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How completely are randomized controlled trials of non-pharmacological interventions following concussion reported? A systematic review

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Journal of Sport and Health Science 2024年第4期13卷 537-547页

作者： Jacqueline Josee van Ierssel Olivia Galea Kirsten Holte Caroline Luszawski Elizabeth Jenkins Jennifer O’Neil Carolyn A Emery Rebekah Mannix Kathryn Schneider Keith Owen Yeates Roger Zemek Children’s Hospital of Eastern Ontario Research Institute OttawaON K1H 8L1Canada The Centre for Health Activity and Rehabilitation ResearchUniversity of OtagoDunedin 9016New Zealand Sport Injury Prevention Research Centre Faculty of KinesiologyUniversity of CalgaryCalgaryAB T2N 1N4Canada Alberta Children’s Hospital Research Institute University of Calgary CalgaryAB T2N 1N4Canada Hotchkiss Brain Institute University of CalgaryCalgaryAB T2N 4N1Canada Department of Psychology University of CalgaryCalgaryAB T2N 1N4Canada g Faculty of MedicineUniversity of OttawaOttawaON K1H 8M5Canada School of Rehabilitation Sciences University of OttawaOttawaON K1H 8M5Canada Bruyere Research Institute OttawaON K1N 5C8Canada Departments of Pediatrics and Emergency Medicine Harvard Medical SchoolBostonMA 02115USA Departments of Pediatrics and Emergency Medicine University of OttawaOttawaON K1H 8M5Canada

Purpose:The study aimed to examine the reporting completeness of randomized controlled trials(RCTs)of non-pharmacological interventions following ***:We searched MEDLINE,Embase,PsycInfo,CINAHL,and Web of Science up to May *** reviewers independently screened studies and assessed reporting completeness using the Template for Intervention Description and Replication(TIDieR),Consensus on Exercise Reporting Template(CERT),and international Consensus on Therapeutic Exercise aNd Training(i-CONTENT)*** information was sought my study authors where reporting was *** of bias(ROB)was assessed with the Cochrane ROB-2 *** examining non-pharmacological interventions following ***:We included 89 RCTs(n=53 high ROB)examining 11 different interventions for concussion:sub-symptom threshold aerobic exercise,cervicovestibular therapy,physical/cognitive rest,vision therapy,education,psychotherapy,hyperbaric oxygen therapy,transcranial magnetic stimulation,blue light therapy,osteopathic manipulation,and head/neck *** scores were:TIDieR 9/12(75%;interquartile range(IQR)=5;range:5-12),CERT 17/19(89%;IQR=2;range:10-19),and i-CONTENT 6/7(86%;IQR=1;range:5-7).Percentage of studies completely reporting all items was TIDieR 35%(31/89),CERT 24%(5/21),and i-CONTENT 10%(2/21).Studies were more completely reported after publication of TIDieR(t_(87)=2.08;p=0.04)and CERT(t_(19)=2.72;p=0.01).Reporting completeness was not strongly associated with journal impact factor(TIDieR:rs=0.27;p=0.01;CERT:r_(s)=-0.44;p=0.06;i-CONTENT:r_(s)=-0.17;p=0.48)or ROB(TIDieR:rs=0.11;p=0.31;CERT:rs=0.04;p=0.86;i-CONTENT:rs=0.12;p=0.60).Conclusion:RCTs of non-pharmacological interventions following concussion demonstrate moderate to good reporting completeness,but are often missing key components,particularly modifications,motivational strategies,and qualified *** completeness improved after TIDieR and CERT publication,but p

关键词： concussion Intervention Randomized controlled trial Systematic review

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Are EPB41 and alpha-synuclein diagnostic biomarkers of sport-related concussion?Findings from the NCAA and Department of Defense CARE Consortium

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Journal of Sport and Health Science 2023年第3期12卷 379-387页

