The Changing Landscape of Sport Concussion

in Kinesiology Review

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Kevin M. Guskiewicz
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Samuel R. Walton
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It was not too long ago that many people referred to concussion as a “hidden injury” and a “complex injury for which we still had much to learn.” We still have a lot to learn about these injuries, but because of the advancement of concussion research we are better informed today than we were just a decade ago. Much of this work began in the early to mid-1990s with studies aimed at equipping clinicians with better concussion-assessment tools. We needed to remove the guesswork, so more systematic and objective concussion-assessment batteries (sideline and clinic) that included symptom checklists, cognitive tests, and balance assessments were developed and validated. As a result, it became easier to detect and/or rule out concussions and to track recovery for several days postinjury. From 2009 through 2014, all 50 states and the District of Columbia passed concussion legislation requiring concussion education for high school and youth athletes, among other things. This was a critical period in which more emphasis was placed on concussion prevention, ultimately leading to increased reporting of these injuries and a reduction in the number of unreported and undiagnosed concussions. More recently, the corpus of science has evolved to identify potential blood and neuroimaging biomarkers to complement the traditional-clinical assessment tools, and newer studies are focused on treatment after concussion—challenging the notions that “rest is best” and that the effects of concussion are permanent and immutable. The research is ongoing, and several large multisite studies will yield important findings to help guide clinical decision making in the next few years.

The authors are with the Center for the Study of Retired Athletes, Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Dept. of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Guskiewicz (gus@email.unc.edu) is corresponding author.
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  • Alosco, M.L., Koerte, I.K., Tripodis, Y., Mariani, M., Chua, A.S., Jarnagin, J., … Stern, R.A. (2018). White matter signal abnormalities in former National Football League players. Alzheimer’s & Dementia, 10, 5665. PubMed ID: 31901122 doi:10.1016/j.dadm.2017.10.003

    • Search Google Scholar
    • Export Citation
  • Asken, B.M., Bauer, R.M., DeKosky, S.T., Svingos, A.M., Hromas, G., Boone, J.K., … Clugston, J.R. (2018). Concussion BASICS III: Serum biomarker changes following sport-related concussion. Neurology, 91(23), e2133e2143. PubMed ID: 30404786 doi:10.1212/WNL.0000000000006617

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Asken, B.M., Bauer, R.M., Guskiewicz, K.M., McCrea, M.A., Schmidt, J.D., Giza, C.C., … Svoboda, S. (2018). Immediate removal from activity after sport-related concussion is associated with shorter clinical recovery and less severe symptoms in collegiate student-athletes. American Journal of Sports Medicine, 46(6), 14651474. PubMed ID: 29558195 doi:10.1177/0363546518757984

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Asken, B.M., McCrea, M.A., Clugston, J.R., Snyder, A.R., Houck, Z.M., & Bauer, R.M. (2016). “Playing through it”: Delayed reporting and removal from athletic activity after concussion predicts prolonged recovery. Journal of Athletic Training, 51(4), 329335. PubMed ID: 27111584 doi:10.4085/1062-6050-51.5.02

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Aubry, M., Cantu, R., Dvorak, J., Graf-Baumann, T., Johnston, K., Kelly, J., … Concussion in Sport Group. (2002). Summary and agreement statement of the first international conference on concussion in sport, Vienna 2001. British Journal of Sports Medicine, 36, 610. PubMed ID: 11867482

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bell, J., Rogers, V., Dietz, W., Ogden, C., Schuler, C., & Popovic, T. (2011, January 21). CDC grand rounds: Childhood obesity in the United States. Morbidity and Mortality Weekly Report. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6002a2.htm

    • Search Google Scholar
    • Export Citation
  • Black, A.M., Macpherson, A.K., Hagel, B.E., Romiti, M.A., Palacios-Derflingher, L., Kang, J., … Emery, C.A. (2016). Policy change eliminating body checking in non-elite ice hockey leads to a threefold reduction in injury and concussion risk in 11- and 12-year-old players. British Journal of Sports Medicine, 50(1), 5561. PubMed ID: 26702018 doi:10.1136/bjsports-2015-095103

