Context Athletic trainers (ATs) are often the first health care providers to conduct concussion assessments and carry out postinjury management. Best practices for concussion evaluation and management have changed rapidly in recent years, outdating previous reports of ATs' concussion practices. Objective To examine ATs' current concussion-assessment and -management techniques. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants A random convenience sample of 8777 ATs (response rate = 15.0% [n = 1307]; years certified = 15.0 ± 10.6) from the National Athletic Trainers' Association membership. Main Outcome Measure(s) Survey Web links were e-mailed to prospective participants, with 2 follow-up e-mails sent by the National Athletic Trainers' Association. The survey collected demographic information, the number of concussions assessed, the concussion-recovery patterns, and the assessment and return-to-participation (RTP) decision-making methods used. Results The ATs reported assessing a median of 12.0 (range = 0–218) concussions per year. A total of 95.3% (953/1000) ATs cited clinical examination as the most frequently used concussion-assessment tool, followed by symptom assessment (86.7%; 867/1000). A total of 52.7% (527/1000) ATs described a 3-domain minimum multidimensional concussion-assessment battery. Published RTP guidelines were the most common RTP decision-making tool (91.0%; 864/949), followed by clinical examination (88.2%; 837/949). The ATs with master's degrees were 1.36 times (95% confidence interval [CI] = 1.02, 1.81) more likely to use a 3-domain concussion-assessment battery than ATs with only bachelor's degrees (χ2 = 4.44, P = .05). Collegiate ATs were 2.12 (95% CI = 1.59, 2.84) and 1.63 (95% CI = 1.03, 2.59) times more likely to use a 3-domain concussion-assessment battery than high school and clinic-based ATs, respectively (χ2 = 26.29, P < .001). Conclusions Athletic trainers were using the clinical examination, standardized assessment tools, and a 3-domain concussion-assessment–battery approach more frequently in clinical practice than previously reported. However, despite practice improvements, nearly half of ATs were not using a 3-domain minimum concussion-assessment battery. Clinicians should strive to implement multidimensional concussion assessments in their practices to ensure optimal diagnosis and management.

Our purpose was to describe the youth flag football head impact burden and make comparisons with youth tackle football. Head impact frequency and magnitude (linear acceleration [g], rotational acceleration [rad/s 2 ]) were collected from 25 tackle and 25 flag youth football players over one season. Athlete exposure (AE) was defined as one player participating in one session. Head impact rates (IR) were calculated and impact rate ratios (IRR) were used to compare youth tackle and flag football. Random-intercept generalized logit models with odds ratios compared the probabilities of sustaining an impact with a linear acceleration of 20.00-29.99g, 30.00-39.99g, and ‡40.00g against the reference of 14.00-19.99g and an impact with a rotational acceleration of 2500.00-7499.99 rad/s 2 or ‡7500.00 rad/s 2 against the reference of £2499.99 rad/s 2 between youth flag and tackle football. We observed 1908 tackle football head impacts (735 in games, 38.5%) across 624 AE and 169 flag football head impacts (101 in games, 59.8%) across 255 AE. Youth tackle football players experienced higher overall IR (3.06, 95% confidence interval [CI]: 2.61, 3.58; IRR = 4.61, 95% CI: 3.94, 5.40) compared with flag football (IR = 0.66, 95% CI: 0.57, 0.78). Youth flag football players had lower odds of sustaining impacts >20g but higher odds of sustaining impacts between 2500.00-7499.99 rad/s 2 compared with youth tackle players. Our preliminary sample of youth flag football players sustained less frequent head impacts at higher rotational accelerations than tackle football players. Flag football is considered a limited-contact sport, but little is known about the true head impact burden. Our findings may be important for policymakers when debating potential changes to youth football participation.

Purpose This study aimed to examine the association between clinical and functional reaction time (RT) assessments with and without simultaneous cognitive tasks among healthy individuals. Methods Participants (n = 41, 49% female; 22.5 ± 2.1 yr; 172.5 ± 11.9 cm; 71.0 ± 13.7 kg) completed clinical (drop stick, Stroop) and functional (gait, jump landing, single-leg hop, anticipated cut, unanticipated cut) RT assessments in random order. All RT assessments, except Stroop and unanticipated cut, were completed under single- (movement only) and dual-task conditions (movement and subtracting by 6s or 7s). Drop stick involved catching a randomly dropped rod embedded in a weighted disk. Stroop assessed RT via computerized neurocognitive testing. An instrumented walkway measured gait RT when center-of-pressure moved after random stimulus. All other functional RT assessments involved participants jumping forward and performing a vertical jump (jump landing), balancing on one leg (single-leg hop), or a 45° cut in a known (anticipated cut) or unknown (unanticipated cut) direction. RT was determined when the sacrum moved following random visual stimulus. Pearson correlation coefficients and a 5 × 2 repeated-measures ANOVA compared RT assessments and cognitive conditions. Results Stroop RT outcomes did not significantly correlate with functional RT assessments (r range = −0.10 to 0.24). A significant assessment by cognitive task interaction (F 4,160 = 14.01; P < 0.001) revealed faster single-task RT among all assessments compared with dual-task (mean differences, −0.11 to −0.09 s; P < 0.001), except drop stick (P = 0.195). Single-leg hop (0.58 ± 0.11 s) was significantly slower compared with jump landing (0.53 ± 0.10 s), anticipated cut (0.49 ± 0.09 s), gait (0.29 ± 0.07 s), and drop stick (0.21 ± 0.03 s; P values ≤ 0.001). Dual-task assessments were significantly slower than single-task assessments (mean difference, 0.08 s; P < 0.001). Conclusions Clinical and functional RT assessments were not correlated with each other, suggesting that sport-like RT is not being assessed after concussion. Functional and dual-task RT assessments may add clinical value and warrant further exploration after concussion.

Context Frequent inspection of sports-related injury epidemiology among National Collegiate Athletic Association (NCAA) women's basketball student-athletes is valuable for identifying injury-related patterns. Background Emerging patterns in epidemiology of NCAA women's basketball injuries are unknown though general sports medicine practices, and playing rules and regulations have evolved in recent years. Methods Athlete exposures (AEs) and injury incidence data were reported to the NCAA Injury Surveillance Program between 2014–2015 and 2018–2019. Injury counts, rates, and proportions were used to examine injury characteristics, and injury rate ratios (IRRs) were used to assess injury rate differences. Results Practice and competition injury rates were 5.93 and 10.35 per 1000 AEs, respectively. Preseason injury rates were higher than regular (IRR = 1.41; 95% CI = 1.31, 1.53) and postseason (IRR = 3.12; 95% CI = 2.39, 4.07). Ankle sprains (14.3%), concussions (7.5%), and anterior cruciate ligament tears (2.5%) were the most commonly reported injuries. Summary Higher rates of practice and competition injuries, as well as ankle sprains, were observed relative to previous reports; continuous monitoring is necessary to identify potential contributing factors to these trends.

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