1
|
Munce TA, Peplowski AD, Bowman TG, Kelshaw PM, Campbell TR, Ahonen SB, Valentine VD, Cifu DX, Resch JE. Concussion diagnosis and recovery in relation to collegiate athletic department classification: a LIMBIC MATARS consortium investigation. Brain Inj 2024:1-11. [PMID: 38334036 DOI: 10.1080/02699052.2024.2310800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE We investigated time to reach concussion diagnosis and recovery milestones in collegiate athletes relative to their schools' National Collegiate Athletic Association (NCAA) classification. METHODS We retrospectively examined 849 (43.1% female) concussion cases from 11 NCAA institutions (Division I Power 5 [n = 4], Division I Non-Power 5 [n = 4], and Division II/III [n = 3]) from the 2015-16 to 2019-20 athletic seasons. Our primary outcome measures were days to reach specific clinical milestones following concussion. RESULTS Median (IQR) time from injury to diagnosis was significantly longer at Division II/III institutions (1 [0-4] days) compared to Division I Power 5 (0 [0-1] days) and Division I Non-Power 5 (0 [0-1] days) institutions (p < 0.001). Likewise, Division II/III athletes (15 [11-22] days) took significantly longer to return to sport after concussion than Division I Power 5 (10 [7-16] days) and Division I Non-Power 5 (11 [7-18.5] days) athletes (p < 0.001). CONCLUSION Division II/III athletes had delayed concussion diagnoses and return to sport timelines compared to Division I athletes. Our results suggest that differences in sports medicine resources across NCAA divisions may influence injury recognition and recovery in collegiate athletes with concussion.
Collapse
Affiliation(s)
- Thayne A Munce
- Environmental Influences on Health & Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - Allison D Peplowski
- Environmental Influences on Health & Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
- Department of Biology, University of South Dakota, Vermillion, South Dakota, USA
| | - Thomas G Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - Patricia M Kelshaw
- Department of Kinesiology, Brain Research and Assessment Initiative of New Hampshire (BRAIN) Laboratory, University of New Hampshire, Durham, New Hampshire, USA
| | - Thomas R Campbell
- School of Rehabilitation Sciences, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Sean B Ahonen
- Intercollegiate Athletics and Community Wellness, Virginia Union University, Richmond, Virginia, USA
| | - Verle D Valentine
- Sanford Orthopedics and Sports Medicine, Sanford Health, Sioux Falls, South Dakota, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jacob E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
| |
Collapse
|
2
|
Walton SR, Kelshaw PM, Munce TA, Beidler E, Bowman TG, Oldham JR, Wilmoth K, Broshek DK, Rosenblum DJ, Cifu DX, Resch JE. Access to athletic trainers and sex as modifiers of time to reach clinical milestones after sport-related concussion in collegiate athletes. Brain Inj 2024:1-8. [PMID: 38318792 DOI: 10.1080/02699052.2024.2310787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE Investigate whether an athlete's biological sex and exposure to a dedicated athletic trainer (AT) were related to clinical milestones after a sports-related concussion (SRC). DESIGN Retrospective chart review. METHODS Medical charts of collegiate athletes (n = 196 [70.9% female]) diagnosed with SRC were reviewed to extract: biological sex, dedicated AT exposure for their sport (yes/no), and time (days) to reaching clinical milestones (diagnosis, symptom resolution, unrestricted return to sport [RTS]). Mann-Whitney U tests were used to determine whether time to clinical milestones differed by sex, AT exposure, or their interaction. Proportions of same-day diagnoses and times to diagnosis, symptom resolution, and unrestricted RTS were evaluated with chi-squared and spearman's rank correlations, respectively. RESULTS There were no significant differences in times to reaching any clinical milestone by sex, AT exposure, or their interaction (ps > 0.05). Forty-three percent of participants were diagnosed on the day of their SRC. This did not differ by sex or AT exposure (ps > 0.29). Longer times to SRC diagnosis were associated with more days to symptom resolution (ρ = 0.236, p = 0.001) and unrestricted RTS (ρ = 0.223, p < 0.001). CONCLUSIONS Athlete sex and AT exposure were not associated with times to reach any clinical milestone; however, delayed diagnosis was associated with longer times to reach clinical recovery.
