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At least 145 records · Page 8Linked to original sources
PubMed2002

Effect of mouthguards on dental injuries and concussions in college basketball.

PURPOSE: Dental injuries can be permanent and disfiguring. They are also universally expensive to treat. Many dentists, sports physicians, and athletic trainers recommend mouthguards for athletes participating in certain competitive sports, including men's college basketball, because of a common perception that mouthguards afford protection from dental injuries, and even some concussions. However, there are few reliable reports of the incidence of dental injuries and concussions in men's college basketball, and good evidence that mouthguards reduce the risk of these injuries in this population of athletes is notably lacking. This study prospectively recorded dental injuries and concussions among 50 men's Division I college basketball teams during one competitive season, then compared injury rates between mouthguard users and nonusers. METHODS: During the 1999 to 2000 basketball season, athletic trainers from 50 men's Division I college basketball programs used an Internet Web site to submit weekly reports of the number of athlete exposures, mouthguard users, concussions, oral soft tissue injuries, dental injuries, and dentist referrals. RESULTS: Response rate was 86%. There were 70,936 athlete exposures. Athletes using custom-fitted mouthguards accounted for 8663 exposures. Injury rates were expressed as number of injuries per 1000 athlete exposures. There were no significant differences between mouthguard users and nonusers in rates of concussions (0.35 vs 0.55) or oral soft tissue injuries (0.69 vs 1.06). Mouthguard users had significantly lower rates of dental injuries (0.12 vs 0.67; P < 0.05) and dentist referrals (0.00 vs 0.72; P < 0.05) than nonusers. CONCLUSION: Custom-fitted mouthguards do not significantly affect rates of concussions or oral soft tissue injuries, but can significantly reduce the morbidity and expense resulting from dental injuries in men's Division I college basketball.

Athletic Injuries↗
PubMed2004

Exercise following a sport induced concussion.

OBJECTIVE: To determine if an athlete's capacity to perform exercise is impaired following concussion and whether this would be reflected by an altered heart rate response. METHODS: Of the 14 concussed athletes, nine missed playing time as a direct result of their concussion and five did not. The concussed athletes performed an exercise protocol on a cycle ergometer within 72 hours of being asymptomatic at rest and a second test at 5 days following the previous assessment. Matched controls (n = 14) were tested using the same time line. The exercise protocol consisted of a 2 minute warm up, 10 minute, low-moderate intensity, steady state exercise session, and a high intensity interval protocol. The interval protocol consisted of a 40 second high intensity bout, followed by a 40 second rest period. This protocol continued until the participant had reached volitional fatigue. RESULTS: The number of exercise bouts completed was not significantly different from their matched controls. However, concussed athletes who missed playing time had a significantly higher heart rate during the steady state exercise session. During this same period, they also exhibited a greater rise in heart rate over time. CONCLUSION: These findings indicate that exercise capacity is unaffected in concussed athletes who are asymptomatic at rest. However, their heart rate response to submaximal exercise is increased.

Adolescent↗
PubMed2005

Effects of heading exposure and previous concussions on neuropsychological performance among Norwegian elite footballers.

BACKGROUND: Cross-sectional studies have indicated that neurocognitive performance may be impaired among football players. Heading the ball has been suggested as the cause, but recent reviews state that the reported deficits are more likely to be the result of head injuries. OBJECTIVE: To examine the association between previous concussions and heading exposure with performance on computer based neuropsychological tests among professional Norwegian football players. METHODS: Players in the Norwegian professional football league (Tippeligaen) performed two consecutive baseline neuropsychological tests (Cogsport) before the 2004 season (90.3% participation, n = 271) and completed a questionnaire assessing previous concussions, match heading exposure (self-reported number of heading actions per match), player career, etc. Heading actions for 18 players observed in two to four matches were counted and correlated with their self-reported values. RESULTS: Neither match nor lifetime heading exposure was associated with neuropsychological test performance. Nineteen players scored below the 95% confidence interval for one or more subtasks, but they did not differ from the rest regarding the number of previous concussions or lifetime or match heading exposure. The number of previous concussions was positively associated with lifetime heading exposure (exponent (B) = 1.97(1.03-3.75), p = 0.039), but there was no relation between previous concussions and test performance. Self-reported number of headings correlated well with the observed values (Spearman's rho = 0.77, p < 0.001). CONCLUSION: Computerised neuropsychological testing revealed no evidence of neuropsychological impairment due to heading exposure or previous concussions in a cohort of Norwegian professional football players.