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Broglio, S.P., Macciocchi, S.N., & Ferrara, M.S. (2007). Sensitivity of the Concussion Assessment Battery. Neurosurgery, 60(6), 10501057. PubMed ID: 17538379 doi:10.1227/01.neu.0000255479.90999.c0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Broglio, S.P., Williams, R.M., O’Connor, K.L., & Goldstick, J. (2016). Football players’ head-impact exposure after limiting of full-contact practices. Journal of Athletic Training, 51(7), 511518. PubMed ID: 27333460 doi:10.4085/1062-6050-51.7.04

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Champagne, A.A., Distefano, V., Boulanger, M.-M., Magee, B., Coverdale, N.S., Gallucci, D., … Cook, D.J. (2019). Data-informed intervention improves football technique and reduces head impacts. Medicine & Science in Sports & Exercise, 51(11), 23662374. PubMed ID: 31269008 doi:10.1249/MSS.0000000000002046

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chin, E.Y., Nelson, L.D., Barr, W.B., McCrory, P., & McCrea, M.A. (2016). Reliability and validity of the Sport Concussion Assessment Tool-3 (SCAT3) in high school and collegiate athletes. American Journal of Sports Medicine, 44(9), 22762285. PubMed ID: 27281276 doi:10.1177/0363546516648141

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Clark, M.D., Varangis, E.M.L., Champagne, A.A., Giovanello, K.S., Shi, F., Kerr, Z.Y., … Guskiewicz, K.M. (2018). Effects of career duration, concussion history, and playing position on white matter microstructure and functional neural recruitment in former college and professional football athletes. Radiology, 286(3), 967977. PubMed ID: 29087238 doi:10.1148/radiol.2017170539

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Coughlin, J.M., Wang, Y., Minn, I., Bienko, N., Ambinder, E.B., Xu, X., … Pomper, M.G. (2017). Imaging of glial cell activation and white matter integrity in brains of active and recently retired National Football League players. JAMA Neurology, 74(1), 67. PubMed ID: 27893897 doi:10.1001/jamaneurol.2016.3764

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Daley, M., Dekaban, G., Bartha, R., Brown, A., Stewart, T.C., Doherty, T., … Fraser, D.D. (2016). Metabolomics profiling of concussion in adolescent male hockey players: A novel diagnostic method. Metabolomics, 12(12), 185. doi:10.1007/s11306-016-1131-5

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Davis, G.A., Purcell, L., Schneider, K.J., Yeates, K.O., Gioia, G.A., Anderson, V., … Kutcher, J.S. (2017). The Child Sport Concussion Assessment Tool 5th edition (Child SCAT5): Background and rationale. British Journal of Sports Medicine, 51(11), 859861. PubMed ID: 28446452 doi:10.1136/bjsports-2017-097492

    • Search Google Scholar
    • Export Citation
  • Di Battista, A.P., Rhind, S.G., Hutchison, M.G., Hassan, S., Shiu, M.Y., Inaba, K., … Baker, A.J. (2016). Inflammatory cytokine and chemokine profiles are associated with patient outcome and the hyperadrenergic state following acute brain injury. Journal of Neuroinflammation, 13(1), 40. doi:10.1186/s12974-016-0500-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Echemendia, R.J., Meeuwisse, W., McCrory, P., Davis, G.A., Putukian, M., Leddy, J., … Herring, S. (2017). The Sport Concussion Assessment Tool 5th edition (SCAT5): Background and rationale. British Journal of Sports Medicine, 51(11), 848850. PubMed ID: 28446453 doi:10.1136/bjsports-2017-097506

    • Search Google Scholar
    • Export Citation
  • Eckner, J.T., Kutcher, J.S., Broglio, S.P., & Richardson, J.K. (2014). Effect of sport-related concussion on clinically measured simple reaction time. British Journal of Sports Medicine, 48(2), 112118. PubMed ID: 23314889 doi:10.1136/bjsports-2012-091579

