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Concussion in Youth Sport: Developmental Aspects

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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Using the Disclosure Decision-Making Model to Understand High School Football Players’ Disclosures of Concussion Symptoms

Gregory A. Cranmer and Sara LaBelle

Despite advancements in concussion treatment and management, health and sports professionals largely depend on athletes’ self-reporting of symptoms to begin the process of diagnosis. With this in mind, recent scholarly attention has focused on understanding the barriers and processes of athletes’ self-disclosure of symptoms. The current study applied the disclosure decision-making model to understand high school football players’ disclosure decisions after experiencing symptoms of a concussion. Data obtained from 184 high school football players from across the United States demonstrated 2 significant paths by which players’ disclosures of concussion symptoms during a game can be understood. First, the perceived severity of these symptoms predicted athletes’ self-efficacy to disclose concussions, which subsequently predicted their intentions to disclose concussion symptoms during a game. Second, the felt stigma around disclosing concussion symptoms predicted athletes’ anticipated responses from coaches to such disclosures, which subsequently predicted their intentions to disclose concussion symptoms during a game. Furthermore, the effect of perceived stigma on the anticipated responses from coaches was moderated by the quality of athletes’ relationships with their coaches. These results highlight the importance of convincing athletes to take concussion symptoms seriously and the role of athlete–coach relationships in combatting stigma around concussion disclosures. These findings suggest that scholars and practitioners should acknowledge the social contexts surrounding disclosure of concussion symptom and shift educational efforts to focus on the dangers of concussions and the process by which athletes should report potential symptoms.

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The Effects of Early Physical Activity Compared to Early Physical Rest on Concussion Symptoms

Landon Lempke, Abbis Jaffri, and Nicholas Erdman

Clinical Scenario: Currently, rest following concussion serves as the keystone of concussion treatment, but substantial evidence to support it is lacking. Recent literature suggests that early physical activity may be beneficial in reducing concussion symptoms which may influence clinical recovery time. Clinical Question: Does early physical activity decrease postconcussion symptoms compared to physical rest following concussion? Summary of Key Findings: A total of 5 articles were included that examined symptom duration changes at multiple time points. All 5 studies utilized follow-up time points compared to initial examination, but there was variance in the specific time points reported. Two studies employed control groups and compared strict or recommended rest to early activity or limited rest. Three studies were observational studies that directly compared baseline measurements to follow-up assessments. Clinical Bottom Line: Current evidence suggests that early physical activity in the acute phase following a concussion may decrease the time needed for symptom resolution compared to immediate rest. Strength of Recommendation: Using Centre for Evidence-Based Medicine 2011 level 3 evidence and higher, the results suggest that early physical activity during the acute phase of a concussion may decrease symptom duration; however, a lack of high-quality studies and inconsistent interventions are limitations to this recommendation.

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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

Key Points ▸ Consensus statements have recently moved away from strict rest following concussion. ▸ Treatments aimed at reducing initial symptom burden may reduce recovery times. ▸ Hyperbaric oxygen therapy may be an effective treatment in high school athletes. Student-athletes typically experience

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The Clinical Practice Characteristics, Self-Confidence, and Barriers Related to Treatment Following Concussion Among Athletic Trainers

Nicholas Hattrup, Hayley J. Root, and Tamara C. Valovich McLeod

indicated only agreeing with the statement thereby indicating a potential area for improvement regardless of years of experience. Over half of respondents indicated that time and limited personnel were barriers to sport-related concussion treatment implementation. While time and limited personnel are a

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Youth Concussion Management Practices Among Athletic Trainers: A Vignette-Based Survey

Reid Skeel, Anissa Maffett, Abigail Feder, Cayla Mitzkovitz, and Sofia Lesica

to months, 2 recent studies have found that earlier presentation for concussion treatment in a specialty clinic setting lowers the risk of extended recovery time. 3 , 4 Consequently, the diagnosis, assessment, and management of concussion—particularly sports-related concussion—has received

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Transitioning Concussion Care to Mental Health Care: A Case Study of an Elite Athlete

Natalie S. Sherry, Abigail Feder, Raymond Pan, Shawn R. Eagle, and Anthony P. Kontos

always clear, especially in chronic cases, but utilizing a biopsychosocial model of care allows us to address all potential contributing factors versus reducing a symptom to a single cause. Individualized Concussion Care Our approach to concussion treatment also functions within the conceptual framework

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Mode and Intensity of Physical Activity During the Postacute Phase of Sport-Related Concussion: A Systematic Review

Barbara Baker, Eric Koch, Kevin Vicari, and Kyle Walenta

these limitations may be attributed to the changing guidelines for concussion treatment during the postacute phase in recent years. Suggestions for Future Research Considering the shifting guidelines for concussion treatment and the limited number of studies that met the inclusion criteria of this

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Concussive Biomechanics in a Women’s Soccer Player: A Validation Clinical Case Report

Hallie D. Sayre and Tom G. Bowman

symptoms of a concussion and recognizing that concussions are dangerous, many of them would continue to play and see how they feel or would take a short break and then return to play rather than seeking medical care. 13 While a delay of symptom reporting is common, this also means that concussion

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The Relationship Between Postinjury Symptomatology and Days Postinjury for the Graded Symptom Scale in Concussed Adolescent Athletes

Richelle M. Williams, R. Curtis Bay, and Tamara C. Valovich McLeod

need to re-evaluate patients’ symptoms regularly and use this information to drive concussion treatment decisions while using active interventions, academic accommodations, and referrals when necessary. Clinicians should be aware that patients may present with symptoms upward to 3 weeks postinjury and