Assessment and Management of Sport-Related Concussions in United States High Schools

Meehan, William P.; d’Hemecourt, Pierre A.; Collins, Christy L.; Comstock, R. Dawn

doi:10.1177/0363546511423503

Cited by 139 publications

(109 citation statements)

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“…This time period was chosen because symptoms resolve within 1 month in 70% to 90% of youth with SRRCs. 6,[16][17][18][19] We conducted a sensitivity analysis using alternate exclusion periods of 2 weeks and 3 months to determine how different time periods affected the estimate. We used 2 weeks as the shortest period based on typical symptom resolution.…”

Section: Figurementioning

confidence: 99%

“…Many of these SRRCs do not result in an encounter with additional health care providers and would not be included in the previously described databases. 16,22,23 To determine the number of high school athletes who receive care exclusively from ATCs, we used data from High School RIO. 24 High School RIO is an Internet-based sports injury surveillance system that records sports-related injuries reported by high school ATCs for a random sample of 100 US high schools.…”

Section: National High School Sports-related Injury Surveillance Systmentioning

confidence: 99%

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Sports- and Recreation-Related Concussions in US Youth

et al. 2016

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The incidence of sports-and recreation-related concussions (SRRCs) in the United States is unknown. More than 44 million youth participate in sports annually, thus understanding the frequency of SRRCs in children is important on a population level. Our objective was to determine the number of SRRCs occurring annually among US youth ≤18 years old. METHODS:We identified SRRCs using 3 national databases: MarketScan, National Electronic Injury Surveillance System, and National High School Sports Related Injury Surveillance System, Reporting Injury Online. We determined the number of SRRCs seen in health care settings (outpatient, inpatient, and emergency department) and SRRCs reported to certified high school athletic trainers (ATCs). We used these data and findings in recently published literature to generate a national estimate of SRRCs. RESULTS:We estimate that between 1.1 and 1.9 million SRRCs occur annually in US children aged ≤18 years. Most children with SRRCs, 511 590 to 1 240 972, were not seen in health care settings. Of children with SRRCs seen in health care settings, most were seen as outpatients with 377 978 visits, compared with between 115 479 and 166 929 ED visits, and between 2886 and 4936 hospitalizations. CONCLUSIONS:This study provides the most accurate and precise estimate to date of the number of concussions among US children annually. SRRCs are a common injury in children. Providers in all health care settings need to be trained in concussion care. There is a need for better surveillance to enhance our understanding of the epidemiology of concussions in youth. Dr Bryan conducted the data gathering and analysis with Dr Rowhani-Rahbar and led the manuscript writing; Dr. Rowhani-Rahbar conducted the data gathering and analysis with Dr Bryan and contributed to the manuscript preparation and intellectual content; Dr Comstock provided data and feedback on manuscript preparation; Dr Rivara conceived of the study and supervised throughout data gathering, analysis, and manuscript preparation; and all authors approved the fi nal manuscript as submitted. WHAT'S KNOWN ON THIS SUBJECT: Sports-and recreation-related concussions (SRRCs) are a common source of morbidity in children. Many of these injuries are not treated within health care settings. It is unknown how many SRRCs occur annually in the US. DOI WHAT THIS STUDY ADDS:We estimate between 1.1 and 1.9 million SRRCs occur annually in US children ≤18 years old. The magnitude of this number emphasizes the need for better national injury surveillance of the incidence of SRRCs.by guest on May 10, 2018 http://pediatrics.aappublications.org/ Downloaded from BRYAN et alConcussions, a form of traumatic brain injury (TBI), are common in children, with sports and recreation as a leading cause in this age group. 1, 2 The incidence of sports-and recreation-related concussions (SRRCs) in the United States is unknown; however, most epidemiologic studies indicate that a large number of SRRCs occur each year. [3][4][5][6][7] More than 44 million youth participate in ...

