Sport-related concussion (SRC) is a growing health concern, particularly in younger, at-risk athletic populations. These injuries commonly present with a wide range of clinical signs (i.e., poor coordination, behavioral, mood changes) and symptoms (i.e., headache, dizziness, difficulty concentrating), along with neurocognitive and vestibular/ocular impairments. This review of SRCs in youth athletes focuses on individuals 5–18 years of age and includes an overview of concussion (i.e., definition, signs/symptoms, epidemiology), as well as concussion education and awareness. This is followed by a review of SRC assessment and management strategies, along with common recovery, return-to-play, and treatment approaches. Finally, suggestions are made for future research and recommendations pertaining to SRC in youth athletes.
Tracey Covassin, Kyle M. Petit and Morgan Anderson
Tracey Covassin, Bryan Crutcher, R.J. Elbin, Scott Burkhart and Anthony Kontos
The present study explored the relationship of neurocognitive performance and symptoms to coping responses at 3 and 8 days postconcussion. A total of 104 concussed athletes (M = 16.41, SD = 2.19 years) completed the Immediate Post Concussion Assessment Cognitive Testing (ImPACT) at baseline and the ImPACT and Brief Cope inventory at 3 and 8 days postconcussion. Concussed athletes reported more frequent use of selfdistraction, behavioral disengagement, religion, and self-blame 3 days postconcussion compared with 8 days. Concussed athletes reported more use of avoidance coping at 3 days than 8 days (Wilks’s Lambda =.95, F [1, 100] =4.71, p = .032, η2=.046) post-injury. Total symptoms were also a significant (p = .001) predictor of avoidance coping 3 days postconcussion and decreased visual memory was associated with increased avoidance coping (p = .03) 8 days post-injury. Time since injury likely impacts neurocognitive performance, symptomology, and coping. Clinicians should be aware of higher reported symptoms early and lingering visual memory deficits 1-week post-injury.
Ryan Morrison, Kyle M. Petit, Chris Kuenze, Ryan N. Moran and Tracey Covassin
Context: Balance testing is a vital component in the evaluation and management of sport-related concussion. Few studies have examined the use of objective, low-cost, force-plate balance systems and changes in balance after a competitive season. Objective: To examine the extent of preseason versus postseason static balance changes using the Balance Tracking System (BTrackS) force plate in college athletes. Design: Pretest, posttest design. Setting: Athletic training facility. Participants: A total of 47 healthy, Division-I student-athletes (33 males and 14 females; age 18.4 [0.5] y, height 71.8 [10.8] cm, weight 85.6 [21.7] kg) participated in this study. Main Outcome Measures: Total center of pressure path length was measured preseason and postseason using the BTrackS force plate. A Wilcoxon signed-rank test was conducted to examine preseason and postseason changes. SEM and minimal detectable change were also calculated. Results: There was a significant difference in center of pressure path length differed between preseason (24.6 [6.8] cm) and postseason (22.7 [5.4] cm) intervals (P = .03), with an SEM of 3.8 cm and minimal detectable change of 10.5 cm. Conclusions: Significant improvements occurred for center of pressure path length after a competitive season, when assessed using the BTrackS in a sample of college athletes. Further research is warranted to determine the effectiveness of the BTrackS as a reliable, low-cost alternative to force-plate balance systems. In addition, clinicians may need to update baseline balance assessments more frequently to account for improvements.