History of concussion and risk of subsequent injury in athletes and service members: A systematic review and meta-analysis

Reneker, Jennifer C.; Babl, Ryan M.; Flowers, Meredith M.

doi:10.1016/j.msksp.2019.04.004

Cited by 47 publications

(42 citation statements)

References 51 publications

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“…Our results support previous medical history and retrospective studies that demonstrated an increased risk of acute musculoskeletal injury after a concussion incident. 32,38 Particularly, our study is in agreement with Lynall et al, 25 who have the only other study to evaluate SRC and the association of subsequent musculoskeletal injury in high school athletes. Both studies used high school athletic trainers to collect data; however, Lynall et al were able to control for previous injury and number of SRCs before a subsequent lower extremity injury.…”

Section: Discussionsupporting

confidence: 91%

“…29 One consequence of an extended neurobiological recovery may be the risk of subsequent musculoskeletal injuries. 32,38 An increased risk of musculoskeletal injury after a concussion incident has been observed in several studies on intercollegiate 4,16,24 and professional 8,26,34,35 athletes, but only 1 study has examined this risk in adolescent athletes. 25 In the United States, an estimated 1.1 to 1.9 million sports or recreational activity-related concussions occur annually in those \18 years of age.…”

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confidence: 99%

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Musculoskeletal Injuries and Their Association With Previous Concussion History: A Prospective Study of High School Volleyball and Soccer Players

et al. 2021

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Background: Sports-related concussions may have a neurobiological recovery period that exceeds the period of clinical recovery, and one consequence of an extended neurobiological recovery may be the risk of subsequent musculoskeletal injuries. Most literature citing an increased risk of musculoskeletal injury after a sports-related concussion has been reported in populations other than adolescent athletes. Purpose/Hypothesis: The purpose was to prospectively determine if incidence rates of musculoskeletal injury differ between adolescent athletes with and without a previous sports-related concussion, while controlling for sex, sport, and age. A secondary aim was to determine if this relationship differs between male and female athletes of the same sport. Our hypotheses were that acute-noncontact injury rates would be higher in athletes with a previous sports-related concussion when compared with athletes without a previous sports-related concussion, and that this relationship would exist only in female athletes and not male athletes. Study Design: Cohort study; Level of evidence, 2. Methods: High school soccer and volleyball players were recruited in 2 prospective cohort studies that observed 4837 athletes during their sporting season (females, 80%; soccer, 57%; mean [SD] age, 15.6 [1.1] years). At preseason, all participants self-reported demographics and previous sports-related concussion within the past 12 months. During the sport season, team athletic trainers electronically recorded athlete exposures and injury data, including injury characteristics. Injury rates per 1000 athlete exposures and injury rate ratios (IRRs) with 95% confidence intervals were calculated. All injury rates and IRRs were adjusted for sex, age, and sport. Results: The rate of acute-noncontact lower extremity injury was 87% greater (IRR, 1.87; 95% CI, 1.29-2.74) in participants with a previous sports-related concussion versus those without one. The acute-noncontact lower extremity injury rates (IRRs) for females and males with a previous sports-related concussion were 1.76 (95% CI, 1.19-2.59) and 2.83 (95% CI, 0.85-9.50), respectively. No difference was detected in acute-contact (IRR, 0.98; 95% CI, 0.56-1.73) or overuse (IRR, 1.09; 95% CI, 0.51-2.37) lower extremity injury rates by previous sports-related concussion. Conclusion: Female adolescent athletes who reported a sports-related concussion within the past 12 months were more likely to sustain an acute-noncontact lower extremity injury during their high school sports season when compared with female athletes without a previous sport-related concussion.

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Section: Discussionsupporting

confidence: 91%

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confidence: 99%

Musculoskeletal Injuries and Their Association With Previous Concussion History: A Prospective Study of High School Volleyball and Soccer Players

et al. 2021

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“…A lack of accurate and robust diagnostics, biomarkers and outcome measures leads to mTBI going undetected (Jeter et al, 2013;Kim et al, 2018;Quinones-Ossa et al, 2019). Undetected mTBI can lead to impaired functional activities, self-medication and return to sport/work/play before recovery is complete, which may lead to increased future injury risk and other health burden (McPherson et al, 2019;Reneker et al, 2019). Interestingly, the incidence of self-reported visual impairments in those following a traumatic brain injury has been reported to be as high as 90% (Ciuffreda et al, 2007), but incidence reports vary with the lowest recorded at 22% (Lara et al, 2001;Cockerham et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

The Measurement of Eye Movements in Mild Traumatic Brain Injury: A Structured Review of an Emerging Area

