Medical Specialties Commons^™

Barriers To Implementation Of Post-Concussion Grade Exercise Tests, Tyler Beauregard

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

The purpose of this study was to assess the potential barriers to sports physical therapy and athletic training clinicians implementing graded exertional tests, specifically for their patients following concussion.

Quality Improvement Of A Post-Concussion Recovery Protocol, Halle Strege, Kaitlyn Burnham, Laura L. Harris

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

To determine the effectiveness of a post-concussion recovery protocol in an adolescent athletic population.

Neurocognitive Performance Differences Between Athletes Who Are Deaf Or Hard-Of-Hearing And Athletes Who Are Hearing, Matthew P. Brancaleone, Jaclyn Caccese, James Onate

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

There are over 71,000 college students in the United States who are deaf or hard-of-hearing (D/HoH), with many participating in athletics. Athletes who are D/HoH have similar concussion rates to athletes who are hearing at the collegiate level. Differences in neurocognitive baseline performance between athletes who are D/HoH and athletes who are hearing may exist due to misunderstanding of written English instructions or differences in sensory processing. Therefore, the purpose of this study was to compare neurocognitive performance between athletes who are hearing and athletes who are D/HoH.

Identifying The Relationship Between Post-Concussion Mental Health And Athletic Status: Is It The Same For All Demographics?, Mary Lorraine Zsolway, Jamie Shoop

Rowan-Virtua Research Day

Purpose: The purpose of this study is to investigate whether athletic status was linked to fewer symptoms of anxiety and depression post-concussion, as well as to explore whether the impact of athletic status on mental health varied by demographics (i.e. age, sex, race, insurance status). The results of this study may assist in identifying at-risk individuals early to help prioritize those who may benefit from early referral to mental health resources.

Introduction: Mental health concerns post-concussion are relatively common, with roughly 1 in 3 individuals experiencing these symptoms. It has been previously shown that youth who participate in …

Interactions Between Repetitive Mild Traumatic Brain Injury And Methylphenidate Administration On Catecholamine Transporter Protein Levels Within The Rodent Prefrontal Cortex, Anna Abrimian, Eleni Papadopoulos, Christopher P. Knapp, J. Loweth, Barry Waterhouse, Rachel Navarra

Rowan-Virtua Research Day

It is theorized that low concentrations of dopamine (DA) and norepinephrine (NE) within in the prefrontal cortex (PFC) following traumatic brain injury (TBI) leads to increased risky behavior. Our lab has shown that repeated mild TBI (rmTBI) sex-differentially increases risky behavior in a rodent model. Methylphenidate (MPH) is a psychostimulant drug used to treat symptoms of Attention-Deficit Hyperactivity Disorder (ADHD), also driven by a hypo-catecholaminergic PFC. MPH elevates catecholamine levels by blocking DA and NE transporters, DAT and NET. While the potential of psychostimulants to treat post-TBI symptoms have been explored, the effects of sub-chronic MPH on transporter levels following …

Standardization Of Discharge Instructions For Mild Traumatic Brain Injury/Concussion In Children Presenting To Ed: A Qi Project, Niralee K. Rana, Nicole Gerber Md, Michael Alfonzo Md, Snezana Osorio Md, Deborah Levine Md

Rowan-Virtua Research Day

Background: Mild traumatic brain injuries (mTBI) or concussions account for high rates of emergency department (ED) visits. Concussion diagnoses are used less often in young children leading to a variability in parental education and discharge instructions. Lack of discharge guidance may increase parental anxiety, impact recovery, and increase ED visits.

Objectives: To increase the proportion of ED patients discharged with age-appropriate instructions for mTBI by 50% by June 1, 2024, and to determine the impact age-appropriate instructions have on decreasing parental anxiety.

Methods: This observational time series with planned sequential experimentation is in progress at a Pediatric ED affiliated with …

Models Of Video Feedback For Youth Athletes Performing An American Football Tackle, Eric Schussler, Richard J. Jagacinski, Ajit Chaudhari, John A. Buford, James A. Onate

Rehabilitation Sciences Faculty Publications

Context: Video feedback is an expeditious method for improving athlete safety when performing activities with an inherent risk of injury. Providing appropriate and validated feedback during tackling training in American football may be a mechanism for athletes to learn safe tackling performance.