Collapse
Affiliation(s)
- Samuel R Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Patricia M Kelshaw
- Department of Kinesiology, Brain Research and Assessment Initiative of New Hampshire Laboratory, University of New Hampshire, Durham, New Hampshire, USA
| | - Thayne A Munce
- Environmental Influences on Health & Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Thomas G Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - Jessie R Oldham
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Kristin Wilmoth
- Departments of Psychiatry and of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Donna K Broshek
- Department of Psychiatry & Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Daniel J Rosenblum
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jacob E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
| |
Collapse
|
3
|
Kimura T, Mącznik AK, Kinoda A, Yamada Y, Muramoto Y, Katsumata Y, Sato K. Prevalence of and Factors Associated with Sports Injuries in 11,000 Japanese Collegiate Athletes. Sports (Basel) 2023; 12:10. [PMID: 38251284 PMCID: PMC10819682 DOI: 10.3390/sports12010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND To establish the 1-year prevalence of sports injuries and explore associations of various factors with a sports injury in Japanese collegiate athletes. METHODS The data were collected through a web-based survey of Japanese collegiate athletes associated with UNIVAS (Japan Association for University Athletics and Sport). The survey questions asked about athletes' personal characteristics, sports participation, and injuries sustained within the previous year. Follow-up questions on the details regarding the three most serious injuries were asked. Differences in proportions of athlete characteristics between males and females and between injured and uninjured were explored with the chi-square test. Factors associated with sustaining an injury were determined with regression analysis. RESULTS The prevalence of injuries among Japanese collegiate athletes is high, and most of the sustained injuries require athletes to take a considerable time off training and competition indicating their severity. Athletes from year two and higher at the university, overweight or obese, training more often per week, and with longer sports experience were more likely to sustain an injury within the previous year. CONCLUSIONS There is compelling evidence to suggest that excessive training and insufficient recovery may be contributing to their increased risk of injury. These findings underscore the importance of implementing evidence-based training programs and recovery strategies to mitigate injury risk and optimize performance outcomes among this population.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (T.K.); (A.K.M.); (A.K.); (Y.Y.); (Y.M.); (Y.K.)
| |
Collapse
|
4
|
Buckley TA, Bryk KN, Hunzinger KJ, Costantini K. National Collegiate Athletic Association athletic trainers' response to the Arrington settlement: management, compliance, and practice patterns. PHYSICIAN SPORTSMED 2023; 51:427-433. [PMID: 36026565 DOI: 10.1080/00913847.2022.2118001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/23/2022] [Indexed: 10/15/2022]
Abstract
The primary purpose of this study was to assess Athletic Trainers' (ATs) report of NCAA member institution compliance with the Arrington settlement, the concussion lawsuit vs. the NCAA, and to elucidate compliance predictors. A secondary purpose was to provide a contemporary concussion management clinical practice pattern description among NCAA collegiate athletic trainers. Head Athletic Trainers from NCAA Division I, II, and III completed an electronic questionnaire in August 2020 regarding their institution's response to the Arrington Settlement and their current concussion management clinical practice patterns. The 37-item questionnaire included AT and institution demographics, current concussion management policies, and response to the Arrington settlement with a specific focus on the five settlement requirements. An overall compliance score on the five requirements, compliance on the individual requirements, and concussion management practices are reported with descriptives. Regression was used to identify specific predictors of both overall and individual settlement requirements. An ANOVA compared compliance by NCAA division level. Being pressured to be non-compliant was assessed between sexes by a chi-square. There were 223 respondents (21.8%), and overall compliance was high (4.1 ± 0.7) with the five required Arrington Settlement components. Settlement requirement 1, pre-season baseline testing, and requirement 5, presence of trained personnel at all contact sport practices, had the lowest compliance rates at 44.8% and 73.3%, respectively. The number of sports the institution offered was the only significant predictor of each requirement. There was no difference in compliance between NCAA divisions. Although the overall rate of being non-compliant pressure was low (13.8%), females were 3.28x more likely report being pressured than males. NCAA institutions are generally compliant with the Arrington settlement; however, lack of clarity in the requirements, particularly requirement 1, raises potential concerns. Concussion management practices continue to incorporate multifaceted approaches and are largely consistent with current best practices.
