Under-reporting of sport-related concussions by adolescent athletes: a systematic review

Pennock, Kaleigh Ferdinand; McKenzie, Braeden; Steacy, Laura McClemont; Mainwaring, Lynda

doi:10.1080/1750984x.2020.1824243

Cited by 44 publications

(23 citation statements)

References 83 publications

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“…13 Unfortunately, however, previous studies consistently show that adolescent athletes fail to report symptoms of their concussions. 35 Parents found themselves advocating for their teen in situations where others did not understand or were not educated on the impact of an SRC and/or denied that an injury had even occurred, which is similar to the experiences that parents in Daprano, Davies, and Berstein 23 had with school and athletic staff. In concert with a support group, parents may also benefit from a roadmap to help navigate through their teen's recovery process and effectively advocate for them.…”

Section: Discussionmentioning

confidence: 82%

Parents’/guardians’ experiences with their adolescents’ prolonged recovery from a sport-related concussion

Lucas

Bolter

Petranek

et al. 2023

Journal of Concussion

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Sport-related concussions (SRCs) occur at alarming rates among adolescents and evidence suggests that adolescents experience more severe and longer-lasting symptoms compared to other age groups. Developmentally, adolescence is a time when youth become less reliant on their parents, establish their personal identity, and rely more on other social support networks (e.g., peers, teammates). However, previous studies show that parents play a prominent role in the recovery process from an SRC, especially in situations where recovery is prolonged. The purpose of this study was to examine the lived experiences of parents/guardians of teens who were recovering from a concussion and whose symptoms were persistent. Participants ( N = 12) were individually interviewed to better understand how they navigated and advocated for their teen during their prolonged recovery. An inductive content analysis revealed eight thematic categories that were interpreted with a developmental lens: (a) difficulties enforcing cognitive and physical rest, (b) concerns about depression and isolation, (c) observing struggles with athletic identity, (d) feelings of frustration, helplessness, and stress, (e) challenges of a hidden injury, (f) decisions about returning to sport, (g) being lied to about symptoms, and (h) offering strategies and practical advice. The themes illustrate how challenging and complicated the recovery process can be for parents of teenagers in particular, which is supported in previous concussion studies and the broader developmental literature. These results reinforce the idea that taking a biopsychosocial approach to care is best in order to adequately support parents/guardians and adolescents during the SRC recovery process.

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Section: Discussionmentioning

confidence: 82%

Parents’/guardians’ experiences with their adolescents’ prolonged recovery from a sport-related concussion

Lucas

Bolter

Petranek

et al. 2023

Journal of Concussion

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“…Additionally, to improve player reporting, it may be beneficial for parents to assure their children that (1) their health is more important than competitive goals, (2) the faster the SRC is reported by the player, the quicker the athlete can return to play, and (3) the parent will not be disappointed in their child if they experience a SRC. These points reflect the barriers to SRC reporting cited in the literature (e.g., Chrisman et al, 2013;Ferdinand Pennock et al, 2020;Wallace et al, 2017). Experimental research can test which messages have the greatest influence on athletes' SRC attitudes through parent-child as well as coach-player communication.…”

Section: Discussionmentioning

confidence: 99%

Breaking the Silence: Examining the Role of Parent Involvement and Concussion Knowledge on Sports-Related Concussion Conversations

Hartman

Quick

2023

Communication & Sport

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The current study investigates the role of parents’ concussion knowledge, value-relevant involvement (VRI), outcome-relevant involvement (ORI), and impression-relevant involvement (IRI) on their intentions to communicate with their children about recognizing and reporting sports-related concussions (SRC) symptoms. Among 249 parents of youth athletes between the ages of 9 and 15, SRC knowledge, VRI, and ORI were positively associated with parents' SRC communication intentions, while IRI was a negative predictor. Contrary to our hypotheses, parents with higher IRI were less likely to report SRC communication intentions as knowledge increased. Similarly, as knowledge increased, parents with higher ORI were also less likely to report intentions to communicate with their child about the importance of reporting a SRC. Additionally, parents with lower SRC knowledge were more likely to seek information about communicating with their child about SRCs. The study highlights the importance of considering the interplay between parental involvement and SRC knowledge, as well as underlying factors of SRC parent-child communication. Future research should identify specific goals for SRC communication to optimize educational intervention efforts and maximize the potential impact of communication on SRC reporting rates in youth sports.