Stuart

Parrington

Martini

et al. 2020

Front. Sports Act. Living

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Mild traumatic brain injury (mTBI), or concussion, occurs following a direct or indirect force to the head that causes a change in brain function. Many neurological signs and symptoms of mTBI can be subtle and transient, and some can persist beyond the usual recovery timeframe, such as balance, cognitive or sensory disturbance that may pre-dispose to further injury in the future. There is currently no accepted definition or diagnostic criteria for mTBI and therefore no single assessment has been developed or accepted as being able to identify those with an mTBI. Eye-movement assessment may be useful, as specific eye-movements and their metrics can be attributed to specific brain regions or functions, and eye-movement involves a multitude of brain regions. Recently, research has focused on quantitative eye-movement assessments using eye-tracking technology for diagnosis and monitoring symptoms of an mTBI. However, the approaches taken to objectively measure eye-movements varies with respect to instrumentation, protocols and recognition of factors that may influence results, such as cognitive function or basic visual function. This review aimed to examine previous work that has measured eye-movements within those with mTBI to inform the development of robust or standardized testing protocols. Medline/PubMed, CINAHL, PsychInfo and Scopus databases were searched. Twenty-two articles met inclusion/exclusion criteria and were reviewed, which examined saccades, smooth pursuits, fixations and nystagmus in mTBI compared to controls. Current methodologies for data collection, analysis and interpretation from eye-tracking technology in individuals following an mTBI are discussed. In brief, a wide range of eye-movement instruments and outcome measures were reported, but validity and reliability of devices and metrics were insufficiently reported across studies. Interpretation of outcomes was complicated by poor study reporting of demographics, mTBI-related features (e.g., time since injury), and few studies considered the influence that cognitive or visual functions may have on eye-movements. The reviewed evidence suggests that eye-movements are impaired in mTBI, but future research is required to accurately Stuart et al. Measurement of Eye-Movements in mTBI and robustly establish findings. Standardization and reporting of eye-movement instruments, data collection procedures, processing algorithms and analysis methods are required. Recommendations also include comprehensive reporting of demographics, mTBI-related features, and confounding variables.

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“…[33][34][35] Similarly, there is emerging evidence that sustaining a concussion increases the risk of an athlete sustaining an injury in the future. 36,37 Our results suggest that athletes with a previous history of either concussion or musculoskeletal injury represent a "high-risk" population that would potentially benefit from individualized injury prevention programs.…”

Section: Player Characteristicsmentioning

confidence: 83%

Incidence and Risk Factors for Injuries in Girls' High School Volleyball: A Study of 2072 Players

McGuine

Post

Biese

et al. 2020

Journal of Athletic Training

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Context: Girls high school volleyball is very popular across the United States. There is limited prospective data regarding the incidence and risk factors of time loss (TL) and non-time loss (NTL) injuries sustained in this population. Objectives: To estimate the incidence and describe the characteristics of injuries (TL and NTL) sustained in a girls' high school volleyball season. Design: Descriptive epidemiology study. Setting: Convenience sample of 78 high school interscholastic volleyball programs. Patients or Other Participants: High school volleyball players participating during the 2018 interscholastic season. Main Outcome Measures: TL and NTL injury rates, proportions, rate ratios, and with 95%CI. Results: A total of 2,072 girls enrolled in the study with 468 subjects (22.5%) sustaining 549 injuries (NTL=28.4%, TL=71.6%) for an overall injury rate of 5.31 [4.89, 5.79] per 1000 AEs. The competition injury rate was greater than the practice injury rate for all injuries (IRR: 1.19, [1.00, 1.41]) and TL injuries (IRR: 1.31, [1.07, 1.60]). Players with a previous musculoskeletal injury had a higher rate of TL than NTL injuries (IRR; 1.36 [1.12, 1.65]). Ankle injuries accounted for the greatest proportion of TL injuries (n=110, 28%), while the greatest proportion of NTL injuries occurred in the hand/fingers (n=34, 22%). Moreover, ligament sprains accounted for 40% of TL injuries (n=156), whereas muscle/tendon strains (n=79, 51%) accounted for over half of all NTL injuries. Conclusions: While the majority of injuries sustained by adolescent girls' volleyball athletes were TL in nature, nearly a third of all injuries were NTL injuries. Injury characteristics differed widely between TL and NTL injuries. Understanding the most common types and characteristics of injury among high school volleyball players is critical for the development of effective injury prevention programs.

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History of concussion and risk of subsequent injury in athletes and service members: A systematic review and meta-analysis

Cited by 47 publications

References 51 publications

Musculoskeletal Injuries and Their Association With Previous Concussion History: A Prospective Study of High School Volleyball and Soccer Players

Musculoskeletal Injuries and Their Association With Previous Concussion History: A Prospective Study of High School Volleyball and Soccer Players

The Measurement of Eye Movements in Mild Traumatic Brain Injury: A Structured Review of an Emerging Area

Incidence and Risk Factors for Injuries in Girls' High School Volleyball: A Study of 2072 Players

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