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Tamara C. Valovich McLeod, Megan N. Houston, and Cailee E. Welch

Concussions resulting from sports and recreational activities are a significant concern in the pediatric population. The number of children and adolescents sustaining sport-related concussions is increasing and, as a result, legislation has been passed in all 50 states to ensure appropriate recognition and referral of pediatric athletes following concussion. The developing brain may make the diagnosis, assessment, and management of concussion more challenging for health care providers and requires the use of specific age-appropriate assessment tools. Concussion management must also include considerations for cognitive and physical rest, a collaborative concussion management team that includes medical and school personnel, and more conservative stepwise progressions for returning to school and to physical activity.

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Charles R. Thompson

The incidence of concussions and potential for long-term health effects has captured the attention of the media, general public, medical professionals, parents, and obviously the athletes themselves. Concussions have been blamed for a variety of mental and physical health issues. The athletic trainer is at the forefront of the concussion management team, as they are typically on the scene when the concussion occurs and are often the first medical personnel to evaluate and, hopefully, remove the athlete from activity. There has been controversy of late regarding the influence of coaches in the care of concussed athletes. Therefore, a move to the “medical model” of sports medicine management can go a long way in resolving conflict of interest issues regarding the care of concussed athletes. A comprehensive concussion team and protocol are also essential to providing the highest level of care. This article takes a closer look at concussion management in the collegiate arena, with a particular focus on Princeton University.

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Nicholas M. Hattrup, Rebekah L. Gardiner, Hannah Gray, Cailee E. Welch Bacon, and Tamara C. Valovich McLeod

necessary or required to meet the standard of care. While there may be differing opinions on the need for baseline neurocognitive testing, 1 , 3 the use of baseline neurocognitive assessments are widely utilized with 71.2% of athletic trainers in the secondary school setting 4 and 74.9% in the collegiate

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Katie Ritter, Ashley N. Marshall, Keenan Robinson, Dilaawar J. Mistry, Meeryo C. Choe, and Tamara Valovich McLeod

divisions are similar to Kerr et al 7 who noted that significantly fewer Division II and III institutions included baseline assessments in their concussion protocols compared with Division I. The use of the ImPACT computerized neurocognitive assessment tool as the most commonly used computerized

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Ke’La Porter, Carolina Quintana, and Matthew Hoch

neuromuscular control during a dripping task, more specifically increased knee valgus. Assessing this neurocognitive domain may be useful in identifying athletes with reduced neuromuscular control. Athletes who performed poorer on baseline neurocognitive assessments also demonstrated knee kinetics and

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Enzo Iuliano, Giovanni Fiorilli, Giovanna Aquino, Alfonso Di Costanzo, Giuseppe Calcagno, and Alessandra di Cagno

exercise. Neurocognitive Assessment The neurocognitive assessment was performed in the university’s medical offices, without any kinds of distraction to avoid influences on the neurocognitive scores. The three tests used for the assessment of memory and memory complaint are described below. The Rey 15

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Cailee E. Welch Bacon, Gary W. Cohen, Melissa C. Kay, Dayna K. Tierney, and Tamara C. Valovich McLeod

athletic trainers noted the lack of experience community physicians had with interpreting information collected from neurocognitive assessments, such as the ImPACT test. In her local area in South Dakota, Sydney noted, “we do not have any neuropsychologists that are able to look at the ImPACT test results

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Robert C. Lynall, Rachel S. Johnson, Landon B. Lempke, and Julianne D. Schmidt

neurocognitive assessments may be predictive of musculoskeletal injury risk, 10 and athletes who tore their anterior cruciate ligament had slower preinjury RT than those who did not. 11 These results suggest RT may provide important information about musculoskeletal injury risk, and it is possible a more

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Eric Schussler, Ryan S. McCann, Nicholas Reilly, Thomas R. Campbell, and Jessica C. Martinez

neurologic function in collegiate football players . Ann Biomed Eng . 2012 ; 40 ( 1 ): 14 – 22 . PubMed ID: 21994067 doi:10.1007/s10439-011-0421-3 10.1007/s10439-011-0421-3 21994067 12. Avery M , Wattie N , Holmes M , Dogra S . Seasonal changes in functional fitness and neurocognitive

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Katie Stephenson, Melissa N. Womble, Shawn R. Eagle, Philip Schatz, Tatiana Gervase, Brett Gustman, Eric Castor, Anthony P. Kontos, and R.J. Elbin

, headache, dizziness, nausea) following injury, and any impairment on assessments (eg, computerized neurocognitive assessments, VOMS). This definition of concussion is supported by the Concussion in Sport Group consensus statement. 16 NPC Distance Measurement The NPC distance measurement was obtained as part of the