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Emery, C., Palacios-Derflingher, L., Black, A.M., Eliason, P., Krolikowski, M., Spencer, N., … Hagel, B.E. (2019). Does disallowing body checking in non-elite 13- to 14-year-old ice hockey leagues reduce rates of injury and concussion? A cohort study in two Canadian provinces. British Journal of Sports Medicine. Advance online publication. doi:10.1136/bjsports-2019-101092

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Guskiewicz, K.M., Ross, S.E., & Marshall, S.W. (2001). Postural stability and neuropsychological deficits after concussion in collegiate athletes. Journal of Athletic Training, 36(3), 263273. PubMed ID: 12937495

    • Search Google Scholar
    • Export Citation
  • Hales, C., Carroll, M., Fryar, C., & Ogden, C. (2017). Prevalence of obesity among adults and youth: United States, 2015–2016. NCH data brief, No. 288. Hyattsville, MD: National Center for Health Statistics.

    • Search Google Scholar
    • Export Citation
  • Hart, J., Kraut, M.A., Womack, K.B., Strain, J., Didehbani, N., Bartz, E., … Cullum, C.M. (2013). Neuroimaging of cognitive dysfunction and depression in aging retired National Football League players: A cross-sectional study. JAMA Neurology, 70(3), 326. PubMed ID: 23303193 doi:10.1001/2013.jamaneurol.340

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Helmick, K.M., Spells, C.A., Malik, S.Z., Davies, C.A., Marion, D.W., & Hinds, S.R. (2015). Traumatic brain injury in the US military: Epidemiology and key clinical and research programs. Brain Imaging and Behavior, 9(3), 358366. PubMed ID: 25972118 doi:10.1007/s11682-015-9399-z

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Howell, D., Lugade, V.A., Potter, M.N., Walker, G., & Wilson, J.C. (2019). A multifaceted and clinically viable paradigm to quantify postural control impairments among adolescents with concussion. Physiological Measurement, 40(8), 084006. PubMed ID: 31342939 doi:10.1088/1361-6579/ab3552

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Howell, D.R., Wilson, J.C., Brilliant, A.N., Gardner, A.J., Iverson, G.L., & Meehan, W.P. (2018). Objective clinical tests of dual-task dynamic postural control in youth athletes with concussion. Journal of Science and Medicine in Sport, 22(5), 521525. PubMed ID: 30509865 doi:10.1016/j.jsams.2018.11.014

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hutchison, M.G., Mainwaring, L., Senthinathan, A., Churchill, N., Thomas, S., & Richards, D. (2017). Psychological and physiological markers of stress in concussed athletes across recovery milestones. Journal of Head Trauma Rehabilitation, 32(3), E38E48. PubMed ID: 27603761 doi:10.1097/HTR.0000000000000252

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Johnson, J.J., Loeffert, A.C., Stokes, J., Olympia, R.P., Bramley, H., & Hicks, S.D. (2018). Association of salivary microRNA changes with prolonged concussion symptoms. JAMA Pediatrics, 172(1), 65. PubMed ID: 29159407 doi:10.1001/jamapediatrics.2017.3884

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kerr, Z.Y., Chandran, A., Nedimyer, A.K., Arakkal, A., Pierpoint, L.A., & Zuckerman, S.L. (2019). Concussion incidence and trends in 20 high school sports. Pediatrics, 144(5), e20192180. PubMed ID: 31615955 doi:10.1542/peds.2019-2180

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kerr, Z.Y., Register-Mihalik, J.K., Kroshus, E., Baugh, C.M., & Marshall, S.W. (2016). Motivations associated with nondisclosure of self-reported concussions in former collegiate athletes. American Journal of Sports Medicine, 44(1), 220225. PubMed ID: 26582799 doi:10.1177/0363546515612082

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kiechle, K., Bazarian, J.J., Merchant-Borna, K., Stoecklein, V., Rozen, E., Blyth, B., … Biberthaler, P. (2014). Subject-specific increases in serum S-100B distinguish sports-related concussion from sports-related exertion. PLoS ONE, 9(1), e84977. PubMed ID: 24416325 doi:10.1371/journal.pone.0084977

