bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concussion characteristics in horse racing
Authors: Mattacola Carl G , Han Dong (Dan) Y , Crots Jed , Glueck Amanda , Abt John , Heebner Nick 
Published: November 2017

ObjectiveTo describe characteristics and modifiable factors in jockeys who have sustained a concussion for the purpose of identifying areas for risk reduction and improved safety.SettingDirect from field; descriptive epidemiology study.Patients or other participantsData were obtained from the Jockey Injury Database from years 2012 to 2016.InterventionsData were collected from Horse Racetracks in the United States.Main outcome measuresDescriptive statistics were used to identify frequency and percentages based on gender, helmet type, track, jockey experience, location of track, size of field, horse gender, track condition & distance.ResultsThere were 36 reported concussions during this period. 29 males and 7 females sustained a concussion. Helmet type was distributed evenly with more concussions occurring with LAS helmets. The majority occurred on dirt (27/66%) versus synthetic surfaces (9/8%). Injury rates were higher (21/58%) in less experienced jockeys (<6 years’ experiences) versus more experienced jockeys (13/36%) (>11 years’ experience). More concussions were identified in the last turn/stretch (21/58%) than the beginning of the race (12/33%). More injuries (23/64%) were identified in fields greater than 8 horses than fields of less than 7 horses (12/33%). More concussions occurred in fast/firm conditions (28/78%) than sloppy/muddy/good (4/11%). More concussions were present in races that were 5,6, &7 furlongs (18/50%) versus more than 1 mile in length (12/33%).ConclusionsThe results of this research establish injury characteristics that can be used to better understand equipment and conditions that contribute to increased risk of concussion.Competing interestsNone.
Concussion incidence and mechanism among youth volleyball players
Authors: Meeuwisse Derek W , MacDonald Kerry , Meeuwisse Willem H , Schneider Kathryn 
Published: November 2017

ObjectiveTo assess the incidence of concussions among adolescent volleyball players in Canada.DesignCross sectional survey.SettingOnline survey.ParticipantsIn total, 663 registered Volleyball Canada members completed a national survey, with a response rate of 13.0%; web-based survey response rates rarely exceed 5%. The 452 (68.2%) female and 211 (31.8%) male responders had a mean age of 16.2 (95% CI: 16.1to 16.4) years with a range from 14 to 19 years.Assessment of risk factorsThe type of environment: controlled non-competitive environment (practice or warm-up) versus competitive game play environment.Outcome measuresWhether the athletes sustained a concussion as defined by the 2012 Zurich Consensus.Main resultsA total of 86 concussions were reported, of which 52 were in the previous 12 months, yielding a one-year cumulative incidence per 100 athletes of 7.1 (95% CI: 4.3 to 11.4) and 7.5 (95% CI: 5.4 to 10.3) for males and females, respectively. In total, 57.1% (95% CI: 46.2 to 67.5) of all concussions involved ball-to-head contact. Player-to-player contact and head-to-floor contact were less prevalent at 20.2% (95% CI: 12.8 to 30.4) and 15.5% (95% CI: 9.1 to 25.1) respectively. Practice environment accounted for 46.5% of all concussions while 38.4% occurred in game play. The remaining 15.1% occurred in warm-up. In total, 61.6% (95% CI: 50.2 to 71.7) of concussions occurred outside of free-flow competitive game play, in a more structured environment.ConclusionsThere is a significant margin for injury prevention as a substantial proportion (61.6%) of concussions happening in a noncompetitive, controlled environment that may be amenable to change that would reduce the potential for such injury.Competing interestsThe authors have no competing interest to state.
Concussion management plan compliance: a study of ncaa power five conference schools
Authors: DiFabio Melissa , Baugh Christine , Buckley Thomas 
Published: November 2017