Collapse
Affiliation(s)
- Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, DE, USA
| | | | - Katherine J Hunzinger
- Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Katelyn Costantini
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| |
Collapse
|
5
|
Lempke LB, Caccese JB, Syrydiuk RA, Buckley TA, Chrisman SPD, Clugston JR, Eckner JT, Ermer E, Esopenko C, Jain D, Kelly LA, Memmini AK, Mozel AE, Putukian M, Susmarski A, Pasquina PF, McCrea MA, McAllister TW, Broglio SP, Master CL. Female Collegiate Athletes' Concussion Characteristics and Recovery Patterns: A Report from the NCAA-DoD CARE Consortium. Ann Biomed Eng 2023:10.1007/s10439-023-03367-y. [PMID: 37751028 DOI: 10.1007/s10439-023-03367-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023]
Abstract
Concussion has been described in the United States (US) collegiate student-athlete population, but female-specific findings are often underrepresented and underreported. Our study aimed to describe female collegiate student-athletes' initial injury characteristics and return to activity outcomes following concussion. Female collegiate student-athletes (n = 1393) from 30-US institutions experienced a concussion and completed standardized, multimodal concussion assessments from pre-injury through unrestricted return to play (uRTP) in this prospective, longitudinal cohort study. Initial injury presentation characteristics, assessment, and return to activity outcomes [<48-h (acute), return to learn, initiate return to play (iRTP), uRTP] were collected. We used descriptive statistics to report injury characteristics, return to activity outcomes, and post-injury assessment performance change categorization (worsened, unchanged, improved) based on change score confidence rank criteria across sport contact classifications [contact (n = 661), limited (n = 446), non-contact (n = 286)]. The median (25th to 75th percentile) days to return to learn was 6.0 (3.0-10.0), iRTP was 8.1 (4.8-13.8), and uRTP was 14.8 (9.9-24.0), but varied by contact classification. Across contact levels, the majority experienced worse SCAT total symptom severity (72.8-82.6%), ImPACT reaction time (91.2-92.6%), and BSI-18 total score (45.2-51.8%) acutely relative to baseline, but unchanged BESS total errors (58.0-60.9%), SAC total score (71.5-76.1%), and remaining ImPACT domains (50.6-66.5%). Our findings provide robust estimates of the typical female collegiate student-athlete presentation and recovery trajectory following concussion, with overall similar findings to the limited female collegiate student-athlete literature. Overall varying confidence rank classification was observed acutely. Our findings provide clinically-relevant insights for athletes, clinicians, researchers, and policymakers to inform efforts specific to females experiencing concussion.
Collapse
Affiliation(s)
- Landon B Lempke
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA.
- Exercise and Sport Science Initiative, University of Michigan, Ann Arbor, MI, USA.
- , 830 North University Avenue, Suite 4000, Ann Arbor, MI, 48109, USA.
| | - Jaclyn B Caccese
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Reid A Syrydiuk
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Sara P D Chrisman
- Division of Adolescent Medicine, University of Washington, Seattle, WA, USA
| | - James R Clugston
- Departments of Community Health Family Medicine and Neurology, University of Florida, Gainesville, FL, USA
| | - James T Eckner
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Elsa Ermer
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Divya Jain
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Louise A Kelly
- Department of Exercise Science, California Lutheran University, Thousand Oaks, CA, USA
| | - Allyssa K Memmini
- Department of Health, Exercise & Sports Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Anne E Mozel
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Adam Susmarski
- Department of Orthopedics and Sports Medicine, United States Naval Academy, Annapolis, MD, USA
| | - Paul F Pasquina
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Michael A McCrea
- Center for Neurotrauma Research, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - Christina L Master
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Orthopaedics and Sports Medicine, Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| |
Collapse
|
6
|
Sidhar K, Baugh CM, Wilson JC, Spittler J, Walker GA, Armento AM, Howell DR. Socioeconomic status and injury history in adolescent athletes: Lower family affluence is associated with a history of concussion. J Clin Transl Res 2022; 8:292-298. [PMID: 35975186 PMCID: PMC9373721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 10/26/2022] Open
Abstract
