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1.
Clin Sports Med ; 40(1): 159-171, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33187606

RESUMO

Concussion remains a common injury among sports participants. Implementing risk-reduction strategies for sport-related concussion (SRC) should be a priority of medical professionals involved in the care of athletes. Over the past few decades, a multifaceted approach to reducing SRC risk has been developed. Protective equipment, rule and policy change/enforcement, educational programs, behavioral modifications, legislation, physiologic modifications, and sport culture change are a few of the programs implemented to mitigate SRC risk. In this article, the authors critically review current SRC risk-reduction strategies and offer insight into future directions of injury prevention for SRC.


Assuntos
Traumatismos em Atletas/prevenção & controle , Concussão Encefálica/prevenção & controle , Educação em Saúde , Humanos , Cultura Organizacional , Equipamentos de Proteção , Política Pública , Fatores de Risco , Esportes/legislação & jurisprudência , Equipamentos Esportivos , Medicina Esportiva/organização & administração
2.
Clin Sports Med ; 40(1): 19-38, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33187609

RESUMO

As awareness on the short-term and long-term consequences of sports-related concussions and repetitive head impacts continues to grow, so too does the necessity to establish biomechanical measures of risk that inform public policy and risk mitigation strategies. A more precise exposure metric is central to establishing relationships among the traumatic experience, risk, and ultimately clinical outcomes. Accurate exposure metrics provide a means to support evidence-informed decisions accelerating public policy mandating brain trauma management through sport modification and safer play.


Assuntos
Traumatismos em Atletas/fisiopatologia , Concussão Encefálica/fisiopatologia , Traumatismos em Atletas/prevenção & controle , Fenômenos Biomecânicos , Concussão Encefálica/prevenção & controle , Transtornos Traumáticos Cumulativos/fisiopatologia , Transtornos Traumáticos Cumulativos/prevenção & controle , Tomada de Decisões , Política de Saúde , Humanos , Fatores de Risco
3.
Med Sci Sports Exerc ; 52(7): 1629-1638, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32541378

RESUMO

INTRODUCTION: Regulatory efforts toward reducing concussion risk have begun to focus on decreasing the number of head impacts (i.e., head impact burden) sustained by athletes in contact sports. To that end, in 2018, the NCAA decreased the number of preseason on-field team activities for Division I teams from 29 to 25. The objective of the current study was to quantify changes in practice schedule and head impact exposure between the 2017 and 2018 football preseasons. METHODS: Athletes from five NCAA Division I football teams (n = 426) were consented and enrolled. RESULTS: On average, athletes participated in 10% fewer contact practices in 2018. However, the effect of this ruling on preseason head impact burden was mixed. Across all athletes, the total preseason head impact burden was essentially the same from 2017 to 2018. However, this study revealed significant team-by-team differences in preseason head impact burden, with one team demonstrating a 35% increase in the average number of recorded head impacts from 2017 to 2018, despite a modest decrease in the number of contact practices. Other teams had similar or decreased head impact burden. CONCLUSIONS: Team-based differences in total preseason head impact burden were attributable to changes in daily practice schedule, with longer practice durations and more intense contact practice sessions contributing to increases in daily head impact exposure that, in turn, led to greater preseason head impact burden. Results of this study have highlighted the difficulty in decreasing contact sport head impact exposure through rule changes targeted at limiting on-field team activities. Future efforts aimed specifically at contact practice duration, daily head impact exposure, or limiting time in specific drills may be more effective at reducing total preseason head impact burden.


Assuntos
Concussão Encefálica/prevenção & controle , Futebol Americano/fisiologia , Cabeça/fisiologia , Condicionamento Físico Humano , Fenômenos Biomecânicos , Concussão Encefálica/fisiopatologia , Humanos , Política Organizacional , Condicionamento Físico Humano/métodos , Condicionamento Físico Humano/fisiologia , Comportamento de Redução do Risco , Esportes , Fatores de Tempo
4.
J Athl Train ; 55(6): 594-600, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32396473