ObjectiveTo examine the concussions management protocols (CMPs) from the 65 institutions within the NCAA Power 5 conferences for compliance with the NCAA 2015 concussion guidelines.DesignDescriptive Study.SettingN/A.Participants65 universities of NCAA conferences: Atlantic Coast, Southeastern, Big Ten, Big 12, and Pacific-12InterventionsThe 65 publicly-available CMPs were evaluated for compliance with the 47 NCAA rules and guidelines (combined N=3,055). Each CMP was reviewed and graded “yes” or “no” for each recommended or required item and compliance was reported descriptively.Outcome measuresOverall compliance rate, mean, item-level, category-level, and institution-level compliance with the 47 items. Each institution’s athletic training staff size, academic performance, and athletic performance were examined as independent predictors with quasi-binomial regression.Main resultsCMPs varied substantially in length (range: 4-66 pages) and level of detail. The overall compliance rate for all components across all institutions was 94.3% (2,880/3,055). Twelve components achieved 100% institutional (65/65) compliance, and the lowest levels of compliance were clustered in “Return-to-Learn” (RTL). There were 22 institutions that achieved a 100% compliance rate; the lowest institutional compliance was 59.6%. There were no significant associations between the independent predictors and institutional compliance.ConclusionsOverall compliance with NCAA concussion management requirements was high, but there remains room for improvement. There was low compliance with RTL as well as limited details provided in the reducing head trauma component. Items with lower compliance (reducing head trauma, return-to-learn) tended to be outside the core competencies of the medical staff, indicating an area for improvement.Competing interestsNone.
Effect of a rule change on concussions and other injuries in professional baseball
Authors: Gary Green , D’Angelo John , Coyles Jon , Valadka Alex 
Published: November 2017

ObjectiveTo evaluate the hypothesis that a rule change can lower the incidence of concussions and other injuries in professional baseball.DesignRetrospective review of professional baseball’s electronic medical record system. All Minor (MiLB) and Major League Baseball (MLB) teams are required to use this system.SettingFive full MiLB and MLB seasons in the United States and Canada.ParticipantsAll players in MiLB and MLB were included. The 30 MLB clubs have 750 active players and play 162 games per season. MiLB has approximately 7500 active players on 200 teams that play 56-144 games annually.InterventionBefore the 2014 season, MLB instituted a rule limiting home plate collisions between base runners and catchers.Outcome measuresAll concussions and other injuries at home plate from 2011 to 2015 were analysed by mechanism and player position.Main resultsFrom 2011-2013, an annual average of 117 injuries occurred at home plate in both MiLB and MLB, with an average of 4823 days lost annually. An average of 13 concussions occurred annually in both MiLB and MLB. Following the rule change, in 2014-2015 there was an annual average of 60 home plate injuries with 1592 days lost. There were 6 MiLB home plate concussions in 2014 and none in 2015. There were no home plate concussions in MLB in 2014-2015 (p=0.07). MiLB and MLB combined for approximately 660,000 athlete exposures per season.ConclusionsThis rule change was associated with a strong trend toward reduced concussions and other injuries at home plate.Competing interestsMr. D’Angelo and Mr. Coyles are employed by Major League Baseball. Dr. Green receives payment from Major League Baseball for his role as Medical Director. Dr. Valadka is a paid consultant to Major League Baseball. The authors have no other disclosures to report.
Head and neck size and neck strength minimise the head acceleration during repeated head impacts
Authors: Caccese Jaclyn B , Buckley Thomas A , Tierney Ryan T , Rose William C , Arbogast Kristy B , Glutting Joseph J , Kaminski Thomas W 
Published: November 2017

