The influence of ADHD on recovery from sport concussion among collegiate athletes in the United States: LIMBIC MATARS consortium investigation

OBJECTIVE

The present study aimed to assess the potential influence of a diagnosis of ADHD on concussion recovery among collegiate athletes.

DESIGN

Retrospective and cross-sectional.

METHODS

Data were extracted retrospectively from medical records across LIMBIC MATARS member institutions (n = 11), representing 1,044 concussion cases among collegiate athletes. After exclusions, 406 concussions were included in our analysis (ADHD: n = 38, age = 20.2 ± 1.67 years, 18.4% female; No ADHD: n = 368, age = 19.8 ± 1.39 years, 40.1% female). Mann-Whitney U tests were used to compare days from injury to diagnosis, symptom resolution, and return to sport among athletes with and without ADHD.

RESULTS

No differences were observed for days from concussion until diagnosis (z = -0.33, p = 0.74), until days to symptom resolution (z = -1.30, p = 0.19), or days until return to sport (z = -0.68, p = 0.49); among concussion cases with or without a previously reported diagnosis of ADHD.

CONCLUSION

Our findings further expand the literature that suggests ADHD is not strongly associated with recovery trajectory following sport concussion in collegiate athletes. Future research should extend these findings to be inclusive of additional preexisting health conditions and moderating effects related to medication usage among diverse athlete levels.

The progression and mechanisms of mental illness symptoms in university student-athletes during the COVID-19 pandemic

A few studies have examined mental illness symptoms in university student-athletes during the COVID-19 pandemic, but the limited use of longitudinal design limits the understanding of the progression of these symptoms and the mechanisms by which they developed. The present research aims to describe the trajectory of variation of mental illness symptoms (anxiety, depression, alcohol consumption disorders, and eating disorders) throughout the pandemic, to test causality between perceived stress and symptoms, and to identify individual characteristics (sociodemographic, perceived stress, and social support) influencing the trajectories of mental illness symptoms. On three occasions during the pandemic, 211 university student-athletes were surveyed. Latent growth models and random intercept crossed-lagged panel models were performed. Results indicate that anxiety and depressive symptoms significantly decreased throughout the COVID-19 pandemic while alcohol consumption disorder symptoms significantly increased and eating disorder symptoms did not change significantly. Second, perceived stress was a significant cause of anxiety and depressive symptoms during this pandemic. Conversely, eating disorder symptoms significantly predicted perceived stress. Finally, average perceived stress and average social support availability throughout the COVID-19 pandemic, and identifying as a visible minority, significantly predicted the trajectory of depressive symptoms, allowing for the identification of a sub-population at higher risk. Based on these findings, teaching stress management strategies should be an essential component of programs to prevent mental illness symptoms in university student-athletes. Reducing environmental stressors and their consequences among this population should also be prioritised.

National Collegiate Athletic Association athletic trainers' response to the Arrington settlement: management, compliance, and practice patterns

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.

Racial identity and concussion diagnosis and recovery trajectories in collegiate athletes: a LIMBIC MATARS investigation

OBJECTIVE

To determine if there were concussion diagnosis and recovery disparities between collegiate athletes with Black and White racial identities.

DESIGN

Retrospective cohort study.

METHODS

Concussion information was extracted from NCAA athlete medical files at LIMBIC MATARS member institutions from the 2015-16' to 2019-20' academic years. A total of 410 concussions from 9 institutions were included that provided all independent (i.e. racial identity of Black or White) and dependent variable information (i.e. dates of injury, diagnosis, symptom resolution, and return to sport) that were analyzed using Mann-Whitney U tests. The sample consisted of 114 (27.8%) concussions sustained by Black athletes and 296 (72.1%) sustained by White athletes.

RESULTS

The overall sample had a median of 0 days between injury occurrence to diagnosis, 7 days to symptom resolution, and 12 days to return to sport. No significant timing differences were observed for concussion diagnosis (p = .14), symptom resolution (p = .39), or return to sport (p = 0.58) between collegiate athletes with Black versus White racial identities.

CONCLUSIONS

These findings may reflect equitable access to onsite sports medicine healthcare resources that facilitate concussion management in the collegiate sport setting. Future work should explore these associations with a larger and more diverse sample of collegiate athletes.

