The recent increase in scientific activity related to traumatic brain injury (TBI)—and in particular, mild TBI and concussion—parallels the growth of public interest in the field. As the international scientific community aligns itself to better diagnose, treat, and manage this injury ( 79 ), which
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Pediatric Traumatic Brain Injury and Exercise Medicine: A Narrative Review
Bhanu Sharma and Brian W. Timmons
Memory Impairments Associated With Mild Traumatic Brain Injury: A Critically Appraised Topic
Karlee Burns, Leah Sanford, Ryan Tierney, and Jane McDevitt
Key Points ▸ Adolescents and young adults with sport-related mild traumatic brain injury (i.e., 9 days to 12 months postinjury) performed worse on memory tests than healthy controls. ▸ There is low-level evidence suggesting structural changes (e.g., cortical thinning) are occurring following sport
Do Cognitive Behavioral Therapy Techniques Reduce Symptom Duration in Children and Adolescents Who Have Sustained a Mild Traumatic Brain Injury?
Carlie K. Elmer and Tamara C. Valovich McLeod
therapy and its effect on symptoms in children and adolescents with diagnosed concussions. Focused Clinical Question Does CBT reduce concussion symptoms among children and adolescents following mild traumatic brain injury? Search Strategy A comprehensive search of PubMed, CINAHL, MEDLINE, SPORTDiscus
Aerobic Exercise as an Intervention for Mild Traumatic Brain Injury: A Critically Appraised Topic
Makayla Florez, Erin Roberge, and Jennifer Ostrowski
participation in the program; previous history of any diagnosed psychiatric disease or current onset of psychiatric problems; suffers from a progressive neurodegenerative disease; previous history of moderate to severe traumatic brain injury; previous history of chronic pain and migraine Intervention
Physical Activity Experiences of Individuals Living With a Traumatic Brain Injury: A Qualitative Research Exploration
Megan Self, Simon Driver, Laurel Stevens, and Ann Marie Warren
Traumatic brain injury (TBI) is a significant public health issue due to the incidence, complexity, and cost associated with treatment. The purpose of this study was to determine physical activity (PA) knowledge, attitudes, intentions, and barriers among individuals with a TBI undergoing outpatient rehabilitation. Seventeen participants completed a series of group interviews regarding their PA needs. A qualitative research design was adopted and trustworthiness was established through investigator triangulation of data. A cross-case analysis was completed to identify themes and conceptual patterns. The main themes identified were (a) an inability to differentiate between PA and physical therapy, (b) a limited knowledge of PA health benefits and the relationship to rehabilitation, and (c) an interest in participating in a PA based health promotion program. Future interventions should educate individuals about PA, the associated health benefits, and the role PA plays in the rehabilitation process.
Hyperbaric Oxygen Therapy to Treat Acute Sport-Related Traumatic Brain Injuries: A Case Series
Patricia R. Roby, Robert C. Lynall, Michael J. Cools, Stephen W. Marshall, Janna C. Fonseca, James R. Stevens, and Jason P. Mihalik
therapy has demonstrated benefits in animal studies, 10 as well as those suffering from moderate to severe traumatic brain injury. 11 Unfortunately, it has not been adequately studied as an acute concussion treatment. Giza and Hovda 2 previously described the neurometabolic cascade resulting from
Is State Anxiety, Trait Anxiety, or Anxiety Sensitivity a Clinical Predictor of Symptoms in Those Presenting With Mild Traumatic Brain Injury or Concussion?
Krista M. Hixson, Alex N. Allen, Andrew S. Williams, and Tamara C. Valovich McLeod
Clinical Scenario:
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.
Clinical Question:
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.
Sleep Dysfunction in Adolescents With Prolonged Postconcussion Symptoms: A Reciprocal Coupling of Traumatic Brain Injury and Sleep-Related Problems
Carter Hughes, Kevin Hunt, Brian Cox, John Raybon, and Rebecca M. Lopez
Clinical Scenario While not often catastrophic, concussions or mild traumatic brain injuries are becoming more common in young athletes. 1 It is estimated that between 1.1 and 1.9 million concussions occur in athletes 18 years old or younger each year. 1 Due to a number of neurometabolic
