Concussion in sport: the importance of accurate and reliable discharge advice

Norton, Cormac

doi:10.7748/en.2018.e1724

Cited by 3 publications

(8 citation statements)

References 23 publications

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“…In recent years, sports-related concussions (SRC) have become one of the most thrilling topics in sports medicine [ 1 , 2 , 3 ]. Historically speaking, the investigation of concussions in sports had already started back in 1928, with the description of neurological deficits in boxers (“punch drunk”) [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Structural changes are detected rarely in conventional imaging, but functional MRI (fMRI) has shown relevant changes in brain activity in affected areas. Pathophysiologically, a complex cascade leads to an energy discrepancy with reduced functionality of the brain cells [ 1 , 10 , 11 ]. After experiencing a traumatic brain injury (TBI), a period of time where athletes are still vulnerable and at a high risk of permanent damage due to repeated concussions was reported [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Sports-Related Concussion Is a Personalized Issue—Evaluation of Medical Assessment and Subjective Feeling of the Athlete in a German Level 1 Trauma Center

Weber

Huber

Frankewycz

et al. 2022

JPM

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Sports-related concussions (SRC) have developed into a highly discussed topic in sports medicine over the last few years and demonstrate a severe issue in the personalized treatment of patients. This retrospective cohort study investigated 86 patients with sports-related concussions in a level 1 trauma center, relating to the mechanism, symptoms, medical history, acute therapy including first assessment and the return to sport. The research is based on medical records as well as questionnaires six months after hospitalization. Loss of consciousness for under 30 min (41.2%), headache (36.5%) and amnesia (29.4%) were the most frequent symptoms when presenting in the emergency room. During the hospitalization, mainly headache and vertigo were documented. Most concussions occurred after incidents in equitation and cycling sports; the most common mechanism was falling to the ground with a subsequent impact (59.3%). At the time of discharge from hospital, in 13.4% of all cases, concussion symptoms were still documented in medical records, in contrast to 39.5% of the concerned athletes who reported symptoms for longer than 24 h, and 41.0% who reported ongoing post-concussion symptoms after six months. Concussions are difficult-to-treat disorders with a challenging diagnostic process and many symptoms in various values and levels of persistence. Therefore, a patient-involving treatment with a complaint-dependent return to sport process should be applied to concerned athletes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sports-Related Concussion Is a Personalized Issue—Evaluation of Medical Assessment and Subjective Feeling of the Athlete in a German Level 1 Trauma Center

Weber

Huber

Frankewycz

et al. 2022

JPM

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“…34 Yet, the recovery advice issued for concussion, at least for individuals who present to hospital, may include a generic instruction to "rest" and then gradually return to normal activities. 35 Thus it is possible that patients have varying interpretations of what it would mean to rest for concussion, and which behaviors they should change. This study aimed to examine how people would interpret CISG-type advice for concussion by measuring their rest and activity intentions for simulated concussion.…”

mentioning

confidence: 99%

An experimental study of the effect on activity intentions of postconcussion recovery advice

Sullivan

Billing

2019

Journal of Concussion

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This study tested the effect of issuing return-to-activity advice on activity intentions at Day 2 and Day 10 days post simulated mild traumatic brain injury. One hundred and twenty-eight volunteers were randomly allocated to one of two groups who received (n ¼ 65) or did not receive standardized post-injury advice (n ¼ 63). To prime the simulation, the participants read a mild traumatic brain injury vignette about a person who is concussed while playing sport. Then the participants role-played the injured person and reported activity intentions for three activity types (cognitive, physical and restful) twice, once for each time frame (i.e. Day 2 and Day 10). The advice was to rest for the first 24-48 h and then gradually resume normal activities. There was no significant group by activity-type interaction (p > .05) at Day 2. When both time frames were considered, there was no significant group Â time frame interaction for any activity type or any item, except for an increase in non-manual (clerical) work and weight training at Day 10 compared to Day 2 in the group with the advice. In general, the intentions for all activity types were consistent with the recovery advice (i.e., rest then increasing activity), even when the advice was not given. However, at Day 10, cognitive and physical activity levels were still expected to be lower than usual (pre-injury), and many participants were uncertain about the concept of cognitive rest. These factors, along with individual patient circumstances, should be taken into account in rehabilitation planning.

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“…El aumento de calcio produce una neurotoxicidad intracelular, aumentando la citosina, la cual inflama la célula y posteriormente le provoca la muerte (Kochanek, et al, 2000). Durante todo este proceso ocurre una inflamación cerebral como consecuencia de la CC (Norton, 2018;Rădoi, et al, 2016).…”

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“…Entre los síntomas emocionales que pueden presentarse después de una CC están la labilidad emocional, irritabilidad, baja tolerancia a la frustración, cambios en la personalidad, nerviosismo, ansiedad, tristeza o depresión, entre otros (Landry, 2002;Patel, Shivdasani y Baker, 2005;McCrory, et al, 2009;Ma, et al, 2012). Con respecto a los síntomas cognitivos, la mayoría de los estudios mencionan alteraciones en la velocidad de procesamiento cognitivo, la concentración, la memoria, el aprendizaje verbal y las funciones ejecutivas (McCrory, et al, 2017;Norton, 2018;Răodi, et al, 2016).…”

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Evaluación Neuropsicológica de Conmoción Cerebral: estudio de caso de un jugador de fútbol americano