ObjectiveTo identify factors that contribute to head acceleration during purposeful soccer heading.DesignProspective.SettingBiomechanics laboratory.ParticipantsOne-hundred soccer players (42 male, 58 female, 17.1±3.5 years (range: 12-24years), 168.5±20.3 cm, 61.5±13.7 kg). Exclusionary criteria: history of neurologic disorder, cervical spine injury, or head injury in the past 6 months.InterventionsWe implemented a soccer heading paradigm that consists of controlled soccer heading (12 headers at 11.2m/s from a JUGS machine) while measuring 3D motion capture kinematics (torso and head-to-torso range-of-motion), sternocleidomastoid and upper trapezius EMG activity (peak and area), and linear and rotational accelerations using a triaxial accelerometer and gyroscope. Head mass, neck girth, and sternocleidomastoid and upper trapezius strength were also evaluated.Outcome measuresLinear and rotational accelerations at the head center-of-gravity.Main resultsMultiple regression analyses suggest that the ten variables predicted linear (R2=0.272, p=0.002) and rotational (R2=0.259, p=0.004) acceleration; however none of the predictors individually made a significant contribution to the model. Linear and rotational accelerations were correlated with head mass (r=-?0.447, p<0.001; r=-0.467,p<0.001), neck girth (r=-0.465, p<0.001; r=-0.438, p<0.001), sternocleidomastoid strength (r=-0.386, p<0.001; r=-0.410, p<0.001), and upper trapezius strength (r=-0.311, p=0.001; r=-0.351, p<0.001).ConclusionsOur findings suggest that head mass, neck girth, and neck strength are important in minimising head acceleration, whereby greater size and strength are associated with lower head accelerations. Soccer players with smaller head-neck segment masses and lower neck strength, may be at risk for greater head acceleration. These athletes may experience a theoretical bobble-head effect, when the neck strength is not great enough to control the mass of the head.Competing interestsNone.
Improved prediction of subconcussive neurophysiological changes by kinematic impulse
Authors: Talavage Thomas M , Breedlove Katherine M , Breedlove Evan L , Abbas Kausar , Shenk Trey , Bowman Thomas G , Nauman Eric A , Leverenz Larry J 
Published: November 2017

ObjectiveFor both subconcussive impacts and traditionally-defined concussion, neither the number of head impacts nor the magnitude has had a strong correlation to the incidence or severity of injury. Recent modelling work has suggested that impulse may be an important biomechanical factor, and therefore it is hypothesised that it may be a good predictor of subconcussive neurophysiological changes.DesignObservational study.SettingAmerican high school football team.ParticipantsNine male high school football athletes (mean age=16.4, range=15–17) volunteered. All participants were enrolled with parental consent.Assessment of risk factorsHead impacts were monitored at all practices and games with the Head Impact Telemetry System. Baseline neurophysiology was measured prior to contact activity using a functional magnetic resonance imaging (fMRI) visual n-back task protocol. Subjects returned throughout the season and were re-evaluated according to the same protocol.Outcome measuresKinematic impulse was computed from head impact telemetry. Changes in neurophysiology were determined as the difference in the 2 vs. 1-back contrast. This contrast was determined for 116 anatomically defined regions of interest (ROI).Main resultsStepwise regressions (P=0.05) relating kinematic impulse to ROI-specific changes in neurophysiology yielded significant correlations for 57/116 ROIs. 22/116 ROIs had an R2 value greater than 0.70. Correlations were found bilaterally for 16 anatomical ROIs, including the executive pre-frontal regions, basal ganglia, and thalamus.ConclusionsThe relationship between kinematic impulse and fMRI changes reported here are the strongest correlations to subconcussive changes reported to date. Correlations were observed bilaterally in regions associated with concussion symptoms.Competing interestsNone.
Previous concussion history influences neurological assessments following an acute bout of purposeful heading in women’s collegiate soccer
Authors: Kaminski Thomas W , Kimmelmann Briana , Caccese Jaclyn B , Glutting Joseph J 
Published: November 2017

ObjectiveDo differences in neurological assessments exists in a cohort of intercollegiate soccer players with varied concussion histories after an acute bout of soccer heading?DesignPre-posttest.SettingSoccer turf field and clinic.Participants67 female collegiate soccer athletes (age=19.1 ± 0.9 yr.; mass=60.5 ± 5.0 kg; height=165.3 ± 5.9 cm). Based on their concussion history subjects were assigned to either the control/simulated heading [G1-17], control/heading [G2-22] 1–2 previous concussion/heading [G3-19], and 3 or more concussion/heading [G4-9] groups.InterventionsConcussion symptoms (SX), BESS errors, ImPACT NP test scores were derived prior to and immediately after a bout of heading (15 total headers/15 minutes @ 12 m/s). Subjects returned to the clinic for post-testing immediately after heading.Outcome measuresSX, BESS and NP scores pre and post ROT and LIN heading.Main resultsG3 (3.9±4.4) and G4 (5.1±6.0) demonstrated higher SX pre-heading compared to G1 (1.9±2.4) and G2 (3.2±3.7). Excluding G1, all groups showed elevated SX post-heading. There was a significant (p=.05) time by group interaction for SX whereby SX in G4 (7.8±7.1; 95% CI=4.9 – 10.7) were significantly (p=0.03) higher post-heading than G1 (2.0±2.5; 95% CI=−0.02 – 4.2).ConclusionsSubjects in G4 had elevated SX at baseline, and those SX appear to be greatly exaggerated immediately following an acute bout of heading. Clinicians should carefully monitor soccer players who have experienced multiple concussions and be cognizant that they may develop concussion-like symptoms, especially after acute bouts of heading. Limitations in soccer heading should also be considered for this group of soccer athletes.Competing interestsNone.
Post-concussion abnormalities in the m60 somatosensory evoked field recorded by magnetoencephalography
Authors: Wennberg Richard , El-Rahimy Youssef , Shampur Nat , Dominguez Luis Garcia 
Published: November 2017

