Rehabilitation and Therapy Commons^™

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 …

Supporting Students After Concussion: What College Faculty Need To Know, Susan C. Davies

Thomas C. Hunt Building a Research Community Day

Returning to university life following concussion can be challenging for students. Our Brain Health Collaboratory, in conjunction with the Center on Brain Injury Research and Training, developed set of online resources to inform college faculty members about brain injuries. The module includes information about concussion effects, academic and environmental accommodations, and the role of college faculty in providing support. This session will share our research that led to development of the module, as well as our plan to evaluate its efficacy.

Head Impact Exposure In Youth And Collegiate American Football, Grace B. Choi, Eric P. Smith, Stefan M. Duma, Steven Rowson, Eamon Campolettano, Mireille E. Kelley, Derek A. Jones, Joel D. Stitzel, Jillian E. Urban, Amaris Genemaras, Jonathan G. Beckwith, Richard M. Greenwald, Arthur C. Maerlender, Joseph J. Crisco

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The relationship between head impact and subsequent brain injury for American football players is not well defined, especially for youth. The objective of this study is to quantify and assess Head Impact Exposure (HIE) metrics among youth and collegiate football players. This multiseason study enrolled 639 unique athletes (354 collegiate; 285 youth, ages 9–14), recording 476,209 head impacts (367,337 collegiate; 108,872 youth) over 971 sessions (480 collegiate; 491 youth). Youth players experienced 43 and 65% fewer impacts per competition and practice, respectively, and lower impact magnitudes compared to collegiate players (95th percentile peak linear acceleration (PLA, g) competition: 45.6 vs …

In-Season Concussion Symptom Reporting In Male And Female Collegiate Rugby Athletes, Emily E. Kieffer,, P. Gunnar Brolinson, Arthur C. Maerlender, Eric Smith, Steven Rowson

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Symptom inventories are generally only collected after a suspected concussion, but regular in-season monitoring may allude to clinical symptoms associated with repetitive subconcussive impacts and potential undiagnosed concussions. Despite sex-specific differences in symptom presentation and outcome of concussion, no return-to-play protocol takes sex into account. The objective of this study was to monitor a cohort of contact-sport athletes and compare the frequency and severity of in-season concussion-like symptom reporting between sexes. Graded symptom checklists from 144 female and 104 male athlete-seasons were administered weekly to quantify the effect of subconcussive impacts on frequency and severity of in-season symptom reporting. In-season, …

The Role Of Pre-Season Health Characteristics As Injury Risk Factors In Female Adolescent Soccer Players, Brent Harper, Adrian Aron, Emmanuel John

Physical Therapy Faculty Articles and Research

[Purpose] Determine if female adolescent soccer players with a history of concussion, impaired K-D scores, and pre-season subjective complaints of neck pain, dizziness, and headache were predisposed to additional risk of musculoskeletal or concussive injury during 10-weeks of competitive play. [Participants and Methods] Twenty-three female high school soccer athletes provided concussion history and reported pre-season subjective complaints. K-D testing was performed pre and postseason. During the 10-week season, all injuries, preventing participation in practice or game, were recorded. [Results] Six reported a history of concussion. Of those six, three injuries were reported, including two concussions and a hamstring strain. Baseline …

The Long-Term Behavioral Effects Of Concussions And Post-Concussion Syndrome, Hannah Belleville

Honors College

The focus of this thesis is to examine the effects of concussions on college athletes, specifically their social activity and behavioral changes. Concussions are mild traumatic brain injuries (mTBI) that occur after receiving a blow to the head or a whiplash injury that causes an altered state of consciousness, including but not limited to, being unconscious. The National Collegiate Athletic Association (NCAA) reports that in the past five years college athletes have suffered 10,500 concussions. Unlike professional athletes, who have the luxury of being able to rest until fully healed, college student athletes have the demands of academics often rushing …

Sleep And Stress In The Acute Phase Of Concussion In Youth, Arthur C. Maerlender, Caitlin Masterson, Jessica L. Calvi, Todd Caze, Ross Mathiasen, Dennis Molfese

