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Rosenbloom C, Chatterjee R, Chu W, Broman D, Okholm Kryger K. Sport-related concussion return-to-play practices of medical team staff in elite football in the United Kingdom. SCI MED FOOTBALL 2021; 6:317-324. [DOI: 10.1080/24733938.2021.1983921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Craig Rosenbloom
- The Football Association, Technical Directorate, Burton-upon-Trent, UK
- Sport and Exercise Medicine, Queen Mary University of London, London, UK
| | - Robin Chatterjee
- Institute of Sport, Exercise and Health, London, UK
- British Association of Sport and Exercise Medicine, Doncaster, UK
| | - Wing Chu
- Vita Health Group, London, UK
- Freedom Clinics, London, UK
| | - Daniel Broman
- The Football Association, Technical Directorate, Burton-upon-Trent, UK
- Isokinetic Medical Group, London, UK
| | - Katrine Okholm Kryger
- Sport and Exercise Medicine, Queen Mary University of London, London, UK
- Health and Applied Science, St Mary’s University, London, UK
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Beaudouin F, Demmerle D, Fuhr C, Tröß T, Meyer T. Head Impact Situations in Professional Football (Soccer). Sports Med Int Open 2021; 5:E37-E44. [PMID: 33718592 PMCID: PMC7946547 DOI: 10.1055/a-1338-1402] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022] Open
Abstract
To assess head impact incidents (HIIs) and to distinguish diagnosed head injuries from other incidents, a video observation analysis of match HIIs was conducted in the German Bundesliga (2017/18 season). Video recordings of each match were screened to identify the respective events. Head injury data were identified by a prospective injury registry. HII and head injury incidence rates (IR) were calculated with 95% CIs. The total number of HIIs was 1,362 corresponding to an IR of 134.9/1000 match hours (95% CI 127.9–142.2). In 123 HII (IR 12.2, 95% CI 10.2–14.5) the contact was classified as severe. Head contact with the opponent was the most frequent cause (85%). The most frequent mechanism was in 44% (combined) the arm and elbow-to-head, followed by head-to-head and hand-to-head contacts (each 13%). In 58%, the HIIs occurred during header duels. Twenty-nine head injuries were recorded (IR 2.9, 95% CI 2.0–4.1). Concussions/traumatic brain injuries accounted for 48%, head/facial fractures 24%, head/facial contusions 21%, and lacerations/abrasions 7%. The number of HIIs not classified as concussions/more severe trauma was high. Identification of HIIs and head injury severity should be improved during on-field assessment as many head injuries might go unrecognised based on the large number of HIIs.
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Affiliation(s)
- Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Daniel Demmerle
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Christoph Fuhr
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tobias Tröß
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
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Scully P, Falvey EC. Concussion management in general practice: a survey of general practitioners in primary care in the Republic of Ireland. Ir J Med Sci 2020; 190:197-203. [PMID: 32642983 DOI: 10.1007/s11845-020-02295-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/01/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Paul Scully
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
- Department of Sport and Exercise Medicine, University College Cork, Cork, Ireland.
| | - Eanna C Falvey
- Department of Sport and Exercise Medicine, University College Cork, Cork, Ireland
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Feddermann-Demont N, Chiampas G, Cowie CM, Meyer T, Nordström A, Putukian M, Straumann D, Kramer E. Recommendations for initial examination, differential diagnosis, and management of concussion and other head injuries in high-level football. Scand J Med Sci Sports 2020; 30:1846-1858. [PMID: 32557913 PMCID: PMC9290574 DOI: 10.1111/sms.13750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/09/2020] [Accepted: 06/04/2020] [Indexed: 12/22/2022]
Abstract
Head injuries can result in substantially different outcomes, ranging from no detectable effect to transient functional impairments to life‐threatening structural lesions. In high‐level international football (soccer) tournaments, on average, one head injury occurs in every third match. Making the diagnosis and determining the severity of a head injury immediately on‐pitch or off‐field is a major challenge for team physicians, especially because clinical signs of a brain injury can develop over several minutes, hours, or even days after the injury. A standardized approach is useful to support team physicians in their decision whether the player should be allowed to continue to play or should be removed from play after head injury. A systematic, football‐specific procedure for examination and management during the first 72 hours after head injuries and a graduated Return‐to‐Football program for high‐level players have been developed by an international group of experts based on current national and international guidelines for the management of acute head injuries. The procedure includes seven stages from the initial on‐pitch examination to the graduated Return‐to‐Football program. Details of the assessments and the consequences of different outcomes are described for each stage. Criteria for emergency management (red flags), removal from play (orange flags), and referral to specialists for further diagnosis and treatment (persistent orange flags) are provided. The guidelines for return to sport after concussion‐type head injury are specified for football. Thus, the present paper presents a comprehensive procedure for team physicians after a head injury in high‐level football.