ObjectiveWe sought to determine whether magnetoencephalography (MEG) might reliably document the presence of neurophysiologic dysfunction after acute concussion. Based on a previous evoked potential study,1we analysed somatosensory evoked fields (SEFs) elicited by stimulation of the median nerve at the wrist.DesignCase-control study.SettingAcademic tertiary care centre.ParticipantsFive patients with acute concussion (<10 days post-injury); mean age 32±18 yrs, 3 women. 23 age/sex matched controls with no history of concussion.Assessment of risk factorIndependent variable, concussion.Outcome measuresDependent variables, bilateral peak latencies of M20, M30, and M60 SEFs.Main resultsNo differences were found between patients (24 recorded values) and controls (46 recorded values) in M20 (21.7±1.6 ms vs. 22.3±1.5 ms) or M30 (35.4±3.8 ms vs. 33.5±3.3 ms) latencies. M60 latencies were significantly delayed in patients compared to controls (90.4±21.5 ms vs. 64.0±8.6 ms; Mann Whitney U-test, U=186.5, p=0.0001). All symptomatic patients had an abnormally delayed M60 value>2 SDs from the control mean on at least one side. Follow-up patient recordings showed gradual decreases in abnormal M60 latencies over months; weekly MEG and ImPACT testing in one patient showed normalisation of verbal memory at week 2, visual memory and symptom scores at week 5 and M60 latencies at week 10.ConclusionsThe M60 SEF represents the first intracortical stage of neuronal processing of external somatosensory input to the brain. In this preliminary study we found significant differences in M60 latencies between subjects with acute concussion and controls, as well as within subject changes during recovery in the weeks after concussion.Competing interestsNone.
Regulator-watching: a typology of regulatory methods adopted by sports governing bodies in concussion management
Authors: Greenhow Annette 
Published: November 2017

ObjectiveResponses to the harm caused by sports-related concussion constitute a new interdisciplinary field of research (Doherty, 2012). Regulatory theory and principles of what constitutes ‘good’ regulation can contribute to the discussion. The aim of this research is to present a typology of regulatory responses adopted by sports governing bodies in those sports with published injury surveillance data, and to classify the responses according to the regulatory methods used by the organisations.Sports governing bodies are voluntary self-regulated associations and custodians of their sport. As the dominant regulator responsible for the development of rules and standards, the organisation carries the responsibility to provide a safe system for participants within its regulatory field, focussing on precautionary-based approaches and risk reduction strategies to preserve the health, safety and welfare of participants. The expectation is that these interventions are based on well-defined objectives and an understanding of the variety of regulatory methods available to achieve the objectives.DesignThis presentation provides the results of a review of the regulatory activities of the sports governing bodies across contact and collision sport. By adopting a qualitative research method, the regulatory actions of the organisations are classified according to the four response areas of concussion management, concussion prevention, concussion research and concussion education.Main resultsA variety of regulatory methods were employed by the organisations across each of the four categories. Early interventions focus on concussion management and concussion prevention with more recent interventions focussed on concussion education and concussion research strategies.ConclusionsThose organisations with clearly defined objectives and comprehensive injury surveillance data reporting systems adopted regulatory methods across each of the four categories.Competing interestsNone
Baseline scat3 in professional football players: data from the canadian football league
Authors: Naidu Dhiren J , Hoeber Shane , Ashworth Nigel , Mrazik Martin 
Published: November 2017