Adult↗
PubMed2006

High school rugby players' understanding of concussion and return to play guidelines.

OBJECTIVE: To document high school players' understanding and attitudes towards concussion return to play guidelines. METHODS: A questionnaire based survey was performed of national high school rugby players as to their knowledge of existing concussion return to play guidelines. RESULTS: A total of 600 male players were surveyed, and 477 responded (response rate 80%). Half (237/477) were aware of concussion guidelines, and 60% (288/477) identified the mandated stand down period that is part of the regulations governing rugby football. Players obtained their information primarily from: teachers/coaches (239 responses), medical personnel (200), and other players (116). Of those players who suspected that they had been concussed (296/477, 62%), only 66 returned to play after medical clearance. CONCLUSIONS AND IMPLICATIONS: This sample of high school players showed a limited knowledge of the concussion guidelines covering their sport, and even when concussed did not follow recommended protocols. This indicates the need for an increased focus on player education.

Adolescent↗
PubMed2006

Converging evidence for the under-reporting of concussions in youth ice hockey.

BACKGROUND: Concussions are potentially serious injuries. The few investigations of prevalence or incidence in youth ice hockey have typically relied on prospective reports from physicians or trainers and did not survey players, despite the knowledge that many athletes do not report probable concussions. OBJECTIVE: This study sought to compare concussion rates in youth ice hockey that were estimated from a variety of reporting strategies. METHODS: Rates were calculated from British Columbia Amateur Hockey Association (BCAHA) official injury reports, from direct game observation by minor hockey volunteers (such as coaches and managers), as well as from retrospective surveys of both elite and non-elite youth players. All research was conducted within the BCAHA. RESULTS: Estimates from official injury reports for male players were between 0.25 and 0.61 concussions per 1000 player game hours (PGH). Concussion estimates from volunteer reports were between 4.44 and 7.94 per 1000 PGH. Player survey estimates were between 6.65 and 8.32 per 1000 PGH, and 9.72 and 24.30 per 1000 PGH for elite and non-elite male youth hockey, respectively. CONCLUSION: It was found that concussions are considerably under-reported to the BCAHA by youth hockey players and team personnel.

Adolescent↗
PubMed2002

Does rugby headgear prevent concussion? Attitudes of Canadian players and coaches.

OBJECTIVES: To examine the attitudes of players and coaches to the use of protective headgear, particularly with respect to the prevention of concussion. METHODS: A questionnaire designed to assess attitudes to headgear was administered to 63 players from four different Canadian teams, each representing a different level of play (high school, university, community club, national). In addition, coaches from all four levels were questioned about team policies and their personal opinions about the use of headgear to prevent concussion. RESULTS: Although the players tended to believe that the headgear could prevent concussion (62%), the coaches were less convinced (33%). Despite the players' belief that headgear offers protection against concussion, only a minority reported wearing headgear (27%) and few (24%) felt that its use should be made mandatory. Common reasons for not wearing headgear were "its use is not mandatory", "it is uncomfortable", and "it costs too much". CONCLUSION: Although most players in the study believe that rugby headgear may prevent concussion, only a minority reported wearing it. Coaches tended to be less convinced than the players that rugby headgear can prevent concussion.

Adolescent↗
PubMed2004

A population based investigation of head injuries and symptoms of concussion of children and adolescents in schools.

