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Article ; Online: Influence of sleep symptoms on recovery from concussion in collegiate athletes: a LIMBIC MATARS consortium investigation.

Donahue, Catherine C / Walton, Samuel R / Oldham, Jessie R / Beidler, Erica / Larson, Michael J / Broshek, Donna / Cifu, David X / Resch, Jacob E

Brain injury

2024 , Page(s) 1–7

Abstract: Objective: Changes in sleep quality and quantity are commonly endorsed by individuals following a concussion. Limited data exists examining the role of sleep disturbances within 72 hours, and throughout recovery, from concussion. The objective of this ... ...

Abstract	Objective: Changes in sleep quality and quantity are commonly endorsed by individuals following a concussion. Limited data exists examining the role of sleep disturbances within 72 hours, and throughout recovery, from concussion. The objective of this study was to determine if the number of days to symptom resolution varied between collegiate athletes with or without sleep-related symptoms following a concussion. Design: Retrospective chart review. Methods: Collegiate athletes ( Results: Of the 539 participants, 250 (46.3%) reported sleep-related symptoms. Participants with sleep-related symptoms took significantly longer (U = 30656, Conclusion: Collegiate athletes that report sleep-related symptoms immediately following concussion (<72 hours) were observed to take, on median, two days longer to achieve symptom resolution at rest when compared to athletes who did not endorse the same symptoms.
Language	English
Publishing date	2024-04-28
Publishing country	England
Document type	Journal Article
ZDB-ID	639115-1
ISSN	1362-301X ; 0269-9052
ISSN (online)	1362-301X
ISSN	0269-9052
DOI	10.1080/02699052.2024.2347542
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Article ; Online: Biopsychosocial Experiences of Elite Athletes Retiring From Sport for Career-Ending Injuries: A Critically Appraised Topic.

Moore, Haley S / Walton, Samuel R / Eckenrod, Morgan R / Kossman, Melissa K

Journal of sport rehabilitation

2022 Volume 31, Issue 8, Page(s) 1095–1099

Abstract: Clinical scenario: Injuries cause individuals varying amounts of time loss from participation, which may depend on injury and sport-specific factors such as level of participation. Athletes who never return to sport either choose or are forced to retire ...

Abstract	Clinical scenario: Injuries cause individuals varying amounts of time loss from participation, which may depend on injury and sport-specific factors such as level of participation. Athletes who never return to sport either choose or are forced to retire due to numerous factors. At elite levels of play, when an athlete chooses retirement, they have the opportunity to create and execute a retirement plan; however, if unexpected (eg, due to career-ending injury), athletes may struggle to transition out of sport effectively, impacting physical, mental, and social health. The biopsychosocial model looks at the relationship between biology, psychology, and socio-environmental factors. Therefore, the purpose of this study was to better understand the biopsychosocial experiences elite athletes face after a career-ending injury so that sport stakeholders can develop and implement strategies to support a healthy transition. Clinical question: How does suffering a career-ending injury affect elite athletes' biopsychosocial experiences during retirement from sport? Summary of key findings: All studies found that a career-ending injury negatively impacted athlete's biopsychosocial health during the transition period. In addition, social support was identified as a positive coping mechanism and research highlighted the role of education in promoting successful transitions. Sport stakeholders should educate athletes regarding the importance of creating secondary plans. By creating a culture of athletic and nonathletic identity, athletes can feel empowered to navigate different phases of their life despite transition being forced upon them due to injury. Clinical bottom line: Career-ending injuries negatively impact the biopsychosocial experiences of elite athletes as they transition out of sport. Athletes may face many transitional challenges including a loss of identity, a lack of external support, and/or mental health decline; those more closely identifying with their role as an athlete tend to have a harder transition. Therefore, it is important for all athletes to be adequately prepared for sport retirement, especially given the uncertainty about when and how retirement may occur. Strength of recommendation: Collectively, the body of evidence included to answer the clinical question aligns with the strength of recommendation of C.
MeSH term(s)	Humans ; Retirement/psychology ; Athletes/psychology ; Sports ; Social Support ; Anxiety ; Athletic Injuries/psychology
Language	English
Publishing date	2022-08-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1106769-x
ISSN	1543-3072 ; 1056-6716
ISSN (online)	1543-3072
ISSN	1056-6716
DOI	10.1123/jsr.2021-0434
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Article ; Online: Access to athletic trainers and sex as modifiers of time to reach clinical milestones after sport-related concussion in collegiate athletes.