Research on sports reform in the network era based on educational psychology in the context of the COVID-19

Introduction

In the context of the continuous progress of the "Internet+" era and the exceptionally severe outbreak of the Covid-19, online education confronts many challenges and also brings unlimited development opportunities.

Methods

In this paper, taking six universities with sports majors in Chongqing as the research objects, we analyze the current situation and problems of the development and construction of online education resources for sports in colleges and universities by browsing the official websites of colleges and universities, investigating the cooperation between colleges and universities and Massive Open Online Course (MOOC), and conducting a questionnaire survey on students.

Results

The results show that it is necessary to innovate the traditional inefficient classroom teaching model based on the values of adapting to the characteristics of the "Internet+" era and learning advanced teaching rules, thus optimizing teaching effectiveness and fostering students' independent learning, thinking and innovation.

Discussion

We investigated students' online learning habits, their experience of using online education platform and the difficulties they encountered in the process, based on which two issues were raised: learning needs and learning experience.

The impact of the COVID-19 pandemic on perceptions of health, well-being, and college experience in Division III student-athletes

Objective: Determine the impact of the COVID-19 pandemic on student-athletes. Participants: Participants (n = 238) were Division III student-athletes (18-24yrs) enrolled at a Pennsylvania State University campus during the Fall 2020 semester. Methods: Student-athletes were emailed a link of a 43-question survey which was deployed using Qualtrics®. The survey asked questions about collegiate experience, health, well-being, sport related training, and physical fitness before and during the pandemic. Results: Approximately 94% of student-athletes reported that COVID-19 worsened their college experience. About 52 and 59% of student-athletes believed that COVID-19 had a negative impact on their health and well-being, respectively. Nearly 79% of student-athletes reported that their sport-related training decreased during the pandemic. Over half of participants believed that their physical fitness, endurance, and strength decreased during the pandemic. Conclusion: The implications of the COVID-19 pandemic on Division III collegiate student-athletes include a worsened college experience as well as worsened health and well-being.

Association Between History of Multiple Concussions and Health Outcomes Among Former College Football Players: 15-Year Follow-up From the NCAA Concussion Study (1999-2001)

BACKGROUND

Previous research has examined associations between concussion history and adverse health outcomes among former professional football players. Less is known about the potential effects of concussion among former college football players without additional exposure at the professional level.

PURPOSE

To examine the association between concussion and adverse health outcomes in a cohort of former college football players without exposure to professional football, 15 years after their playing careers ended.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

A sample of 204 former collegiate football players (23.4% of eligible athletes with available contact information)-all of whom played at least 1 season of football from 1999 to 2001 in the National Collegiate Athletic Association (NCAA) and had no professional football exposure-completed a general health survey that assessed lifetime concussion history and included the following: the Veterans RAND 36 Item Health Survey, containing a physical composite score (PCS) and mental composite score (MCS); the depression module of the Patient Health Questionnaire; and the 4-item CAGE alcohol dependence questionnaire (for "cutting down, annoyance by criticism, guilty feeling, and eye-openers"). Multivariable binomial regression models estimated adjusted prevalence ratios (PRs) with 95% CIs while controlling for demographics and playing history covariates through forward selection model building.

RESULTS

Most participants reported a concussion history (84.3%). Overall, 22.1% and 39.2% of participants reported a PCS and an MCS <50, respectively (indicating worse health than the US national average); 19.1% reported Patient Health Questionnaire scores ≥10 (indicating moderate/severe depression); and 24.8% reported CAGE scores ≥2 (indicating alcohol dependence). The prevalence of having an MCS <50 was higher among those reporting ≥3 versus 0 concussions (PR, 2.5; 95% CI, 1.3-4.9). Controlling for body mass index (BMI), the prevalence of moderate/severe depression was higher among those reporting ≥3 versus 0 concussions (PR, 4.2; 95% CI, 1.0-16.3). Controlling for BMI, the prevalence of having a PCS <50 was higher among those reporting ≥3 versus 1 or 2 concussions (PR, 2.6; 95% CI, 1.3-5.0) but not 0 concussions (PR, 1.5; 95% CI, 0.6-3.6). No associations were found for alcohol dependence.