RESUMO

CONTEXT: Detection of subtle changes in brain sensorimotor processes may enable clinicians to identify athletes who would derive the greatest benefit from interventions designed to reduce the risk for future injury and progressive neurologic or musculoskeletal dysfunction. OBJECTIVE: To develop a generalizable statistical model for identifying athletes who possess subtle alterations in sensorimotor processes that may be due to previous concussion. DESIGN: Cross-sectional study. SETTING: Residential Olympic Training Center sports medicine clinic. PATIENTS OR OTHER PARTICIPANTS: A primary cohort of 35 elite athletes and a secondary cohort of 40 elite athletes who performed identical tests the preceding year. INTERVENTION(S): Two upper extremity tests of visual-motor reaction time and 2 tests of whole-body reactive agility were administered. The whole-body tests required lateral or diagonal responses to virtual-reality targets, which provided measures of reaction time, speed, acceleration, and deceleration. MAIN OUTCOME MEASURE(S): Sport-related concussion history, which was reported by 54% (n = 19) of the athletes in the primary cohort and 45% (n = 18) of the athletes in the secondary cohort. RESULTS: Univariable analyses identified 12 strong predictors of sport-related concussion history, which we combined to create a composite metric with maximum predictive value. Composite lateral asymmetry for whole-body reactive movements and persisting effects of previous musculoskeletal injury yielded a logistic regression model with exceptionally good discrimination (area under the curve = 0.845) and calibration (predicted-observed probabilities within 7 subgroups: r = 0.959, P = .001). Application of the derived model to compatible data acquired from another cohort of elite athletes demonstrated very good discrimination (area under the curve = 0.772) and calibration (within 8 subgroups: r = 0.849, P = .008). CONCLUSIONS: Asymmetry in whole-body reactive movement capabilities may be a manifestation of a subtle abnormality in the functional connectivity of brain networks that might be relevant to previously reported associations between sport-related concussion history and musculoskeletal injury occurrence.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Retroalimentação Sensorial/fisiologia , Lateralidade Funcional , Desempenho Psicomotor , Adulto , Atletas , Traumatismos em Atletas/fisiopatologia , Traumatismos em Atletas/prevenção & controle , Traumatismos em Atletas/psicologia , Concussão Encefálica/fisiopatologia , Concussão Encefálica/prevenção & controle , Estudos Transversais , Feminino , Humanos , Masculino , Modelos Estatísticos , Neurofisiologia/métodos , Tempo de Reação/fisiologia , Medição de Risco , Fatores de Risco
5.
Int J Sports Med ; 41(9): 616-627, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32365387

RESUMO

US Soccer eliminated soccer heading for youth players ages 10 years and younger and limited soccer heading for children ages 11-13 years. Limited empirical evidence associates soccer heading during early adolescence with medium-to-long-term behavioral deficits. The purpose of this study was to compare sensory reweighting for upright stance between college-aged soccer players who began soccer heading ages 10 years and younger (AFE ≤ 10) and those who began soccer heading after age 10 (AFE > 10). Thirty soccer players self-reported age of first exposure (AFE) to soccer heading. Sensory reweighting was compared between AFE ≤ 10 and AFE > 10. To evaluate sensory reweighting, we simultaneously perturbed upright stance with visual, vestibular, and proprioceptive stimulation. The visual stimulus was presented at two different amplitudes to measure the change in gain to vision, an intra-modal effect; and change in gain to galvanic vestibular stimulus (GVS) and vibration, both inter-modal effects. There were no differences in gain to vision (p=0.857, η2=0.001), GVS (p=0.971, η2=0.000), or vibration (p=0.974, η2=0.000) between groups. There were no differences in sensory reweighting for upright stance between AFE ≤ 10 and AFE > 10, suggesting that soccer heading during early adolescence is not associated with balance deficits in college-aged soccer players, notwithstanding potential deficits in other markers of neurological function.


