Evaluation and management of sport-related concussions in adolescent athletes.
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ABSTRACT:
SUBMITTER: Patel DR
PROVIDER: S-EPMC5532189 | biostudies-other | 2017 Jul
REPOSITORIES: biostudies-other
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Project description:Sport-related concussions in young athletes are common, generally under reported and often unrecognized. Preventive strategies include education, modification of sport rules, use of equipment such as headgears, face masks and mouth guards, and neck muscle training. Evidence is limited to support effectiveness of these preventive measures with the exception of rule modification in some sports. In the United States, laws have been enacted that require medical evaluation and clearance prior to return to play; however, evidence thus far does not show that laws have been effective in reducing the incidence of concussions in sport. More research is needed in all areas of preventive measures. Sports participation is a complex personal decision on the part of the adolescent and his or her family. They should be provided with all information on inherent risks so that they can make an informed decision.
| S-EPMC5532196 | biostudies-other
Project description:BackgroundAlthough performance-enhancing drugs appear to be prevalent in adolescent sports, relatively little attention has been paid to why adolescent athletes decide to use these drugs. In this study, we examine doping among adolescents from a motivational perspective and explore how motivational variables, such as achievement goal orientations and the perceived self-determination of sports activities, may be related to moral attitudes, doping intentions and doping behavior in adolescents who participate in competitive sports.MethodologyThe study included 1035 adolescents participating in competitive sports from all regions of the Czech Republic (mean age = 16.3 years). The respondents completed a battery of questionnaires assessing their achievement goal orientations (task, ego), sports motivation at various levels of self-determination (intrinsic motivation, external regulation, amotivation), moral attitudes toward sport competition (acceptance of cheating, keeping winning in proportion, attitudes toward doping), doping intentions and doping behavior. A structural equation model was used to test the relations among motivational variables, attitudes, intentions and doping behavior.Principal resultsOur analyses indicated a good fit with the proposed model, which explained 59% of the variance in doping intentions and 17.6% of the variance in doping behavior. Within the model, task orientation was positively associated with intrinsic motivation and lower amotivation, whereas ego orientation was positively associated with extrinsic regulation and amotivation. Furthermore, intrinsic motivation was positively associated with keeping winning in proportion and negatively associated with acceptance of cheating and attitudes toward doping; the less self-determined forms of motivation showed opposite relationships. However, only the acceptance of cheating and attitudes toward doping were related to doping intention, which subsequently predicted doping behavior.Conclusions/significanceThe results provide further evidence that sports motivation represents a psychological variable that should be considered in anti-doping policies, programs, and interventions aimed at the adolescent population because motivation was linked to the doping-related attitudinal variables and also partially mediated the effect of achievement goal orientations in this regard. On the basis of these results, we may argue that the focus on intrinsic enjoyment, self-referenced criteria of success and self-improvement may be related to more negative attitudes toward doping and cheating, lower doping intentions and less frequent doping behavior, whereas the emphasis on competition, comparison with others and external motivation appear to be related to the opposite outcomes.
| S-EPMC6171920 | biostudies-literature
Project description:Concussion is a traumatic transient disturbance of the brain. In sport, the initial time and severity of concussion is known giving an opportunity for subsequent analysis. Variability in susceptibility and recovery between individual athletes depends, among other parameters, on genetic factors. The genes-encoding polypeptides that determine incidence, severity and prognosis for concussion are the primary candidates for genetic analysis. Genetic polymorphisms in the genes contributing to plasticity and repair (APOE), synaptic connectivity (GRIN2A), calcium influx (CACNA1E), uptake and deposit of glutamate (SLC17A7) are potential biomarkers of concussion incidence and recovery rate. With catalogued genetic variants, prospective genotyping of athletes at the beginning of their career will allow medical professionals to improve concussion management and return-to-play decisions.
