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John M. Rosene, Christian Merritt, Nick R. Wirth and Daniel Nguyen

Subconcussive head impacts in sport may have a greater impact on neurological degradation versus concussive hits given the repetitive nature of these head impacts. The purpose of this investigation was to quantify the frequency, magnitude, and location of head impacts in an NCAA Division III men’s lacrosse team. There was no significant difference (p ≤ .05) in peak linear acceleration, peak rotational acceleration, and peak rotational velocity between games and practices. There was no significant difference (p ≤ .05) for PLA among player position and location of head impact. The quantity and intensity of subconcussive head impacts between practices and games were similar. These multiple subconcussive head impacts have the potential to lead to future neurological impairments.

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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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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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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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David R. Howell, Jessie R. Oldham, Melissa DiFabio, Srikant Vallabhajosula, Eric E. Hall, Caroline J. Ketcham, William P. Meehan III and Thomas A. Buckley

Gait impairments have been documented following sport-related concussion. Whether preexisting gait pattern differences exist among athletes who participate in different sport classifications, however, remains unclear. Dual-task gait examinations probe the simultaneous performance of everyday tasks (ie, walking and thinking), and can quantify gait performance using inertial sensors. The purpose of this study was to compare the single-task and dual-task gait performance of collision/contact and noncontact athletes. A group of collegiate athletes (n = 265) were tested before their season at 3 institutions (mean age= 19.1 ± 1.1 years). All participants stood still (single-task standing) and walked while simultaneously completing a cognitive test (dual-task gait), and completed walking trials without the cognitive test (single-task gait). Spatial-temporal gait parameters were compared between collision/contact and noncontact athletes using MANCOVAs; cognitive task performance was compared using ANCOVAs. No significant single-task or dual-task gait differences were found between collision/contact and noncontact athletes. Noncontact athletes demonstrated higher cognitive task accuracy during single-task standing (P = .001) and dual-task gait conditions (P = .02) than collision/contact athletes. These data demonstrate the utility of a dual-task gait assessment outside of a laboratory and suggest that preinjury cognitive task performance during dual-tasks may differ between athletes of different sport classifications.