Assuntos
Cabeça/fisiologia , Destreza Motora/fisiologia , Equilíbrio Postural/fisiologia , Futebol/fisiologia , Adolescente , Adulto , Fatores Etários , Percepção Auditiva/fisiologia , Fenômenos Biomecânicos , Concussão Encefálica/prevenção & controle , Criança , Humanos , Vestíbulo do Labirinto/fisiologia , Vibração , Percepção Visual/fisiologia , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-32294972

RESUMO

Coach and parent concussion education programs are essential for the prevention, diagnosis, management, and return to play of youth athletes. This systematic review examined the content and efficacy (changes in knowledge, impact on concussion incidence) of concussion education programs for coaches and parents of youth and high school athletes. Six databases were searched: SPORTDiscus, Academic Search Premiere, CINAHL, PsycINFO, PubMed, and Google Scholar. Studies evaluated the use and/or efficacy of concussion education programs among coaches or parents of youth athletes. A total of 13 articles (out of 1553 articles) met selection criteria. Although different concussion education programs exist, only three have been evaluated in the literature: ACTive Athletic Concussion Training™, USA Football's Heads Up Football, and the Center for Disease Control and Prevention's HEADS UP. These programs are well liked among coaches and parents and the suggested practices are easily implemented by coaches. These programs increased concussion knowledge among coaches and parents and promoted behavioral changes among coaches to reduce the concussion risk in high school sports. Few studies have assessed the efficacy of concussion education programs on youth athlete health outcomes. No studies included a longitudinal follow up to determine the degree of knowledge retention following the intervention. While online educational programs are sufficient to improve coach knowledge, in-person training may be a more effective educational tool for reducing the incidence of youth sport concussion. Future studies addressing the efficacy of concussion education programs should include a longitudinal follow up to assess knowledge retention and fidelity.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Atletas , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/prevenção & controle , Concussão Encefálica/epidemiologia , Concussão Encefálica/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pais
8.
J Athl Train ; 55(5): 469-474, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32216659

RESUMO

CONTEXT: Whereas much attention has been paid to identifying mechanisms for decreasing concussion rates in women's soccer players, which strategies are currently being used is unknown. In addition, athletic trainers' (ATs') knowledge and beliefs about the efficacy of concussion-prevention practices have not been studied. OBJECTIVES: To evaluate the concussion-prevention strategies being used in National Collegiate Athletic Association Division I and Division II women's soccer and identify the beliefs of certified ATs regarding mechanisms for preventing concussion. DESIGN: Cross-sectional study. SETTING: Online survey. PATIENTS OR OTHER PARTICIPANTS: A total of 223 women's soccer team ATs employed at Division I or II universities. MAIN OUTCOME MEASURE(S): A survey instrument of structured questions and open-ended, follow-up questions was developed to identify the use of cervical-strengthening programs, headgear, and other techniques for preventing concussion. Questions also addressed ATs' beliefs regarding the effectiveness of cervical strengthening, headgear, and mouthguards in concussion prevention. Data were collected via questionnaire in Qualtrics survey software. Descriptive statistics of frequencies and percentages were calculated for close-ended questions. Open-ended questions were evaluated for common themes, which were then reported by response frequency. RESULTS: Cervical strengthening or stability for concussion prevention was reported by 38 (17.12%) respondents; 153 (69.86%) ATs believed that cervical strengthening would aid in concussion prevention. Seventy-eight (35.49%) reported that their players wore headgear. Nineteen (8.76%) believed that soccer headgear prevented concussions; 45 (20.74%) believed that mouthguards prevented concussions. Education in proper soccer technique was reported by 151 (69.59%) respondents. Fourteen (0.06%) respondents cited nutritional strategies for concussion prevention. CONCLUSIONS: Although ATs believed that cervical strengthening could help prevent concussions, few had implemented this strategy. However, the ATs whose teams used headgear outnumbered those who believed that headgear was an effective prevention strategy. Based on our findings, we saw a disconnect among the current use of concussion-prevention strategies, ATs' beliefs, and the available evidence.


