bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 35 Subjective and Objective Cognitive Functioning Differences among University Athletes
Authors: Hansen J , Mrazik M , David C , Ree-Fedun Q , Wagner R , White R , Naidu D 
Published: July 2024

Abstract

Purpose
To investigate the differences between objective cognitive scores and self-reported cognitive symptoms among university athletes.

Method
A prospective, quasi-experimental design was used for the study. Participants included athletes from a Canadian university over consecutive seasons who were diagnosed with a Sports Related Concussion (SRC) and underwent a post-injury assessment within 24–48 hours. Nineteen male and female athletes (ages M = 25.11, SD = 3.63) with complete data from the Sideline Concussion Assessment Tool (SCAT-5) were included. An independent T-test and correlational analysis were used to evaluate the relationship between subjective symptoms (memory and concentration) and objective cognitive functioning.

Results
There were no significant differences between baseline and post-injury testing on SCAT-5’s learning, concentration and delayed recall tests (p &gt; 0.05) but significant differences between baseline and post-injury symptom report of concentration t(36) = −3.4, p &lt; 0.001 and memory t(36) = −3.0, p &lt; 0.001.
At baseline, there was a significant negative correlation between memory total score and the reported cognitive symptoms, (r = −0.61, p &lt; 0.05) and between total cognitive score and self-reported symptom report (r = −61, p &lt; 0.05). In contrast, at post-injury, there were no significant correlations between the memory total score or total cognitive scores and the reported symptoms (r = 0.7, p = 0.79; r = 0.11, p = 0.67).

Conclusions
Participants endorse a significant increase in symptoms at post injury in spite of no significant changes in their cognitive performance. Psychological distress at injury may impact perceptions of cognitive difficulties.
A - 36 Long-Term Psychological Symptoms Following Concussion in Adolescent Ice Hockey Players
Authors: David C V , Mrazik M , Yeates K O , Galarneau J-M , Emery C A 
Published: July 2024

Abstract

Purpose
Concussion symptoms typically resolve within 30 days from injury; however, in up to 35% of cases, symptoms may be prolonged and continue months, or even years, and may be associated with longer-term mental health problems. This study aimed to assess long-term psychological and emotional symptoms in adolescent youth ice hockey players after medical clearance to return to play.

Method
This study used data collected prospectively as part of a larger longitudinal cohort study involving injury surveillance in hockey players (11-18 years), conducted over five seasons from 2013 through 2018. Pre-season baseline measures of psychological and emotional functioning were compared across two consecutive time points, for youth with an intervening concussion, musculoskeletal.
(MSK) injury, or no intervening injury. Random intercept models with players nested by team and individuals, captured the effects of players contributing to the analysis multiple times. Covariates included age, sex, and body checking policy.

Results
Adolescent ice hockey players who sustained a concussion showed no evidence of worsening self-reported psychological and emotional symptoms after injury, compared to youth with MSK injury or no injury. Compared to athletes with MSK or no injury, athletes who sustained a concussion also showed no worsening symptoms based on parent ratings.

Conclusions
The present study found no evidence of worsening psychological and emotional symptoms among adolescent ice hockey players up to one-year post-concussion, compared to youth with MSK injury or no injury. These findings support the expected recovery trajectory timeline of concussions and support current return-to-play policies for this group.
A - 37 Baseline Mental Health Functioning in University Student Athletes.
Authors: Ree-Fedun Bradyn Quinn , Hansen Jessica , David Claire , White Ryan , Mrazik Martin 
Published: July 2024

Abstract

Purpose
Examine the prevalence of mental health difficulties in university student-athletes during baseline concussion assessment.

Method
Two hundred and forty-three university athletes (male = 163, female = 80) completed the.
Sideline Concussion Assessment Tool, 3rd Edition (SCAT3) Symptom Evaluation scale and the Brief Symptom Inventory (BSI-18) self-report questionnaire at baseline evaluation across two consecutive seasons. The BSI-18 measured psychological distress using 5-point rating scales to calculate three emotional scales (Somatization, Depression, Anxiety) and one total scale (Global Severity Index). The four psychological symptoms from the SCAT3 Symptom Evaluation scale (more emotional, irritability, sadness, and nervous or anxious) were selected to calculate a total psychological symptom score out of 24. Existing normative data informed the SCAT3 symptom severity, including classifications of mild (1–2), moderate (3–4), and severe (5–6).

