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Tracey Covassin, Kyle M. Petit and Morgan Anderson

Sport-related concussion (SRC) is a public health concern that has received increased research attention over the past decade. This paper is a review of recent literature on SRCs in youth athletes age 5–18 years. We focus on six key areas: concussion overview (e.g., definition, signs

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Ryan Morrison, Kyle M. Petit, Chris Kuenze, Ryan N. Moran and Tracey Covassin

The most commonly reported symptoms following a sport-related concussion (SRC) are headaches, dizziness, and balance problems. 1 Best practices for SRC assessment include symptom evaluation, neuropsychological testing, vestibular and ocular motor testing, and balance assessment. 1 The National

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Janelle Prince, Eric Schussler and Ryan McCann

Clinical Scenario An estimated 1.6 to 3.8 million concussions occur in sport and recreational activities annually. 1 A sport-related concussion (SRC) is contemporarily defined as a traumatic brain injury induced by biomechanical forces. 2 Symptoms of concussion are caused by the metabolic cascade

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Ashley E. Evans, Madeline Curtis, Marguerite (Meg) Montjoy and Erica Beidler

football athletes and matched controls: evidence for a possible second mechanism of sport-related concussion . Ann Biomed Eng . 2019 ; 47 ( 10 ): 2057 – 2072 . PubMed ID: 30362082 doi: 10.1007/s10439-018-02136-6 30362082 14. Bahrami N , Sharma D , Rosenthal S , et al . Subconcussive head

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Corey P. Ochs, Melissa C. Kay and Johna K. Register-Mihalik

performance may be affected on return to play. Therefore, the purpose of this review was to examine postconcussion game performance within professional-level football and ice hockey players. Focused Clinical Question Upon return-to-play clearance, how does sport-related concussion affect game performance of

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Kevin M. Guskiewicz

“Concussion” is all over the news, and—yes—it has implications for combating chronic diseases such as obesity and diabetes. Many parents are pushing their children away from collision sports such as football, hockey, and lacrosse because they fear the risk of chronic neurodegenerative problems later in life. However, there is good logic in emphasizing the importance of physical activities such as collision type sports, during the developmental years. Physical educators, researchers, policy makers, and coaches must work together to encourage safe play and rules changes that can keep youth and adolescents active in sports that build character, discipline, and teach teamwork. Understanding the complexity of the highly adaptable adolescent brain both prior to and following sport-related concussion is critically important in accomplishing this goal.

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Theresa Miyashita

Sport-related concussions have recently been at the forefront of mainstream media, where the attention is now turning to the safety of our young athletes. With the recent rise of concussion lawsuits, coaches need to know concussion basics to protect their athletes and themselves. What we know about concussions has evolved, and it is critical that coaches understand these changes and how they impact the management of their teams’ injuries. In the absence of medical personnel, coaches are responsible for removing athletes from play if they have potentially sustained a concussion. Coaches must therefore understand the different mechanisms of injury, signs and symptoms, and the protocol to follow if they believe their athlete has sustained a concussion.

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Andrea Cripps and Scott C. Livingston

Clinical Scenario:

Sport-related concussions are a significant health issue due to the high incidence of concussions sustained each sports season. Current approaches to the evaluation of acutely concussed athletes include the use of balance assessments to identify and monitor underlying postural instability arising from concussion. Balance assessment has been recommended as a primary measurement tool for monitoring recovery and for making return-to-play decisions. Balance impairments have been shown to occur in the initial postconcussion period (ie, 1–10 d). Numerous clinical and laboratory measures have been used in the assessment of balance immediately after concussion, and clinicians are faced with deciding which measures to use.

Focused Clinical Question:

How do clinical or field-based balance-assessment tools compare to laboratory-based balance measures in identifying deficits in postural stability among acutely concussed athletes?

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Jaclyn B. Caccese, Thomas A. Buckley and Thomas W. Kaminski

The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r = .332) and tandem firm (r = .474), and double-leg foam (r = .660); and with sway velocity for single-leg (r = .406) and tandem firm (r = .601), and double-leg (r = .575) and single-leg foam (r = .434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass–center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures.

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Jaebin Shim, Deanna H. Smith and Bonnie L. Van Lunen

Clinical Scenario:

Over the past decade, sport-related concussions have received increased attention due to their frequency and severity over a wide range of athletics. Clinicians have developed return-to-play protocols to better manage concussions in young athletes; however, a standardized process projecting the length of recovery time after concussion has remained an elusive piece of the puzzle. The recovery times associated with such an injury once diagnosed can last anywhere from 1 wk to several months. Risk factors that could lead to protracted recovery times include a history of 1 or multiple concussions and a greater number, severity, and duration of symptoms after the injury. Examining the possible relationship between on-field or sideline signs and symptoms and recovery times would give clinicians the confident ability to properly treat and manage an athlete’s recovery process in a more systematic manner. Furthermore, identifying factors after a head injury that may be predictive of protracted recovery times would be useful for athletes, parents, and coaches alike.

Focused Clinical Question:

Which on-field and sideline signs and symptoms affect length of recovery after concussion in high school and college athletes?