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kroshus, E., Buth, D., Parsons, J.T., & Hainline, B. (2019). Randomized evaluation of the National Collegiate Athletic Association’s concussion education fact sheet for coaches. Health Education & Behavior, 46(6), 960968. PubMed ID: 31565969 doi:10.1177/1090198119864621

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kroshus, E., Garnett, B., Hawrilenko, M., Baugh, C.M., & Calzo, J.P. (2015). Concussion under-reporting and pressure from coaches, teammates, fans, and parents. Social Science & Medicine, 134, 6675. PubMed ID: 25917137 doi:10.1016/j.socscimed.2015.04.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kurowski, B.G., Pomerantz, W.J., Schaiper, C., Ho, M., & Gittelman, M.A. (2015). Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes. Journal of Trauma and Acute Care Surgery, 79(3 Suppl. 1), S21S28. PubMed ID: 26308118 doi:10.1097/TA.0000000000000675

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Langlois, J.A., Rutland-Brown, W., & Wald, M.M. (2006). The epidemiology and impact of traumatic brain injury: A brief overview. Journal of Head Trauma Rehabilitation, 21(5), 375378. PubMed ID: 16983222

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lininger, M.R., Wayment, H.A., Craig, D.I., Huffman, A.H., & Lane, T.S. (2019). Improving concussion-reporting behavior in National Collegiate Athletic Association Division I football players: Evidence for the applicability of the socioecological model for athletic trainers. Journal of Athletic Training, 54(1), 2129. PubMed ID: 30721092 doi:10.4085/1062-6050-47-18

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lynall, R.C., Blackburn, J.T., Guskiewicz, K.M., Marshall, S.W., Plummer, P., & Mihalik, J.P. (2019). Functional balance assessment in recreational college-aged individuals with a concussion history. Journal of Science and Medicine in Sport, 22(5), 503508. doi:10.1016/j.jsams.2018.10.012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mannix, R., Meehan, W.P., & Pascual-Leone, A. (2016). Sports-related concussions—Media, science and policy. Nature Reviews Neurology, 12(8), 486490. PubMed ID: 27364748 doi:10.1038/nrneurol.2016.99

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McCrea, M., Hammeke, T., Olsen, G., Leo, P., & Guskiewicz, K. (2004). Unreported concussion in high school football players: Implications for prevention. Clinical Journal of Sport Medicine, 14(1), 1317. PubMed ID: 14712161 doi:10.1097/00042752-200401000-00003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McCrea, M., Meier, T., Huber, D., Ptito, A., Bigler, E., Debert, C.T., … McAllister, T. (2017). Role of advanced neuroimaging, fluid biomarkers and genetic testing in the assessment of sport-related concussion: A systematic review. British Journal of Sports Medicine, 51(12), 919929. PubMed ID: 28455364 doi:10.1136/bjsports-2016-097447

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McCrory, P. (2005). Summary and agreement statement of the 2nd international conference on concussion in sport, Prague 2004. British Journal of Sports Medicine, 39(Suppl. 1), i78i86. doi:10.1136/bjsm.2005.018614

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McCrory, P., Meeuwisse, W., Dvorak, J., Aubry, M., Bailes, J., Broglio, S., … Vos, P.E. (2017). Consensus statement on concussion in sport—The 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838847. PubMed ID: 28446457 doi:10.1136/bjsports-2017-097699

    • Search Google Scholar
    • Export Citation
  • Meehan, W.P., & Mannix, R. (2010). Pediatric concussions in United States emergency departments in the years 2002 to 2006. Journal of Pediatrics, 157(6), 889893. PubMed ID: 20708747 doi:10.1016/j.jpeds.2010.06.040

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Meier, T.B., Nelson, L.D., Huber, D.L., Bazarian, J.J., Hayes, R.L., & McCrea, M.A. (2017). Prospective assessment of acute blood markers of brain injury in sport-related concussion. Journal of Neurotrauma, 34(22), 31343142. PubMed ID: 28699381 doi:10.1089/neu.2017.5046