| S-EPMC6096436 | biostudies-literature
Project description:Background and objectivesSport-related concussions affect millions of individuals across the United States each year, and current techniques to diagnose and monitor them rely largely on subjective measures. Our goal was to discover and validate objective, quantifiable noninvasive biomarkers with the potential to be used in sport-related concussion diagnosis.MethodsUrine samples from a convenience series of healthy control collegiate athletes who had not sustained a concussion and athletes who sustained a concussion as diagnosed by a sports medicine physician within 7 days were collected prospectively and studied. Participants also completed an instrumented single-task gait analysis as a functional measure. Participants were recruited from a single collegiate athletic program and were ≥18 years of age and were excluded if they had a concomitant injury, active psychiatric conditions, or preexisting neurologic disorders. Using Tandem Mass Tags (TMT) mass spectroscopy and ELISA, we identified and validated urinary biomarkers of concussion.ResultsForty-eight control and 47 age- and sex-matched athletes with concussion were included in the study (51.6% female, 48.4% male, average age 19.6 years). Participants represented both contact and noncontact sports. All but 1 of the postconcussion participants reported experiencing symptoms at the time of data collection. Insulin-like growth factor 1 (IGF-1) and IGF binding protein 5 (IGFBP5) were downregulated in the urine of athletes with concussions compared to healthy controls. Multivariable risk algorithms developed to predict the probability of sport-related concussion showed that IGF-1 multiplexed with single-task gait velocity predicts concussion risk across a range of postinjury time points (area under the curve [AUC] 0.786, 95% confidence interval [CI] 0.690-0.884). When IGF-1 and IGFBP5 are multiplexed with single-task gait velocity, they accurately distinguish between healthy controls and individuals with concussion at acute time points (AUC 0.835, 95% CI 0.701-0.968, p < 0.001).DiscussionThese noninvasive biomarkers, discovered in an objective and validated manner, may be useful in diagnosing and monitoring sport-related concussions in both acute phases of injury and several days after injury.Trial registration informationClinicalTrials.gov Identifier: NCT02354469 (submitted February 2015, first patient enrolled August 2015).Classification of evidenceThis study provides Class III evidence that urinary IGF-1 and IGFBP5 multiplexed with single-task gait velocity may be useful in diagnosing sport-related concussion.
| S-EPMC8762586 | biostudies-literature
Project description:Human brains develop across the life span and largely vary in morphology. Adolescent collision-sport athletes undergo repetitive head impacts over years of practices and competitions, and therefore may exhibit a neuroanatomical trajectory different from healthy adolescents in general. However, an unbiased brain atlas targeting these individuals does not exist. Although standardized brain atlases facilitate spatial normalization and voxel-wise analysis at the group level, when the underlying neuroanatomy does not represent the study population, greater biases and errors can be introduced during spatial normalization, confounding subsequent voxel-wise analysis and statistical findings. In this work, targeting early-to-middle adolescent (EMA, ages 13-19) collision-sport athletes, we developed population-specific brain atlases that include templates (T1-weighted and diffusion tensor magnetic resonance imaging) and semantic labels (cortical and white matter parcellations). Compared to standardized adult or age-appropriate templates, our templates better characterized the neuroanatomy of the EMA collision-sport athletes, reduced biases introduced during spatial normalization, and exhibited higher sensitivity in diffusion tensor imaging analysis. In summary, these results suggest the population-specific brain atlases are more appropriate towards reproducible and meaningful statistical results, which better clarify mechanisms of traumatic brain injury and monitor brain health for EMA collision-sport athletes.
