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Kerr ZY, Chandran A, Nedimyer AK, Rothschild AE, Kay MC, Gildner P, Byrd KH, Haarbauer-Krupa JK, Register-Mihalik JK. Use of sport-related concussion information sources among parents of United States middle school children. J Sport Health Sci 2022; 11:716-724. [PMID: 32417468 PMCID: PMC9729916 DOI: 10.1016/j.jshs.2020.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/14/2020] [Accepted: 03/16/2020] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Parents may use various information sources to obtain information about sport-related concussions (SRC). This study examined SRC-related information sources used by parents of United States middle school children (age: 10-15 years). METHODS A panel of 1083 randomly selected U.S. residents, aged ≥18 years and identifying as parents of middle school children, completed an online questionnaire capturing parental and child characteristics, and utilization and perceived trustworthiness of various sources of SRC-related information. Multivariable logistic regression models identified factors associated with utilizing each source. Adjusted odds ratios (OR) with 95% confidence intervals (95%CIs) excluding 1.00 were deemed significant. RESULTS Doctors/healthcare providers (49.9%) and other healthcare-related resources (e.g., Centers for Disease Control and Prevention, WebMD) (37.8%) were common SRC-related information sources; 64.0% of parents utilized ≥1 of these sources. Both sources were considered "very" or "extremely" trustworthy for SRC-related information among parents using these sources (doctors/healthcare providers: 89.8%; other healthcare-related resources: 70.9%). A 10-year increase in parental age was associated with higher odds of utilizing doctors/healthcare providers (adjusted odd ratio (ORadjusted) = 1.09, 95%CI: 1.02-1.16) and other healthcare-related resources (ORadjusted = 1.11, 95%CI: 1.03-1.19). The odds of utilizing doctors/healthcare providers (ORadjusted = 0.58, 95%CI: 0.40-0.84) and other healthcare-related resources (ORadjusted = 0.64, 95%CI: 0.44-0.93) were lower among parents whose middle school children had concussion histories versus the parents of children who did not have concussion histories. CONCLUSION One-third of parents did not report using doctors/healthcare providers or other healthcare-related resources for SRC-related information. Factors associated with underutilization of these sources may be targets for future intervention. Continuing education for healthcare providers and educational opportunities for parents should highlight accurate and up-to-date SRC-related information.
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Affiliation(s)
- Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA.
| | - Avinash Chandran
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Aliza K Nedimyer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Human Movement Science Curriculum, University of North Carolina, Chapel Hill, NC 27599-8700, USA
| | - Allison E Rothschild
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7400, USA
| | - Melissa C Kay
- School of Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - K Hunter Byrd
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Juliet K Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Johna K Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
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Haarbauer-Krupa JK, Register-Mihalik JK, Nedimyer AK, Chandran A, Kay MC, Gildner P, Kerr ZY. Factors associated with concussion symptom knowledge and attitudes towards concussion care-seeking among parents of children aged 5-10 years. J Safety Res 2021; 78:203-209. [PMID: 34399916 PMCID: PMC9139453 DOI: 10.1016/j.jsr.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/26/2021] [Accepted: 05/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Understanding parents' concussion-related knowledge and attitudes will contribute to the development of strategies that aim to improve concussion prevention and sport safety for elementary school children. This study investigated the association between parent- and child-related factors and concussion symptom knowledge and care-seeking attitudes among parents of elementary school children (aged 5-10 years). METHODS Four hundred parents of elementary school children completed an online questionnaire capturing parental and child characteristics; concussion symptom knowledge (25 items, range = 0-50; higher = better knowledge); and concussion care-seeking attitudes (five 7-point scale items, range = 5-35; higher = more positive attitudes). Multivariable ordinal logistic regression models identified predictors of higher score levels. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) excluding 1.00 were deemed statistically significant. RESULTS Select parent and child characteristics were associated with higher score levels for both outcomes. For example, odds of better knowledge level in parents were higher with increased age (10-year increase aOR = 1.59; 95% CI = 1.10-2.28), among females (aOR = 3.90; 95% CI = 2.27-6.70), and among white/non-Hispanics (aOR = 1.79; 95%CI = 1.07-2.99). Odds of more positive concussion care-seeking attitude levels were higher among parents with a college degree (aOR = 1.98; 95%CI = 1.09-3.60). Child sports participation was not associated with higher score levels for either outcome. CONCLUSIONS Certain elementary school parent characteristics were associated with parents' concussion symptom knowledge and care-seeking attitudes. While the findings suggest providing parents with culturally and demographically relevant concussion education might be helpful, they also emphasize the importance of ensuring education/prevention regardless of their children's sports participation. Practical Applications: Pediatric healthcare providers and elementary schools offer an optimal community-centered location to reach parents with this information within various communities.