作者： Rany Vorn Christina Devoto Timothy B.Meier Chen Lai Sijung Yun Steven P.Broglio Sara Mithani Thomas W.McAllister Christopher C.Giza Hyung-Suk Kim Daniel Huber Jaroslaw Harezlak Kenneth L.Cameron Gerald McGinty Jonathan Jackson Kevin M.Guskiewicz Jason P.Mihalik Alison Brooks Stefan Duma Steven Rowson Lindsay D.Nelson Paul Pasquina Michael A.McCrea Jessica M.Gill the CARE Consortium Investigators Johns Hopkins School of Nursing and Medicine BaltimoreMD 21205USA National Institutes of Health BethesdaMD 20892USA Department of Neurosurgery Medical College of WisconsinMilwaukeeWI 53226USA Predictiv Care Inc.Mountain ViewCA 94086USA Michigan concussion Center University of MichiganAnn ArborMI 48109USA Department of Psychiatry Indiana University School of MedicineIndianapolisIN 46202USA Departments of Pediatrics and Neurosurgery University of California at Los Angeles(UCLA)Los AngelesCA 90024USA Department of Epidemiology and Biostatistics School of Public Health–Bloomington Indiana UniversityBloomingtonIN 47405USA John A.Feagin Sports Medicine Fellowship Keller Army Community HospitalWest PointNY 10996USA United States Air Force Academy Colorado SpringsCO 80840USA Mathew Gfeller Center Department of Exercise and Sport ScienceUniversity of North Carolina at Chapel HillChapel HillNC 27514USA Department of Orthopedics Division of Sports MedicineSchool of Medicine and Public HealthUniversity of WisconsinMadisonWI 53705USA Department of Biomedical Engineering and Mechanics Virginia TechBlacksburgVA 24061USA Center for Neuroscience&Regenerative Medicine Uniformed Services UniversityBethesdaMD 20814USA 不详 Current affiliation:School of Nursing University of Texas Health Science Center San AntonioSan AntonioTX 78229USA

Background:Current protein biomarkers are only moderately predictive at identifying individuals with mild traumatic brain injury or ***,more accurate diagnostic markers are needed for sport-related ***:This was a multicenter,prospective,case-control study of athletes who provided blood samples and were diagnosed with a concussion or were a matched non-concussed control within the National Collegiate Athletic Association-Department of Defense concussion Assessment,Research,and Education Consortium conducted between 2015 and *** blood was collected within 48 h of injury to identify protein abnormalities at the acute and subacute *** with concussion were divided into 6 h post-injury(0-6 h post-injury)and after 6 h postinjury(7-48 h post-injury)*** applied a highly multiplexed proteomic technique that used a DNA aptamers assay to target 1305proteins in plasma samples from athletes with and without sport-related ***:A total of 140 athletes with concussion(79.3%males;aged 18.71±1.10 years,mean±SD)and 21 non-concussed athletes(76.2%males;19.14±1.10 years)were included in this *** identified 338 plasma proteins that significantly differed in abundance(319 upregulated and 19 downregulated)in concussed athletes compared to non-concussed *** top 20 most differentially abundant proteins discriminated concussed athletes from non-concussed athletes with an area under the curve(AUC)of 0.954(95%confidence interval:0.922-0.986).Specifically,after 6 h of injury,the individual AUC of plasma erythrocyte membrane protein band 4.1(EPB41)and alpha-synuclein(SNCA)were 0.956 and 0.875,*** combination of EPB41 and SNCA provided the best AUC(1.000),which suggests this combination of candidate plasma biomarkers is the best for diagnosing concussion in athletes after 6 h of ***:Our data suggest that proteomic profiling may provide novel diagnostic protein markers and that a combina

关键词： Biomarkers College athletes concussion Mild traumatic brain injury Sport injury

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Diffusion tensor tractography characteristics of axonal injury in concussion/mild traumatic brain injury

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Neural Regeneration Research 2022年第5期17卷 978-982页

作者： Sung Ho Jang You Sung Seo Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaeguRepublic of Korea