Background While healthcare and health outcome disparities have been studied across a variety of different injuries, their relation to concussion incidence and management are relatively understudied. Aim The aim of this study was to evaluate the association between history of concussion or musculoskeletal injury, and family affluence and/or school-level measures of socioeconomic status. Methods We conducted a cross-sectional study of adolescent athletes in a local school district. Adolescent athletes (n = 192; mean age = 15.3, SD = 1.6 years; 49% female), who presented for a pre-participation physical evaluation reported concussion and injury history, and family affluence scale (FAS) scores. We also examined the percent of students on free/reduced lunch at each school compared to state averages. Independent variables, individual FAS score and school-based marker of socioeconomic status, were compared between those with and without a history of concussion and time-loss musculoskeletal injury. Results Of the participants, 40 (21%) reported a history of concussion. Athletes with a concussion history had significantly lower FAS scores than athletes without a history of concussion (mean difference = 0.7, 95%CI = 0.1, 1.4; P = 0.027). There was no significant difference in FAS scores between those with and without a history of time-loss musculoskeletal injury (mean difference = 0.0, 95% CI = -0.5, 0.5; P = 0.97). Athletes with a history of concussion had a higher proportion of a prior time-loss musculoskeletal injury (68% vs. 32%; P < 0.001). After adjusting for age, school free-reduced lunch rate, and history of musculoskeletal injury, a lower FAS score was associated with concussion history (adjusted odds ratio = 0.79; 95% CI = 0.64, 0.96; P = 0.019). Concussion and musculoskeletal injury were not associated with school-level markers of socioeconomic status. Conclusion Lower individual measures, but not school-level measures, of socioeconomic status were associated with a history of concussion in our sample of adolescent athletes. Relevance for Patients Enhance providers' understanding of how socioeconomic factors may impact concussion history and empower providers to adequately screen for and provide concussion education to mitigate disparities.
Collapse
Affiliation(s)
- Kartik Sidhar
- 1Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA,2Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Christine M. Baugh
- 3Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO, USA,4Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Julie C. Wilson
- 1Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA,2Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA,5Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jack Spittler
- 6Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gregory A. Walker
- 1Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA,2Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Aubrey M. Armento
- 1Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA,2Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - David R. Howell
- 1Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA,2Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA,Corresponding author: David R. Howell, Sports Medicine Center, Children’s Hospital Colorado; Department of Orthopedics, University of Colorado School of Medicine. Address: 13123 E. 16th Avenue, B060 Aurora, CO 80045. Tel: +1 7207771502. E-mail:
| |
Collapse
|
7
|
Sheehy DJ, Toohey LA, Panagodage Perera NK, Drew MK. Despite maintaining a high daily training availability, a quarter of athletes start the season injured and three quarters experience injury in an Australian State Academy of Sport. J Sci Med Sport 2021; 25:139-145. [PMID: 34556402 DOI: 10.1016/j.jsams.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/03/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To 1) investigate the incidence, prevalence, burden and characteristics of injuries; and 2) explore the frequency of physiotherapy and medical servicing for elite sports academy athletes over a 12-month season. DESIGN Prospective cohort study. METHODS Medical attention and time-loss injuries were prospectively recorded by Physiotherapy and Medical (Sports Physician) staff for 94 athletes (72.3% females). The number of linked physiotherapy and medical servicing appointments was also recorded. Injury incidence rates (IIR), point and period prevalence, and injury burden were calculated and compared by athlete gender, sport, and categorisation (performance level) using incidence rate ratios (IRR). RESULTS The number of injuries reported was 193 in 71 (75.5%) athletes. The IIR was 2.1 (95%CI: 1.8 to 2.4) injuries per 365 days, with no gender difference observed (IRR: 1.1, 0.8 to 1.4). The injury burden was 43.5 (95%CI: 37.8 to 50.1) days absent per 365 days. More than one-quarter (point prevalence, 26.6%) of athletes commenced the season with an injury. In-season injury risk was 2.5 fold greater in athletes who started the season with an injury compared to athletes who started the season without an injury (IRR: 2.5, 1.9 to 3.4). The majority (81.2%) of the 1164 appointments recorded were physiotherapy, with an overall 4.3:1.0 physiotherapy to medical appointment ratio. CONCLUSIONS One in four athletes began the elite pathway season with a pre-existing injury, while also demonstrating a 2.5 fold greater risk of subsequent injury in the scholarship period. Sports should not assume their athletes are uninjured at the beginning of their scholarship. Injury profiles, and physiotherapy and medical servicing varied across sports. To reduce health as a barrier in the successful transition of talented young athletes to elite athletes, injury management strategies at the commencement of recruitment and throughout the scholarship should be prioritised in the development pathway.