Results
Descriptive statistics indicated that 7.5% of athletes reported depressive symptoms and.
9.5% reported anxious symptoms on the BSI-18. The SCAT3 psychological symptoms score showed that 6.5% of athletes were within the mild range. Significant correlations existed between the SCAT3 total psychological symptom score and the BSI’s Anxiety, Depression, Somatization, and Global Severity Index scales (p &lt; 0.01).

Conclusions
A small but significant number of collegiate athletes reported experiencing psychological symptoms during baseline concussion evaluation. These results indicate that the psychological symptoms of the SCAT’s Symptom Evaluation scale may help identify players with more significant mental health concerns who will likely benefit from mental health support.
A - 38 Examining Persisting State Anxiety and Concussion Clinical Outcomes across Concussion Recovery
Authors: Durfee K J , Jennings S , Womble M N , Amalfe S , Elbin R J 
Published: July 2024

Abstract

Purpose
Document changes in state anxiety over the course of recovery from concussion and examine the effect of persisting state anxiety on concussion clinical outcomes.

Method
Patients (ages 15–51 yrs) seeking care for a sport or non-sport-related concussion within 1–7 days post-injury were included in this study. Participants completed a self-report measure of state anxiety (STAI) at each clinical visit. Differences in STAI scores from visit 1 and visit 2 were calculated and used to categorize patients into a PERSIST (scores stayed the same or got worse) and an IMPROVE group (scores improved). Changes in STAI scores across two clinical visits were examined with a paired samples t-test, and a series of independent samples t-tests and chi-square analyses were used to examine between-group differences in clinical outcomes (symptom score, neurocognitive scores, vestibular/ocular motor symptoms and impairment, and recovery time).

Results
187 participants (M = 22.37, SD = 10.67 yrs, 65% female) completed study measures at 4.25 (SD = 1.68) (visit 1) and 13.20 (SD = 28.65) (visit 2) post-injury. STAI scores significantly differed between first (M = 20.99, SD = 6.05) and second visit (M = 17.41, SD = 6.21, p &lt; 0.001). The PERSIST group (n = 41, M = 25.90, SD = 20.03) had significantly higher total symptom scores at visit 2 compared to those in the IMPROVE group (n = 122, M = 16.23, SD = 16.17, p = 0.002). There were no significant differences in other clinical outcomes between those with and without persisting state anxiety.

Conclusions
State anxiety changes throughout concussion recovery and individuals with persisting state anxiety exhibit higher symptom scores at visit 2. Assessment, reassurance and recognition of anxiety is important for overall symptom recovery.
A - 39 Self-Reported Behavioral Regulation and Post-Concussion Symptom Burden
Authors: Amalfe S , Jennings S , Womble M , Durfee K , Elbin R J 
Published: July 2024

Abstract

Purpose
Examine the effects of self-reported behavioral regulation adherence levels on post-concussion symptom burden in individuals with sport-related concussion (SRC).

Method
A retrospective chart review of patients (ages 15-25 yrs) seeking care for a SRC within 90 days post-injury were included in this study. Participants completed a self-report, 4-point Likert scale (0-Never, 3-Most of the Time) questionnaire that assessed the previous week’s frequency of Sleep, Physical Activity (PA), Diet, Hydration, and Stress Management (Stress) behavioral regulation domains. Scores were divided into HIGH (Most of the Time) and LOW (Some of the Time - Never) regulation groups for each domain. A series of independent samples t-tests and analyses of covariance (ANCOVA; controlling for sex, history of anxiety/depression) were used to compare groups on Post-Concussion Symptom Scale (PCSS) total score at first clinical visit.

Results
Five-hundred thirty-seven participants (M = 15.35, SD = 2.40 yrs, 54% female) completed the study measures at 9.38 days post-injury (SD = 10.33). Participants in the HIGH behavioral regulation groups for Sleep (F (1, 537) = 68.16, p &lt; 0.001), Diet (F (1, 537) = 22.42, p &lt; 0.001), PA (F (1, 537) = 15.47, p &lt; 0.001), and Stress (F (1, 537) = 6.70, p &lt; 0.01), demonstrated significantly lower total symptom scores than the LOW groups. There were no significant between-group differences for Hydration (F (1, 537) = 3.62, p = 0.06).

