bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between previous history of concussion and sport-specific skills in youth ice hockey players
Authors: Eliason Paul H , McKay Carly D , Meeuwisse Willem H , Hagel Brent E , Nadeau Luc , Emery Carolyn A 
Published: November 2017

ObjectiveTo determine the association between previous history of concussion and sport-specific skill performance in youth ice hockey players.DesignCross-sectional.SettingArenas in Calgary, Alberta, Canada over three seasons of play (2012–2015).ParticipantsFive hundred and ninety-six players were recruited from youth hockey teams [525 males and 71 females, aged 11-17, representing elite (upper 30% by division of play) and non-elite (lower 70%)].Assessment of risk factorsPlayers completed a baseline questionnaire including the number, date of occurrence, and length of recovery following any previous concussions.Outcome measuresOn-ice skills performance was measured using the Hockey Canada Skills Test (HCST) battery including forward agility weave, forward to backward transition agility, forward/backward speed skate, and a 6-repeat endurance skateResultsPrevious history of concussion and time since most recent concussion were not associated with any HCST component. Players reporting two or more concussions were faster than those with no history of concussion on forward agility weave with the puck [−7.32 (95% CI: −11.05, −3.59)]. For every additional day of recovery post-concussion, a player’s time was significantly faster on forward agility weave with [−0.11 (95% CI: −0.16, −0.05] and without the puck [−0.08 (95% CI: −0.13, −0.04], transition agility without the puck [−0.01 (95% CI: −0.02, −0.01], and backward speed with [−0.06 (95% CI: −0.1, −0.03)] and without the puck[−0.05 (95% CI: −0.07, −0.03)].ConclusionsPlayers with a concussion history had similar HCST performance scores to those without. A longer post-concussion recovery was associated with better performance. These results provide reference values which will inform risk assessment and future injury prevention studies.Competing interestsNone.
A retrospective review of baseline balance scores in college athletes
Authors: Delasobera Elizabeth , Shasteen Mallory , Parsa Keon , Wierenga Justin 
Published: November 2017

ObjectiveThis study examines differences in baseline balance scores in order to establish normative data in college athletes, and also determine the potential effect of gender, sport, and concussion history on baseline performance.DesignRetrospective reviewSettingPre-participation evaluations of athletes at an American university.Participants961 varsity athletes, ages 17 to 21, both male and female from 2011 to 2015.Independent VariablesGender, sport, and history of prior concussions.Dependent VariableBaseline Balance Error Scoring System (BESS) scores.Main ResultsThe baseline BESS score for all athletes averaged 16.13 (range 2 to 40). Baseline BESS scores were significantly different in males (15.78) compared to females (16.84), with a difference of 1.056 (95% CI 0.233 to 1.890, P=0.013). Baseline scores averaged 17.40 in athletes with history of concussion compared to 16.45 in athletes with no prior concussion (CI 0.866 to 2.780, P=0.301). When comparing scores by sport, there were no significant differences in baseline scores between females who played field hockey, softball, volleyball, basketball, lacrosse, or soccer. There were no significant differences in baseline scores between males who played baseball, football, basketball, lacrosse, or soccer.ConclusionsWhen balance testing is used to assess an athlete after concussion injury, normative balance scores may be used in the absence of baseline scores. History of concussion and type of sport do not play a significant role in baseline balance assessment, however gender may alter the normative baseline data slightlyCompeting interestsNone.
Adolescent athletes’ social perspectives following a sport-related concussion
Authors: Valovich McLeod Tamara , Wagner Alyssa J , Parsons John T , Welch Bacon Cailee E 
Published: November 2017