Objective: To determine the effect of video feedback in the instruction of tackling form.

Design: Controlled laboratory study.

Setting: Laboratory.

Patients or Other Participants: A total of 32 youth football athletes (28 boys, 4 girls; age ¼ 11.8 6 0.8 years) participated in 1 day of training. Of those, 14 participants completed 2 additional days of training and …

A Headfirst Approach – Concussion Management And Novel Diagnostic Testing, Madison Cohen, Kevin Wang, Julienne Ryland, Donald Penney

Research Day

INTRODUCTION: The incidence of concussions has become increasingly prevalent across a multitude of sports. Despite this, the current guidelines for concussion management are not well defined, which creates a significant barrier to proper evaluation and care.

OBJECTIVES: This manuscript was designed to help physicians, athletic trainers, coaches, and parents understand the clinical signs of concussion and management from the moment of injury to the athlete’s return to play. Additionally, we reviewed post-concussion sequelae and their incidence following concussion management.

METHODS: In order to better define the current approach to the management of sports-related concussions we completed a comprehensive literature review …

Unreported Concussions Within Law Enforcement Officers, Bailee Faulkner, Jennifer Walker, Audrey Wagstaff

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

Understand the degree to which concussions go unreported among members of the Law Enforcement community.

The Value Of The Vestibular/Ocular Motor Screening (Voms) In Evaluating Adolescent Patients With Concussions, Laura Harris, Kirstin Antonaros, Hayley Cole, Patrick Daniels, Kurtis Gould, Trent Ivey, Alexa Lewis, Alexis Maxwell, Paul Miles

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

To determine the VOMS can differentiate between typical and protracted recoveries in adolescent patients.

Serum Micrornas Associated With Concussion In Football Players, Dorota Wyczechowska, Paul Harch, Shelly Mullenix, Erin S. Fannin, Brenda B. Chiappinelli, Duane Jeansonne, Adam Lassak, Nicolas G. Bazan, Francesca Peruzzi

School of Medicine Faculty Publications

Mild Traumatic Brain Injury (mild TBI)/concussion is a common sports injury, especially common in football players. Repeated concussions are thought to lead to long-term brain damage including chronic traumatic encephalopathy (CTE). With the worldwide growing interest in studying sport-related concussion the search for biomarkers for early diagnosis and progression of neuronal injury has also became priority. MicroRNAs are short, non-coding RNAs that regulate gene expression post-transcriptionally. Due to their high stability in biological fluids, microRNAs can serve as biomarkers in a variety of diseases including pathologies of the nervous system. In this exploratory study, we have evaluated changes in the …

Evaluation Of Concussion Assessment Tools For Collegiate Athletes, Jacqueline D. Villanueva Arevalo, Emily R. Brown

Student Scholar Showcase

BACKGROUND: Due to the increase in sports-related concussions in the United States, there is a rising concern about concussion assessments in collegiate athletes with regard to long term vestibular ocular motor dysfunction and post-concussion syndrome.

PURPOSE: Due to varying practices in concussion diagnosis, this systematic review analyzed three concussion diagnostic instruments, The King Devick, Screening Concussion Assessment Tool (SCAT-5), and Vestibular Oculomotor Screening Tool (VOMS), to determine the most appropriate instrument(s) for reducing vestibular ocular-motor dysfunction and post-concussion symptoms in collegiate athletes.