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Affiliation(s)
- Nina Feddermann-Demont
- University Hospital and University of Zurich, Zurich, Switzerland.,Swiss Concussion Center, Schulthess Clinic, Zurich, Switzerland
| | - Georges Chiampas
- US Soccer Federation, Chicago, IL, USA.,Departments of Emergency and Orthopedics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbruecken, Germany
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Margot Putukian
- University Health Services, Princeton University, Princeton, NJ, USA.,Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Dominik Straumann
- University Hospital and University of Zurich, Zurich, Switzerland.,Swiss Concussion Center, Schulthess Clinic, Zurich, Switzerland
| | - Efraim Kramer
- Division of Sports Medicine, University of Pretoria, Pretoria, South Africa
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Niederer D, Engeroff T, Lange K, Vogt L, Banzer W. Return-to-play after concussion: state of knowledge, frequency of use and application barriers of guidelines among decision-makers in rugby. Brain Inj 2018; 32:1096-1102. [PMID: 29870281 DOI: 10.1080/02699052.2018.1483032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Validated strategies and guidelines for a safe and individualized diagnosis and return-to-play (RTP) after concussion in rugby are needed. Little is known about the state of knowledge, frequency of use and application barriers of state-of-the-art guidelines among decision-makers in professional or semi-professional rugby teams. Participants (n = 195) from the coaching team (head coach, assistance coach, athletic coach), the medical team (physiotherapist, physician, rehabilitation therapist, neuropsychologist), or from the officials of a professional or semi-professional rugby team (top three major leagues in Germany), filled in a questionnaire on their knowledge, frequency of use and application barriers of evidence-based guidelines (Graduated RTP protocol and The 5R). Depending on their function in the team and on the league of play, the state of knowledge and application of the diagnostic tools and the RTP guidelines differ. A considerable number are aware of one or both guidelines, but do not apply these guidelines (up to 27% of respondants). The main reasons for the non-usage were not my decision (59%), use of concurrent guidelines (54%), each player must decide by his own (36%), never experienced a concussion in my players (30%), other (19%), the guideline is useless (18%) and a player may play despite a concussion (14%). Raising awareness of the state-of-the-art guidelines is important to educate further the coaching, medical and official team members in identifying symptoms and executing the RTP-process in accordance with evidence-based strategies.
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Affiliation(s)
- Daniel Niederer
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Tobias Engeroff
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Kevin Lange
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Lutz Vogt
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Winfried Banzer
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
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Welch Bacon CE, Kay MC, Weber ML, Tierney DK, Valovich McLeod TC. School Nurses' Perceived Challenges With Concussion Management Procedures in the Secondary School Setting. SAGE Open Nurs 2018; 4:2377960818798437. [PMID: 33415205 PMCID: PMC7774346 DOI: 10.1177/2377960818798437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/03/2018] [Indexed: 11/17/2022] Open
Abstract
School nurses have an integral role in managing student health concerns throughout the school day, yet little is known about their specific role in concussion management. Therefore, the purpose of this study was to explore the challenges encountered by school nurses regarding concussion management in the secondary school setting. Twenty-two school nurses employed in the secondary school setting were interviewed via phone. We analyzed the data via the consensual qualitative research paradigm. Overall, we found school nurses face consistent challenges with their role on the concussion management team, specifically related to education of school personnel, parents, and community health-care providers. Challenging topics included the inconsistency of community health-care provider recommendations and others' perceptions of school nurses' preparation and training to be important members of the concussion management team. Efforts to increase concussion education and improve communication across all stakeholders of the concussion management team should be implemented.