The main advantage of diffusion tensor tractography is that it allows the entire neural tract to be *** addition,configurational analysis of reconstructed neural tracts can indicate abnormalities such as tearing,narrowing,or discontinuations,which have been used to identify axonal injury of neural tracts in concussion *** review focuses on the characteristic features of axonal injury in concussion or mild traumatic brain injury(m TBI)patients through the use of diffusion tensor *** injury in concussion(m TBI)patients is characterized by their occurrence in long neural tracts and multiple injuries,and these characteristics are common in patients with diffuse axonal injury and in concussion(m TBI)patients with axonal ***,the discontinuation of the corticospinal tract is mostly observed in diffuse axonal injury,and partial tearing and narrowing in the subcortical white matter are frequently observed in concussion(m TBI)patients with axonal *** difference appears to be attributed to the observation that axonal injury in concussion(m TBI)patients is the result of weaker forces than those producing diffuse axonal *** addition,regarding the fornix,in diffuse axonal injury,discontinuation of the fornical crus has been frequently reported,but in concussion(m TBI)patients,many collateral branches form in the fornix in addition to these findings in many case *** is presumed that the impact on the brain in TBI is relatively weaker than that in diffuse axonal injury,and that the formation of collateral branches occurs during the fornix recovery *** the occurrence of axonal injury in multiple areas of the brain is an important feature of diffuse axonal injury,case studies in concussion(m TBI)have shown that axonal injury occurs in multiple neural *** axonal injury lesions in m TBI patients may persist for approximately 10 years after injury onset,the characteristics of axonal injury in co

关键词： axonal injury brain injury concussion diffusion tensor imaging diffusion tensor tractography mild traumatic brain injury neural tract

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Which psychosocial factors are associated with return to sport following concussion? A systematic review

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Journal of Sport and Health Science 2022年第4期11卷 438-449页

作者： Jacqueline van Ierssel Kaleigh Ferdinand Pennock Margaret Sampson Roger Zemek Jeffrey G.Caron Children’s Hospital of Eastern Ontario Research Institute OttawaON K1H 8L1Canada Faculty of Kinesiology and Physical Education University of TorontoTorontoON M5S 2W6Canada Department of Pediatrics Faculty of MedicineUniversity of OttawaOttawaON K1H 8M5Canada Faculty of Medicine University of MontrealMontrealQC H3T 1J4Canada Center for Interdisciplinary Research in Rehabilitation MontrealQC H3S 1M9Canada

Background:Psycho social factors predict recurrent inj ury and return to preinjury level of performance following orthopedic injury but are poorly understood following *** management protocols prioritize physical measures of ***,the objective of this study was to describe the psychosocial factors associated with return to sport(RTS) and how they are measured in athletes who sustained a ***:MEDLINE,Embase,APA PsycINFO,CINAHL,and SPORTDiscus were searched through February 2,*** studies included original peer-reviewed publications describing psychosocial factors associated with RTS following a diagnosed *** primary outcome was scales or measures employed and/or key thematic ***:Of the 3615 studies identified,10 quantitative cohort studies(Oxford Centre for Evidence-Based Medicine Level-3) representing 2032 athletes(85% male;high-school and collegiate collision/contact athletes) and 4 qualitative studies representing 66 athletes(74% male;70% American football;aged 9-28 years) were *** identified 3 overarching themes and 10 outcome measures related to psychosocial factors associated with RTS following concussion:(a) fear(e.g,of recurrent concussion,of RTS,of losing playing status);(b) emotional factors(e.g,depression,anxiety,perceived stress,mental health,disturbance mood);and(c) contextual factors(e.g,social support,pressure,sense of identity).Conclusion:Although current medical clearance decisions prioritize physical measures of recovery,evidence suggests diverse psychosocial factors influence RTS following *** remains unclear which psychosocial factors contribute to a successful RTS,including the influence of sex/gender and *** studies should evaluate the association of psychological readiness with physical measures of recovery at medical clearance,preinjury level of performance,and risk of recurrent concussion to support RTS clinical decision-making.

关键词： concussion Recovery Rehabilitation Sport psychology Sporting injuries

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concussion management in soccer

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Journal of Sport and Health Science 2014年第4期3卷 307-313页

作者： Jason P.Mihalik Robert C.Lynall Elizabeth F.Teel Kevin A.Carneiro Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center Department of Exercise and Sport ScienceThe University of North CarolinaChapel Hill.NC 27599.USA Curriculum in Human Movement Science.Department of Allied Health Sciences School of MedicineThe University of North CarolinaChapel Hill.NC 27599.USA Injury Prevention Research Center.The University of North Carolina Chapel HillNC 27599USA Department of Physical Medicine & Rehabilitation The University of North CarolinaChapel Hill.NC 27599.USA

Brain injuries in sports drew more and more public attentions in recent years. Brain injuries vary by name, type, and severity in the athletic setting. It should be noted, however, that these injuries are not isolated to only the athletic arena, as non-athletic mechanisms （e.g., motor vehicle accidents） are more common causes of traumatic brain injuries （TBI） among teenagers. Notwithstanding, as many as 1.6 to 3.8 million TBI result from sports and recreation each year in the United States alone. These injuries are extremely costly to the global health care system, and make TBI among the most expensive conditions to treat in children. This article serves to define common brain injuries in sport; describe their prevalence, what happens to the brain following injury, how to recognize and manage these injuries, and what you can expect as the athlete recovers. Some return-to-activity considerations for the brain-injured athlete will also be discussed.