| S-EPMC7979742 | biostudies-literature
Project description:The purpose of the study was to test the utility of unique panel of blood biomarkers as a means to reflect one's recovery process after sport-related neurotrauma. We established a panel of biomarkers that reacted positive with CD81 (extracellular vesicle marker) and various neuron- and glia-specific antigens [e.g., neurofilament light polypeptide (NF-L), tau, synaptosome-associated protein 25 (SNAP25), glial fibrillary acidic protein, and myelin basic protein]. We first evaluated test-retest reliabilities of brain-derived exosome markers, followed by an application of these markers in eight professional ice hockey players to detect cumulative neuronal burden from a single ice hockey season. During the season, two players were diagnosed with concussions by team physician based on an exhibition of symptoms as well as abnormality in balance and ocular motor testing. One player reached symptom-free status 7 days after the concussion, while the other player required 36 days for symptoms to completely resolve. Blood samples and clinical assessments including balance error scoring system and near point of convergence throughout recovery process were obtained. Biomarkers indicative of axonal damage, neuronal inflammation, and glial activation showed excellent test-retest reliabilities (intraclass correlation coefficient: 0.713-0.998, p's < 0.01). There was a statistically significant increase in the NF-L marker at post-season follow-up compared to pre-season baseline (Z = -2.100, P = 0.036); however the statistical significance did not withstand Bonferroni correction for multiple comparisons. In concussion cases, neuronal and microglia markers notably increased after concussions, with the unique expression patterns being similar to that of concussion recovery process. These longitudinal data coupled with excellent test-retest reliabilities of novel array of blood biomarkers potentially reflect the damage in neural cell structures and metabolic crisis due to concussion. However, future studies with larger sample size and appropriate control groups to evaluate sensitivity and specificity of these markers are needed. This preliminary case report suggests the potential utility of multimodal blood biomarkers for concussion prognosis and recovery assessment.
| S-EPMC5906531 | biostudies-literature
Project description:ContextPlyometric training has been shown to be beneficial in adolescent overhead athletes. However, existing research on the effects of plyometrics on sport performance has been limited.ObjectiveTo systematically review the current literature to investigate whether plyometric training intervention improves upper- and lower-body sport performance.Data sourcesTwo electronic databases (MEDLINE and Web of Science) were searched using specific Medical Subject Headings (MeSH) terms up to February 2019, and hand-searching was performed by looking to relevant studies that were cited in other studies.Study selectionA total of 932 items were identified and were further assessed for the eligibility in the systematic review. For a study to be eligible, each of the following inclusion criteria had to be met: (1) participants were aged 13 to 18 years and selected from a sports or athletic population and the study (2) involved the evaluation of a plyometric training intervention with an aim to improve sports performance; (3) must have included a control intervention and/or control group; (4) included a quantitative objective measure of sport performance variables concerning throwing, jumping, running, and sprinting; and (5) was published in English.Study designSystematic review.Level of evidenceLevel 3.Data extractionA first screening was conducted based on title and abstract of the articles. In the second screening, the full text of the remaining articles was evaluated for the fulfillment of the inclusion criteria.ResultsA total of 14 studies were included in this review. The methodological quality of the included studies ranged from low to moderate. There is moderate evidence that plyometric training intervention improves throwing and jumping performances. There is also preliminary evidence that plyometric training intervention improves sprint performance.ConclusionThe current evidence suggests that sport performance consisting of throwing capacity, jumping ability, and sprint performance significantly improved due to plyometric training interventions in adolescent overhead athletes.
| S-EPMC7734361 | biostudies-literature
Project description:ContextIn the spring of 2020, US schools closed to in-person teaching and sports were cancelled to control the transmission of coronavirus disease 2019 (COVID-19). It is critical to understand the mental and physical health of adolescent athletes during this time.ObjectiveTo describe the health of athletes during COVID-19-related school closures and sport cancellations.DesignCross-sectional study.SettingA national sample recruited via social media.Patients or other participantsA total of 13 002 US adolescent athletes (age = 16.3 ± 1.2 years, females = 52.9%, males = 47.0%) completed an anonymous online survey.Main outcome measure(s)Demographic information collected was sex, grade, sport(s) played, and zip code. Assessments used were the General Anxiety Disorder 7-Item for anxiety, Patient Health Questionnaire 9-Item for depression, the Pediatric Functional Activity Brief Scale for physical activity, and the Pediatric Quality of Life Inventory 4.0 for quality of life. Mental health, physical activity, and health-related quality-of-life variables were compared among sex, grade, sport(s) played, and poverty level using means and 95% confidence intervals (CIs) from the survey-weighted analysis of variance.ResultsFemales reported a higher prevalence of moderate to severe anxiety symptoms (females = 43.7% versus males = 28.2%). The Pediatric Functional Activity Brief Scale score was highest (best) for grade 9 (mean = 14.5, 95% CI = 14.0, 15.0) and lowest for grade 11 (mean = 10.9, 95% CI = 10.5, 11.3). The prevalence of depression symptoms was highest in team sport (74.1%) and lowest in individual sport (64.9%) participants. The total Pediatric Quality of Life Inventory score was lowest (worst) for athletes from counties with the highest poverty levels (high: mean = 74.5, 95% CI = 73.7, 75.3; middle: mean = 78.9, 95% CI = 78.0, 79.8; and low: mean = 78.3, 95% CI = 77.4, 79.1).ConclusionsThe health of US adolescents during the COVID-19-related school closures and sport cancellations varied to differing degrees depending on sex, grade level, type of sport participation, and level of poverty. Health policy experts should consider these findings in the future when creating and implementing policies to improve the health of adolescents in the United States.