Collapse
Affiliation(s)
- Daniel J Sheehy
- ACT Academy of Sport, Australia; Sports Medicine, Australian Institute of Sport, Australia.
| | - Liam A Toohey
- Athlete Availability Program, Australian Institute of Sport, Australia
| | | | - Michael K Drew
- Athlete Availability Program, Australian Institute of Sport, Australia
| |
Collapse
|
8
|
A Time for Clinical Transformation: Emerging Implications From COVID-19 for Athlete Transition Research and Clinical Practice. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2021. [DOI: 10.1123/jcsp.2021-0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The COVID-19 pandemic has resulted in changes to the structure of sport and the experiences of athletes. In this commentary, we consider how these changes, including schedule disruptions and the early termination of careers, have contributed to a reconsideration of how athlete transition should be defined, examined, and intervened upon. We outline our rationale for this proposed reconfiguration, including implications for researchers and practitioners working with athletes during the COVID-19 pandemic and beyond. For researchers, we recommend updating the transition definition, reconsidering the measurement of salient transition-related variables, and utilizing study designs/methods that best facilitate this work. For practitioners, we recommend considering the dynamic nature of transition within holistic athlete care, building momentum on mental health destigmatization achieved during the pandemic, athlete transition education, and clinician advocacy for transition-related resources for athletes. Ultimately, we hope this work will spark continued innovations in athlete transition research and practice moving forward.
Collapse
|
9
|
D'Alonzo BA, Bretzin AC, Chandran A, Boltz AJ, Robison HJ, Collins CL, Morris SN. Epidemiology of Injuries in National Collegiate Athletic Association Men's Lacrosse: 2014-2015 Through 2018-2019. J Athl Train 2021; 56:758-765. [PMID: 34280286 DOI: 10.4085/1062-6050-612-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The popularity of National Collegiate Athletic Association (NCAA) men's lacrosse has been steadily increasing since the early 1980s. BACKGROUND Injury surveillance is an important tool to aid in identifying emerging patterns of sport-related injury in NCAA men's lacrosse. METHODS Injury data collected from a sample of men's lacrosse teams through the NCAA Injury Surveillance Program for the academic years 2014-2015 through 2018-2019 were analyzed. Athlete exposures were estimated and computed based on collected exposure data. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated to estimate differences in injury rates. RESULTS The overall injury rate was 4.90 per 1000 athlete exposures (AEs), and the competition injury rate was higher than the practice injury rate (IRR = 2.59; 95% CI = 2.35, 2.84). The overall preseason injury rate was higher than the regular and postseason injury rates. The most reported injuries were concussions (8.0%), ankle sprains (7.7%), and hamstring tears (6.9%). CONCLUSIONS Study findings were comparable with existing epidemiological evidence. The overall burden of concussions and lower extremity injuries warrant further attention in this population.
Collapse
Affiliation(s)
| | - Abigail C Bretzin
- Penn Injury Science Center, University of Pennsylvania, Philadelphia
| | | | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Sarah N Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| |
Collapse
|
10
|
Chandran A, Morris SN, Boltz AJ, Robison HJ, Collins CL. Epidemiology of Injuries in National Collegiate Athletic Association Women's Cross-Country: 2014-2015 Through 2018-2019. J Athl Train 2021; 56:622-628. [PMID: 34280273 DOI: 10.4085/1062-6050-395-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Women's cross-country is a thriving sport at the National Collegiate Athletic Association (NCAA) level with over 1000 sponsored programs association-wide. BACKGROUND Routine examinations of women's cross-country injuries are important for identifying emerging time trends in injury incidence and outcomes. METHODS Exposure and injury data collected in the NCAA Injury Surveillance Program from 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. RESULTS The overall injury rate was 3.96 per 1000 athlete-exposures. Most reported injuries were inflammatory conditions (33.6%), strains (17.7%), and fractures (9.1%). The most commonly reported injuries were medial tibial stress syndrome (10.0%) and lateral ligament complex tears (ankle sprains; 4.2%). SUMMARY Findings of this study were not entirely consistent with existing evidence. Future studies are needed to examine the nature of inflammatory conditions and fractures in this population, as well as temporal patterns in commonly reported injuries.