OBJECTIVE: To examine the incidence of head injury and symptoms of concussion among children at school and to determine the relationship of age, gender, and cause to incidence rates. DESIGN: Incident reports involving head injury for schools in the Province of Ontario, Canada during the year 2000 were evaluated. PARTICIPANTS: The population base for the schools represented was 1 372 979 children aged 6 to 16. SETTING: 95% of schools in the province of Ontario, Canada participated in the injury reporting system. MAIN OUTCOME MEASURES: A head injury was defined as any injury to the head that came to the attention of a school official. Head injuries accompanied by symptoms of concussion became a secondary outcome measure. RESULTS: There were 11 068 unduplicated head injury reports for the year 2000 of which 1861 qualified as producing signs or symptoms of concussion. Young children were more likely to have a head injury than older children, but slightly less likely to experience concussive symptoms. The primary cause of injury to young children was falls. Older children were more likely to receive head injuries and symptoms of concussion from sports activities. CONCLUSIONS: Overall rate of injury (3.98 per 100 children) was consistent with previous studies using prospective injury reporting systems. Probability of a head injury with symptoms of concussion among schoolchildren was only 1.9% for boys and <1% for girls during the course of their school years. There is ample justification for prevention efforts in schools.

Accidental Falls↗
PubMedDate not supplied

Concussion history in elite male and female soccer players.

A unique feature of soccer is the purposeful use of the head for controlling, passing, and shooting a soccer ball. Some concern has been expressed in the literature on the cumulative effects of heading on soccer players. Certain neurophysiologic and neuropsychologic changes have been reported in current or retired players, with heading being blamed. A major factor that could influence some of the findings is a player's history of concussive episodes, which are known to influence brain function. These episodes can occur during aspects of the game other than heading. We interviewed all male and female soccer players (N = 137, average age = 20.5 years) who competed at the U.S. Olympic Sports Festival in 1993. The mechanisms of injuries, frequency, and sequelae were determined. There were 74 concussions in 39 male players (grade I = 50) and 28 concussions in 23 female players (grade I = 19). For the men, 48 of the 74 episodes were from collisions with another player. For the women, 20 of 28 were from such collisions. Headaches, being "dazed," and dizziness were the most common symptoms reported. Based on concussion history, the odds are 50% that a man, and 22% that a woman, will sustain a concussion within a 10-year period. The data indicate that concussions from player-to-player contact are a frequent hazard in soccer. Head injuries incurred this way may be more of an influence for published findings of physiologic and psychologic deficiencies than routine heading of the soccer ball.

Adult↗
PubMed2003

Epidemiological considerations of concussions among intercollegiate athletes.

The purpose of this study was to examine epidemiological trends of concussions among 15 different intercollegiate sports during the 1997-1998, 1998-1999, and 1999-2000 seasons. Data were collected using the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS). For the 15 sports studied during the 3 academic years, the NCAA ISS documented 3,535 team-seasons, 40,547 reportable injuries, 5,566,924 practice athlete exposures (AEs), and 1,090,298 game AEs. Concussions accounted for 6.2% of all reported injuries during this 3-year study. Of all the reported injuries, women lacrosse players (13.9%) reported the highest percentage of suffering a concussion during a game followed by women's soccer (11.4%), men's ice hockey (10.3%), men's lacrosse (10.1%), football (8.8%), women's basketball, (8.5%), field hockey (7.2%), men's soccer (7.0%), wrestling (6.6%), men's basketball (5.0%), baseball (4.2%), and women's volleyball (4.1%). Female athletes from all 7 sports were found to be at a lower risk for suffering concussions during practice sessions than the 8 male sports. However, female athletes were found to be at a greater risk for suffering concussions during games compared to male athletes. Injury trends over the 3- year period indicate concussions continue to be on the rise for athletes participating in collegiate football, men's soccer, and women's and men's basketball.

Adult↗
PubMed1997

Standardized assessment of concussion in football players.

