Key Points ▸ All three studies selected demonstrated a delay in symptom recovery in patients suffering from cervicogenic symptoms. ▸ Cervicogenic symptoms were identified in 32–70% of participants with diagnosed sport-related concussion. ▸ In one randomized controlled trial, patients with symptoms
Kelly M. Cheever, Jane McDevitt and Jacqueline Phillips
Jeffrey J. Milroy, Stephen Hebard, Emily Kroshus and David L. Wyrick
seeking is delayed ( Asken, McCrea, Clugston, Snyder, & Houck, 2016 ). At present time, it is estimated that between 12% and 60% of athletes delay seeking care after sustaining a concussion. Differences in sport-related concussion (SRC) care seeking have been attributed to a number of different immutable
Tywan G. Martin, Jessica Wallace, Young Ik Suh, Kysha Harriell and Justin Tatman
A number of media reports have surfaced over the last couple of years citing many concerns about sport-related concussion (SRC) and its short- and long-term consequences. In particular, American football has received a significant amount of media coverage in this area. Published empirical studies
Ryan D. Henke, Savana M. Kettner, Stephanie M. Jensen, Augustus C.K. Greife and Christopher J. Durall
Clinical Scenario Historically, adolescent athletes with sport-related concussion (SRC) have been advised to abstain from physical activity until asymptomatic, at which point they may begin a graduated return to sport protocol. 1 Some researchers, however, have proposed that subsymptom
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.
Michael McCrea and Matthew R. Powell
This article reviews the essential components of a practical, evidenced-based approach to the management of sport-related concussion in an ambulatory care setting. The model presented is based on the core philosophy that concussion assessment and management be approached from the biopsychosocial perspective, which recognizes the medical/physiological, psychological, and sociological factors that influence recovery and outcome following concussion. Based on the biopsychosocial paradigm, we outline a care delivery model that emphasizes an interdisciplinary approach in which the clinical neuropsychologist is a key participant. We discuss the importance of nonmedical, psychoeducational interventions introduced during the acute phase to facilitate recovery after sport-related concussion. Finally, using the local experience of our “Concussion Clinic” as a backdrop, we offer two separate case studies that demonstrate the value of this model in evaluating and managing athletes after sport-related concussion. The overall objective of this paper is to provide an adaptable template that neuropsychologists and other healthcare providers can use to improve the overall care of athletes with sport-related concussion and civilians with mild traumatic brain injury.
Jeffrey G. Caron, Gordon A. Bloom and Andrew Bennie
There is a need to improve concussion education and prevention efforts for youth athletes and those responsible for their care. The purpose of this study was to understand Canadian high school coaches’ insights and perceptions of concussions. Using a case study design, eight high school coaches were interviewed and the data were analysed using a hierarchical content analysis. Findings indicated that participants primarily acquired information about concussions through their own experiences as athletes and parents, and from reports in the sports media. The coaches’ felt their role with concussions was to teach athletes safety techniques during practices and competitions and to encourage them to accurately report their concussion symptoms. In addition, participants forwarded a number of recommendations to improve the dissemination of information to coaches. Results from this study will add to a limited body of concussion research with youth sport coaches. Participants’ insights provide researchers and clinicians with information about coaches’ perceived role with sport-related concussions.
Hyung Rock Lee, Jacob E. Resch, Tae Kyung Han, Jessica D. Miles and Michael S. Ferrara
Few studies have been conducted on individuals’ knowledge of sport-related concussions (SRCs) in South Korea. The purpose of this study was to examine South Korean athletes’ knowledge and recognition of SRC. A cross-sectional survey assessing (a) the recognition of specific signs and symptoms associated with SRC; (b) history of SRC; and (c) knowledge of the return-to-play decision (RTP) process after SRC was distributed to 410 high school and collegiate student-athletes from a variety of sports. No participants correctly identified all 9 items on the checklist of SRC signs and symptoms. While 8.9% reported a history of SRC, approximately 50% of those never reported their postconcussion signs and symptoms. Furthermore, 63.9% of the athletes who reported SRC made RTP decisions on their own. These results reflect the lack of knowledge in South Korean athletics of common signs, symptoms, and appropriate RTP decisions following concussion.
Zachary C. Merz, Joanne E. Perry and Michael J. Ross
practice by describing a process in which individuals with sport-related concussion or a mTBI are acutely evaluated and treated. Referrals for follow-up care are provided depending on the needs of the individual. However, given that the clinical sport neuropsychologist reflects a clinician with specialized
Enda F. Whyte, Nicola Gibbons, Grainne Kerr and Kieran A. Moran
Context: Determination of return to play (RTP) after sport-related concussion (SRC) is critical given the potential consequences of premature RTP. Current RTP guidelines may not identify persistent exercise-induced neurocognitive deficits in asymptomatic athletes after SRC. Therefore, postexercise neurocognitive testing has been recommended to further inform RTP determination. To implement this recommendation, the effect of exercise on neurocognitive function in healthy athletes should be understood. Objective: To examine the acute effects of a high-intensity intermittent-exercise protocol (HIIP) on neurocognitive function assessed by the Symbol Digits Modality Test (SDMT) and Stroop Interference Test. Design: Cohort study. Setting: University laboratory. Participants 40 healthy male athletes (age 21.25 ± 1.29 y, education 16.95 ± 1.37 y). Intervention: Each participant completed the SDMT and Stroop Interference Test at baseline and after random allocation to a condition (HIIP vs control). A mixed between-within-subjects ANOVA assessed time- (pre- vs postcondition) -by-condition interaction effects. Main Outcome Measures: SDMT and Stroop Interference Test scores. Results: There was a significant time-by-condition interaction effect (P < .001, η 2 = .364) for the Stroop Interference Test scores, indicating that the HIIP group scored significantly lower (56.05 ± 9.34) postcondition than the control group (66.39 ± 19.6). There was no significant time-by-condition effect (P = .997, η 2 < .001) for the SDMT, indicating that there was no difference between SDMT scores for the HIIP and control groups (59.95 ± 10.7 vs 58.56 ± 14.02). Conclusions: In healthy athletes, the HIIP results in a reduction in neurocognitive function as assessed by the Stroop Interference Test, with no effect on function as assessed by the SDMT. Testing should also be considered after high-intensity exercise in determining RTP decisions for athletes after SRC in conjunction with the existing recommended RTP protocol. These results may provide an initial reference point for future research investigating the effects of an HIIP on the neurocognitive function of athletes recovering from SRC.