Collapse
Affiliation(s)
- Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Sarah N Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| |
Collapse
|
11
|
Lempke LB, Chandran A, Boltz AJ, Robison HJ, Collins CL, Morris SN. Epidemiology of Injuries in National Collegiate Athletic Association Women's Basketball: 2014-2015 Through 2018-2019. J Athl Train 2021; 56:674-680. [PMID: 34280270 DOI: 10.4085/1062-6050-466-20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Frequent inspection of sports-related injury epidemiology among National Collegiate Athletic Association (NCAA) women's basketball student-athletes is valuable for identifying injury-related patterns. BACKGROUND Emerging patterns in epidemiology of NCAA women's basketball injuries are unknown though general sports medicine practices, and playing rules and regulations have evolved in recent years. METHODS Athlete exposures (AEs) and injury incidence data were reported to the NCAA Injury Surveillance Program between 2014-2015 and 2018-2019. Injury counts, rates, and proportions were used to examine injury characteristics, and injury rate ratios (IRRs) were used to assess injury rate differences. RESULTS Practice and competition injury rates were 5.93 and 10.35 per 1000 AEs, respectively. Preseason injury rates were higher than regular (IRR = 1.41; 95% CI = 1.31, 1.53) and postseason (IRR = 3.12; 95% CI = 2.39, 4.07). Ankle sprains (14.3%), concussions (7.5%), and anterior cruciate ligament tears (2.5%) were the most commonly reported injuries. SUMMARY Higher rates of practice and competition injuries, as well as ankle sprains, were observed relative to previous reports; continuous monitoring is necessary to identify potential contributing factors to these trends.
Collapse
Affiliation(s)
- Landon B Lempke
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Sarah N Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| |
Collapse
|
12
|
Bretzin AC, D'Alonzo BA, Chandran A, Boltz AJ, Robison HJ, Collins CL, Morris SN. Epidemiology of Injuries in National Collegiate Athletic Association Women's Lacrosse: 2014-2015 Through 2018-2019. J Athl Train 2021; 56:750-757. [PMID: 34280267 DOI: 10.4085/1062-6050-613-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Lacrosse is an increasingly popular sport; the number of teams participating in collegiate women's lacrosse has increased by 21.4% in the past 5 years. BACKGROUND The growth of National Collegiate Athletic Association women's lacrosse, coupled with the ongoing discussions surrounding protective equipment, necessitates further epidemiologic studies in this population. METHODS Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios with 95% CIs were used to examine differential injury rates. RESULTS The overall injury rate was 4.99 per 1000 athlete exposures. Less than 30% of injuries were time-loss injuries; injuries were most commonly attributed to noncontact (26.6%) and overuse (25.2%) mechanisms. The most commonly reported specific injuries were lateral ligament complex tears (ankle sprains; 9.1%), concussions (7.2%), and hamstring tears (3.8%). SUMMARY Findings from this study were consistent with the existing epidemiologic evidence in previous studies. Injury incidence in practices, in preseason, and as a result of player contact warrant further attention in this population.
Collapse
Affiliation(s)
- Abigail C Bretzin
- Department of Biostatistics, Epidemiology and Informatics, Penn Injury Science Center, University of Pennsylvania, Philadelphia
| | - Bernadette A D'Alonzo
- Department of Biostatistics, Epidemiology and Informatics, Penn Injury Science Center, University of Pennsylvania, Philadelphia
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Adrian J Boltz
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Hannah J Robison
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Sarah N Morris
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| |
Collapse
|
13
|
Master CL, Katz BP, Arbogast KB, McCrea MA, McAllister TW, Pasquina PF, Lapradd M, Zhou W, Broglio SP. Differences in sport-related concussion for female and male athletes in comparable collegiate sports: a study from the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium. Br J Sports Med 2020; 55:1387-1394. [PMID: 33355211 DOI: 10.1136/bjsports-2020-103316] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine sex differences in sport-related concussion (SRC) across comparable sports. METHODS Prospective cohort of collegiate athletes enrolled between 2014 and 2017 in the Concussion Assessment, Research and Education Consortium study. RESULTS Among 1071 concussions (females=615; 57.4%), there was no difference in recovery (median days to full return to play) (females=13.5 (IQR 9.0, 23.1) vs males=11.8 (IQR 8.1, 19.0), p=0.96). In subgroup analyses, female recovery was longer in contact (females=12.7 days (IQR 8.8, 21.4) vs males=11.0 days (IQR 7.9, 16.2), p=0.0021), while male recovery was longer in limited contact sports (males=16.9 days (IQR 9.7, 101.7) vs females=13.8 days (IQR 9.1, 22.0), p<0.0001). There was no overall difference in recovery among Division I schools (females=13.7 (IQR 9.0, 23.1) vs males=12.2 (IQR 8.2 19.7), p=0.5), but females had longer recovery at the Division II/III levels (females=13.0 (IQR 9.2, 22.7) vs males=10.6 (IQR 8.1, 13.9), p=0.0048). CONCLUSION Overall, no difference in recovery between sexes across comparable women's and men's sports in this collegiate cohort was found. However, females in contact and males in limited contact sports experienced longer recovery times, while females had longer recovery times at the Division II/III level. These disparate outcomes indicate that, while intrinsic biological sex differences in concussion recovery may exist, important, modifiable extrinsic factors may play a role in concussion outcomes.