The recent formulation of guidelines for the management of concussion in sports adopted by the American Academy of Neurology specifically calls for the development of a standardized, systematic sideline evaluation for the immediate assessment of concussion in athletes. The present study involved the preliminary investigation of the feasibility and clinical validity of a standardized version of a brief sideline examination complied in accordance with these guidelines. This examination, intended for use by athletic trainers, was administered by three trainers to 141 nonconcussed high school football players at three separate schools. All players suspected of suffering a concussion (N = 6) during the fall 1995 season were also tested immediately following their injury. The examination was easily administered and scored. The concussed players as a group scored significantly below the nonconcussed controls and below their own baseline (pre-injury) performance, despite their all having been considered by the trainers to have suffered mild, grade 1 concussions. Although preliminary, these data suggest that a standardized sideline examination of this type can be useful in detecting concussion and determining fitness to return to play.

Adolescent↗
PubMed2006

Neurophysiological anomalies in symptomatic and asymptomatic concussed athletes.

OBJECTIVE: Concussion in sports is a problem of such magnitude that improvements in diagnosis and management are desirable. The aim of the present study was to investigate the effect of concussion on event-related potentials, in symptomatic as well as in asymptomatic athletes. METHODS: Twenty symptomatic and asymptomatic athletes who sustained a concussion were compared with 10 control athletes in a modified auditory Oddball task. The task included a sequence of tones containing standard and deviant stimuli. Participants were asked to respond to the target tone presented in the left ear and to ignore tones presented in the right ear. The electroencephalogram was recorded from 28 electrodes during the task. RESULTS: The results showed a reduction in the amplitude of N1, P2, and P3 components in symptomatic and asymptomatic athletes in comparison with control athletes. No between-group differences were observed in reaction times or in latency of the event-related potentials components, except for P3 latency, in which the controls showed shorter latency than the concussed groups. CONCLUSION: Concussions seem to produce deficits in the early and late stages of auditory information processing, which possibly reflect impaired brain functioning in symptomatic and asymptomatic concussed athletes. The fact that asymptomatic athletes have an electrophysiological profile similar to that of symptomatic athletes challenges the validity of return-to-play guidelines for which the absence of symptoms is a major issue.

Adult↗
PubMed2003

Assessment of postural stability following sport-related concussion.

Despite the increased amount of research being conducted in the area of sport-related concussion, there is still a limited understanding regarding its effect on the injured brain's ability to control motor functions and coordination. This review determines the efficacy of postural stability testing as an adjunct to concussion assessment of athletes. Multiple studies, using both sophisticated force plate technology, as well as those using less sophisticated clinical balance tests, have identified postural stability deficits lasting several days following sport-related concussion. It appears that postural stability testing provides a useful tool for objectively assessing the motor domain of neurologic functioning, and should be considered a reliable and valid adjunct to the assessment of athletes suffering from concussion. Although symptom severity, neurocognitive function, and postural stability are often affected initially following concussion, they are not necessarily related or even affected to the same degree. Each of these should be considered when attempting to make return-to-play decisions following concussion.

Ataxia↗
PubMed2004

Heart rate variability of recently concussed athletes at rest and exercise.

PURPOSE: The objective of this study was to assess the neuroautonomic cardiovascular regulation in recently concussed athletes at rest and in response to low-moderate steady-state exercise, using heart rate variability (HRV). METHODS: A 5-min ECG sample was taken at rest from the 14 concussed athletes at 1.8 (+/- 0.2) days postinjury and again at 5 d later. Once asymptomatic at rest, the concussed athletes and their matched controls (N = 14) participated in an exercise protocol. The protocol consisted of a 2-min warm-up with a pedaling frequency between 50 and 60 rpm against a load of 40 W. After the warm-up, the athletes engaged in a low-moderate intensity steady state 10-min exercise bout where the pedaling frequency and load increased to 80-90 rpm and 1.5 W x kg(-1) body weight, respectively. The protocol was repeated 5 d later. A 5-min ECG sample from minutes 4 to 9 of the low-moderate intensity steady state exercise bout was used to assess HRV during exercise. Mixed model ANOVA were used to analyze the data. RESULTS: No difference at rest was detected between the concussed athletes and their matched controls in any of the HRV variables measured. However, across both exercise tests, the concussed group demonstrated a significant decrease in the mean RR interval, and low- and high-frequency power (P < 0.05) in relation to their matched controls. CONCLUSION: Low-moderate steady-state exercise elicits a neuroautonomic cardiovascular dysfunction in concussed athletes that is not present in a rested state. This dysfunction alludes to an exercise induced uncoupling between the autonomic and cardiovascular systems.