METHODS: Nested Knowledge was used to identify articles from PubMed, Europe Pubmed Central, and ClinicalTrials.gov databases. Key search …

Emotionally Concussed: The Impact Of Pre-Existing Anxiety On Concussion Recovery, Grace Szucs

Honors Theses

Recent advances in concussion research have shed light on numerous mental and physiological factors that may complicate concussion recovery. Systematic reviews of the existing literature have found that premorbid mental health conditions such as depression and anxiety may be a predictor of complicated concussion recovery, but studies have not had an appropriate design to isolate anxiety or depression as a predictor of lengthened recovery. This study investigated if athletes with a history of premorbid anxiety and/or depression would have a longer time of recovery than athletes without this history. Male and female athletes from a Division-1 athletic department treated for …

Increasing Access Of Outpatient Therapeutic Services For Adolescents With Persistent Symptoms After Sport-Related Traumatic Brain Injury, Natalie J. Bales

Family Medicine Clerkship Student Projects

Persistent symptoms lasting at least 21 days after initial traumatic brain injury occur in about 15-20% of adolescents. Initial assessment of concussions can be done using the SCAT5 and a wide variety of other standardized assessment tools. However, there are striking gaps in standard clinical procedure for follow-up care for athletes who have persistent symptoms. Furthermore, there are many issues with accessibility to therapeutic services including long wait times that prevent timely referral to those services. This pilot intervention was implemented at the University of Vermont to address those issues by providing a hotline resource for families to use and …

The Clinical Value Of Oculomotor Assessments Across The Continuum Of Concussion, Dillon Richards

Electronic Thesis and Dissertation Repository

Concussions are complex conditions that are difficult to manage medically. Variations in symptom presentation, intricate neurophysiological processes, and the availability of a variety of possible assessment tools may contribute to this complexity. Clinicians must use a broad approach, employing both subjective symptom assessment and objective assessments to confirm a diagnosis and/or monitor progression and recovery. Oculomotor function after concussion may be an important indicator of injury, given the interconnectedness of oculomotor function, vestibulo-ocular and visual systems, and even cognition. Oculomotor function may be assessed objectively or indirectly using patient-reported symptom checklists as part of subjective assessments. One way of objectively …

Association Between Concussions And Suicidality In High School Students In The United States, Grant L. Iverson, Justin E. Karr

Sanders-Brown Center on Aging Faculty Publications

Importance: Prior research has shown a statistically significant association between sustaining a concussion and suicidality in adolescents, but this prior research controlled for relatively few variables predictive of suicidality.

Objective: To examine whether sustaining a concussion remained a significant predictor of suicidality after controlling for relevant covariates (e.g., sexual abuse/assault, bullying, substance use, depression), hypothesizing that the relationship between concussion and suicidality would become non-significant after controlling for these variables.

Design: This study involved secondary data analysis of the 2019 Youth Risk Behavior Surveillance (YRBS) System, a national cross-sectional study of adolescents. Analyses were stratified by gender. …

The Rationale Behind And Impact Of One Hospital’S Provision Of Secondary School Athletic Training Services: A Five-Year Case Study, Caroline E. Faure Edd; Atc

Internet Journal of Allied Health Sciences and Practice

Purpose: Sports-related injuries are common and often require physician or hospital care. Since the advent of concussion laws in fifty states, hospitals across the country have come forward to partner with secondary schools in the provision of sports medicine healthcare. The outreach agreements are consistent: Hospitals hire athletic trainers (ATs) and then outsource them to schools. ATs help mitigate risk in sports programs. Onsite at the schools daily, ATs provide immediate evaluation and treatment for injuries that occur and render decisions regarding the appropriateness of an injured athlete’s return to participation. The goal of this case study was to describe …

A Meta-Analysis: Significance Of Biofluid Biomarkers In Sports-Related Traumatic Brain Injury, Stephanie Oliveira

Honors Undergraduate Theses

Background: To reduce the reliance on clinical judgment for the regulation of sports-related traumatic brain injury, identifying and measuring objective to biofluid biomarkers can provide important insight into the diagnosis (Determining the type and origin of a disorder) and prognosis (Determining the chance of survival of a disorder) of SR-TBIs. A biomarker is a qualitative or quantitative measurement that provides a measure of a subject’s physiological or pathological condition at a specific time or during a disease state. Recent literature has suggested that biomarkers can help in the screening of patients exhibiting symptoms of mild traumatic brain injury (mTBI). Despite …