Collapse
Affiliation(s)
- Christina L Master
- Orthopaedics and Sports Medicine, Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA .,Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Barry P Katz
- Biostatisics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kristy B Arbogast
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Michael A McCrea
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Thomas W McAllister
- Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Paul F Pasquina
- Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Michelle Lapradd
- Biostatisics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Wenxian Zhou
- Biostatisics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | | |
Collapse
|
14
|
Baugh CM, Kroshus E, Meehan WP, McGuire TG, Hatfield LA. Accuracy of US College Football Players' Estimates of Their Risk of Concussion or Injury. JAMA Netw Open 2020; 3:e2031509. [PMID: 33372973 PMCID: PMC7772718 DOI: 10.1001/jamanetworkopen.2020.31509] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Despite increased concern about the health consequences of contact sports, little is known about athletes' understanding of their own risk of sports-related injury. OBJECTIVE To assess whether college football players accurately estimate their risk of concussion and nonconcussion injury and to identify characteristics of athletes who misestimate their injury risk. DESIGN, SETTING, AND PARTICIPANTS In this survey study, questionnaires were given to 296 current college football players on 4 teams from the 3 of the 5 most competitive conferences of the US National Collegiate Athletic Association. Surveys were conducted between February and May 2017. Data were analyzed from June 2017 through July 2020. MAIN OUTCOMES AND MEASURES Multiple approaches were taken to compare athlete perceptions of their risks of concussion and nonconcussion injury with individual probabilities of these risks, which were modeled using logistic regression. RESULTS Of 296 male college-aged athletes from 4 football teams who participated in the survey, 265 (89%) answered all questions relevant for this study. Participating teams were similar to nonparticipating teams across nearly all measured characteristics. One hundred athletes (34%) had sustained 1 or more concussions, and 197 (68% of the 289 who responded to the question) had sustained 1 or more injuries in the previous football season. Logistic regression models of single-season injury and concussion had reasonably good fit (area under the curve, 0.75 and 0.73, respectively). Of the 265 participants for whom all relevant data were available, 111 (42%) underestimated their risk of concussion (χ2 = 98.6; P = .003). A similar proportion of athletes (113 [43%]) underestimated their risk of injury, although this was not statistically significant (χ2 = 34.0; P = .09). An alternative analytic strategy suggested that 241 athletes (91%) underestimated their risk of injury (Wilcoxon statistic, 7865; P < .001) and 167 (63%) underestimated their risk of concussion (Wilcoxon statistic, 26 768; P < .001). CONCLUSIONS AND RELEVANCE The findings of this survey study suggest that college football players may underestimate their risk of injury and concussion. The implications for informed participation in sport are unclear given that people generally underestimate health risks. It is necessary to consider whether athletes are sufficiently informed and how much risk is acceptable for an athlete to participate in a sport.
Collapse
Affiliation(s)
- Christine M. Baugh
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
- Center for Bioethics and Humanities, University of Colorado Denver Anschutz Medical Campus, Aurora
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora
| | - Emily Kroshus
- Department of Pediatrics, University of Washington, Seattle
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington
| | - William P. Meehan
- Sports Concussion Clinic, Department of Sports Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Thomas G. McGuire
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Laura A. Hatfield
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
15
|
Baugh CM. Athlete Concussion Reporting: It Is Time to Think Bigger. J Adolesc Health 2020; 66:643-644. [PMID: 32473716 DOI: 10.1016/j.jadohealth.2020.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/17/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Christine M Baugh
- Division of General Internal Medicine, Center for Bioethics and Humanities, University of Colorado School of Medicine, Aurora, Colorado
| |
Collapse
|