postinjury concussion management. 5 However, although the utility and frequency of baseline testing for student-athletes that are still maturing and developing has been argued, 6 – 8 researchers have reported that baseline assessment scores improve as an adolescent matures. 8 – 11 Therefore, if baseline
Cailee E. Welch Bacon, Gary W. Cohen, Melissa C. Kay, Dayna K. Tierney, and Tamara C. Valovich McLeod
Reid Skeel, Anissa Maffett, Abigail Feder, Cayla Mitzkovitz, and Sofia Lesica
with significant symptoms, (2) continued brain recovery in which symptoms abate, and finally (3) full recovery to preclinical neurological baseline. 7 The primary goals of concussion management are to prevent further injury during the vulnerable acute phase, provide physical and cognitive rest for the
David R. Howell, Corrine N. Seehusen, Mathew J. Wingerson, Julie C. Wilson, Robert C. Lynall, and Vipul Lugade
pediatric concussion management . J Athl Train . 2020 . doi:10.4085/323-20 10.4085/323-20 33150416 14. Howell DR , Lugade V , Potter MN , Walker G , Wilson JC . A multifaceted and clinically viable paradigm to quantify postural control impairments among adolescents with concussion
Athletic health care professionals, team physicians, and athletic trainers have an ethical obligation to safeguard the short- and long-term well-being of the athlete they care for. The potential long-term negative consequences to the student-athlete’s physical, cognitive, and mental health as a result of concussions and their mismanagement is a reality. How the athletic health care professional attends to this top priority of providing optimal health care to the concussed athlete while navigating the mitigating circumstances and influences of nonmedical entities found in competitive athletics is one of the great ethical challenges of present day sports medicine. Effectively navigating the complex challenges faced by athletic health care professionals is as important as the care delivered. Understanding the ethical challenges faced by athletic health care decision makers should be a central focus in providing the optimal care the patient deserves.
J.D. DeFreese, Michael J. Baum, Julianne D. Schmidt, Benjamin M. Goerger, Nikki Barczak, Kevin M. Guskiewicz, and Jason P. Mihalik
. Methods Participants A convenience sample of 165 incoming freshman and transfer student-athletes at a Division I institution completed baseline concussion testing in a sports medicine center as part of an ongoing clinical concussion management program. This population was chosen as the transition into
Maureen R. Weiss
Tamara C. Valovich McLeod and Gerard A. Gioia
Edited by John Parsons
Scott E. Benedict, Jeffrey W. Hinshaw, Ryan Byron-Fields, Harsimran S. Baweja, and Daniel J. Goble
Fatigue has been shown to adversely affect balance results, as measured by the Balance Error Scoring System (BESS). The present study aimed to determine whether a new low-cost force plate for concussion balance assessment, the Balance Tracking System (BTrackS), is subject to similar fatigue effects. Significant fatigue effects were only evident immediately following a fatigue protocol (p > .05), and were fully resolved within 5 min postfatigue. These results suggest that the BTrackS Balance Test (BBT) is more fatigue resistant than the BESS, and support use of the BBT as a potentially more reliable alternative to the BESS during immediate sideline balance testing.
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.