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Tag: epidemiology

Conservative Management May Reduce Repetitive Concussions

Return to play and risk of repeat concussion in collegiate football players: comparative analysis from the NCAA Concussion Study (1999–2001) and CARE Consortium (2014–2017)          McCrea M, Broglio S, McAllister T, Zhou W, Zhao S, Katz B, Kudela M, Harezlak J, Nelson L, Meier T, Marshall SW, Guskiewicz KM, On behalf of CARE Consortium Investigators. Br J Sports Med. 2019 [Epub ahead of print]https://bjsm.bmj.com/content/early/2019/05/08/bjsports-2019-100579 Take Home Message: College football players diagnosed with a concussion are being managed more conservatively with stricter return-to-play protocols, which may be related to a lower risk of repeat concussions during a season compared to 15 years ago. Over the past 15 years, an increase in concussion awareness and research has lead to new policies, rule changes in sport, and enhanced concussion assessment and management protocols. Understanding how these changes influence outcomes, such as the risk of repeat concussion, may help support current policies and consensus recommendations. Hence, the authors compared data from two prospective cohorts to examine if injury management, return to play (RTP), and risk of repeated concussions among collegiate football players changed over 15 years.Read more »…

Who Gets Chronic Traumatic Encephalopathy?

Association between contact sports participation and chronic traumatic encephalopathy: a retrospective study. Bieniek KF, Blessing MM, Heckman MG, Diehl NN, Serie AM, Paolini MA, Boeve BF, Savica R, Reichard RR, and Dickson DW. Brain Pathol. 2019. [Epub Ahead of Print]. Full Text Freely Available                                                                         Take Home Message: Among 750 samples of brain tissue from individuals with and without a history of sport participation, less than 6% of people showed chronic traumatic encephalopathy (CTE)-related pathology. While most people don’t develop CTE, roughly 1 in 7 former football players had evidence of CTE-related pathology compared with ~1 in 18 peers.Chronic traumatic encephalopathy (CTE) is a debilitating neurological disorder that has gained a lot of attention because it is related to repeated brain trauma. Despite the media attention we know very little about whether the risk of developing CTE is related to participation in sports at nonelite levels of competition. The researchers of this study used the Mayo Clinic Tissue Registry to review samples of brain tissue from 300 former athletes and 450 non-athletes for the presence CTE pathology or features of CTE.Read more »…

Sudden Death Among Youth Sport Athletes in the United States

Epidemiology of Sudden Death in Organized Youth Sports in the United States, 2007-2015Endres BD, Kerr ZY, Stearns RL, Adams WM, Hosokawa Y, Huggins RA, Kucera KL, Casa DJ. Journal of Athletic Training. 2019;54(4):349–355Full Text Freely AvailableTake Home Message: During the years 2007-2015, there were 45 sudden deaths among youth sport athletes (middle school, youth leagues, recreational sports). Sudden deaths were typically cardiac related (76%) and most common among males or basketball players and during practice (71%). In the year 2015 alone, more than 28 million youth athletes between the ages of 6 and 17 years participated in sports. While researchers have extensively studied sudden death in athletics in high school or collegiate populations, little is known about sudden death among individuals who compete in youth sports outside of the high school setting. Therefore, Endres and colleagues described the epidemiology of sudden death among athletes aged 6 to 17 years participating in organized middle school, youth league, or recreational sports in the United States.Read more »…

Parents are Open to Age Restrictions for Tackling in Football

Parents’ Perspectives Regarding Age Restriction for Tackling in Youth FootballChrisman S, Whitlock KB, Kroshus E, Schwien C, Herring SA, Rivara FP. Pediatrics. 2019; 143(5) [Epub ahead of print]. https://pediatrics.aappublications.org/content/early/2019/03/28/peds.2018-2402?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+tokenTake Home Message: In the United States, the majority of parents (61%) support a minimum age for tackling in football. An additional 24% indicated that they would “maybe” support such an age limit. In recent years, there have been increasing concerns about the acute and chronic effects of concussive and sub-concussive head impacts that occur during sports. Some sport organizations like US Soccer and USA Hockey have recently implemented age restrictions on heading and checking respectively with marked success with reducing injury in the latter. Despite football being the most popular youth sport for boys, no such age restriction exists for tackling. Furthermore, it is unclear if the public would support such restrictions if they were imposed. Therefore, Chrisman and colleagues surveyed a nationally representative sample of parents with school-aged children to determine the level of national support present for age restrictions on tackling.Read more »…

Rest Days are Unrelated with Concussion Rates

National Rugby League Match Scheduling and Rate of ConcussionGardner AJ, Howell DR, Iverson GL. J Sci Med Sport. 2019 [Epub ahead of print]https://www.ncbi.nlm.nih.gov/pubmed/30885613Take Home Message: A rugby player was most likely to sustain a concussion during the first rugby match of the year compared with any other match. The number of rest days before a match was unrelated to concussions.Rugby athletes are at high risk of suffering a concussion during a match. Over the past 12 years in Australia, the National Rugby League (NRL) added matches on Mondays (beginning of 2007 season) and Thursdays (beginning of 2012) rather than just on weekends. The scheduling changes resulted in fewer rest days during the 24-game season. Additionally, the NRL introduced the “concussion interchange rule” at the beginning of the 2014 season to allow for proper concussion medical care. This rule allows for a brief (up to 15 minutes) sideline concussion evaluation to decide if a player has a concussion and should be removed from play or if not then to return without costing the team one of its 12 player interchanges. No one has studied if the decreased rest time is associated with a higher rate of concussion or was more likely to…