ObjectiveTo explore adolescent athletes’ social perspectives regarding sport and concussion.DesignQualitative inquiry.SettingIndividual in-person interviews.Participants12 interscholastic athletes (4 females, 8 males; age=15.7±1.7 years; grade level=10.2±1.4; sports=football, soccer, volleyball, basketball, and wrestling) were interviewed.Outcome measuresA semi-structured interview protocol was used. Interviews focused on injury details, and explored the physical, psychosocial, emotional, and spiritual components of sport and health. Themes and categories were identified based on the consensus process by a three-person research team. A comprehensive codebook that captured the main themes and categories resulted.ResultsFollowing concussion, participants discussed two primary themes: perceptions regarding the social aspects of sport and social perspectives regarding their concussion. Specific categories related to the social aspects of sport included friendships and family and decision to participate based on peers. Specific categories regarding the social perspectives of the concussion included: uncertainty of the diagnosis, perceptions of others regarding their injury, being ashamed of the concussion, parent and peer roles, and communication and expectation about their concussion.ConclusionsParticipation in sport and removal from sport following a concussion have significant social implications for adolescent athletes. Specifically, the perceptions of peers, parents, and others regarding the injury can influence reporting of symptoms and recovery following concussion. Limited communication regarding recovery and expectations post-concussion may cause undue social pressures to return to activity prematurely. Anticipatory guidance, with education regarding the possible signs and symptoms, risk factors pre- and post-injury, and recovery expectations following a concussion are important to include in post-injury management.Competing interestsFunded from a grant from the National Operating Committee on Standards for Athletic Equipment.
Annual baseline drift in professional rugby league players
Authors: Hodgson Lisa , Gissane Conor , Walker P , Maruff Paul , Darby D 
Published: November 2017

ObjectiveAnnual baseline testing within professional Rugby League has been mandatory since 2004. The question, do annual baselines drift over time or as a result of a concussion in rugby league players is unanswered. If they do drift, what is the magnitude and in what tasks and is this correlated to associated concussions. The study evaluated if baselines drift over time and if so is this related to concussive injury or accumulating injury.DesignRetrospective studyMethodParticipant players were those who held a professional contract between the 2006–2012 season. It is mandatory to provide an annual baseline test using CogSport and following any diagnosed concussion, with full symptom resolution, a valid return to play test. Concussion test data was provided by CogState Australia from tests performed over 7 seasons.ResultsOver the 7-year period 4762 players suffered 470 concussions (2.65/1000 hours, 95% Confidence Interval 2.4 to 2.9). Identification increased with previous concussion (0.017, 0.001 to 0.029, P=0.05) but not season. One Back Memory decreased with concussion (−.05 to −.05, P=0.001). One Card Learning decreased with previous concussion (−0.041, −0.049 to −0.34, P=0.001) and season (−0.006, −0.007 to −0.005, P=0.001).ConclusionsOver seven seasons, item scores within the CogSport test varied as a function of previous concussion and time. Individual items within the CogSport test were influenced by differing factors and further examination of the individual items is warranted.Competing interestsLisa Hodgson, Conor Gissane, P Walker – None.Paul Maruff – Full time employee of CogStateD Darby – Former Founder and Director of Cogstate
Assessment of blood biomarkers of mild traumatic brain injury in professional rugby: a case control study
Authors: Wilson Fiona , Kelly Aine , Boyle Noreen , Oresic Matej , Hyotylainen Tuulia , Denvir Karl , Farrell, Garreth , O’Connell Brendan 
Published: November 2017

Objectiveto investigate plasma S100b concentration following competitive play and concussive episodes; to compare plasma S100b concentration in professional rugby players with age matched non-contact athletic controls; to develop an objective blood biomarker to aid in the diagnosis of concussion.DesignProspective case-control studySettingProfessional rugby club, Elite rowing clubs.ParticipantsProfessional rugby players (n=44); elite rowers (age/activity matched athletic controls) (n=16).InterventionsBlood samples were collected at baseline (14 days prior to training/competitive play) in both the rugby and rowing cohort. Rugby players were again assessed one hour following competitive games in the early, middle and late season (3 times). This was repeated again the following season (6 data sets). Concussed players were re-evaluated following concussion.OutcomesPlasma was prepared and assessed for S100b concentration by ELISA (Abnova). Metabolomic profiling of samples was carried out by two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC×GC-TOFMS).Main resultsThere was significant increase in plasma S100b following competitive play, compared to baseline (p<0.001). Over 1000 metabolites were detected by GC×GC-TOFMS in a single sample run, covering a functionally wide range of small molecules. The post-match metabolic profile showed significant changes in several metabolites; these are at present being validated and analysed further.ConclusionsThere is a significant effect of competitive play on circulating S100b. Data on metabolomic profiles are being collected continually throughout the season and being clustered according to concussive and non-concussive episodes. It is hoped that this analysis may reveal concussion-specific changes in the metabolomic profile of players.Competing interestsNone.
Clinician knowledge and practice habits when evaluating sports related concussion in the emergency department
Authors: Duignan Martin , O’Connor Niall , Tillett Eleanor , Kipps Courtney 
Published: November 2017