Conclusions
Effectively engaging in light PA, stress management, and consistent sleep and diet following SRC affects post-concussion symptom severity and should be considered an acute treatment plan. Hydration appears less influential in reducing symptom burden at initial clinical visit.
A - 40 The Impact of Early Access on Sports-Related Concussions in Youth Hockey Players
Authors: Bouchard H , Weis L , Vasquez D , Caze T 
Published: July 2024

Abstract

Purpose
Sports-related concussions are the most common setting for adolescents to sustain a concussion. Delayed access to care is a risk factor for recovery and youth athletes have limited access to early intervention often due to lack of athletic trainer coverage. The purpose of this study was to evaluate the effect of early access on sports-related concussions in youth hockey players.

Method
Participants (n = 67) included youth athletes from hockey organizations who partnered with a local specialty concussion clinic. Athletes presented to clinic for care (median = 2 days) after sustaining a concussion. We examined whether the number of days since injury to initial exam (DSI) significantly predicted recovery time while controlling for common injury modifiers, such as symptom severity, anxiety sensitivity, and age. Recovery was measured in number of days since injury to the date of medical clearance.

Results
Multivariate general linear analyses indicated that DSI (M = 4.96, SD = 8.90), significantly predicted the number of recovery days (M = 12.85, SD = 9.47), with each day earlier to initial exam predicting almost one day faster recovery (B = 0.92; p &lt; 0.001; Œ∑p2 = 0.813). Variables of age (M = 13.78, SD = 2.59), anxiety sensitivity (M = 8.91, SD = 9.69), and concussion severity (M = 19.22, SD = 8.90), were not predictive recovery.

Conclusions
Early access resulted in faster medical clearance. This sample of youth hockey players do not have access to an athletic trainer to provide early intervention. Our results suggest that the ability to have early intervention through a specialty concussion clinic partnership resulted in faster recovery, highlighting the importance of continuing to explore and cultivate these relationships with youth sports.
A - 41 Relationship between Fear-Avoidance Behavior, Clinical Outcomes, and Recovery Time in Adults Following Concussion
Authors: Zynda A J , Perry C , Reed A , Collins M W , Kontos A P , Trbovich A M 
Published: July 2024

Abstract

Purpose
To examine the relationship between fear-avoidance behavior, clinical outcomes, and recovery time in adults following concussion.

Method
This prospective study included patients aged 18–50 years who presented to a specialty clinic 5–30 days post-concussion. Participants completed a clinical intake (e.g., demographics/medical history), multidomain clinical assessment (Clinical Profile Screen [CP-Screen], Immediate Post-concussion Cognitive Testing [ImPACT], Vestibular/Ocular Motor Screen [VOMS], Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-7 [GAD-7]), and the Fear-Avoidance Components Scale (FACS). Recovery time was ascertained at a subsequent visit(s). Fear-avoidant (FA) and non-fear-avoidant (NFA) groups were classified using cutoffs from the FACS (FA = 41–100; NFA = 0–40) and compared using independent samples t-tests, X2 tests, and analyses of covariance.

Results
Seventy-two participants (M = 28.7¬ ± 8.5 years, 69.4% female) were included: 37 (51.4%) in the FA and 35 (48.6%) in the NFA group. Groups did not differ on demographics, medical history, injury characteristics, or CP-Screen. A greater proportion of the FA group had the anxiety/mood profile (62.2% vs 31.4%, p &lt; 0.01). The FA group had worse ImPACT reaction time (t(68) = −2.7, p &lt; 0.01, d = −0.7), VOMS visual motion sensitivity (t(67) = −2.3, p = 0.03, d = −0.5), GAD-7 (t(70) = −3.9, p &lt; 0.01, d = −0.9), and PHQ-9 (t(69) = −2.8, p &lt; 0.01, d = −0.7) scores, and longer recovery (t(24) = −2.8, p = 0.01, d = −0.9), even when controlling for age and time to clinic (F[1, 22] = 4.6, p = 0.04, ηp2 = 0.17).