关键词： concussion Football Futbol Injury management Mild traumatic brain injury Soccer

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Effectiveness of hand self-shiatsu to improve sleep following sport-related concussion in young athletes: a proof-of-concept study

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Journal of Integrative Medicine 2019年第1期17卷 24-29页

作者： Pei Qin Bruce D.Dick Ada Leung Cary A.Brown Faculty of Rehabilitation Medicine University of Alberta Department of Anesthesiology and Pain Medicine Faculty of Medicine and Dentistry University of Alberta Department of Occupational Therapy Faculty of Rehabilitation Medicine University of Alberta

Objective: The prevalence of sport-related concussion(SRC) is high and results in a number of serious health consequences. One area that has received minimal research is the relationship between SRC and sleep. The literature shows that sleep deficiency is a frequent negative consequence of SRC. At the same time, sleep deficiency delays recovery from SRC and contributes added risk of symptom recurrence.A 2014 study of chronic pain patients who learned to apply the complementary and alternative medicine intervention hand self-shiatsu(HSS) had promising, sleep-promoting results that warrant further investigation with other populations. This proof-of-concept study explored the feasibility of HSS as an intervention to promote sleep onset and continuity for young adults with ***: This study employed a prospective case-series design, where participants act as their own controls. Baseline and follow-up data included standardized self-reported assessment tools and sleep ***: Seven athletes, aged between 18 and 25 years, participated in the study. Although statistically significant improvement in actigraphy sleep scores between baseline and follow-up was not achieved,metrics for sleep quality and daytime fatigue showed significant ***: These findings support the hypothesis that HSS has the potential to improve sleep and reduce daytime fatigue in young postconcussion athletes. This pilot study provides guidance to refine research protocols and lays a foundation for further, large-sample, controlled studies.

关键词： concussion Insomnia Youth Complementary and alternative medicine Self-management

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English professional football players concussion knowledge and attitude

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Journal of Sport and Health Science 2016年第2期5卷 197-204页

作者： Joshua M.Williams Jody L.Langdon James L.Mc Millan Thomas A.Buckley Department of Intercollegiate Athletics Wagner College School of Health and Kinesiology Georgia Southern University Department of Kinesiology and Applied Physiology University of Delaware

Background： concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers. Methods： Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum concussion Knowledge and Attitudes Survey （RoCKAS） and a semi-structured interview. The RoCKAS contains separate knowledge （055） and attitude （15-75） scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions. Results： The mean score on the *** knowledge was 16.4± 2.9 （range 11-22） and the attitude score was 59.6 ± 8.5 （range 41-71）. The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting. Conclusion： The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers.

关键词： concussion concussion recovery concussion reporting Football Mild traumatic brain injury RoCKAS

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Gender differences in nonlinear motor performance following concussion

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Journal of Sport and Health Science 2019年第6期8卷 540-547页

作者： Breanna E.Studenka Adam Raikes Kinesiology and Health Science Utah State University

Purpose:To quantify differences in nonlinear aspects of performance on a seated visual-motor tracking task between clinically asymptomatic males and females with and without a self-reported mild traumatic brain injury ***:Seventy-three individuals with a self-reported concussion history(age:21.40±2.25 years,mean±SD)and 75 without completed the visual-motor tracking task(age:21.50±2.00 years).Participants pressed an index finger against a force sensor,tracing a line across a computer screen(visual-motor tracking).The produced signal's root-mean-square error(RMSE),sample entropy(SampEn,a measure of regularity),and average power(AvP)between 0 and 12 Hz were ***:Males with a history of 0 or 1 concussion had greater RMSE(worse performance)than females with 0(pconcussion(p=0.052).Additionally,females with 2+concussions exhibited lower SampEn than females with no history(p=0.001)or a history of 1 concussion(p=0.026).Finally,females with 2+concussions had lower 8-12 Hz AvP than males with 2+concussions(p=0.031).Few differences were observed in the male ***:Females with a self-reported history of multiple concussions exhibited lower SampEn in the visual-motor tracking-task force output structure as compared to those with no reported history of concussion and their male *** SampEn and lower power between 8 and12 Hz indicated persistent impairment in visual processing and feed-forward or predictive motor control systems.