The Use of PROMs Among Athletic Trainers Remains Low

Use of Patient-Reported Outcome Measures in Athletic Training: Common Measures, Selection Considerations, and Practical Barriers.Lam KC, Harrington KM, Cameron KL, Valier ARS. J Athl Train. 2019 [Epub ahead of print]Full Text is Freely AvailableTake Home Message: The use of patient-reported outcome measures (PROMs) remains low among athletic trainers; however, athletic trainers who use PROMs commonly use injury- or joint-specific PROMs or single-item PROMs. Time to complete and score PROMs are important barriers to using PROMs.The “Athletic Training Education Competencies” and the “Role Delineation/Practice Analysis” emphasizes the support for the implementation of patient-reported outcome measures (PROMs) into clinical practice to enhance patient care. However, athletic trainers appear reluctant to use them due to barriers such as time constraints. A better understanding of how athletic trainers perceive and use PROMs may help improve the adoption of PROMs into clinical practice. Therefore, the authors created a survey, which was distributed to ~18,000 athletic trainers to describe the commonly used PROMs, why those PROMS are selected, and barriers and reasons for not using PROMs.Read more »…

An Evaluation of Patient-Reported Outcome Measure Usage in Secondary School ATs

The Use of Patient-Reported Outcome Measures: Secondary School Athletic Trainers' Perceptions, Practices, and Barriers.Coulombe BJ, Games KE, Eberman LE; J Athl Train. 2019 Feb;54(2):142-151. doi:10.4085/1062-6050-86-17. Epub 2018 Aug 10.Full Text Freely AvailableTake Home Message: Many secondary school athletic trainers viewed patient-reported outcomes as beneficial; however, skip using them because of time constraints (e.g., time to fill-out, score, or analyze).A clinician can use patient-reported outcome (PRO) measures to assess how a patient perceives their symptoms, function, and rehabilitation progress. PROs are an essential way to inform how patient-centered care is provided after an injury. Unfortunately, clinicians, especially secondary school athletic trainers, may skip using PROs for many reasons. Understanding how and why a secondary school athletic trainer uses PROs may lead to strategies to promote the use of PROs. Hence, the authors used a web-based survey to evaluate the views that exist regarding the application, benefits, and problems associated with implementing PROs in the clinical practice of secondary school athletic trainers.Read more »…

It’s Not Boys Being Boys on College Campus: Males in Fraternities and Sports More Likely to Commit Sexual Assaults Than Their Peers

Is campus rape primarily a serial or one-time problem? Evidence from a multicampus studyFoubert JD, Clark-Taylor A, Wall AF. Violence Against Women. 2019, 1-16. DOI: 10.1177/1077801219833820https://journals.sagepub.com/doi/abs/10.1177/1077801219833820Warning: This post includes sensitive information on sexual assault in the athletic community.Take Home Message: Nine in 10 alcohol-involved sexual assaults on college campuses are committed by serial perpetrators. Men in fraternities and athletics are more likely to commit this crime than other college-aged men.Social activities that include alcohol are often seen as a right of passage for many college-aged students. Unfortunately, alcohol use, especially high-risk drinking behaviors, plays a major role in sexual violence. Furthermore, male student-athletes and fraternity members are more likely to commit sexual assault against women than their peers. To develop an efficient strategy to address alcohol-involved sexual assault on college campuses it is critical to understand how prevalent it is and who is involved on today’s campuses. Hence, the authors aimed to use data from the Core Alcohol and Other Drug Survey, which captured data from 49 community and 4-year colleges in a Midwestern state to address 5 questions:Read more »…

Let’s Chat: 1 in 8 Patients Are Diagnosed with Osteoarthritis within 5 Years of an ACL Reconstruction

Post-traumatic osteoarthritis diagnosed within 5 years following ACL reconstructionBodkin SG, Werner BC, Slater LV, and Hart JM. Knee Surg Sports Traumatol Arthrosc. 2019. [Epub Ahead of Print].https://link.springer.com/article/10.1007%2Fs00167-019-05461-y  Take Home Message: Almost 1 in 8 patients seek medical care and are diagnosed with knee osteoarthritis within 5 years of an anterior cruciate ligament reconstruction.Anterior cruciate ligament (ACL) rupture can lead to long-term changes in joint health and greatly affect an person’s short- and long-term quality of life. However, most studies have relied on sending surveys or inviting former patients back for an evaluation. Few studies have used large samples of healthcare data to identify people who are diagnosed with symptomatic knee osteoarthritis and seeking medical care. Therefore, Bodkin and colleagues completed an analysis of a national insurance-based, for-fee database of patient records to calculate the incidence of osteoarthritis following an ACL reconstruction and examine the risk factors related with osteoarthritis development.Read more »…

The Heat is On – But Many States Are Leaving Us Out in the Cold

The Association between Mandated Preseason Heat Acclimatization Guidelines and Exertional Heat Illness during Preseason High School American Football PracticesKerr ZY, Reigster-Mihalik JK, Pryor RR, Pierpoint LA, Scareno SE, Adams WM, Kucera KL, Casa DJ, & Marshall SW.  Environ Health Perspect. 2019; 127(4).  DOI: 10.1289/EHP4163  https://www.ncbi.nlm.nih.gov/pubmed/30969138 Take Home Message: Mandating the use of the National Athletic Trainers’ Association Inter-Association Task Force (NATA-IATF) “acclimatization” guidelines in high school football is related to fewer athletes experiencing exercise-induced heat illness.  The authors of the 2009 NATA-IATF “acclimatization” guidelines aimed to reduce exertional heat illnesses, which include heat stroke, heat syncope, heat exhaustion, and heat edema. Some state high school athletic associations have implemented these guidelines, yet the effectiveness of these guidelines is unknown.  Kerr and his colleagues assessed the relationship between state high school athletic associations adopting the NATA-IATF guidelines and the rate of exertional heat illnesses among high school students during preseason American football practices.Read more »…