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Faude O, Rössler R, Junge A, Aus der Fünten K, Chomiak J, Verhagen E, Beaudouin F, Dvorak J, Feddermann-Demont N. Head injuries in children's football-results from two prospective cohort studies in four European countries. Scand J Med Sci Sports 2017; 27:1986-1992. [PMID: 28054391 DOI: 10.1111/sms.12839] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/27/2022]
Abstract
Head injuries are considered harmful in children. We analyzed head and neck injuries in organized football in 7- to 12-year-old children. Data for this analysis were obtained from a prospective cohort study over two consecutive football seasons in two European countries, and a randomized intervention trial over one season in four European countries. Football exposure and injuries were documented through an online database. Detailed information regarding injury characteristics and medical follow-up was retrieved from coaches, children and parents by phone. Thirty-nine head injuries and one neck injury (5% of all 791 injuries) were documented during 9933 player-seasons (total football exposure 688 045 hours). The incidence was 0.25 [95%CI 0.15, 0.35] head/neck injuries per 1000 match hours (N=23 match injuries) and 0.03 [95%CI 0.02, 0.03] per 1000 training hours. Eleven concussions (27.5%), nine head contusions (22.5%), eight lacerations or abrasions (20%), two nose fractures (2.5%), and two dental injuries (2.5%) occurred. The remaining eight injuries were nose bleeding or other minor injuries. Thirty injuries (75%) resulted from contact with another player, and ten injuries were due to collision with an object, falling or a hit by the ball. Whereas 70% of all head injuries (N=28) were due to frontal impacts, 73% of concussions (N=8) resulted from an impact to the occiput. The incidence and severity of head injuries in children's football are low. Coaches and parents, however, should be sensitized regarding the potential of concussions, particularly after an impact to the occiput.
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Affiliation(s)
- O Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - R Rössler
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - A Junge
- Medical School Hamburg, Hamburg, Germany.,Swiss Concussion Center (SCC) and Schulthess Clinic, Zurich, Switzerland
| | - K Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, FIFA-Medical Centre of Excellence, Saarbrücken, Germany
| | - J Chomiak
- Department of Orthopaedics, 1st Faculty of Medicine of Charles University and Hospital Na Bulovce, FIFA-Medical Centre of Excellence, Prague, Czech Republic
| | - E Verhagen
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - F Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, FIFA-Medical Centre of Excellence, Saarbrücken, Germany
| | - J Dvorak
- Swiss Concussion Center (SCC) and Schulthess Clinic, Zurich, Switzerland
| | - N Feddermann-Demont
- Swiss Concussion Center (SCC) and Schulthess Clinic, Zurich, Switzerland.,Department of Neurology, Interdisciplinary Center for Vertigo and Neurological Visual Disorders, University Hospital & University of Zurich, Zurich, Switzerland
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Pangrazio O, Forriol F. Epidemiology of soccer players traumatic injuries during the 2015 America Cup. Muscles Ligaments Tendons J 2016; 6:124-30. [PMID: 27331040 DOI: 10.11138/mltj/2016.6.1.124] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM to provide an overview of the traumatic injuries sustained by players in the 2015 America Cup. MATERIAL AND METHODS we collected the medical reports on all the matches held during the 2015 America Cup, in Chile, in 2015. Twelve American teams took part in the championship, consisted of 26 matches with a total of 276 players. The physician for each team sent a request form of the traumatic injuries sustained, including the time at which the injury was produced, the location and diagnosis, its severity and the circumstances (contact injury, sanction, treatment required). RESULTS the mean number of minutes played was 233 (SD: 147) (5-570) minutes. An injury occurred every 58 minutes, which means that there were 17.25 injuries per 1,000 minutes of match time. We found 44 injuries in 30 players. There were 14 non-contact injuries, and 30 contact injuries, of which 13 were declared fouls and resulted in cards being given. Five teams had one injured player, two had 2, two had 4, and one had 25 injuries. The most frequent injuries were those to the lower limbs. The muscles strains happened in the second part of the second half of the match, the ACL rupture at the end of the first half, and the other sprains and strains in the second half. The contusions occurred at all times throughout the match, although they seemed to be concentrated towards the end of the first half, while the cases of tendinitis were caused in the first part of the second half. CONCLUSION football injuries are very common, and even though serious injuries are rare, it is increasingly necessary to set protocols for action which ensure good medical attention at all levels to address the problems that arise, both during training and in competitions, and to be prepared to treat serious injuries if these occur.