Walton, Samuel R / Kelshaw, Patricia M / Munce, Thayne A / Beidler, Erica / Bowman, Thomas G / Oldham, Jessie R / Wilmoth, Kristin / Broshek, Donna K / Rosenblum, Daniel J / Cifu, David X / Resch, Jacob E

Brain injury

2024 , Page(s) 1–8

Abstract: Objective: Investigate whether an athlete's biological sex and exposure to a dedicated athletic trainer (AT) were related to clinical milestones after a sports-related concussion (SRC).: Design: Retrospective chart review.: Methods: Medical charts ...

Abstract	Objective: Investigate whether an athlete's biological sex and exposure to a dedicated athletic trainer (AT) were related to clinical milestones after a sports-related concussion (SRC). Design: Retrospective chart review. Methods: Medical charts of collegiate athletes ( Results: There were no significant differences in times to reaching any clinical milestone by sex, AT exposure, or their interaction (ps > 0.05). Forty-three percent of participants were diagnosed on the day of their SRC. This did not differ by sex or AT exposure (ps > 0.29). Longer times to SRC diagnosis were associated with more days to symptom resolution (ρ = 0.236, Conclusions: Athlete sex and AT exposure were not associated with times to reach any clinical milestone; however, delayed diagnosis was associated with longer times to reach clinical recovery.
Language	English
Publishing date	2024-02-06
Publishing country	England
Document type	Journal Article
ZDB-ID	639115-1
ISSN	1362-301X ; 0269-9052
ISSN (online)	1362-301X
ISSN	0269-9052
DOI	10.1080/02699052.2024.2310787
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Article ; Online: Sport Type and Risk of Subsequent Injury in Collegiate Athletes Following Concussion: a LIMBIC MATARS Consortium Investigation.

Oldham, Jessie R / Bowman, Thomas G / Walton, Samuel R / Beidler, Erica / Campbell, Thomas R / Smetana, Racheal M / Munce, Thayne A / Larson, Michael J / Cullum, C Munro / Bushaw, Mark A / Rosenblum, Daniel J / Cifu, David X / Resch, Jacob E

Brain injury

2024 , Page(s) 1–9

Abstract: Objective: To investigate the association between sport type (collision, contact, non-contact) and subsequent injury risk following concussion in collegiate athletes.: Materials and methods: This retrospective chart review of 248 collegiate athletes ... ...

Abstract	Objective: To investigate the association between sport type (collision, contact, non-contact) and subsequent injury risk following concussion in collegiate athletes. Materials and methods: This retrospective chart review of 248 collegiate athletes with diagnosed concussions (age: 20.0 ± 1.4 years; height: 179.6 ± 10.9 cm; mass: 79.0 ± 13.6 kg, 63% male) from NCAA athletic programs ( Results: Approximately 28% (70/248) of athletes sustained a subsequent acute injury within six months post-concussion. Collision sport athletes had a significantly higher risk of sustaining any injury (HR: 0.41, Conclusion: Collision sport athletes had a higher rate of any subsequent injury, lower, and upper extremity injuries following concussion. Future research should focus on sport-specific secondary injury prevention efforts.
Language	English
Publishing date	2024-02-05
Publishing country	England
Document type	Journal Article
ZDB-ID	639115-1
ISSN	1362-301X ; 0269-9052
ISSN (online)	1362-301X
ISSN	0269-9052
DOI	10.1080/02699052.2024.2310782
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Article ; Online: Reevaluating clinical assessment outcomes after unrestricted return to play following sport-related concussion.