Visual Rehabilitation As A Treatment Tool For Collegiate Athletes Post-Mtbi To Improve Return To Sport Outcomes, Maria Asimakis

Featured Student Work

Introduction: Fifty percent of the 46 000 concussions seen in Canada are sports related, with post-concussive syndrome (PCS) impacting up to 30% of those patients. Individuals who experience PCS will often report headaches, dizziness, and blurred vision with visual disturbances reported in 20-85% depending on the nature of the visual deficit. A concussion is a type of traumatic brain injury (TBI) and results from an external insult leading to axonal shearing of nerve fibers, which are responsible for the signs and symptoms experienced. Current best practice in treatment involves initial rest followed by increasing aerobic activity as well as visual …

Lower Extremity Risk Assessment In Athletes Following A Traumatic Brain Injury, Carlos D. Villalpando

Theses and Graduate Projects

Background: According to the Centers for Disease Control and Prevention, Concussions are a major health disorder. Continued research regarding the impact of concussions on athletes has led to an increased risk for lower extremity injury across a variety of populations following head trauma. Guidelines from the CDC use a self-reported symptom and cognitive examination for return to play.

Purpose: Current recommended guidelines increase the risk of lower extremity injury due to failure of identifying neurological deficits that persist following a concussion. This literature review aims to identify if athletes diagnosed with a concussion are at an increased risk …

An Exploration Of Effective Patient Education With An Emphasis On Concussion, Kayla M. Ruopp

Health, Human Performance and Recreation Undergraduate Honors Theses

Concussion is a prevalent healthcare issue in the US, with approximately 1.6-3.8 million sports and recreation-related concussions each year in all ages. A concussion can be defined as a traumatic brain injury caused by biomechanical forces. When an athlete sustains a concussion, a physiologic cascade of events occurs. The most common signs and symptoms of a concussion include: loss of balance, disorientation, headache and confusion. Concussion assessments are important in order to determine the presence of an impairment and there are a multitude of tests that clinicians can use in order to isolate each type of damage. Studies have shown …

Do Memory Test Scores Improve After Organized Sport Activity?, Olivia B. Smith, Erika Smith-Goodwin, Jennifer Walker

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Please enjoy Volume 7, Issue 1 of the JSMAHS. In this issue, you will find Professional, Graduate, and Undergraduate research abstracts, and case reports.

Thank you for viewing this 7^th Annual OATA Special Edition.

The Impact Of Multiple Concussions On The Lives Of Student-Athletes, Jenny L. Toonstra, Andrea E. Cripps, Lauren R. Meyers

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Please enjoy Volume 7, Issue 1 of the JSMAHS. In this issue, you will find Professional, Graduate, and Undergraduate research abstracts, and case reports.

Thank you for viewing this 7^th Annual OATA Special Edition.

Developing Methods To Detect And Diagnose Chronic Traumatic Encephalopathy During Life: Rationale, Design, And Methodology For The Diagnose Cte Research Project, Jeffrey Cummings, Numerous Authors, See Full List Below

School of Medicine Faculty Publications

Background: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that has been neuropathologically diagnosed in brain donors exposed to repetitive head impacts, including boxers and American football, soccer, ice hockey, and rugby players. CTE cannot yet be diagnosed during life. In December 2015, the National Institute of Neurological Disorders and Stroke awarded a seven-year grant (U01NS093334) to fund the “Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy (DIAGNOSE CTE) Research Project.” The objectives of this multicenter project are to: develop in vivo fluid and neuroimaging biomarkers for CTE; characterize its clinical presentation; refine …

A Kinetic Model For Blood Biomarker Levels After Mild Traumatic Brain Injury, Sima Azizi, Daniel B. Hier, Blaine Allen, Tayo Obafemi-Ajayi, Gayla R. Olbricht, Matthew S. Thimgan, Donald C. Wunsch