Jiménez

Fernández

Muñoz

et al. 2019

CPD

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La conmoción cerebral (CC) es la principal causa de lesión cerebral en deportistas de contacto siendo el fútbol americano (FA) uno de los más populares. La CC produce una amplia gama de síntomas físicos, cognitivos y emocionales que hasta el 36.1% de los jugadores desconocen. Los cambios cognitivos ocurren en la atención, memoria, flexibilidad mental, fluidez verbal, planeación, memoria de trabajo, inhibición y velocidad de procesamiento. El objetivo fue evaluar el rendimiento cognitivo de un jugador defensivo de FA categoría mayor, de 23 años de edad y 15 años de escolaridad, antes y después de presentar una CC. Se aplicaron los siguientes instrumentos: Cuestionario de Datos Generales, test de MoCA, Dígitos y Cubos en regresión, Detección Visual, Fluidez Verbal Semántica, test de Stroop, Torre de Hanoi y Wisconsin. Se estableció su perfil cognitivo basal en pretemporada y se reevaluó durante la temporada una semana posterior a una CC. En la evaluación pretemporada el jugador presentó un perfil cognitivo dentro de los rangos esperados para su edad y escolaridad. En la fase aguda de la CC, el jugador disminuyó su rendimiento en tareas de velocidad de procesamiento (pre: 26 seg; post:120 seg), atención sostenida (pre:7 puntos; post:6 puntos), inhibición (pre: 84 aciertos; post: 82 aciertos) y planeación (pre: 15 movimientos; post: 20 movimientos). La EN ha demostrado ser una herramienta sensible y confiable para la detección de los síntomas cognitivos en fase aguda y posterior a la CC. Palabras claves: neuropsicología, fútbol, cognición Cerebral Concussion (CC) is the main cause of brain injury in contact athletes, with American football (AF) being one of the most popular. The CC produces a wide range of physical, cognitive and emotional symptoms that most of the players (36,1%) do not know. Cognitive changes are observed in attention and memory processes, mental flexibility, verbal fluency, planning, working memory, inhibition and speed of processing. The Neuropsychological Assessment (NA) is fundamental for the detection and management of CC in the acute phase and its sequelae. The objective was to evaluate the cognitive performance of a defensive player of american football, major category, of 23 years of age and 15 years of schooling, before and after presenting a CC. Instruments were: General Data Questionnaire, MoCA test, Digits and Cubes in regression, Visual Detection, Semantic Verbal Fluency, Stroop test, Tower of Hanoi and Wisconsin Sorting Cards. Baseline cognitive profile was established and reevaluated during the season one week after a CC. In the pre-season evaluation the player presented a cognitive profile within the ranges expected. In the acute phase of CC, the player decreased his performance in processing speed tasks (pre: 26 sec, post: 120 sec), sustained attention (pre: 7 points, post: 6 points), inhibition (pre: 84) hits, post: 82 hits) and planning (pre: 15 movements, post: 20 movements). The NA has proven to be a sensitive and reliable tool for the detection of cognitive symptoms in the acute and post-CC phase. Key words: neuropsychology, football, cognition. A concussão (CC) é a principal causa de lesão cerebral em atletas de contato, sendo o futebol americano (AF) um dos mais populares. O CC produz uma ampla gama de sintomas físicos, cognitivos e emocionais que até 36,1% dos jogadores não conhecem. Mudanças cognitivas ocorrem na atenção, memória, flexibilidade mental, fluência verbal, planejamento, memória de trabalho, inibição e velocidade de processamento. Objetivou-se avaliar o desempenho cognitivo de um jogador defensivo da categoria sênior de AF, 23 anos de idade e 15 anos de escolaridade, antes e depois de apresentar um CC. Foram aplicados os seguintes instrumentos: Questionário de dados gerais, teste MoCA, Dígitos e regressão cubos, detecção visual, Fluência Verbal Semântica, teste Stroop, Torre de Hanói e Wisconsin. Seu perfil cognitivo basal foi estabelecido na pré-temporada e reavaliado durante a estação uma semana após o CC. Na avaliação neuropsicológica pré-temporada o jogador apresentou um perfil cognitivo dentro das faixas esperadas para sua idade e escolaridade. Na fase aguda da CC, o jogador diminuição do desempenho em tarefas velocidade de processamento (pré: 26 seg; coloca-120 seg), atenção sustentada (pré: 7 pontos; pós 6 pontos), a inibição (pré: 84 hits, post: 82 hits) e planejamento (pré: 15 movimentos, post: 20 movimentos). Na avaliação neuropsicológica provou ser uma ferramenta sensível e confiável para a detecção de sintomas cognitivos em fase aguda e subsequente CC. Palavras-chave: neuropsicologia, futebol, cognição.

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Concussion in sport: the importance of accurate and reliable discharge advice

Cited by 3 publications

References 23 publications

Sports-Related Concussion Is a Personalized Issue—Evaluation of Medical Assessment and Subjective Feeling of the Athlete in a German Level 1 Trauma Center

Sports-Related Concussion Is a Personalized Issue—Evaluation of Medical Assessment and Subjective Feeling of the Athlete in a German Level 1 Trauma Center

An experimental study of the effect on activity intentions of postconcussion recovery advice

Evaluación Neuropsicológica de Conmoción Cerebral: estudio de caso de un jugador de fútbol americano

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