Conclusions
Adults who reported high fear-avoidance (e.g., avoiding activity, catastrophizing) had worse clinical outcomes and longer recovery following concussion compared to non-fear-avoidant adults, despite no differences in demographics, medical history, injury characteristics, or symptoms. Clinicians should screen for and counsel adults post-concussion against engaging in fear-avoidance behaviors to improve recovery outcomes.
A - 42 Differences in Exercise Tolerance and Autonomic Function Based on Concussion Clinical Profile
Authors: Burley C , Zynda A J , Kehinde F , Trbovich A , Holland C , Womble M , Collins M W , Elbin R J , Kontos A P 
Published: July 2024

Abstract

Purpose
This study examined differences in clinical profiles (e.g., post-traumatic migraine, vestibular, anxiety/mood, oculomotor, and cognitive) between exercise tolerance groups determined by the Buffalo Concussion Bike Test (BCBT). We hypothesized the exercise-intolerant group would be more likely to have anxiety and/or vestibular profiles.

Method
Patients (18–49 years; 8 days to 6 months from concussion) completed demographic and medical history, the Clinical Profile Screen, Brief Symptom Inventory-18, and BCBT. Participants were adjudicated into one or more clinical profiles and classified as exercise tolerant or intolerant. Independent-sample t-tests and chi-square tests were used to compare demographics, clinical profiles, reasons for stopping the BCBT, and ANS metrics.

Results
One hundred six participants (mean age = 27.9¬ ± 8.1, 62.3% female) were included in the study (71 exercise-intolerant; 35 exercise-tolerant). No demographic or medical history differences were noted between groups. The exercise-intolerant group had significantly lower odds of having an adjudicated headache profile (OR = 0.39, 95%CI = 0.16–0.93, p = 0.03) and significantly greater odds of having an adjudicated autonomic profile (OR = 2.28, 95%CI = 1.01–5.21, p = 0.04). A greater proportion of those with the vestibular profile stopped the BCBT due to symptom exacerbation than those without (90.5% vs. 9.5%, p = 0.04).

Conclusions
Adjudicated clinical profiles and ANS metrics were similar between exercise-tolerant and intolerant groups. Vestibular sensitivities have a considerable contribution to symptom provocation during the BCBT, as a significant proportion of participants with the vestibular profile discontinued the BCBT due to symptom exacerbation. These findings corroborate previous research and suggest that exercise intolerance is pervasive across all concussion clinical profiles and should be considered in all evaluations.
A - 43 Impact of Pre-Existing Attention-Deficit/Hyperactivity Disorder on Vestibular/Ocular Motor Outcomes Following Concussion
Authors: Guercio H A , Zynda A J , Todd M , Bunker N , Burley C , Patel S , Ramirez N , Fazio V , Kegel N , Collins M W , Kontos A P 
Published: July 2024

Abstract

Purpose
The purpose of this study was to examine differences in post-injury VOMS outcomes in athletes with and without pre-existing ADHD. The authors hypothesized individuals with pre-injury ADHD would demonstrate greater NPC distance as well as increased headache and dizziness on the VOMS.

Method
This prospective cohort study included patients aged 11–29 years who presented to a specialty concussion clinic within 30 days of a diagnosed concussion, categorized into groups with and without pre-existing ADHD. Independent samples t-tests and chi-square tests examined differences between groups in demographics, medical history, injury mechanism, and VOMS outcomes. A follow-up analysis of covariance was performed to determine the influence of significant covariates on VOMS outcomes.

Results
One hundred eighty-nine participants (107 male; age = 15.9 ¬ ± 2.5 years) were included; 160 (83.3%) without ADHD and 29 (15.1%) with pre-existing ADHD. Participants with pre-existing ADHD demonstrated significantly greater NPC average (5.29 vs. 2.87, p = 0.04) and total dizziness (14.32 vs. 9.54, p = 0.03). When controlling for sex, race, and history of anxiety, only VOMS dizziness total remained significantly different between groups (F(1, 177) = 4.56, p = 0.03).