| S-EPMC7863599 | biostudies-literature
Project description:Previous studies have reported an association between global measures of bilateral strength and change of direction (COD) ability. Yet, little is known about the association between unilateral muscle strength qualities and COD ability. The aim of this study was to explore the associations between unilateral muscle strength qualities and COD measures (COD speed (CODS) and COD deficit) when matched limb-for-limb (i.e., right limb vs. right limb, left limb vs. left limb) in adolescent team-sport athletes. One hundred and fifteen athletes (56 males, 59 females) active in cricket, netball, and basketball participated in this investigation. Each player performed trials of countermovement jump (CMJ), single-leg hop (SLH), isometric mid-thigh pull (IMTP) and eccentric knee extensor torque (ECC-EXT) to assess muscle strength qualities and 505 and modified 505 (505mod) to evaluate COD ability. Moderate-to-large correlations were observed between SLH and CODS (r = -0.43 to -0.67). Another important finding was that CMJ measures demonstrated moderate-to-large correlations with CODS (r = -0.38 to -0.69) and small-to-moderate correlations with COD deficit (r = -0.24 to -0.45). COD is underpinned by distinct muscle strength qualities and each contribute to specific phases of a COD task. It is therefore likely that such connections exist between muscle strength qualities and COD, with all qualities contributing to overall COD ability.
| S-EPMC6162690 | biostudies-literature
Project description:Sport-related concussions (SRC) are characterized by impaired autonomic control. Heart rate variability (HRV) offers easily obtainable diagnostic approaches to SRC-associated dysautonomia, but studies investigating HRV during sleep, a crucial time for post-traumatic cerebral regeneration, are relatively sparse. The aim of this study was to assess nocturnal HRV in athletes during their return to sports (RTS) after SRC in their home environment using wireless wrist sensors (E4, Empatica, Milan, Italy) and to explore possible relations with clinical concussion-associated sleep symptoms. Eighteen SRC athletes wore a wrist sensor obtaining photoplethysmographic data at night during RTS as well as one night after full clinical recovery post RTS (>3 weeks). Nocturnal heart rate and parasympathetic activity of HRV (RMSSD) were calculated and compared using the Mann-Whitney U Test to values of eighteen; matched by sex, age, sport, and expertise, control athletes underwent the identical protocol. During RTS, nocturnal RMSSD of SRC athletes (Mdn = 77.74 ms) showed a trend compared to controls (Mdn = 95.68 ms, p = 0.021, r = -0.382, p adjusted using false discovery rate = 0.126) and positively correlated to "drowsiness" (r = 0.523, p = 0.023, p adjusted = 0.046). Post RTS, no differences in RMSSD between groups were detected. The presented findings in nocturnal cardiac parasympathetic activity during nights of RTS in SRC athletes might be a result of concussion, although its relation to recovery still needs to be elucidated. Utilization of wireless sensors and wearable technologies in home-based settings offer a possibility to obtain helpful objective data in the management of SRC.
| S-EPMC10181314 | biostudies-literature