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mucha, A., Collins, M.W., Elbin, R.J., Furman, J.M., Troutman-Enseki, C., DeWolf, R.M., … Kontos, A.P. (2014). A brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: Preliminary findings. American Journal of Sports Medicine, 42(10), 24792486. PubMed ID: 25106780 doi:10.1177/0363546514543775

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Oldham, J.R., Difabio, M.S., Kaminski, T.W., Dewolf, R.M., Howell, D.R., & Buckley, T.A. (2018). Efficacy of tandem gait to identify impaired postural control after concussion. Medicine & Science in Sports & Exercise, 50(6), 11621168. PubMed ID: 29315170 doi:10.1249/MSS.0000000000001540

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Oresic, M., Posti, J.P., Kamstrup-Nielsen, M.H., Takala, R.S.K., Lingsma, H.F., Mattila, I., … Hyotylainen, T. (2016). Human serum metabolites associate with severity and patient outcomes in traumatic brain injury. EBioMedicine, 12, 118126. PubMed ID: 27665050 doi:10.1016/j.ebiom.2016.07.015

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Papa, L., Brophy, G.M., Welch, R.D., Lewis, L.M., Braga, C.F., Tan, C.N., … Hack, D.C. (2016). Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury. JAMA Neurology, 73(5), 551. PubMed ID: 27018834 doi:10.1001/jamaneurol.2016.0039

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Peters, M.E., Rahman, S., Coughlin, J.M., Pomper, M.G., & Sair, H.I. (2019). Characterizing the link between glial activation and changed functional connectivity in National Football League players using multimodal neuroimaging. Journal of Neuropsychiatry and Clinical Neurosciences. Advance online publication. doi:10.1176/appi.neuropsych.18110274

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pfaller, A.Y., Brooks, M.A., Hetzel, S., & McGuine, T.A. (2019). Effect of a new rule limiting full contact practice on the incidence of sport-related concussion in high school football players. American Journal of Sports Medicine, 47(10), 22942299. PubMed ID: 31306587 doi:10.1177/0363546519860120

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Practice parameter: The management of concussion in sports (summary statement). (1997). Neurology, 48(3), 581585. doi:10.1212/WNL.48.3.581

    • Search Google Scholar
    • Export Citation
  • Rawlins, M.L.W., Johnson, B.R., Register-Mihalik, J.K., DeAngelis, K., Schmidt, J.D., & D’Lauro, C.J. (2019). United States Air Force Academy cadets’ perceived costs of concussion disclosure. Military Medicine, usz162. doi:10.1093/milmed/usz162

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Register-Mihalik, J.K., Guskiewicz, K.M., Marshall, S.W., McCulloch, K.L., Mihalik, J.P., Mrazik, M., … Active Rehab Study Consortium Investigators. (2019). Methodology and implementation of a randomized controlled trial (RCT) for early post-concussion rehabilitation: The Active Rehab Study. Frontiers in Neurology, 10, 1176. PubMed ID: 31781021 doi:10.3389/fneur.2019.01176

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Register-Mihalik, J.K., Kay, M.C., Kerr, Z.Y., Peck, K.Y., Houston, M.N., Gildner, P., … Cameron, K.L. (2019). Influence of concussion education exposure on concussion-related educational targets and self-reported concussion disclosure among first-year service academy cadets. Military Medicine, usz414. doi:10.1093/milmed/usz414

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Register-Mihalik, J.K., Valovich McLeod, T.C., Linnan, L.A., Guskiewicz, K.M., & Marshall, S.W. (2017). Relationship between concussion history and concussion knowledge, attitudes, and disclosure behavior in high school athletes: Clinical Journal of Sport Medicine, 27(3), 321324. PubMed ID: 27437911 doi:10.1097/JSM.0000000000000349

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Resch, J.E., Brown, C.N., Schmidt, J., Macciocchi, S.N., Blueitt, D., Cullum, C.M., & Ferrara, M.S. (2016). The sensitivity and specificity of clinical measures of sport concussion: Three tests are better than one. BMJ Open Sport & Exercise Medicine, 2(1), e000012. PubMed ID: 27900145 doi:10.1136/bmjsem-2015-000012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Riemann, B.L., & Guskiewicz, K.M. (2000). Effects of mild head injury on postural stability as measured through clinical balance testing. Journal of Athletic Training, 35(1), 1925. PubMed ID: 16558603