Thompson, Xavier D / Erdman, Nicholas K / Walton, Samuel R / Broshek, Donna K / Resch, Jacob E

Brain injury

2021 Volume 35, Issue 12-13, Page(s) 1577–1584

Abstract: Primary objective: The objective of this study was to examine neurocognition, postural control, and symptomology at multiple timepoints following concussion. We hypothesized that collegiate athletes would perform similar to or better than their baseline ...

Abstract	Primary objective: The objective of this study was to examine neurocognition, postural control, and symptomology at multiple timepoints following concussion. We hypothesized that collegiate athletes would perform similar to or better than their baseline in terms of each outcome at both timepoints. Research design: This was a retrospective study of 71 collegiate athletes (18.3 ± 0.89 years old; 182.2 ± 10.05 cm; 84.2 ± 20.07 kg) to observe changes in outcomes from a previously established clinical protocol. Methods and procedures: Participants were administered ImPACT™, the Sensory Organization Test (SOT), and the revised head injury scale (HIS-r) prior to their seasons (baseline); upon reporting symptom-free following concussion (post-injury); and approximately 8-months after return-to-play to establish a new baseline. Main outcomes and results: There were no changes in ImPACT scores or HIS-r reporting over time. ImPACT total symptom score (TSS) decreased over time ( Conclusions: Our data suggest no decline in neurocognition, balance, or symptom burden approximately eight months post-injury. As clinicians continue to explore "best practices" for concussion management and potential long-term implications of these injuries it is important to monitor outcome measures longitudinally.
MeSH term(s)	Adolescent ; Adult ; Athletes ; Athletic Injuries/complications ; Brain Concussion ; Humans ; Neuropsychological Tests ; Outcome Assessment, Health Care ; Retrospective Studies ; Return to Sport ; Young Adult
Language	English
Publishing date	2021-09-20
Publishing country	England
Document type	Journal Article
ZDB-ID	639115-1
ISSN	1362-301X ; 0269-9052
ISSN (online)	1362-301X
ISSN	0269-9052
DOI	10.1080/02699052.2021.1975818
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Article ; Online: Concussion Assessment and Management Practices Among Irish and Canadian Athletic Therapists: An International Perspective.

Lempke, Landon B / Bergeron, Glen / O'Connor, Siobhán / Lynall, Robert C / Resch, Jacob E / Walton, Samuel R

Journal of athletic training

2022 Volume 58, Issue 4, Page(s) 293–304

Abstract: Context: Certified athletic therapists in Ireland and Canada serve essential concussion assessment and management roles, but their health care practices and concussion knowledge have not been established.: Objective: To examine Irish and Canadian ... ...