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Affiliation(s)
- Osvaldo Pangrazio
- Comisión Médica Conmebol (Confederación Su-damericana de Fútbol), Asunción, Paraguay
| | - Francisco Forriol
- Department of Clínica Sciences, University San Pablo - CEU, Boadilla del Monte, Spain
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Epidemiology of injuries sustained by players during the 16th Under-17 South American Soccer Championship. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016. [DOI: 10.1016/j.recote.2016.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pangrazio O, Forriol F. Epidemiology of injuries sustained by players during the 16th Under-17 South American Soccer Championship. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016; 60:192-9. [PMID: 26838188 DOI: 10.1016/j.recot.2015.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/19/2015] [Accepted: 12/02/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE We performed an epidemiological study of the traumatic injuries during the XVI South American U-17 Football Championship, 2015. MATERIAL AND METHODS Observational surveys submitted by the 10 teams medical services of 220 players. Thirty-five games were held and 116 goals (3.31 per game) were recorded. RESULTS 103 lesions, ie, 2.94 per game or 32.7 injuries per 1,000 min were recorded. Fifty-six were from direct contact and 66 requiring treatment. 36% of the injuries were punished by fault and 26% of the injuries also saw card. Injuries were most common in the ankle (15 cases), Achilles tendon (14 cases) and thigh (14 cases), followed by trauma to the knee and foot (7 cases each), face and the lumbar region (6 cases each), being rare in the upper extremity. CONCLUSION Injuries during Soccer World Cup are difficult to predict and prevent, but serious injuries are rare. Is necessary to establish protocols that get adequate health care at all levels to solve problems produce, both in training and during the competition, and be prepared to solve the serious problems that may arise.
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Affiliation(s)
- O Pangrazio
- Comisión Médica Conmebol (Confederación Sudamericana de Fútbol), Universidad San Pablo-CEU, Madrid, España
| | - F Forriol
- Facultad de Medicina, Universidad San Pablo-CEU, Madrid, España.
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Fortington LV, Twomey DM, Finch CF. Concussion in community Australian football - epidemiological monitoring of the causes and immediate impact on play. Inj Epidemiol 2015; 2:20. [PMID: 27747752 PMCID: PMC5005765 DOI: 10.1186/s40621-015-0052-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 08/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Head injuries, particularly concussion, are a major cause of concern in many sports, particularly the football codes, driving a need to better understand injury mechanisms and potential methods of prevention. The aim of this study was to describe the mechanisms and follow up care of concussion injuries sustained in adult male community Australian football to identify target areas for prevention and management. METHODS Secondary analysis of injury data collected in a cluster randomised controlled trial in community Australian football across two states of Australia in 2007 and 2008. There were 1564 players from 18 clubs. The main outcome measures were the number and rate of head/neck/face (HNF) injuries and concussion sustained in games. A specific description of the mechanisms of the concussion injuries is presented along with the immediate return-to-play status of concussion cases. RESULTS 143 HNF injuries were sustained by 132 players. The game HNF injury incidence was 4.9 per 1000 game hours (n = 138; 95 % confidence interval 4.1; 5.7). Just under a quarter (n = 34) of all HNF injuries were recorded as concussion. All concussions occurred during games (none in training), with all but one related to body contact with other players. Overall, 68 % of the concussions were considered within game rules, while 32 % were either outside of the rules or unclear. Most (88 %) players left the field immediately following concussion but 47 % later returned to play in the same game. CONCLUSIONS Prevention strategies for concussion need to be based on knowledge of the mechanisms of injury. Most concussions in community Australian football occurred through body contact with other players or during tackling. Management of players post-concussion was generally poor with over half of the cases continuing to play in the same game. Therefore, new primary prevention strategies that target body-contact/tackling skills and improved secondary prevention measures relating to compliance with return-to-play protocols would be valuable.
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Affiliation(s)
- Lauren V. Fortington
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, VIC 3353 Australia
| | - Dara M. Twomey
- Faculty of Health, Federation University Australia, Ballarat, Australia
| | - Caroline F. Finch
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, VIC 3353 Australia
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