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A Pediatric Perspective on Sport-Related Concussion

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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A Scale Measuring Academic-Related Anxiety Following Concussion

Michael Dressing, Jillian Wise, Jennifer Katzenstein, and P. Patrick Mularoni

symptoms, leading to different recovery timelines. The return to school and sports after concussions depends on many variables, and is evaluated with different tools and neurocognitive tests in different practices, making it very difficult to predict a “physiologic time window” for concussion recovery

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Early Controlled Exercise and Timing of Treatment Following Concussion: A Critically Appraised Topic

Nicholas Hattrup, Hannah Gray, Mark Krumholtz, and Tamara C. Valovich McLeod

demonstrated that initiating aerobic exercise had a positive effect on returning to school/work and sport sooner rather than delayed exercise. • All 5 articles 14 – 18 demonstrated that implementing early controlled aerobic exercise did not have a detrimental effect on recovery. • One article 17 demonstrated

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Clinical Outcomes Assessment for the Management of Sport-Related Concussion

Tamara C. Valovich McLeod and Johna K. Register-Mihalik

Patient Scenario:

An adolescent female youth soccer athlete, with a previous concussion history, suffered a second concussion 4 wk ago. Her postconcussive symptoms are affecting her school performance and social and family life.

Clinical Outcomes Assessment:

Concussion is typically evaluated via symptoms, cognition, and balance. There is no specific patient-oriented outcomes measure for concussion. Clinicians can choose from a variety of generic and specific outcomes instruments aimed at assessing general health-related quality of life or various concussion symptoms and comorbidities such as headache, migraine, fatigue, mood disturbances, depression, anxiety, and concussion-related symptoms.

Clinical Decision Making:

The data obtained from patient self-report instruments may not actively help clinicians make return-to-play decisions; however, these scales may be useful in providing information that may help the athlete return to school, work, and social activities. The instruments may also serve to identify issues that may lead to problems down the road, including depression or anxiety, or serve to further explore the nature of an athlete’s symptoms.

Clinical Bottom Line:

Concussion results in numerous symptoms that have the potential to linger and has been associated with depression and anxiety. The use of outcomes scales to assess health-related quality of life and the effect of other symptoms that present with a concussion may allow clinicians to better evaluate the effects of concussion on physical, cognitive, emotional, social, school, and family issues, leading to better and more complete management.

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Device-Measured Change in Physical Activity in Primary School Children During the UK COVID-19 Pandemic Lockdown: A Longitudinal Study

James Scales, Jasmine Chavda, Erika Ikeda, Ivelina Tsocheva, Rosamund E. Dove, Helen E. Wood, Harpal Kalsi, Grainne Colligan, Lewis Griffiths, Bill Day, Cheryll Crichlow, Amanda Keighley, Monica Fletcher, Chris Newby, Florian Tomini, Fran Balkwill, Borislava Mihaylova, Jonathan Grigg, Sean Beevers, Sandra Eldridge, Aziz Sheikh, James Gauderman, Frank Kelly, Gurch Randhawa, Ian S. Mudway, Esther van Sluijs, and Christopher J. Griffiths

when children returned to school after a stay-at-home lockdown. 13 Finally, a repeated measures cross-sectional design has highlighted that children engaged in 7 minutes per day less MVPA while attending school during the pandemic. 14 To date, research has only reported total daily physical activity

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Concussion Management Among National Collegiate Athletic Association Swim Programs

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

The recognition and treatment of sport-related concussion has continued to improve over the past 10 years. Concussion management protocols 1 – 3 have expanded to include elements such as preparticipation screening and testing, follow-up examinations, treatment strategies, return-to-school, and

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Acute Subdural Hematoma in a High School Football Player Requiring Emergent Decompressive Craniectomy

Christine C. Center, Samuel J. Wilkins, Ross Mathiasen, and Adam B. Rosen

was discharged the following day. He continued extensive rehabilitation with a 10-lb lifting restriction and returned to school 3 months postinjury. He returned to weightlifting and working out approximately 4 months postinjury. He was instructed to avoid high-impact activities for 1 year from the

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Concussion in Youth Sport: Developmental Aspects

Tracey Covassin, Kyle M. Petit, and Morgan Anderson

, youth athletes with abnormal vestibular function took longer to return to school than did those without ( Corwin et al., 2015 ). Future research should continue to examine the utility of the Vestibular and Ocular Motor Screening as an assessment tool in youth athletes. Given that it is dependent on

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Are Irish Athletic Therapy Students Confident in Concussion Assessment and Management? A Cross-Sectional Study of Final Year Students’ Self-Efficacy

Anna P. Postawa, Enda F. Whyte, and Siobhán O’Connor

nutrition 33.27 ± 33.41 18.83 ± 29.98 .529 <.001* Providing advice on driving 56.29 ± 38.33 35.90 ± 38.97 .629 <.001* Providing advice on return to school/learning activities 58.56 ± 32.13 41.46 ± 37.46 .608 <.001* Prescription of aerobic exercise 62.71 ± 33.10 51.34 ± 39.47 .693 <.001* Return

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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

return to school process. 4.6 (7) 21.6 (33) 30.1 (46) 34.6 (53) 9.2 (14)  Treatments following a concussion attempt to accelerate the return to play process. 3.3 (5) 15.0 (23) 26.1 (40) 46.4 (71) 9.2 (14)  Vestibular therapy is within the scope of athletic training practice if they have additional