Abstract	Context: Certified athletic therapists in Ireland and Canada serve essential concussion assessment and management roles, but their health care practices and concussion knowledge have not been established. Objective: To examine Irish and Canadian athletic therapist cohorts' (1) concussion knowledge, (2) current concussion assessment and management techniques across all job settings, and (3) the association of concussion assessment and management practices with years of clinical experience and highest degree attained. Design: Cross-sectional cohort study. Setting: Online survey. Patients or other participants: Licensed Irish (49.7%, n = 91/183) and Canadian (10.1%, n = 211/2090) athletic therapists. Main outcome measure(s): Athletic therapists completed an online survey assessing their demographics, concussion knowledge (symptom recognition, patient-clinician scenarios), frequency of concussions assessed annually, and assessment and return-to-play (RTP) measures using a modified, previously validated survey. Symptom recognition consisted of 20 (8 true, 12 false) items on recognition of signs and symptoms that were scored as total correct. Descriptive statistics and odds ratios were used to examine survey responses where appropriate. Results: Irish (86.8%, n = 46/53) and Canadian (93.4%, n = 155/166) athletic therapists indicated RTP guidelines were the most common method for determining RTP. Symptom recognition scores were 72.8% ± 17.0% among Irish and 76.6% ± 17.0% among Canadian athletic therapists. Irish (91.2%, n = 52/57) and Canadian (90.4%, n = 161/178) athletic therapists reported standardized sideline assessments as the most used concussion assessment method. Irish and Canadian athletic therapists' use of 2-domain (Irish: 38.6% [n = 22/57]; Canadian: 73.6% [n = 131/178]) and 3-domain (Irish: 3.5% [n = 2/57]; Canadian: 19.7% [n = 35/178]) minimum assessments (ie, symptoms, balance, or neurocognitive) was not associated with education or clinical experience (P ≥ .07), except for Canadian athletic therapists with master's degrees having greater odds of completing 2-domain assessments at initial evaluation than those with bachelor's degrees (odds ratio = 1.80; 95% CI = 1.41, 1.95). Conclusions: Irish and Canadian athletic therapists demonstrated similar concussion knowledge; however, most did not fully adhere to international consensus guidelines for concussion assessment as evidenced by low 2- and 3-domain assessment use. Athletic therapists should aim to implement multidimensional concussion assessments to ensure optimal health care practices and patient safety.
MeSH term(s)	Humans ; Athletic Injuries/diagnosis ; Athletic Injuries/therapy ; Sports Medicine/methods ; Cross-Sectional Studies ; Canada ; Brain Concussion/diagnosis ; Brain Concussion/therapy ; Sports ; Internationality
Language	English
Publishing date	2022-06-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2070051-9
ISSN	1938-162X ; 1062-6050
ISSN (online)	1938-162X
ISSN	1062-6050
DOI	10.4085/1062-6050-0097.22
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Article: Examining racial and ethnic disparities in adult emergency department patient visits for concussion in the United States.

Lempke, Landon B / Kerr, Zachary Yukio / Melvin, Patrice / Walton, Samuel R / Wallace, Jessica S / Mannix, Rebekah C / Meehan, William P / Ward, Valerie L

Frontiers in neurology

2022 Volume 13, Page(s) 988088

Abstract: Background: Racial and ethnic differences in emergency department (ED) visits have been reported among adolescent patients but are unsubstantiated among adults. Therefore, our purpose in this study was to examine the relationship between race/ethnicity ... ...

Abstract	Background: Racial and ethnic differences in emergency department (ED) visits have been reported among adolescent patients but are unsubstantiated among adults. Therefore, our purpose in this study was to examine the relationship between race/ethnicity and adult ED visits for concussions, their injury mechanisms, and computed tomography (CT) scan use among a nationally representative sample. Methods: We used the National Hospital Ambulatory Medical Care Survey database from 2010-2015 to examine 63,725 adult (20-45 years old) patient visits, representing an estimated 310.6 million visits presented to EDs. Of these visits, 884 (4.5 million national estimate) were diagnosed with a concussion. Visit records detailed patient information (age, sex, race/ethnicity, geographic region, primary payment type), ED visit diagnoses, injury mechanism (sport, motor vehicle, fall, struck by or against, "other"), and head CT scan use. The primary independent variable was race/ethnicity (non-Hispanic Asian, non-Hispanic Black or African American, Hispanic/Latinx, non-Hispanic multiracial or another, and non-Hispanic White). We used multivariable logistic and multinomial regression models with complex survey sampling design weighting to examine the relationship between concussion ED visits, injury mechanisms, and CT scan use separately by race/ethnicity while accounting for covariates. Results: There were no associations between race/ethnicity and concussion diagnosis among adult ED visits after accounting for covariates. Relative to sports-related injuries, non-Hispanic Black or African American patient visits were associated with a motor vehicle (OR = 2.69, 95% CI: 1.06-6.86) and "other" injury mechanism (OR = 4.58, 95% CI: 1.34-15.69) compared to non-Hispanic White patients. Relative to sports-related injuries, non-Hispanic Asian, multiracial, or patients of another race had decreased odds of falls (OR = 0.20, 95% CI: 0.04-0.91) and "other" injuries (OR = 0.09, 95% CI: 0.01-0.55) compared to non-Hispanic White patients. The odds of a CT scan being performed were significantly lower among Hispanic/Latinx patient visits relative to non-Hispanic White patients (OR = 0.52, 95% CI: 0.30-0.91), while no other race/ethnicity comparisons differed. Conclusion: Our findings indicate that the overarching concussion ED visit likelihood may not differ by race/ethnicity in adults, but the underlying mechanism causing the concussion and receiving a CT scan demonstrates considerable differences. Prospective future research is warranted to comprehensively understand and intervene in the complex, multi-level race/ethnicity relationships related to concussion health care to ensure equitable patient treatment.
Language	English
Publishing date	2022-09-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2022.988088
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Article ; Online: Investigating the association between subjective and objective performance-based cognitive function among former collegiate football players.