Adolescent↗
PubMed2005

Sex differences in outcome following sports-related concussion.

OBJECT: Females comprise an increasing percentage of the athlete population across all age groups, and analysis of recent literature reveals that they sustain more concussions in collegiate sports. Results of human and animal studies indicate that females may have poorer outcomes after traumatic brain injury; however, no return-to-play guideline takes sex or other individual differences into account. In the present study the authors evaluated the influence of patient sex on objective neurocognitive performance and subjective reporting of symptoms following sports-related concussion. METHODS: According to preseason baseline neurocognitive computerized testing in 2340 male and female high school and collegiate athletes, individuals who sustained sports-related concussions (155 persons) were reevaluated using an alternate form of the cognitive test. Sex differences in the magnitude of cognitive change from baseline levels and the subjective experience of symptoms were analyzed. To account for the possible protective effects of helmets, comparisons were performed among females, males with helmets, and males without helmets; none of the female athletes wore helmets. Female athletes had significantly greater declines in simple and complex reaction times relative to preseason baseline levels, and they reported more postconcussion symptoms compared with males. As a group, females were cognitively impaired approximately 1.7 times more frequently than males following concussions. Furthermore, females experienced more objective and subjective adverse effects from concussion even after adjusting for the use of helmets by some groups of male athletes (for example, in football). CONCLUSIONS: Return-to-play decisions and concussion management must be objective and made on an individual basis, including consideration of factors such as patient sex rather than relying on a one-size-fits-all guideline.

Adolescent↗
PubMed2001

Concussion in sports: minimizing the risk for complications.

Mild traumatic brain injury, or concussion, is a common consequence of collisions, falls and other forms of contact in sports. Concussion may be defined as an acute trauma-induced alteration of mental function lasting fewer than 24 hours, with or without preceding loss of consciousness. The physician's responsibilities in assessing an athlete with concussion include determining the need for emergency intervention and offering guidance about the athlete's ability to return to play. Concussion may be complicated by cerebral edema related to the second impact syndrome, cumulative neuropsychologic deficits, intracranial bleeding or the postconcussion syndrome. The risk of complications is increased in athletes who prematurely return to play and in those with prolonged loss of consciousness or post-traumatic amnesia. An athlete with prolonged loss of consciousness or signs and symptoms that worsen or persist after a concussion should be evaluated in the emergency department. An athlete should not be allowed to resume sports participation until all symptoms of a concussion have resolved.

Athletic Injuries↗
PubMed2002

Mechanism and treatment principle for cerebral vessel spasm caused by concussion.

