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Dean Ritchie, Will G. Hopkins, Martin Buchheit, Justin Cordy and Jonathan D. Bartlett

Context:

Training volume, intensity, and distribution are important factors during periods of return to play.

Purpose:

To quantify the effect of injury on training load (TL) before and after return to play (RTP) in professional Australian Rules football.

Methods:

Perceived training load (RPE-TL) for 44 players was obtained for all indoor and outdoor training sessions, while field-based training was monitored via GPS (total distance, high-speed running, mean speed). When a player sustained a competition time-loss injury, weekly TL was quantified for 3 wk before and after RTP. General linear mixed models, with inference about magnitudes standardized by between-players SDs, were used to quantify effects of lower- and upper-body injury on TL compared with the team.

Results:

While total RPE-TL was similar to the team 2 wk before RTP, training distribution was different, whereby skills RPE-TL was likely and most likely lower for upper- and lower-body injury, respectively, and most likely replaced with small to very large increases in running and other conditioning load. Weekly total distance and high-speed running were most likely moderately to largely reduced for lower- and upper-body injury until after RTP, at which point total RPE-TL, training distribution, total distance, and high-speed running were similar to the team. Mean speed of field-based training was similar before and after RTP compared with the team.

Conclusions:

Despite injured athletes’ obtaining comparable TLs to uninjured players, training distribution is different until after RTP, indicating the importance of monitoring all types of training that athletes complete.

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Taylor K. Wise

). Return-to-play should be determined by the medical factors associated with the athlete’s condition and the acceptable level of risk (individual to each athlete) that would accompany participating in their specific sport ( Creighton, Shrier, Shultz, Meeuwisse, & Matheson, 2010 ). Eating disorder policies

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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.

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Tracey Covassin, Kyle M. Petit and Morgan Anderson

/symptoms, prevalence), concussion education and awareness, concussion assessment and management, concussion recovery and return to play, concussion treatment, and future research and recommendations for youth sport stakeholders. We also address sex and developmental considerations throughout this review. In reviewing

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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

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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

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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.

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Nicole Reams, Rodney A. Hayward, Jeffrey S. Kutcher and James F. Burke

Purpose:

Lingering neurologic injury after concussion may expose athletes to increased risk if return to play is premature. The authors explored whether on-field performance after concussion is a marker of lingering neurologic injury.

Design:

Retrospective cohort study on 1882 skill-position players who played in the National Football League (NFL) during 2007–2010.

Methods:

Players with concussion based on the weekly injury report were compared with players with other head and neck injuries (controls) on measures of on-field performance using Football Outsiders’ calculation of defense-adjusted yards above replacement (DYAR), a measure of a player’s contribution controlling for game context. Changes in performance, relative to a player’s baseline level of performance, were estimated before and after injury using fixed-effects models.

Results:

The study included 140 concussed players and 57 controls. Players with concussion performed no better or worse than their baseline on return to play. However, a decline in DYAR relative to their prior performance was noted 2 wk and 1 wk before appearing on the injury report. Concussed players performed slightly better than controls in situations where they returned to play the same week as appearing on the injury report.

Conclusions:

On return, concussed NFL players performed at their baseline level of performance, suggesting that players have recovered from concussion. Decline in performance noted 2 wk and 1 wk before appearing on the injury report may suggest that concussion diagnosis was delayed or that concussion can be a multihit phenomenon. Athletic performance may be a novel tool for assessing concussion injury and recovery.

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Lara Mitchinson, Amity Campbell, Damian Oldmeadow, Will Gibson and Diana Hopper

Volleyball players are at high risk of overuse shoulder injuries, with spike biomechanics a perceived risk factor. This study compared spike kinematics between elite male volleyball players with and without a history of shoulder injuries. Height, mass, maximum jump height, passive shoulder rotation range of motion (ROM), and active trunk ROM were collected on elite players with (13) and without (11) shoulder injury history and were compared using independent samples t tests (P < .05). The average of spike kinematics at impact and range 0.1 s before and after impact during down-the-line and cross-court spike types were compared using linear mixed models in SPSS (P < .01). No differences were detected between the injured and uninjured groups. Thoracic rotation and shoulder abduction at impact and range of shoulder rotation velocity differed between spike types. The ability to tolerate the differing demands of the spike types could be used as return-to-play criteria for injured athletes.

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Lynda M. Mainwaring, Sean M. Bisschop, Robin E.A. Green, Mark Antoniazzi, Paul Comper, Vicki Kristman, Christine Provvidenza and Doug W. Richards

Despite suggestions that emotions influence recovery from injury, there is little research into the emotional sequelae of mild traumatic brain injury (MTBI), or “concussion,” in sport. This examination compares emotional functioning of college athletes with MTBI to that of uninjured teammates and undergraduates. A short version of the Profile of Mood States (POMS; Grove & Prapavessis, 1992) assessed baseline emotions in all groups, and serial emotional functioning in the MTBI and undergraduate groups. Whereas preinjury profiles were similar across groups, the MTBI group showed a significant postinjury spike in depression, confusion, and total mood disturbance that was not seen for the other groups. The elevated mood disturbances subsided within 3 weeks postinjury. Given that concussed athletes were highly motivated to return to play, these data could be used as a benchmark of normal emotional recovery from MTBI. Findings are discussed in relation to current literature on emotional reaction to injury and directions for future research.