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“…We also identified MDC cut-offs for endorsed symptoms as ≥1 for the aerobic component, ≥2 for the dynamic component, and ≤3 for total EXiT symptoms. Despite recent evidence to suggest concussion-associated symptoms increase following exertion among healthy athletes 38,40 and are prone to underreporting by athletes motivated to return to sport, 9,12 symptom provocation is the primary criterion in current postconcussion exertion evaluations to inform RTP. Although symptom reporting will always be subjective, the MDC scores identified in the current study may suggest a better method for evaluating symptom provocation during EXiT.…”

Section: Discussionmentioning

confidence: 99%

Test-Retest, Interrater Reliability, and Minimal Detectable Change of the Dynamic Exertion Test (EXiT) for Concussion

Sinnott¹,

Eagle²,

Kochick³

et al. 2022

Sports Health: A Multidisciplinary Approach

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Background: The Dynamic Exertion Test (EXiT) was developed to inform return-to-play (RTP) decision-making following clinical recovery from sport-related concussion (SRC). The purpose of the current study was to document intrarater and test-retest reliability and minimal detectable change (MDC) scores for physiological [heart rate (HR) and blood pressure], performance (change-of-direction task completion time and errors), and clinical outcomes (endorsed symptoms, perceived exertion) of EXiT, and interrater reliability of performance outcomes. Hypothesis: Healthy athletes would exhibit stable physiological responses to the EXiT across visits, demonstrate consistent change-of-direction task completion time between consecutive trials at each visit, and the fastest time (of 2 trials) across visits, and endorse equivocal symptoms and effort across visits. Study Design: Cross-sectional, test-retest. Level of Evidence: Level 3. Methods: Seventy-nine (female: 34 [43%], 19.6 ± 5.0 years) athletes completed the EXiT at 2 study visits (8.7 ± 4.7 days between visits). Two-way, mixed, intraclass correlation coefficients (ICCs) were used to evaluate intrarater and test-retest reliability. Cronbach’s alpha was used to document the internal consistency of symptoms at each visit, and MDC scores were calculated on the physiological, performance, and clinical outcomes. Results: Measured and percentage of age-estimated maximum HR were reliable following EXiT (ICC = 0.579-0.618). Change-of-direction task completion time (MDC range = 0.75-8.70 s) had good-to-excellent test-retest (ICC = 0.703-0.948) and interrater (ICC = 0.932-0.965) reliability. Symptoms had a high internal consistency at visits 1 ( α = 0.894) and 2 ( α = 0.805) and were reliable across visits (ICC = 0.588). Conclusion: The current investigation established test-retest reliability in addition to MDC scores of an objective dynamic exercise assessment among healthy adolescent and adult athletes. The EXiT may be an objective approach to inform RTP decision-making following SRC recovery. Clinical Relevance: The EXiT is a clinically feasible exertion-based assessment that can be readily administered in a variety of outpatient clinical settings.

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Under-reporting of sport-related concussions by adolescent athletes: a systematic review

Cited by 44 publications

References 83 publications

Parents’/guardians’ experiences with their adolescents’ prolonged recovery from a sport-related concussion

Parents’/guardians’ experiences with their adolescents’ prolonged recovery from a sport-related concussion

Breaking the Silence: Examining the Role of Parent Involvement and Concussion Knowledge on Sports-Related Concussion Conversations

Test-Retest, Interrater Reliability, and Minimal Detectable Change of the Dynamic Exertion Test (EXiT) for Concussion

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