Management of Sport-Related Concussion in the Pediatric and Adolescent Population

Provance, Aaron J.; Engelman, Glenn H.; Terhune, E. Bailey; Coel, Rachel A.

doi:10.3928/01477447-20151218-13

Cited by 11 publications

(10 citation statements)

References 30 publications

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“…Rugby, ice hockey, and lacrosse are other sports with high risk of concussion. It has been noted that the incidence rate in females is greater than males [ 5 ]. To help ensure the health and safety of young athletes, the CDC developed the “Heads Up!” Concussion in Youth Sports [ 6 ] initiative to offer information about concussions to coaches, parents, and athletes involved in youth sports.…”

Section: Introductionmentioning

confidence: 99%

Awareness of the CDC “Heads Up!” to Youth Sports Campaign among Pediatric Sports Coaches: A Pilot Survey Study

Stead¹,

Rastogi²,

Hedna³

et al. 2016

Cureus

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Objectives:This study sought to: 1) estimate the penetrance (in terms of youth coaches being aware of them) of the CDC “Heads Up!” guidelines, 2) determine whether these guidelines changed the coaches’ practice, and 3) understand whether these guidelines resulted in a perceived decrease in the number of concussions.Methods:This was a cross-sectional survey of pediatric sports coaches in the United States designed to assess the impact of the CDC "Heads Up!" guidelines. “Heads Up!” Concussion in Youth Sports is a free, online course available to coaches, parents, and others helping to keep athletes safe from concussions. The “Heads Up!” fact sheet provides important information on preventing, recognizing, and responding to a concussion.Results:Half the cohort had heard of the CDC “Heads Up!” campaign. Fifty-five percent of the cohort thought that pediatric concussions in youth sports was a “big deal” (rated on a Likert scale from 1-10). Coaches who were also parents (58%) were significantly more likely to have heard of the campaign (P=0.0032, 95% CI=0.1153-0.5513). Having heard of the “Heads Up!” campaign was significantly associated with how important coaches thought pediatric concussions are (P=0.0133, 95% CI=0.0590-0.4960), as was higher income of the coaches (P=0.0100), and this was significantly correlated with the coach being more likely to call the athlete’s parent at injury (P=0.0030, 95% CI=0.1160-0.5471). Coaches of football/soccer were significantly more likely to think pediatric concussions were a “big deal” (P=0.0021,95% CI=0.1374-0.5947). More than a third of coaches 35% reported that the “Heads Up!” campaign decreased the number of concussions on their team.

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Section: Introductionmentioning

confidence: 99%

Awareness of the CDC “Heads Up!” to Youth Sports Campaign among Pediatric Sports Coaches: A Pilot Survey Study

Stead¹,

Rastogi²,

Hedna³

et al. 2016

Cureus

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“…This biologically inert surface modification leads to an increase in surface hardness, while maintaining the strength and toughness of the metal substrate [ 28 ]. Further, the TiN coating acts as a barrier that inhibits the release of ions from the metal substrate, protecting the patient from allergy-inducing ions like chromium or cobalt [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

High wear resistance of femoral components coated with titanium nitride: a retrieval analysis

Fabry

Zietz

Baumann

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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Purpose The objective of this study was to evaluate the in vivo wear resistance of cobalt-chromium femoral components coated with titanium nitride (TiN). Our null hypothesis was that the surface damage and the thickness of the TiN coating do not correlate with the time in vivo.Methods Twenty-five TiN-coated bicondylar femoral retrievals with a mean implantation period of 30.7 ± 11.7 months were subjected to an objective surface damage analysis with a semi-quantitative assessment method. A visual examination of scratches, indentations, notches and coating breakthroughs of the surfaces was performed. The roughness and the coating thickness of the TiN coating were evaluated in the main articulation regions.ResultsNarrow scratches and indentations in the range of low flexion angles on the retrieval surfaces were the most common modes of damage. There was no evidence of delamination on the articulation surface but rather at the bottom of isolated severe indentations or notches. An analysis of three retrievals revealed a coating breakthrough in the patellofemoral joint region, resulting from patella maltracking and a dislocation. The arithmetical mean roughness of the TiN surface slightly increased with the implantation period. In contrast, the maximum peak height of the roughness profile was reduced at the condyles of the retrieved components in comparison with new, unused surfaces. No significant association between the coating thickness and implantation period was determined. Moreover, the measured values were retained in the range of the initial coating thickness even after several years of in vivo service.ConclusionsAs was demonstrated by the results of this study, the surface damage to the TiN coating did not deteriorate with the implantation period. The calculated damage scores and the measured coating thickness in particular both confirmed that the TiN coating provides low wear rates. Our findings support the use of wear-resistant TiN-coated components in total knee arthroplasty with the objective of reducing the risk of aseptic loosening. However, in terms of TiN-coated femoral components, particular attention should be paid to a correct patellar tracking in order to avoid wear propagation at the implant.

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“…Most of these are nonspecific and may also be seen in other medical conditions; therefore, it is important to relate the onset of signs and symptoms to the head injury (4,11,19,20). Some signs and symptoms may appear soon after the concussion, while other may appear over a period of several days to weeks.…”

Section: Clinical Aspectsmentioning

confidence: 99%

“…Management of young athletes with concussion has evolved rapidly over the past decade resulting the development of different guidelines that describe a fundamentally similar approach for the treatment of concussions (1)(2)(3)(4)(19)(20)(21)(22). Concussion severity grading based on various criteria such as the presence or absence and duration of loss of consciousness, confusion and memory are no longer used or found clinically useful (1,5,10).…”

Section: Managementmentioning

confidence: 99%

Evaluation and management of sport-related concussions in adolescent athletes

2017

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Sport-related concussions in young athletes are common, generally under reported and often go unrecognized. Concussion in sport may result either from a direct impact to the head or from indirect forces transmitted to the brain from impact elsewhere on the body. Concussions may also result from sudden acceleration, deceleration or rotational forces to the brain. The key features of concussion include confusion, impaired memory and reduced speed of information processing. Recovery may occur from a few days to several weeks or months. Both physical and cognitive rests are recommended for recovery.Long-term cognitive and behavioral complications are a concern. Preventive strategies include education, modification of sport rules, use of equipment such as headgears, face masks and mouth guards, and neck muscle training. Evidence is limited to support effectiveness of these preventive measures with the exception of rule modification in some sports. Laws have been enacted that require medical evaluation and clearance prior to return to play; however, evidence thus far does not show that laws have been effective in reducing the incidence of concussions in sport. More research is needed in all areas of preventive measures. Sports participation is a complex personal decision on the part of adolescent and his or her family. They should be provided with all information on inherent risks so that they can make an informed decision.

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Management of Sport-Related Concussion in the Pediatric and Adolescent Population

Cited by 11 publications

References 30 publications

Awareness of the CDC “Heads Up!” to Youth Sports Campaign among Pediatric Sports Coaches: A Pilot Survey Study

Awareness of the CDC “Heads Up!” to Youth Sports Campaign among Pediatric Sports Coaches: A Pilot Survey Study

High wear resistance of femoral components coated with titanium nitride: a retrieval analysis

Evaluation and management of sport-related concussions in adolescent athletes

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