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Affiliation(s)
- Juliet K Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Johna K Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Aliza K Nedimyer
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, USA
| | - Melissa C Kay
- School of Health Professions, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Kerr ZY, Nedimyer AK, Kay MC, Chandran A, Gildner P, Byrd KH, Haarbauer-Krupa JK, Register-Mihalik JK. Factors associated with concussion-symptom knowledge and attitudes toward concussion care seeking in a national survey of parents of middle-school children in the US. J Sport Health Sci 2021; 10:113-121. [PMID: 32919064 PMCID: PMC7987565 DOI: 10.1016/j.jshs.2020.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/18/2020] [Accepted: 08/04/2020] [Indexed: 06/06/2023]
Abstract
BACKGROUND Developing appropriate concussion prevention and management paradigms in middle school (MS) settings requires understanding parents' general levels of concussion-related knowledge and attitudes. This study examined factors associated with concussion-symptom knowledge and care-seeking attitudes among parents of MS children (aged 10-15 years). METHODS A panel of 1224 randomly selected U.S. residents, aged ≥ 18 years and identifying as parents of MS children, completed an online questionnaire capturing parental and child characteristics. The parents' concussion-symptom knowledge was measured using 25 questions, with possible answers being "yes", "maybe", and "no". Correct answers earned 2 points, "maybe" answers earned 1 point, and incorrect answers earned 0 point (range: 0-50; higher scores = better knowledge). Concussion care-seeking attitudes were also collected using five 7-point scale items (range: 5-35; higher scores = more positive attitudes). Multivariable ordinal logistic regression models identified predictors of higher scores. Models met proportional odds assumptions. Adjusted odds ratios (aORs) with 95% confidence intervals (95%CIs) (excluding 1.00) were deemed statistically significant. RESULTS Median scores were 39 (interquartile range: 32-44) for symptom knowledge and 32 (interquartile range: 28-35) for care-seeking attitude. In multivariable models, odds of better symptom knowledge were higher in women vs. men (aOR = 2.28; 95%CI: 1.71-3.05), white/non-Hispanics vs. other racial or ethnic groups (aOR = 1.88; 95%CI: 1.42-2.49), higher parental age (10-year-increase aOR = 1.47; 95%CI: 1.26-1.71), and greater competitiveness (10%-scale-increase aOR = 1.24; 95%CI: 1.13-1.36). Odds of more positive care-seeking attitudes were higher in white/non-Hispanics vs. other racial or ethnic groups (aOR = 1.45; 95%CI: 1.06-1.99) and in older parental age (10-year-increase aOR = 1.24; 95%CI: 1.05-1.47). CONCLUSION Characteristics of middle school children's parents (e.g., sex, race or ethnicity, age) are associated with their concussion-symptom knowledge and care-seeking attitudes. Parents' variations in concussion knowledge and attitudes warrant tailored concussion education and prevention.
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Affiliation(s)
- Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA.
| | - Aliza K Nedimyer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Human Movement Science Curriculum, University of North Carolina, Chapel Hill, NC 27599-8700, USA
| | - Melissa C Kay
- School of Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN 46202, USA
| | - Paula Gildner
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - K Hunter Byrd
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Juliet K Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Johna K Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA; Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, NC 27599-8700, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27510, USA
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Lowry R, Haarbauer-Krupa JK, Breiding MJ, Thigpen S, Rasberry CN, Lee SM. Concussion and Academic Impairment Among U.S. High School Students. Am J Prev Med 2019; 57:733-740. [PMID: 31753255 PMCID: PMC10956705 DOI: 10.1016/j.amepre.2019.08.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Sports and physical activities are a frequent cause of traumatic brain injury, primarily concussions, among adolescents. These concussions may adversely affect students' ability to learn and impair academic achievement in educational settings. METHODS The 2017 Youth Risk Behavior Survey, conducted among a nationally representative sample of 14,765 U.S. high school students, was analyzed in 2018 to examine associations between self-reported sports- and physical activity-related concussions and symptoms of cognitive impairment (difficulty concentrating, remembering, or making decisions) and self-reported academic grades (mostly A's=4.0, mostly B's=3.0, mostly C's=2.0, mostly D's=1.0, mostly F's=0.0). Adjusted prevalence ratio and the difference in self-reported estimated grade point average were adjusted for sex, race/ethnicity, grade, and athlete status (participation on sports teams) and considered statistically significant if p<0.05. RESULTS Male students were more likely than female students (17.1% vs 13.0%), and athletes were more likely than nonathletes (21.4% vs 7.6%) to have a self-reported sports- and physical activity-related concussion in the 12 months preceding the survey. Students with a reported sports- and physical activity-related concussion were more likely than students without one to report symptoms of cognitive impairment regardless of whether they were male (adjusted prevalence ratio=1.49), female (adjusted prevalence ratio=1.37), athletes (adjusted prevalence ratio=1.45), or nonathletes (adjusted prevalence ratio=1.42). Self-reported grade point averagedecreased significantly from 3.14 among students who reported no concussions (referent), to 3.04 among students who reported a single concussion, and 2.81 among students who reported ≥2 concussions. CONCLUSIONS School-based programs are needed to monitor students' academic performance and provide educational support and resources to promote academic success following a concussion.