CONCLUSION

Associations between a history of multiple concussions and adverse health outcomes were found among former collegiate football players without professional football exposure but were limited to those reporting ≥3 prior concussions. Because only 23.4% of eligible athletes responded to the survey, the possibility of ascertainment bias exists, and our findings should thus be interpreted with some caution. Continued examination within nonprofessional football populations is needed, but findings highlight the need for prevention efforts to reduce concussion incidence.

Epidemiology of National Collegiate Athletic Association Women's Lacrosse Injuries, 2009-10 Through 2014-15

CONTEXT

Participation in collegiate women's lacrosse has increased dramatically, but little recent epidemiological data exists regarding injuries.

OBJECTIVE

Describe the epidemiology of National Collegiate Athletic Association (NCAA) women's lacrosse injuries during the 2009-10 through 2014-15 academic years.

SETTING

Aggregate injury and exposure data collected from 40 women's lacrosse programs providing 83 team-seasons of data.

PATIENTS OR OTHER PARTICIPANTS

Collegiate women's lacrosse student-athletes.

INTERVENTION

Women's lacrosse data from the NCAA Injury Surveillance Program were analyzed.

MAIN OUTCOME MEASURES

Injury rates; injury rate ratios; and injury proportions by body site, diagnosis, and injury mechanism were reported with 95% confidence intervals (CI). Time loss (TL) injuries resulted in participation restriction time of at least 24 hours. Nontime loss (NTL) injuries resulted in participation restriction time under 24 hours.

RESULTS

There were 705 TL and NTL women's lacrosse injuries, resulting in an injury rate of 4.93/1000 athlete-exposures (AEs; 95% CI: 4.57-5.30). The TL and NTL injury rates were 2.18/1000 AE (95% CI: 1.93-2.42) and 2.64/1000 AE (95% CI: 2.37-2.90), respectively. Most injuries were to the lower extremity (competition: 64.4%; practice: 71.2%). Most injuries in competition were sprains (26.0%), contusions (19.6%), and strains (19.2%); most injuries in practice were strains (21.4%), sprains (18.1%), and inflammatory conditions (15.8%). Concussions comprised the highest proportion of head/face injuries (competition: 82.1%; practice: 54.5%). No eye injuries were reported. The highest proportion of injuries were player contact (27.4%) in competitions and noncontact (32.1%) in practices. Contact with the ball and stick comprised 21.5% of competition and 14.0% of practice injuries.

CONCLUSIONS

This study is the most robust assessment of collegiate women's lacrosse injuries to date, utilizing surveillance data that includes both TL and NTL injuries. Over half of all injuries were NTL; inclusion of such injuries further highlights the breadth of injuries managed by team medical staff.

Physiological Characteristics of Incoming Freshmen Field Players in a Men's Division I Collegiate Soccer Team

Freshmen college soccer players will have lower training ages than their experienced teammates (sophomores, juniors, seniors). How this is reflected in field test performance is not known. Freshmen (n = 7) and experienced (n = 10) male field soccer players from the same Division I school completed soccer-specific tests to identify potential differences in incoming freshmen. Testing included: vertical jump (VJ), standing broad jump, and triple hop (TH); 30-m sprint, (0–5, 5–10, 0–10, and 0–30 m intervals); 505 change-of-direction test; Yo-Yo Intermittent Recovery Test Level 2 (YYIRT2); and 6 × 30-m sprints to measure repeated-sprint ability. A MANOVA with Bonferroni post hoc was conducted on the performance test data, and effect sizes and z-scores were calculated from the results for magnitude-based inference. There were no significant between-group differences in the performance tests. There were moderate effects for the differences in VJ height, left-leg TH, 0–5, 0–10 and 0–30 m sprint intervals, and YYIRT2 (d = 0.63–1.18), with experienced players being superior. According to z-score data, freshmen had meaningful differences below the squad mean in the 30-m sprint, YYIRT2, and jump tests. Freshmen soccer players may need to develop linear speed, high-intensity running, and jump performance upon entering a collegiate program.