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Section: Figurementioning

confidence: 99%

Section: National High School Sports-related Injury Surveillance Systmentioning

confidence: 99%

Sports- and Recreation-Related Concussions in US Youth

et al. 2016

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“…Athletes with longer-duration symptoms were more likely to obtain physician clearance before returning to play. 49 Athletic trainers on the field are therefore an important component of concussion management in the acute phase. However, even current practice patterns among athletic trainers lack standardization and adherence to current guidelines.…”

Section: Current Awareness and Practicesmentioning

confidence: 99%

Comparative analysis of state-level concussion legislation and review of current practices in concussion

Tomei¹,

Doe²,

Prestigiacomo³

et al. 2012

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Object Forty-two states and the District of Columbia have passed legislation based on the Lystedt law of Washington state, enacted in 2009 to protect young athletes who have sustained a concussion. The aim of this study was to note the several similarities and differences among the various laws. Methods Concussion legislation was compared for 50 states and the District of Columbia. Evaluation parameters of this study included stipulations of concussion education, criteria for removal from play, requirements for evaluation and return to play after concussion, and individuals required to assess young athletes. Other parameters that were not consistent across states were also noted. Results Forty-three states and the District of Columbia have passed concussion legislation, and an additional 4 states have pending legislation. All states with existing legislation support concussion education for coaches; however, only 48% require coaches to undergo formal education. Athletes must be educated on concussion in 86% of states and parents in 88.7%. Suspicion of concussion is a criterion for removal from play in 75% of states; signs and symptoms of concussion are criteria for removal from play in 16% of states. The individuals allowed to evaluate and clear an athlete for return to play differ greatly among states. Conclusions Injury prevention legislation holds historical precedent, and given the increasing attention to long-term sequelae of repeated head trauma and concussion, concussion legislation has been rapidly passed in 43 states and the District of Columbia. Although the exact stipulations of these laws vary among states, the overall theme is to increase recognition of concussion in young athletes and ensure that they are appropriately cleared for return to play after concussion.

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“…11,12 One important component of such an individualized plan is cognitive rest. Cognitive rest is imperative for the healing process because it allows the brain time to recover without exacerbating symptoms.…”

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confidence: 99%

Athletic Trainers' Familiarity With and Perceptions of Academic Accommodations in Secondary School Athletes After Sport-Related Concussion

Williams

Welch

Parsons

et al. 2015

Journal of Athletic Training

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Context: Sport-related concussion can affect athletes' sport participation and academic success. With the recent emphasis on cognitive rest, student-athletes may benefit from academic accommodations (AA) in the classroom; however, athletic trainers' (ATs') perceived familiarity with, and use of, AA is unknown.Objective: To assess secondary school ATs' perceived familiarity with, attitudes and beliefs about, and incorporation of AA for student-athletes after sport-related concussion. A secondary purpose was to determine whether employment status altered familiarity and use of AA.Design: Cross-sectional study. years).Main Outcome Measure(s): Participants were solicited via e-mail to complete the Beliefs, Attitudes and Knowledge Following Pediatric Athlete Concussion among Athletic Trainers employed in the secondary school setting (BAKPAC-AT) survey. The BAKPAC-AT assessed ATs' perceived familiarity, perceptions, and roles regarding 504 plans, Individualized Education Programs (IEPs), and returning student-athletes to the classroom. Independent variables were employment status (full time versus part time), employment model (direct versus outreach), years certified, and years of experience in the secondary school setting. The dependent variables were participants' responses to the AA questions. Spearman rank-correlation coefficients were used to assess relationships and Mann-Whitney U and v 2 tests (P , .05) were used to identify differences.Results: Respondents reported that approximately 41% of the student-athletes whose sport-related concussions they managed received AA. Respondents employed directly by the school were more familiar with 504 plans (P , .001) and IEPs (P , .001) and had a greater belief that ATs should have a role in AA. Both the number of years certified and the years of experience at the secondary school were significantly correlated with perceived familiarity regarding 504 plans and IEPs.Conclusions: The ATs employed directly by secondary schools and those with more experience as secondary school ATs were more familiar with AA. Understanding AA is important for all ATs because cognitive rest and ''return to learn'' are becoming more widely recommended in concussion management.

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Assessment and Management of Sport-Related Concussions in United States High Schools

Cited by 139 publications

References 25 publications

Sports- and Recreation-Related Concussions in US Youth

Sports- and Recreation-Related Concussions in US Youth

Comparative analysis of state-level concussion legislation and review of current practices in concussion

Athletic Trainers' Familiarity With and Perceptions of Academic Accommodations in Secondary School Athletes After Sport-Related Concussion

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