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

This study sought to address the complex interplay between both biological and psychological perceptions of stress and sleep in the acute stages following a mild traumatic brain injury. A secondary goal was to identify potential targets for intervention. Eleven acutely injured youth (mean age 12 years) were studied at home with overnight actigraphy, salivary cortisol and melatonin assays, and subjective ratings of stress and fatigue (injured group). Nine matched control youth also were assessed (control group). Results suggested longer sleep latencies (time to fall asleep) and higher levels of fatigue in the injured group exist (p ¼ 0.025 and p …

Diagnosing Mild Traumatic Brain Injury Using Saliva Rna Compared To Cognitive And Balance Testing, Steven D. Hicks, Cayce Onks, Raymond Y. Kim, Kevin J. Zhen, Jayson Loeffert, Andrea C. Loeffert, Robert P. Olympia, Gregory Fedochak, Samantha Devita, Aakanksha Rangnekar, John Leddy, Mohammad N. Haider, Zofia Gagnon, Callan D. Mcloughlin, Matthew Badia, Jason Randall, Miguel Madeira, Aaron M. Yengo-Kahn, Justin Wenzel, Matthew Heller, Hallie Zwibel, Aaron Roberts, Samantha Johnson, Chuck Monteith, Michael N. Dretsch, Thomas R. Campbell, Rebekah Mannix, Christopher Neville, Frank Middleton

Rehabilitation Sciences Faculty Publications

BACKGROUND: Early, accurate diagnosis of mild traumatic brain injury (mTBI) can improve clinical outcomes for patients, but mTBI remains difficult to diagnose because of reliance on subjective symptom reports. An objective biomarker could increase diagnostic accuracy and improve clinical outcomes. The aim of this study was to assess the ability of salivary noncoding RNA (ncRNA) to serve as a diagnostic adjunct to current clinical tools. We hypothesized that saliva ncRNA levels would demonstrate comparable accuracy for identifying mTBI as measures of symptom burden, neurocognition, and balance.

METHODS: This case‐control study involved 538 individuals. Participants included 251 individuals with mTBI, enrolled …

Confirmatory Factor Analysis Of Two Computerized Neuropsychological Test Batteries: Immediate Post-Concussion Assessment And Cognitive Test (Impact) And C3 Logix, Caitlin Masterson, Julie Tuttle, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Introduction: Tests of memory and speed of cognitive and motor responses have been the primary foci in sports-related concussion assessment. This study sought to assess the construct validity of neuropsychological tests within C3 Logix.

Method: Results of both baseline C3 Logix and the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) computerized tests from 86 Division I collegiate athletes were submitted to a two-factor confirmatory analysis using structural equation modeling. The two factors of Speed and Memory have been confirmed in previous studies of ImPACT.

Results: Results confirmed the two-factor model of ImPACT, whereas C3 Logix did not …

Validity And Reliability Of Baseline Testing In A Standardized Environment, Kathryn L. Higgins, Todd Caze, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Objective — The Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) is a computerized neuropsychological test battery commonly used to determine cognitive recovery from concussion based on comparing post-injury scores to baseline scores. This model is based on the premise that ImPACT baseline test scores are a valid and reliable measure of optimal cognitive function at baseline. Growing evidence suggests that this premise may not be accurate and a large contributor to invalid and unreliable baseline test scores may be the protocol and environment in which baseline tests are administered. This study examined the effects of a standardized environment and administration …

Sandbagging On The Immediate Post-Concussion Assessment And Cognitive Testing (Impact) In A High School Athlete Population, Kathryn L. Higgins, Robert L. Denny, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a computerized neuropsychological test battery commonly used to assess cognitive functioning after a concussion. It is recommended that application of ImPACT utilizes a baseline administration so athletes have an individualized baseline with which to compare post-injury results should they sustain a concussion. It has been suggested that athletes may provide suboptimal effort, called “sandbagging,” in order to return to their baseline cognitive scores, and thus to play, more quickly. This research examines ImPACT baseline scores when high school athletes were asked to attempt to “sandbag,” and compares those scores with scores …