Background:Previous studies have identified the effect of sport-related concussion on health-related quality of life through the use of patient-reported outcome measures. However, there has been little research exploring the underlying mechanisms that influence these perceptions of health-related quality of life among adolescent athletes who have sustained a sport-related concussion.Purpose:To explore the psychosocial aspects of concussion among adolescent athletes.Study Design:Case series; Level of evidence, 4.Methods:A total of 12 interscholastic athletes (4 girls, 8 boys; mean ± SD age, 15.7 ± 1.7 years; grade level, 10.2 ± 1.4) were interviewed via a semistructured interview protocol between 15 and 30 days postinjury. Data analysis was guided by the consensual qualitative research tradition. Themes and categories emerged through consensus by a 3-person research team, and bias was minimized through the use of multiple-analyst triangulation.Results:Participants identified numerous postconcussion symptoms that resulted in increasing difficulty with emotions (eg, irritable, easily frustrated), roles at school (eg, concentration difficulties, fatigue), and roles in their social environment (eg, letting the team down, not being able to contribute to sport). As a result, participants expressed how they tried to minimize or mask symptoms to decrease the potential of being viewed differently by their peers.Conclusion:Adolescent athletes perceived a significant effect of sport-related concussion on numerous areas of psychosocial and emotional health and well-being. Anticipatory guidance—with education regarding the possible signs and symptoms, risk factors, and recovery expectations following a concussion—is important to include in postinjury management. A better understanding of sport-related concussion and expected recovery could help to improve perceptions of this injury among interscholastic athletes. Additionally, best practices should be identified to assist health care professionals and school personnel in the development of temporary adjustments or formal academic adjustment policies in the secondary school setting, therefore ensuring that the patients receive the support that they need to maintain their roles as students.

Clinical Scenario: Eating disorders in female athletes are a commonly underdiagnosed condition. Better screening tools for eating disorders in athletic females could help increase diagnosis and help athletes get the treatment they need. Focused Clinical Question: Should screening tools be used to detect eating disorders in female athletes? Summary of Key Findings: The literature was searched for studies that included information regarding the sensitivity and specificity of screening tools for eating disorders in female athletes. The search returned 5 possible articles related to the clinical question; 3 studies met the inclusion criteria (2 cross-sectional studies, 1 cohort study) and were included. All 3 studies reported sensitivity and specificity for the Athletic Milieu Direct Questionnaire version 2, the Brief Eating Disorder in Athletes Questionnaire version 2, and the Physiologic Screening Test to Detect Eating Disorders Among Female Athletes. All 3 studies found that the respective screening tool was able to accurately identify female athletes with eating disorders; however, the screening tools varied in sensitivity and specificity values. Clinical Bottom Line: There is strong evidence to support the use of screening tools to detect eating disorders in female athletes. Screening tools with higher sensitivity and specificity have demonstrated a successful outcome of determining athletes with eating disorders or at risk for developing an eating disorder. Strength of Recommendation: There is grade A evidence available to demonstrate that screening tools accurately detect female athletes at risk for eating disorders.

Purpose: To explore athletic trainers' perceptions of academic adjustments for student-athletes following a concussion. Methods:Sixteen secondary school athletic trainers selected via criterion-based and random purposeful sampling were interviewed via telephone. Inclusion criteria were: certified by the Board of Certification; completed the Beliefs, Attitudes, and Knowledge of Pediatric Athletes with Concussions survey; and had a minimum of 5 years of athletic trainer experience in the secondary school setting. Following transcription, a fourperson research team established thematic consensus.Results: Athletic trainers identified five primary themes from the overall study. This study focused on two due to their overlapping goals: the importance of using formalized policy and a variety of academic adjustments for student-athletes with concussion and their perceptions of which key personnel should be included in a concussion management team. Conclusions:This study demonstrates the need for, or enforcement of, policy, a defined progression, and a concussion management team within the school to successfully implement academic adjustments throughout recovery after concussion.

ObjectiveTo explore adolescent athletes’ social perspectives regarding sport and concussion.DesignQualitative inquiry.SettingIndividual in-person interviews.Participants12 interscholastic athletes (4 females, 8 males; age=15.7±1.7 years; grade level=10.2±1.4; sports=football, soccer, volleyball, basketball, and wrestling) were interviewed.Outcome measuresA semi-structured interview protocol was used. Interviews focused on injury details, and explored the physical, psychosocial, emotional, and spiritual components of sport and health. Themes and categories were identified based on the consensus process by a three-person research team. A comprehensive codebook that captured the main themes and categories resulted.ResultsFollowing concussion, participants discussed two primary themes: perceptions regarding the social aspects of sport and social perspectives regarding their concussion. Specific categories related to the social aspects of sport included friendships and family and decision to participate based on peers. Specific categories regarding the social perspectives of the concussion included: uncertainty of the diagnosis, perceptions of others regarding their injury, being ashamed of the concussion, parent and peer roles, and communication and expectation about their concussion.ConclusionsParticipation in sport and removal from sport following a concussion have significant social implications for adolescent athletes. Specifically, the perceptions of peers, parents, and others regarding the injury can influence reporting of symptoms and recovery following concussion. Limited communication regarding recovery and expectations post-concussion may cause undue social pressures to return to activity prematurely. Anticipatory guidance, with education regarding the possible signs and symptoms, risk factors pre- and post-injury, and recovery expectations following a concussion are important to include in post-injury management.Competing interestsFunded from a grant from the National Operating Committee on Standards for Athletic Equipment.