theory the lone-physician approach to injury rehabilitation is considered inferior to approaches aligned with the biopsychosocial model, it is still commonly used in practice as evidenced by continual reports of return-to-play decisions based only on physical measures of healing ( Creighton et al., 2010
Courtney W. Hess, Stacy L. Gnacinski and Barbara B. Meyer
Krista M. Hixson, Alex N. Allen, Andrew S. Williams and Tamara C. Valovich McLeod
Mild traumatic brain injury, or concussion, has been associated with physical, cognitive, and emotional sequelae. Little is understood in regard to many characteristics, such as anxiety, and their effect on post-concussion symptoms.
Is state anxiety, trait anxiety, or anxiety sensitivity a clinical predictor of symptoms in those presenting with mild traumatic brain injury or concussion?
Summary of Key Findings:
A literature search returned 3 possible studies; 3 studies met inclusion criteria and included. One study reported in athletes that greater social support was associated with decreased state-anxiety, lower state anxiety post-concussion was associated with increased social support, and that those with greater social support may experience reduced anxiety, regardless of injury type sustained. One study reported baseline trait anxiety in athletes was not significantly associated with post-concussion state anxiety, but that symptoms of depression at baseline was the strongest predictor for post-concussion state anxiety. Three studies reported that state and trait anxiety are not related to increased post-concussion symptom scores. One study reported that greater anxiety sensitivity is related to higher reported post-concussion symptom scores, which may manifest as somatic symptoms following concussion, and revealed that anxiety sensitivity may be a risk factor symptom development.
Clinical Bottom Line:
There is low-level to moderate evidence to support that anxiety sensitivity is linked to post-concussion symptoms. State and trait anxiety do not appear to be related to post-concussion symptoms alone. Post-concussion state anxiety may occur if post-concussion symptoms of depression are present or if baseline symptoms of depression are present. Better social support may improve state anxiety post-concussion.
Strength of Recommendation:
There is grade B evidence to support that state and trait anxiety are not risk factors for post-concussion symptom development. There is grade C evidence to support anxiety sensitivity as a risk factor for developing post-concussion symptoms.
Lynda Mainwaring and Max Trenerry
This current special issue of the Journal of Clinical Sport Psychology was conceived and developed to provide a resource for clinicians who have contact with athletes who are at risk for or have sustained a concussion during sport participation. The special issue is part of an exciting two-issue series. This first installment contains papers from leaders in the field of sport concussion who review the frequency and mechanisms of concussion, models for managing concussion, the emotional aspects of concussion in sport, practical examples from a model sport concussion clinic, and the importance of sport concussion education and prevention. As Guest Editors, we hope that this timely and unique special series will be used by clinicians who help care for athletes and their families who have experienced concussion in their sport life.
Michael Girdwood, Liam West, David Connell and Peter Brukner
tactical training. At this stage, he was kicking on the affected side without restriction. He resumed full contact training a week later. Outcomes The player was able to return to play a full match at 8 weeks. The player did not report any ongoing issues for the rest of the season. Given the unusual nature
Caroline Lisee, Lindsay Slater, Jay Hertel and Joe M. Hart
knee injury after initial ACLR. 8 Understanding how to better prepare these populations at higher risk of encountering these challenges, especially at the time of return to play, is important throughout the rehabilitation process. To improve return-to-play rates and minimize risk of secondary injury
Jenny H. Conviser, Amanda Schlitzer Tierney and Riley Nickols
and recovery status and, as such, ongoing re-evaluation by the MDTT during treatment is necessary. It is critical that the MDTT agree upon previously established parameters for return to play ( Cook et al., 2016 ) since a premature return to sport may increase risk of aggravated illness, injury or re
Bhanu Sharma and Brian W. Timmons
inform return-to-play decisions ( 11 ). Therefore, exercise testing can help assess concussion recovery as it relates to symptom burden, although future studies should incorporate alternate recovery end points and outcome measures (cognitive and/or neuroimaging) to determine whether non
Matt Hausmann, Jacob Ober and Adam S. Lepley
Clinical Scenario Ankle sprains are the most prevalent athletic-related musculoskeletal injury treated by athletic trainers, often affecting activities of daily living and delaying return to play. 1 Most of these cases present with pain and swelling in the ankle, resulting in decreased range of
Luke M. Mueller, Ben A. Bloomer and Chris J. Durall
Anterior cruciate ligament (ACL) injuries are associated with a lengthy recovery time, decreased performance, and an increased rate of reinjury. To improve performance of the injured knee, affected athletes often undergo surgical reconstruction and rehabilitation. Determining when an athlete is ready to safely return to play (RTP), however, can be challenging for clinicians. Although various outcome measures have been recommended, their ability to predict a safe RTP is questionable.
Focused Clinical Question:
Which outcome measures should be used to determine readiness to return to play after ACL reconstruction?
Iñigo Mujika, Juanma Santisteban, Paco Angulo and Sabino Padilla
A 7-week, 10-session individual training program was implemented with a youth elite football (soccer) player who had been underperforming because of poor aerobic fitness. The intervention focused on developing aerobic power and high lactate production and contributed to a 32.3% improvement in a football-specific performance test. The player was able to return to play and exceed expected performance levels during competitive match play.