Conclusions
Results indicate patients with pre-existing ADHD report higher levels of dizziness during post-injury VOMS when compared to patients without ADHD history. Notably, group differences in NPC were attenuated when controlling for demographic information. Findings reinforce the importance of comprehensive evaluation and assist in interpretation of post-injury vestibular screening for patients with ADHD. Future research should examine recovery trajectories, efficacy of targeted treatments, and influence of post-injury anxiety among individuals with ADHD in order to provide effective treatment recommendations.
A - 44 A Comparison of Multi-Domain Clinical Assessment Outcomes in Older Adults Following Concussion
Authors: Ramirez N R , Zynda A J , Perry C , Burley C , Patel S , Guercio H , Bunker N , French J E , Trbovich A M , Collins M W , Kontos A P 
Published: July 2024

Abstract

Purpose
To examine differences in demographics, medical history, injury characteristics, and multidomain clinical assessment outcomes between different age groups of older adults following concussion.

Method
This prospective study included participants aged 50+ years with a diagnosed concussion (&lt;12 months) who presented to a specialty concussion clinic. Participants completed a clinical intake/interview (e.g., demographics) and a multidomain clinical assessment comprising symptoms (Clinical Profile Screen [CP-Screen]), cognitive (Repeatable Battery for the Assessment of Neuropsychological Status [RBANS]), psychological health (Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disoder-7 [GAD-7]), vestibular/ocular (Vestibular/Ocular Motor Screen [VOMS]), and quality of life (Neurological Quality of Life [Neuro-QoL]) at an initial visit. Older adults aged 50–59 and 60+ years were compared using independent samples t-tests, X2 tests, and analyses of covariance.

Results
76 participants (M = 59.6¬ ± 6.3 years, 55.3% female) were included, 41 (53.9%) aged 50–59 and 35 (46.1%) aged 60+ years. The 50–59-year group had a greater proportion of females (68.3% vs. 40.0%, p = 0.01) and a history of anxiety (39.0% vs. 17.1%, p = 0.036). The 50–59-year group had worse Neuro-QoL (F[1, 72] = 5.1, p = 0.03, ηp2 = 0.10), RBANS recall (F[1, 72] = 7.1, p &lt; 0.01, ηp2 = 0.09), RBANS fluency (F[1, 72] = 5.0, p = 0.03, ηp2 = 0.06), and RBANS list recognition (F[1, 72] = 4.1, p = 0.04, ηp2 = 0.06), controlling for sex and history of anxiety.

Conclusions
This study demonstrated that adults aged 50–59 years were more likely to be female and have a history of anxiety compared to adults 60+ years. Interestingly, older adults 50–59 years demonstrated greater perceived difficulties in their cognitive abilities post-concussion, which was reflected in impairments on cognitive testing compared to adults 60+ years.
A - 47 Missed Steps: Collegiate Athletes’ Beliefs Towards Physical Activity and Kinesiophobia after Acute Concussion
Authors: Rosenblum D J , Smetana R M , Broshek D K , Resch J E 
Published: July 2024

Abstract

Purpose
Physical activity (PA) may support recovery following concussion in collegiate athletes. Fear of PA (i.e., kinesiophobia), may influence recovery from concussion. The purpose was to examine perception of PA, as well as how biological sex and mood history, influenced kinesiophobia values after concussion.

Method
Division I collegiate athletes (n = 183[42% female], 20.1+/−1.5 years of age) participated in this descriptive cohort study. Participants completed the Tampa Scale of Kinesiophobia-17 (TSK) within 72 hours of concussion. The TSK’s fourth, twelfth, and fourteenth items query: “My pain would probably be relieved if I were to exercise”, “Although my condition is painful, I would be better off if I were physically active”, and “It’s really not safe for a person with a condition like mine to be physically active”, in relationship to PA after concussion on a four-point Likert scale. Mann Whitney U tests were used to compare total TSK values by biological sex and history of anxiety/depression.

Results
Most participants (72% and 63%) disagreed with the fourth and twelfth items, respectively. Fifty-three percent of participants agreed with the fourteenth item. On median [interquartile range], females had significantly higher (p &lt; 0.001) kinesiophobia (38.0[9]) than males (34.0[8.0]). Participants with (40.0[7.5]) compared to those without (34.5[9.0]) a history of anxiety/depression had significantly higher (p &lt; 0.001) kinesiophobia values.

Conclusions
The majority of collegiate athletes indicated that PA would not support recovery from concussion. Total kinesiophobia scores were also influenced by biological sex and a history of anxiety/depression. Misconceptions of PA after concussion should be addressed by clinicians to facilitate recovery from the injury.