Bryant, Andrew M / Kerr, Zachary Y / Walton, Samuel R / Barr, William B / Guskiewicz, Kevin M / McCrea, Michael A / Brett, Benjamin L

The Clinical neuropsychologist

2022 Volume 37, Issue 3, Page(s) 595–616

Abstract: Objective: Studies have observed variable associations of prior contact sport participation with subjective and objective measures of cognitive function. This study directly investigated the association between subjective self-report and objective ... ...

Abstract	Objective: Studies have observed variable associations of prior contact sport participation with subjective and objective measures of cognitive function. This study directly investigated the association between subjective self-report and objective performance-based cognition among former collegiate football players, as well as its relationship to self-reported concussion history. Methods: Former collegiate football players (N = 57; mean age = 37.9 years [ Results: Subjective cognition was not significantly associated with any objective measures of cognitive functioning ( Conclusions: Reliance on self-reported measures of cognitive functioning alone is insufficient when assessing cognition in former contact sport athletes. Assessment of other factors known to influence subjective cognitive complaints should also be examined in determining the presence of cognitive deficits.
MeSH term(s)	Adult ; Humans ; Football/psychology ; Quality of Life ; Neuropsychological Tests ; Cognition ; Brain Concussion/complications ; Brain Concussion/psychology ; Athletes/psychology
Language	English
Publishing date	2022-06-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	639080-8
ISSN	1744-4144 ; 0920-1637 ; 1385-4046
ISSN (online)	1744-4144
ISSN	0920-1637 ; 1385-4046
DOI	10.1080/13854046.2022.2083021
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Article ; Online: Physical activity and recovery following concussion in collegiate athletes: a LIMBIC MATARS Consortium Investigation.

Bowman, Thomas G / Lininger, Monica R / Oldham, Jessie R / Smetana, Racheal M / Kelshaw, Patricia M / Beidler, Erica / Campbell, Thomas R / Walton, Samuel R / Munce, Thayne A / Larson, Michael J / Didehbani, Nyaz / Cullum, C Munro / Rosenblum, Daniel J / Cifu, David X / Resch, Jacob E

Brain injury

2024 , Page(s) 1–8

Abstract: Objective: To investigate whether routine daily activities (RDA), non-prescribed exercise (Non-ERx), or prescribed exercise (ERx) were associated with recovery from sport-related concussion (SRC) in collegiate athletes.: Materials and methods: Data ... ...