关键词： Average power concussion Isometric motor control Nonlinear analyses Sample entropy Visual-motor processing

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Impaired motor control after sport-related concussion could increase risk for musculoskeletal injury:Implications for clinical management and rehabilitation

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Journal of Sport and Health Science 2021年第2期10卷 154-161页

作者： Terese L.Chmielewski Justin Tatman Shuhei Suzuki MaryBeth Horodyski Darcy S.Reisman Russell M.Bauer James R.Clugston Daniel C.Herman TRIA Orthopedic Center BloomingtonMN 55431USA ATP Tour Inc. Ponte Vedra BeachFL 32082USA Department of Orthopaedics and Rehabilitation University of FloridaGainesvilleFL 32607USA Department of Physical Therapy University of DelawareNewarkDE 19716USA Department of Clinical and Health Psychology University of FloridaGainesvilleFL 32611USA Department of Community Health&Family Medicine University of FloridaGainesvilleFL 32603USA

This review presents a conceptual framework and supporting evidence that links impaired motor control after sport-related concussion(SRC)to increased risk for musculoskeletal *** studies have found that athletes who are post-SRC have higher risk for musculoskeletal injury compared to their counterparts.A small body of research suggests that impairments in motor control are associated with musculoskeletal injury *** control involves the perception and processing of sensory information and subsequent coordination of motor output within the central nervous system to perform a motor *** control is inclusive of motor planning and motor *** sensory information is not accurately perceived or there is interference with sensory information processing and cognition,motor function will be altered,and an athlete may become vulnerable to injury during sport *** with SRC show neuroanatomic and neurophysiological changes relevant to motor control even after meeting return to sport criteria,including a normal neurological examination,resolution of symptoms,and return to baseline function on traditional concussion *** conjunction,altered motor function is demonstrated after SRC in muscle activation and force production,movement patterns,balance/postural stability,and motor task performance,especially performance of a motor task paired with a cognitive task(i.e.,dual-task condition).The clinical implications of this conceptual framework include a need to intentionally address motor control impairments after SRC to mitigate musculoskeletal injury risk and to monitor motor control as the athlete progresses through the return to sport continuum.

关键词： Clinical management concussion Injury Motor control Rehabilitation

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What do coaches want to know about sports-related concussion?A needs assessment study

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Journal of Sport and Health Science 2018年第1期7卷 102-108页

作者： Lindsay Sullivan Michal Molcho School of Health Sciences Discipline of Health Promotion NUI Galway School of Arts Social Sciences and Celtic Studies Children’s Studies Programme NUI Galway

Purpose: This study aims to identify the concussion-related training and education needs of Gaelic Athletic Association(GAA) coaches in Ireland,as well as the preferred method of concussion education ***: We used a self-report questionnaire to collect data from a convenience sample of 108 GAA coaches in Ireland. Data were captured on(1) informational needs and desires,(2) preferred methods of delivery, and(3) concussion practices and procedures. Questionnaires were completed electronically from June 3 rd–September 29 th, ***: Coaches indicated that they were most interested in receiving information about the(1) signs and symptoms of concussion,(2) assessment of concussion, and(3) return-to-play guidelines. Over two-thirds of participants indicated that in-person training would be the most effective mode of delivery of concussion education for this population. Additionally, only 10% coaches reported that before the start of the season they talked to their athletes about concussion management and safety, and this was more common among coaches who reported being formally educated about ***: Our findings reveal a disconnect between the concussion education needs and the education that is currently provided to GAA coaches, in terms of content and delivery modality. Our results suggest a need for a multifaceted approach to concussion education, tailored to the needs and learning preferences of the target population.

关键词： Coaches concussion concussion education GAA Mild traumatic brain injury Needs assessment

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