ObjectiveTo investigate emergency department (ED) clinicians’ knowledge and practice habits when evaluating and treating concussions in the Republic of Ireland (ROI)DesignAn 84-item anonymous questionnaireSettingEmergency Departments and Minor Injury Units in the ROIParticipantsThe survey was distributed by email to the national cohort of Registered Advanced Nurse Practitioners (RANP; n-84), and Emergency Medicine Consultants (n=86), working in EDs in the ROIMain results101 Surveys were completed (43 RANP, 43 NCHD, 15 EM Consultants). 60% of all respondents rated themselves as very confident in identifying the signs and symptoms of concussion. Only 40% had heard of or were mildly familiar with the SCAT3 concussion assessment tool. 15% believed MRI and/or CT would demonstrate damage following a concussion. 60% felt that they were very confident giving discharge advice and return to play (RTP) instructions following concussion although half of all respondents advise waking the patient up several times over the first 24hours. Only 37% believe that adolescent players (<18 yrs) take longer to recover from concussion than adults. 70% of all respondents believe appropriate headgear can help prevent concussion.ConclusionsCurrent guidelines regarding assessment tools have not reached the majority of ED clinicians. Additionally, knowledge gaps exist regarding concussion symptom identification and management, and further education is warranted.Competing interestsNone.
Deficits in dynamic balance during tandem gait after concussion may be exacerbated by dual-tasks
Authors: Lynall RC , Blackburn JT , Guskiewicz KM , Marshall SW , Plummer P , Mihalik JP 
Published: November 2017

ObjectiveExpert consensus recommends tandem gait (heel-to-toe walking) to assess concussion. Failure rate when only assessing time-to-task completion is unacceptably high among healthy participants. Our purpose was to assess tandem gait centre of pressure and dual-task cost with and without cognitive distraction in recently concussed individuals.DesignCross-sectional.SettingUniversity.SubjectsThirty college-aged recreational athletes in two 15-person groups: 1) recent concussion (median time post-concussion=126 days, range 28-432d), and 2) healthy sex-, age- (±1 yr), mass- (±10%), and height- (±5%) matched controls.InterventionParticipants completed 3 trials each of 4 tandem gait conditions: 1) tandem gait (eyes open, no cognitive distraction), 2) tandem gait (eyes closed, no cognitive distraction), 3) tandem gait (eyes open, Brooks Visuospatial Task cognitive distraction), and 4) tandem gait (eyes closed, Brooks Visuospatial Task cognitive distraction).Outcome measuresCentre of pressure velocity, speed, path length, and dual-task cost.ResultsThe recent concussion group (25.15 cm/s) demonstrated slower tandem gait velocity compared to the control group (29.20 cm/s; p=0.049; 95% CI:0.02-8.06 cm/s). After controlling for group velocity differences, the recent concussion group (23.5%) had higher centre of pressure speed dual-task cost during the eyes closed dual-task condition than did the control group (16.3%; p=0.032; 95% CI:2.70-11.48%).ConclusionsWe observed subtle centre of pressure group differences more than one month after post-concussion return to activity. It remains unclear if these differences impact clinical outcomes post-concussion. Longitudinal investigations should study acute post-concussion movement deficits, and discern the recovery of these deficits in comparison to recovery using traditional concussion assessment tools.Competing interestsNone.
Knowledge and practice habits of hospital doctors who manage sports-related concussion in sri lanka
Authors: Goonetilleke Chaminda , Medici Akbar de , Kipps Courtney 
Published: November 2017

