show that CVR is impaired as early as 4 days and remains impaired up to 3 months post-injury despite symptom resolution. Persistent perturbations in CVR may therefore be involved in secondary injury. Future studies with a larger sample size and longer follow-up period are needed to validate this finding and delineate the duration of this vulnerable period.
| S-EPMC6909747 | biostudies-literature
Project description:Objective/backgroundPoor quality and inadequate sleep are associated with impaired cognitive, motor, and behavioral components of sport performance and increased injury risk. While prior work identifies sports-related concussions as predisposing factors for poor sleep, the role of sleep as a sports-related concussion risk factor is unknown. The purpose of this study was to quantify the effect of poor sleep quality and insomnia symptoms on future sports-related concussion risk.Patients/methodsIn this study, 190 NCAA Division-1 athletes completed a survey battery, including the Insomnia Severity Index (ISI) and National Health and Nutrition Examination Survey (NHANES) Sleep module. Univariate risk ratios for future sports-related concussions were computed with ISI and NHANES sleepiness scores as independent predictors. An additional multiple logistic regression model including sport, sports-related concussion history, and significant univariate predictors jointly assessed the odds of sustaining a concussion.ResultsClinically moderate-to-severe insomnia severity (RR = 3.13, 95% CI: 1.320-7.424, p = 0.015) and excessive daytime sleepiness two or more times per month (RR = 2.856, 95% CI: 0.681-11.977, p = 0.037) increased concussion risk. These variables remained significant and comparable in magnitude in a multivariate model adjusted for sport participation.ConclusionInsomnia and daytime sleepiness are independently associated with increased sports-related concussion risk. More completely identifying bidirectional relationships between concussions and sleep requires further research. Clinicians and athletes should be cognizant of this relationship and take proactive measures - including assessing and treating sleep-disordered breathing, limiting insomnia risk factors, improving sleep hygiene, and developing daytime sleepiness management strategies - to reduce sports-related concussion risk and support overall athletic performance.
| S-EPMC7604222 | biostudies-literature
Project description:There is great interest in developing physiological-based biomarkers such as diffusion tensor imaging to aid in the management of concussion, which is currently entirely dependent on clinical judgment. However, the time course for recovery of white matter abnormalities following sports-related concussion (SRC) is unknown. We collected diffusion tensor imaging and behavioral data in forty concussed collegiate athletes on average 1.64 days (T1; n = 33), 8.33 days (T2; n = 30), and 32.15 days post-concussion (T3; n = 26), with healthy collegiate contact-sport athletes (HA) serving as controls (n = 46). We hypothesized that fractional anisotropy (FA) would be increased acutely and partially recovered by one month post-concussion. Mood symptoms were assessed using structured interviews. FA differences were assessed using both traditional and subject-specific analyses. An exploratory analysis of tau plasma levels was conducted in a subset of participants. Results indicated that mood symptoms improved over time post-concussion, but remained elevated at T3 relative to HA. Across both group and subject-specific analyses, concussed athletes exhibited increased FA in several white matter tracts at each visit post-concussion with no longitudinal evidence of recovery. Increased FA at T1 and T3 was significantly associated with an independent, real-world outcome measure for return-to-play. Finally, we observed a nonsignificant trend for reduced tau in plasma of concussed athletes at T1 relative to HA, with tau significantly increasing by T2. These results suggest white matter abnormalities following SRC may persist beyond one month and have potential as an objective biomarker for concussion outcome. Hum Brain Mapp 37:833-845, 2016. © 2015 Wiley Periodicals, Inc.
| S-EPMC6867335 | biostudies-literature