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Affiliation(s)
- Richard Lowry
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
| | - Juliet K Haarbauer-Krupa
- Traumatic Brain Injury Team, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Matthew J Breiding
- Traumatic Brain Injury Team, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Sally Thigpen
- Division of Analysis, Research, and Practice Integration, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Catherine N Rasberry
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Sarah M Lee
- School Health Branch, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
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Kowalski RG, Haarbauer-Krupa JK, Bell JM, Corrigan JD, Hammond FM, Torbey MT, Hofmann MC, Dams-O'Connor K, Miller AC, Whiteneck GG. Acute Ischemic Stroke After Moderate to Severe Traumatic Brain Injury: Incidence and Impact on Outcome. Stroke 2017; 48:1802-1809. [PMID: 28611087 DOI: 10.1161/strokeaha.117.017327] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/14/2017] [Accepted: 05/08/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Traumatic brain injury (TBI) leads to nearly 300 000 annual US hospitalizations and increased lifetime risk of acute ischemic stroke (AIS). Occurrence of AIS immediately after TBI has not been well characterized. We evaluated AIS acutely after TBI and its impact on outcome. METHODS A prospective database of moderate to severe TBI survivors, admitted to inpatient rehabilitation at 22 Traumatic Brain Injury Model Systems centers and their referring acute-care hospitals, was analyzed. Outcome measures were AIS incidence, duration of posttraumatic amnesia, Functional Independence Measure, and Disability Rating Scale, at rehabilitation discharge. RESULTS Between October 1, 2007, and March 31, 2015, 6488 patients with TBI were enrolled in the Traumatic Brain Injury Model Systems National Database. One hundred and fifty-nine (2.5%) patients had a concurrent AIS, and among these, median age was 40 years. AIS was associated with intracranial mass effect and carotid or vertebral artery dissection. High-velocity events more commonly caused TBI with dissection. AIS predicted poorer outcome by all measures, accounting for a 13.3-point reduction in Functional Independence Measure total score (95% confidence interval, -16.8 to -9.7; P<0.001), a 1.9-point increase in Disability Rating Scale (95% confidence interval, 1.3-2.5; P<0.001), and an 18.3-day increase in posttraumatic amnesia duration (95% confidence interval, 13.1-23.4; P<0.001). CONCLUSIONS Ischemic stroke is observed acutely in 2.5% of moderate to severe TBI survivors and predicts worse functional and cognitive outcome. Half of TBI patients with AIS were aged ≤40 years, and AIS patients more often had cervical dissection. Vigilance for AIS is warranted acutely after TBI, particularly after high-velocity events.
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Affiliation(s)
- Robert G Kowalski
- From the Research Department, Craig Hospital, Englewood, CO (R.G.K., M.C.H., G.G.W.); Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA (J.K.H.-K., J.M.B.); Department of Physical Medicine and Rehabilitation (J.D.C.), and Departments of Neuroscience, Neurology and Neurological Surgery, Division of Cerebrovascular Disease and Neurocritical Care (M.T.T.), Ohio State University Wexner Medical Center, Columbus; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (F.M.H.); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (K.D.-O.); and National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services (A.C.M.).
| | - Juliet K Haarbauer-Krupa
- From the Research Department, Craig Hospital, Englewood, CO (R.G.K., M.C.H., G.G.W.); Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA (J.K.H.-K., J.M.B.); Department of Physical Medicine and Rehabilitation (J.D.C.), and Departments of Neuroscience, Neurology and Neurological Surgery, Division of Cerebrovascular Disease and Neurocritical Care (M.T.T.), Ohio State University Wexner Medical Center, Columbus; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (F.M.H.); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (K.D.-O.); and National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services (A.C.M.)