    • Search Google Scholar
    • Export Citation
  • Schmidt, J.D., Weber, M.L., Suggs, D.W., Bierema, L., Miller, L.S., Reifsteck, F., … Dunham, J. (2019). Improving concussion reporting across National College Athletic Association divisions using a theory-based, data-driven, multimedia concussion education intervention. Journal of Neurotrauma. Advance online publication. doi:10.1089/neu.2019.6637

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Shahim, P., Tegner, Y., Marklund, N., Blennow, K., & Zetterberg, H. (2018). Neurofilament light and tau as blood biomarkers for sports-related concussion. Neurology, 90(20), e1780e1788. PubMed ID: 29653990 doi:10.1212/WNL.0000000000005518

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Shanley, E., Thigpen, C., Kissenberth, M., Gilliland, R.G., Thorpe, J., Nance, D., … Tokish, J. (2019). Heads up football training decreases concussion rates in high school football players. Clinical Journal of Sport Medicine. Advance online publication. doi:10.1097/JSM.0000000000000711

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Strain, J.F., Womack, K.B., Didehbani, N., Spence, J.S., Conover, H., Hart, J., … Cullum, C.M. (2015). Imaging correlates of memory and concussion history in retired National Football League athletes. JAMA Neurology, 72(7), 773. PubMed ID: 25985094 doi:10.1001/jamaneurol.2015.0206

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sun, Y., Bai, L., Niu, X., Wang, Z., Yin, B., Bai, G., … Zhang, M. (2019). Elevated serum levels of inflammation-related cytokines in mild traumatic brain injury are associated with cognitive performance. Frontiers in Neurology, 10, 1120. PubMed ID: 31708858 doi:10.3389/fneur.2019.01120

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Swartz, E.E., Myers, J.L., Cook, S.B., Guskiewicz, K.M., Ferrara, M.S., Cantu, R.C., … Broglio, S.P. (2019). A helmetless-tackling intervention in American football for decreasing head impact exposure: A randomized controlled trial. Journal of Science and Medicine in Sport, 22(10), 11021107. PubMed ID: 31204104 doi:10.1016/j.jsams.2019.05.018

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Van Kampen, D.A., Lovell, M.R., Pardini, J.E., Collins, M.W., & Fu, F.H. (2006). The “value added” of neurocognitive testing after sports-related concussion. American Journal of Sports Medicine, 34(10), 16301635. PubMed ID: 16816151 doi:10.1177/0363546506288677

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ventura, R.E., Balcer, L.J., & Galetta, S.L. (2015). The concussion toolbox: The role of vision in the assessment of concussion. Seminars in Neurology, 35(5), 599606. PubMed ID: 26444405 doi:10.1055/s-0035-1563567

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wasserman, E.B., Kerr, Z.Y., Zuckerman, S.L., & Covassin, T. (2016). Epidemiology of sports-related concussions in National Collegiate Athletic Association athletes from 2009–2010 to 2013–2014: Symptom prevalence, symptom resolution time, and return-to-play time. American Journal of Sports Medicine, 44(1), 226233. PubMed ID: 26546304 doi:10.1177/0363546515610537

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Willer, B.S., Haider, M.N., Bezherano, I., Wilber, C.G., Mannix, R., Kozlowski, K., & Leddy, J.J. (2019). Comparison of rest to aerobic exercise and placebo-like treatment of acute sport-related concussion in male and female adolescents. Archives of Physical Medicine and Rehabilitation, 100(12), 22672275. PubMed ID: 31377190 doi:10.1016/j.apmr.2019.07.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Yang, J., Comstock, R.D., Yi, H., Harvey, H.H., & Xun, P. (2017). New and recurrent concussions in high-school athletes before and after traumatic brain injury laws, 2005–2016. American Journal of Public Health, 107(12), 19161922. PubMed ID: 29048967 doi:10.2105/AJPH.2017.304056

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