OBJECTIVE: To discuss the mechanism of cerebral vessel spasm caused by concussion and the effect of Nimodipine on concussion. METHODS: A total of 224 patients who were treated from March 1995 to October 1999 were divided into two groups randomly, ie, Nimodipine group (113 cases) and control group (111 cases). Middle cerebral artery (MCA), basilar artery (BA) and the average peak forward velocity of cerebral blood flow were observed by color three-dimensional transcranial Doppler (3D-TCD) within 24 hours after admission and at the end of 3-6 days of treatment. Cerebral blood flow changes, characteristics and treatment effect were analyzed and determined by clinical main symptom disappearance rate. RESULTS: In concussion, cerebral blood flow was divided into 3 phases: cerebral blood flow low infusion dilation phase, cerebral blood vessel spasm phase and cerebral blood flow recovery phase. In the Nimodipine group, clinical main symptom disappearance rate was higher than that in the control group in the cerebral spasm and recovery phases with a significant difference (P < 0.01). CONCLUSIONS: Cerebral vessel spasm, hypoxia and ischemia lesion are the main pathological changes. Whether cerebral dysfunction is reversible or not is mainly determined by spasm time of cerebral blood vessel. Nimodipine has a good effect on releasing spasm and diminishing the cerebral blood flow velocity. It not only improves curative effect on concussion, but also reduces and prevents concussion sequelae. Hence, concussion patients who have cerebral spasm confirmed by 3D-TCD should be given Nimodipine routinely and early.

Adolescent↗
PubMed2003

[Study on the expressions of basic fibroblast growth factor and nervous growth factor genes in rat cerebral concussion].

OBJECTIVE: To study the expressions of basic fibroblast growth factor (bFGF) and nervous growth factor(NGF) genes in rat cerebral concussion. METHODS: Eighty Wistar male rats were used for animal model of cerebral concussion, which were sacrificed on 1, 3, 7, 14 and 30 days after injury and the brain tissue was taken out. The expressions of bFGF and NGF genes were studied in the course of cerebral concussion by means of immunohistochemistry and in situ hybridization. RESULTS: Rats in 100 g group were seen the clinical manifestation for typical cerebral concussion. The protein and mRNA of bFGF were increased on day 1, obtained at peak on day 3-7, decreased on day 14 and also increased on day 30 compared with controls. The positive area was seen in the plasma of neurons in cerebral cortex, hippocampus, thalamus and cerebellum. NGF protein and mRNA showed strong positive and increased in the plasma of neurons in cerebral cortex, hippocampus, thalamus and cerebellum on day 1, and they were continuously positive but gradually decreased within 30 days after injury. CONCLUSION: The expression of bFGF gene participates in the course of cerebral concussion, might play an important role in the nervous cells degeneration and necrosis; NGF gene expression participates in the whole course of cerebral concussion, especially in the early phase.

Animals↗
PubMed2003

[Expression and significance of enkephalin and dopamine in experimental rat cerebral concussion tissue].

AIM: To explore the expression and significance of enkephalin and dopamine in rat cerebral concussion tissue. METHODS: 80 Wistar male rats were used to make animal model of cerebral concussion, which were sacrificed on 1,3,7,14 and 30 days after postconcussion and the brain tissues were taken out. The expression patterns of enkephalin and dopamine were studied in the course of cerebral concussion by immunohistochemical staining. RESULTS: The clinical manifestation with typical cerebral concussion character was seen in rat group with 100 g body weight. The mainly pathologic changes were cerebral vascular constriction and dilatation, congestion and edema of cerebral tissue, and neuronal degeneration and necrosis. Expression of enkephalin was increased on day 1 after injury and the enkephalin positive area was in the plasma of endothelial cells in cerebral cortex, hippocamp and cerebellum. The expression of enkephalin reached the peak on day 7 after injury, and the positive area was also seen in the plasma of neurons in cerebral cortex, hippocamp and cerebellum. From 14 days after injury, the expression of enkephalin decreased gradually, but until 30 days after injury it was still higher than that of controls. Expression of dopamine increased in 7 days after injury and the positive area was seen in the plasma of endothelial cells and in the vessel wall in cerebral cortex, hippocamp, thalamus and cerebellum, and had no notable changes at other time points. CONCLUSION: The mainly pathologic changes after cerebral concussion were blood circulatory disorder and denaturation and necrosis of parenchymal cells. Enkephalin and dopamine may participate in the pathophysiological course of cerebral injury after cerebral concussion, and play an important role in the blood vessel injury, regulation of blood-brain barrier and the denaturation and necrosis of nerve cells.

Animals↗