Mathematics and Statistics Faculty Research & Creative Works

Traumatic brain injury (TBI) imposes a significant economic and social burden. The diagnosis and prognosis of mild TBI, also called concussion, is challenging. Concussions are common among contact sport athletes. After a blow to the head, it is often difficult to determine who has had a concussion, who should be withheld from play, if a concussed athlete is ready to return to the field, and which concussed athlete will develop a post-concussion syndrome. Biomarkers can be detected in the cerebrospinal fluid and blood after traumatic brain injury and their levels may have prognostic value. Despite significant investigation, questions remain as …

Adult Knowledge Of Childhood Head Injury Management At Home, Christian Muller, Adarsh Gupta, Joanna Petrides

Rowan-Virtua Research Day

Adults are able to recognize concussion warning symptoms; however, they lack the knowledge on how to manage and treat a child’s head injury.

Acute Depression And Anxiety Symptoms Following Concussion In An Adolescent Outpatient Population, Ari M. Fish, Julia Vanni, Kristy Arbogast, Phd, Catherine C. Mcdonald, Phd, Rn, Christina Master, Md, Caqsm

Phase 1

Introduction: Research has shown that concussed youth are at increased risk of developing psychiatric symptoms as compared to non-concussed youth. Few studies, however, have detailed the presence and severity of acute depression and anxiety symptoms following a concussion in adolescents, specifically. Thus, the current study aims to describe depression and anxiety symptoms in concussed and non-concussed adolescents using validated measures of depression and anxiety.

Methods: The current study includes 284 adolescents (114 cases, 170 controls), 13-18 years of age. Cases included concussed patients at the Children’s Hospital of Philadelphia, and controls were recruited from a local, Philadelphia high school. …

A Systematic Review Of Center Of Mass As A Measure Of Dynamic Postural Control Following Concussion, Sarah Patejak, Joshua Forrest, Emily Harting, Mable Sisk, Eric Schussler

Rehabilitation Sciences Faculty Publications

BACKGROUND: The incidence of sports-related concussion in the US is between 1.6-3.8 million annually. Identification of ongoing impairment post-concussion continues to be challenging, as research indicates many patients are cleared for return to activity while still suffering subclinical impairment of function. Purpose: To identify and review the current literature on the use of center of mass (COM) during gait as a potential indicator variable after concussive injury. Study Design: Systematic Review.

METHODS: A Pubmed search was undertaken utilizing search terms involving gait performance and concussion. Study inclusion criteria included: (1) COM used as a variable in data analysis, (2) study …

Epidemiology Of Concussive Injuries In Collegiate Recreational Athletics, Maddison R. Flowers

Electronic Theses and Dissertations

Background: The epidemiology of concussion in collegiate and high school athletes has been extensively researched. Concussive injury in collegiate recreation, a less supervised sample, is limited. This preliminary study retrospectively examined the incidence and prevalence rates of concussive injuries in intramural and club sports at one institution. Methods: Injury reports were analyzed during the 2016-2019 calendar years. Concussion prevalence, incidence, and odds ratios (reported with 95% CIs) were calculated for intramural and club sports. Results: During the study period, a total of 805 injuries were reported between intramural and club sports with 111 injuries being documented as concussions. Intramural sports …

The Relationship Between Sport-Related Concussion And Sensation-Seeking, Spencer W. Liebel, Kathryn L. Van Pelt, Gian-Gabriel P. Garcia, Lauren L. Czerniak, Michael A. Mccrea, Thomas W. Mcallister, Steven P. Broglio, Care Consortium Investigators

Sanders-Brown Center on Aging Faculty Publications

Sensation-seeking, or the need for novel and exciting experiences, is thought to play a role in sport-related concussion (SRC), yet much remains unknown regarding these relationships and, more importantly, how sensation-seeking influences SRC risk. The current study assessed sensation-seeking, sport contact level, and SRC history and incidence in a large sample of NCAA collegiate athletes. Data included a full study sample of 22,374 baseline evaluations and a sub-sample of 2037 incident SRC. Independent samples t-test, analysis of covariance, and hierarchical logistic regression were constructed to address study hypotheses. Results showed that (1) among participants without SRC, sensation-seeking scores were …