Abstract	Objective: To investigate whether routine daily activities (RDA), non-prescribed exercise (Non-ERx), or prescribed exercise (ERx) were associated with recovery from sport-related concussion (SRC) in collegiate athletes. Materials and methods: Data for this cross-sectional, retrospective chart review of collegiate athletes diagnosed with SRC ( Results: Those in the Non-ERx group took nearly 1.3 times longer to achieve SR (IRR = 1.28, 95% CI: 1.11, 1.46) and, 1.8 times longer for RTS (IRR = 1.82, 95% CI: 1.11, 2.71) when compared to those in the RDA group. No other comparisons were significant. Conclusion: Collegiate athletes in the Non-ERx group took approximately 1 week longer to achieve SR as compared to the RDA and ERx groups. Our findings suggest that if exercise is recommended following SRC, it must be clearly and specifically prescribed. If exercise parameters cannot be prescribed, or monitored, RDA appear to be similarly beneficial during recovery for collegiate athletes with concussion.
Language	English
Publishing date	2024-02-07
Publishing country	England
Document type	Journal Article
ZDB-ID	639115-1
ISSN	1362-301X ; 0269-9052
ISSN (online)	1362-301X
ISSN	0269-9052
DOI	10.1080/02699052.2024.2310791
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Article: Headache among combat-exposed veterans and service members and its relation to mild traumatic brain injury history and other factors: a LIMBIC-CENC study.

Walker, William C / Clark, Sarah W / Eppich, Kaleb / Wilde, Elisabeth A / Martin, Aaron M / Allen, Chelsea M / Cortez, Melissa M / Pugh, Mary Jo / Walton, Samuel R / Kenney, Kimbra

Frontiers in neurology

2023 Volume 14, Page(s) 1242871

Abstract: Background: Headache (HA) is a common persistent complaint following mild traumatic brain injury (mTBI), but the association with remote mTBI is not well established, and risk factors are understudied.: Objective: Determine the relationship of mTBI ... ...

Abstract	Background: Headache (HA) is a common persistent complaint following mild traumatic brain injury (mTBI), but the association with remote mTBI is not well established, and risk factors are understudied. Objective: Determine the relationship of mTBI history and other factors with HA prevalence and impact among combat-exposed current and former service members (SMs). Design: Secondary cross-sectional data analysis from the Long-Term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium prospective longitudinal study. Methods: We examined the association of lifetime mTBI history, demographic, military, medical and psychosocial factors with (1) HA prevalence ("lately, have you experienced headaches?") using logistic regression and (2) HA burden via the Headache Impact Test-6 (HIT-6) using linear regression. Each lifetime mTBI was categorized by mechanism (blast-related or not) and setting (combat deployed or not). Participants with non-credible symptom reporting were excluded, leaving Results: At a median 10 years since last mTBI, mTBI positive participants had higher HA prevalence (69% overall, 78% if 3 or more mTBIs) and greater HA burden (67% substantial/severe impact) than non-TBI controls (46% prevalence, 54% substantial/severe impact). In covariate-adjusted analysis, HA prevalence was higher with greater number of blast-related mTBIs (OR 1.81; 95% CI 1.48, 2.23), non-blast mTBIs while deployed (OR 1.42; 95% CI 1.14, 1.79), or non-blast mTBIs when not deployed (OR 1.23; 95% CI 1.02, 1.49). HA impact was only higher with blast-related mTBIs. Female identity, younger age, PTSD symptoms, and subjective sleep quality showed effects in both prevalence and impact models, with the largest mean HIT-6 elevation for PTSD symptoms. Additionally, combat deployment duration and depression symptoms were factors for HA prevalence, and Black race and Hispanic/Latino ethnicity were factors for HA impact. In sensitivity analyses, time since last mTBI and early HA onset were both non-significant. Conclusion: The prevalence of HA symptoms among formerly combat-deployed veterans and SMs is higher with more lifetime mTBIs regardless of how remote. Blast-related mTBI raises the risk the most and is uniquely associated with elevated HA burden. Other demographic and potentially modifiable risk factors were identified that may inform clinical care.
Language	English
Publishing date	2023-09-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1242871
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