ObjectiveTo investigate the knowledge and practice habits of hospital doctors who evaluate and treat concussions in Sri Lanka.Designemail questionnaire surveySettingEmergency departments and surgical wards in hospitals in Sri LankaParticipantsThe survey was distributed via email to 400 ED and surgical doctors working in hospital practice in Sri Lanka. Only doctors who routinely deal with sport-related concussion were included. Doctors who did not manage concussion were excluded.Outcome measuresSurvey analysis of concussion knowledge and management habits.Main results88 surveys from doctors who met the inclusion criteria were returned completed. Respondents answered a mean 72.9% of the concussion signs and symptoms knowledge questions correctly. However only 21 (23%) of doctors surveyed were aware of any concussion management guidelines and 41 (47%) believed that players could resume normal training once they were symptom-free. 71 (80.7%) respondents believed that wearing headgear could help prevent concussion. There was no significant difference in concussion knowledge between consultants and non-consultant grades (p=0.5).23/88 respondents said they have been pressurised (by the injured player (n=14), coach or manager (13), other players (5), parents (4), other administrators (8)) to return to play early.ConclusionsED and surgical doctors in Sri Lanka have a moderate level of knowledge of sports-related concussion, however few are aware of concussion management guidelines and many continue to adhere to outdated advice. This is the first such survey in Sri Lanka and demonstrates a need for additional sports concussion education.Competing interestsNone.
Objective quantification of a clinical dynamic balance assessment
Authors: Johnston William , Moran Thomas , Dolan Kara , Reid Niamh , Coughlan Garrett , Caulfield Brian 
Published: November 2017

ObjectiveTo investigate whether addition of inertial sensor data can provide additional insight into the nature of postural stability deficits during a clinical dynamic balance assessment, with a view to enhancing accuracy of post-concussion monitoring protocols.DesignDescriptive laboratory study.SettingUniversity performance laboratory.ParticipantsFifteen physically active adults (age 23±4 years, height 175±8 cm, weight 67.5±8 kg).InterventionsAn inertial measurement unit (IMU) was mounted at the level of the 4thlumbar vertebra. Subjects completed repeated Y-Balance tests (YBT) 10 minutes and immediately prior to a modified 60 second Wingate anaerobic fatiguing test. Post-fatigue YBTs were completed immediately following the test, and at 10 and 20 minutes.Outcome measuresNormalised YBT reach distances, and IMU derived RMS acceleration, velocity and angular velocity.Main resultsPrior to the fatiguing intervention, participant’s demonstrated excellent stability/reliability for all reach directions (Intra-class correlation coefficient 0.872-0.994). Significantly lower reach distances (P<0.05) were observed immediately post-fatigue for the postero-medial and postero-lateral, but not anterior reach direction. Observed deficits returned to pre-fatigue levels by 10 minutes. However, IMU derived measures of postural stability remained significantly reduced (P<0.05) for up to 20 minute post-fatigue.ConclusionsThese results demonstrate the ability of both traditional YBT reach distances and inertial sensor data to detect centrally driven postural stability deficits. However, the inertial sensor provided a greater degree of granularity in characterising the nature of these postural stability deficits. This suggests that addition of IMUs to clinical balance measurement tests/protocols may better detect deficits associated with concussion.Competing interestsNone.
Prevention activity can reduce catastrophic head injuries in judo players
Authors: Nagahiro Shinji , Mizobuchi Yoshifumi 
Published: November 2017

ObjectiveTo determine the features of catastrophic judo head injuries and the effects of prevention activities.Study DesignRetrospective descriptive epidemiological studyMethodsWe reviewed catastrophic head injuries in 44 judo players reported in the System for Compensation of Loss or Damage in the All Japan Judo Federation from 2003 to 2015. Prevention activities such as safety manual creation and enlightenment courses for judo instructors, including understanding of the consensus statement on concussion, were introduced in 2011. The incidences of death and poor outcomes before (Group A) and after (Group B) these prevention activities were compared.ResultsThe majority of catastrophic head injuries were acute subdural hematoma. The average patient age was 16.5 years. Most of the injured patients were novices without fully developed physical stamina and skills. Furthermore, Ukemi, a protection technique applied while being thrown, had not been fully mastered. Among 36 Group A players, 8 (23%) had a prior history of judo-related head injury with posttraumatic headache. In 4 of these 8 patients, CT and/or MRI detected a thin subdural hematoma during evaluation for persistent headache. Annual rates of catastrophic head injury were 4.0 in Group A for 9 years and 2.0 in Group B for 4 years, and the annual respective mortality rates were 2.0 and 0.25. Both rates were reduced after the prevention action introduced in 2011, although the decreases were not statistically significant.ConclusionsContinuous prevention activities can reduce catastrophic judo head injuries.Competing interestsAuthors have no conflicts of interest regarding this study.
Tandem gait performance following concussion
Authors: Oldham Jessie R , DiFabio Melissa S , DeWolf Ryan M , Kaminski Thomas W , Buckley Thomas A 
Published: November 2017