ObjectiveTo establish baseline normative concussion data for Canadian Football League (CFL) players.DesignCross-Sectional.SettingProfessional American football.Participants596 male professional football players from the 2014 CFL season. All asymptomatic players were included in the study. Players with a diagnosis of concussion were excluded.Interventions (or Assessment of Risk Factors)Data from the baseline SCAT3 assessments was collected and analysed to determine the prevalence and severity of symptoms on the symptom evaluation and average values for the cognitive and physical examination.Outcome measuresAnalysis of SCAT3 categories.Main results47.4% players had a previous concussion with symptoms lasting 6.28 (22.9)* days on average. Athletes reported 1.09 (2.13) symptoms with a total symptom score of 1.86 (4.09). The most frequently reported symptoms were nervousness/anxiety (11.9%), trouble falling asleep (11.2%), fatigue (11.2%), sensitivity to light (9.1%), and neck pain (7.7%). Scores for orientation, immediate memory, concentration, and delayed recall were 4.89 (0.35), 14.25 (1.23), 3.75 (1.16), and 3.79 (1.13) respectively. Balance testing revealed 0.02 (0.13), 1.91 (2.00), and 0.92 (1.36) errors on double leg, single leg, and tandem stance respectively. * parentheses indicate 1 standard deviation from the mean.ConclusionsThere are abnormalities on baseline SCAT3 testing of asymptomatic CFL players. This is consistent with past studies of similar athletic populations. This is expected as not all SCAT3 symptoms are specific for the diagnosis of concussion. Future research could be done to see if athletes who fall outside of the normative baseline values have different outcomes post concussion.Competing interestsNone.
Day of injury dizziness is related to prolonged recovery following concussion
Authors: Luoto Teemu M , Hänninen Timo , Parkkari Jari , Tuominen Markku , Iverson Grant L , Vartiainen Matti , Öhman Juha 
Published: November 2017

ObjectiveTo examine the relation between day of injury concussion symptomology and prolonged recovery.DesignProspective cohort.SettingFinnish professional ice hockey league.ParticipantsSCAT3 baseline and post-injury testing has been mandatory in the Finnish ice hockey league since 2013. Of the reported injuries, between seasons 2013-2016, all cases with a day of injury SCAT3 symptom scale completed were selected. The teams’ medical staff confirmed 28 concussions, which were assessed on the day of injury.Outcome measuresThe SCAT3 symptom scale was completed on the day of injury. All 22 symptoms were analysed separately. Team medical staff followed up all concussed players and the day of return to play (RTP) was recorder for each athlete. Concussion recovery was considered prolonged if the time of RTP was over 10 days. RTP was analysed as a continuous and a dichotomized variable.Main resultsAll concussed players (n=28) were Caucasian. The average age was 26.4 years (SD=4.3). The mean Symptom Score was 12.1 (SD=4.3) and the Symptom Severity 26.4 (SD=13.5), respectively. The median time to RTP was 9 days (M=21, SD=47, range=4–248) with 36% of the players being out of play for more than 10 days. There was a significant correlation between Symptom Severity and RTP (p=0.046). Symptom Score was not related to RTP. Dizziness was the only symptom with a consistent statistical relation to longer RTP (Spearman rho=0.4, p=0.029; Mann-Whitney U=4.9, p=0.038; Binary univariate logistic regression: OR=2.6, p=0.04).ConclusionsAcute day of injury dizziness was related to prolonged recovery following concussion.Competing interestsTeemu M. Luoto, Timo Hnninen, Jari Parkkari, Markku Tuominen, Matti Vartiainen, Juha hman: None.Grant L. Iverson has been reimbursed by the government, professional scientific bodies, and commercial organisations for discussing or presenting research relating to mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums. He has a clinical and consulting practice in forensic neuropsychology involving individuals who have sustained mild TBIs (including professional athletes). He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He has not received research support from a test publishing company in the past 5 years.None.