| | - Jeneita M Bell
- From the Research Department, Craig Hospital, Englewood, CO (R.G.K., M.C.H., G.G.W.); Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA (J.K.H.-K., J.M.B.); Department of Physical Medicine and Rehabilitation (J.D.C.), and Departments of Neuroscience, Neurology and Neurological Surgery, Division of Cerebrovascular Disease and Neurocritical Care (M.T.T.), Ohio State University Wexner Medical Center, Columbus; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (F.M.H.); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (K.D.-O.); and National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services (A.C.M.)
| | - John D Corrigan
- From the Research Department, Craig Hospital, Englewood, CO (R.G.K., M.C.H., G.G.W.); Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA (J.K.H.-K., J.M.B.); Department of Physical Medicine and Rehabilitation (J.D.C.), and Departments of Neuroscience, Neurology and Neurological Surgery, Division of Cerebrovascular Disease and Neurocritical Care (M.T.T.), Ohio State University Wexner Medical Center, Columbus; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (F.M.H.); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (K.D.-O.); and National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services (A.C.M.)
| | - Flora M Hammond
- From the Research Department, Craig Hospital, Englewood, CO (R.G.K., M.C.H., G.G.W.); Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA (J.K.H.-K., J.M.B.); Department of Physical Medicine and Rehabilitation (J.D.C.), and Departments of Neuroscience, Neurology and Neurological Surgery, Division of Cerebrovascular Disease and Neurocritical Care (M.T.T.), Ohio State University Wexner Medical Center, Columbus; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (F.M.H.); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (K.D.-O.); and National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services (A.C.M.)
| | - Michel T Torbey
- From the Research Department, Craig Hospital, Englewood, CO (R.G.K., M.C.H., G.G.W.); Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA (J.K.H.-K., J.M.B.); Department of Physical Medicine and Rehabilitation (J.D.C.), and Departments of Neuroscience, Neurology and Neurological Surgery, Division of Cerebrovascular Disease and Neurocritical Care (M.T.T.), Ohio State University Wexner Medical Center, Columbus; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (F.M.H.); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (K.D.-O.); and National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services (A.C.M.)
| | - Melissa C Hofmann
- From the Research Department, Craig Hospital, Englewood, CO (R.G.K., M.C.H., G.G.W.); Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA (J.K.H.-K., J.M.B.); Department of Physical Medicine and Rehabilitation (J.D.C.), and Departments of Neuroscience, Neurology and Neurological Surgery, Division of Cerebrovascular Disease and Neurocritical Care (M.T.T.), Ohio State University Wexner Medical Center, Columbus; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (F.M.H.); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (K.D.-O.); and National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services (A.C.M.)
| | - Kristen Dams-O'Connor
- From the Research Department, Craig Hospital, Englewood, CO (R.G.K., M.C.H., G.G.W.); Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA (J.K.H.-K., J.M.B.); Department of Physical Medicine and Rehabilitation (J.D.C.), and Departments of Neuroscience, Neurology and Neurological Surgery, Division of Cerebrovascular Disease and Neurocritical Care (M.T.T.), Ohio State University Wexner Medical Center, Columbus; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (F.M.H.); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (K.D.-O.); and National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services (A.C.M.)
| | - A Cate Miller
- From the Research Department, Craig Hospital, Englewood, CO (R.G.K., M.C.H., G.G.W.); Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA (J.K.H.-K., J.M.B.); Department of Physical Medicine and Rehabilitation (J.D.C.), and Departments of Neuroscience, Neurology and Neurological Surgery, Division of Cerebrovascular Disease and Neurocritical Care (M.T.T.), Ohio State University Wexner Medical Center, Columbus; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (F.M.H.); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (K.D.-O.); and National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services (A.C.M.)
| | - Gale G Whiteneck
- From the Research Department, Craig Hospital, Englewood, CO (R.G.K., M.C.H., G.G.W.); Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA (J.K.H.-K., J.M.B.); Department of Physical Medicine and Rehabilitation (J.D.C.), and Departments of Neuroscience, Neurology and Neurological Surgery, Division of Cerebrovascular Disease and Neurocritical Care (M.T.T.), Ohio State University Wexner Medical Center, Columbus; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (F.M.H.); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (K.D.-O.); and National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services (A.C.M.)
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