ObjectiveTo examine post-concussion tandem gait (TG) performance.DesignProspective Longitudinal.SettingResearch Laboratory.SubjectsTwenty-two NCAA Division I student-athletes: twelve diagnosed with sport-related concussions (Age: 20.3 ± 1.2 years; Height: 180.1 ± 12.4 cm; Weight: 80.5 ± 21.0 kg), and ten healthy controls (Age: 19 ± 1.2 years; Height: 176.3 ± 8.4 cm; Weight: 71.9 ± 9.4 kg).InterventionTG was performed in accordance with the SCAT3. Participants walked heel-to-toe down a 3-metre line and back as quickly as possible four times. All participants were tested prior to the season. The concussed group was re-tested acutely (<48 hours) post-concussion; controls were re-tested at 4 months. An MDC value, or the smallest meaningful change, was calculated from the controls, and the data were compared using a 2 × 2 (group × time) ANOVA.Outcome measuresFastest time to complete TG.Main resultsThe MDC was 0.38 seconds. There was no significant interaction (p=0.08), but there was a main effect for time (p=0.04); Post-concussion, the mean time increased by 2.3 seconds (10.6 ± 2.0 seconds and 12.9 ± 3.7) and 10 of the 12 participants exceeded the MDC. The control mean increased by 0.3 seconds (11.5 ± 1.2 seconds and 11.8 ± 0.5 seconds), which was less than the MDC.ConclusionsFollowing concussion, there was a group increase of 2.3 seconds. Ten of the twelve student-athletes exceeded the MDC of TG acutely post-concussion, which differs from other clinical tests, such as the BESS, where the average number of errors following concussion falls below the MDC. This suggests TG might be a more stable test of post-concussion postural control.Competing interestsNone.
The necessity of using baseline data to determine balance recovery post-concussion during the asymptomatic phase
Authors: Fedy Laura , Cinelli Michael 
Published: November 2017

ObjectiveTo determine whether sensory manipulation balance testing was able to detect balance control impairments in previously concussed asymptomatic (PCA) athletes. We hypothesised that PCA athletes would have balance control deficits in the A/P direction with sensory manipulations.Participants27 female athletes (19.78±1.3 years); 13 were previously concussed (PC) within the past 12 months and 14 had no history of concussions (NC).DesignManipulation of visual, somatosensory, and vestibular contribution to balance control within the following trials: 3 eyes open (EO); 3 eyes closed (EC); 1 dual-task arithmetic (DUAL); compliant surface with eyes open (EOc) and eyes closed (ECc); 1 horizontal eye movement task (VOR); and 1 horizontal head turns with EC (HHT). Participants tested prior to the start of season; four of them sustained a concussion during the season and were retested following the resolution of symptoms (i.e., RTP-2).ProceduresParticipants stood for 45s on a Bertec force plate (collected at 100Hz) in a Romberg stance. Trials were presented in order of increasing difficulty: EO1, EC1, dual task, EOc, ECc, VOR, EO2, EC2, HHT, EO3, and EC3.Data analysisRoot mean square (RMS) of centre of pressure displacement and velocity (dCOP and vCOP) were calculated in the A/P and M/L directions.Statistical analysisIndependent (PC vs. NC) and paired (baseline vs. RTP-2) t-tests were performed for each condition in both directions for dCOP and vCOP.Main resultsHHT condition revealed that A/P vCOP RMS (mm/s) was significantly greater in PC (Mean Diff=2.63, p=0.02) and within at RTP-2 (Mean Diff=5.24, p=0.02).ConclusionsBalance impairments exist up to 12 months post-concussion in PCA athletes when their vestibular systems were perturbed (HHT) and higher-order analyses (vCOP) were calculated.Competing interestsNone.