Assuntos
Concussão Encefálica/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Condicionamento Físico Humano/psicologia , Futebol/lesões , Estudos Transversais , Feminino , Dispositivos de Proteção da Cabeça , Humanos , Protetores Bucais , Músculos do Pescoço/fisiologia , Treinamento de Resistência , Inquéritos e Questionários , Universidades
10.
J Sports Sci Med ; 19(1): 65-77, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32132829

RESUMO

Sport-related concussion (SRC) is a public health issue of increasing concern. Sports coaches and match officials are important stakeholders in facilitating early recognition, immediate management and appropriate return-to-play following SRC. This systematic review analyses the current evidence on SRC knowledge amongst sports coaches and match officials. The review was conducted in accordance to PRISMA guideline. A qualitative analysis of knowledge on identification, management, prevention and consequences of SRC as well as return-to-play principles was performed. The Appraisal Tool for Cross-sectional Studies was employed to assess the quality and reliability of each study. Searches were conducted on PubMed, Medline Ovid, Web of Science, CINAHL, SPORTDiscus and Psycinfo. Studies included were primary studies in English published in peer-reviewed journals assessing the level of concussion knowledge or education level amongst coaches, officials or both, regardless of sports or competitive level. A total of 20880 studies were identified, from which 27 were included in this review. There were 26 cross-sectional studies and one randomized controlled trial; 20 assessed SRC knowledge amongst coaches, one considered only officials and six studies assessed both groups. Concussion knowledge amongst coaches and match officials was deemed moderate in most studies, although significant knowledge gaps were identified. There is considerable room for further education on SRC amongst coaches and officials, particularly with the less commonly recognized symptoms of SRC and misconceptions about SRC management and prevention. Beyond knowledge assessment, further investigation should explore the translation of concussion knowledge to on-field management of players with SRC.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/terapia , Concussão Encefálica/diagnóstico , Concussão Encefálica/terapia , Conhecimentos, Atitudes e Prática em Saúde , Medicina Esportiva , Traumatismos em Atletas/prevenção & controle , Concussão Encefálica/prevenção & controle , Humanos , Capacitação em Serviço , Tutoria , Volta ao Esporte , Medicina Esportiva/educação
12.
Br J Sports Med ; 54(14): 866-870, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31937578

RESUMO

BACKGROUND: Concussion is the most common injury in youth ice hockey. Whether mouthguard use lowers the odds of concussion remains an unanswered question. OBJECTIVE: To determine the association between concussion and mouthguard use in youth ice hockey. METHODS: Nested case-control design. Cases and controls were identified from two prospective cohort studies using valid injury surveillance methods. Cases were players concussed during a game or practice; controls were players who sustained a non-concussion injury during a game or practice. The primary exposure was mouthguard use at time of injury; mouthguard type (dental custom fit or off the shelf) was a secondary exposure. Physician-diagnosed or therapist-suspected concussion was the primary outcome. Dental injury was a secondary outcome. Multilevel logistic regression with random effect at a team level was used to obtain ORs for the mouthguard effect, adjusted for level of play, age group, position, concussion history, mechanism of injury, cohort, session type and body checking policy. RESULTS: Among cases, 236/315 (75%) were wearing a mouthguard at time of injury, while 224/270 (83%) controls were wearing a mouthguard at time of injury. Any mouthguard use was associated with an adjusted OR for concussion of 0.36 (95% CI 0.17 to 0.73). Off-the-shelf mouthguards were associated with a 69% lower odds of concussion (adjusted OR: 0.31; 95% CI 0.14 to 0.65). Dental custom-fit mouthguards were associated with a non-significant 49% lower odds of concussion (adjusted OR: 0.51; 95% CI 0.22 to 1.10). No dental injuries were identified in either cohort. CONCLUSION: Mouthguard use was associated with lower odds of concussion. Players should be required to wear mouthguards in youth ice hockey.


Assuntos
Concussão Encefálica/prevenção & controle , Hóquei/lesões , Protetores Bucais , Adolescente , Estudos de Casos e Controles , Criança , Desenho de Equipamento , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Traumatismos Dentários/prevenção & controle
13.
Phys Sportsmed ; 48(1): 46-52, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31131669

RESUMO

Objective: This study aimed to determine whether collegiate women's ice hockey players are receiving pre-season concussion education and evaluate the nature and delivery of this education. Secondarily, we aimed to assess whether players who recall receiving this education have greater knowledge about concussion or are more likely to have reported suspected concussions than their peers.Methods: An anonymous survey was completed by 459 NCAA women's ice hockey players. Players self-reported receipt of pre-season concussion education, year in school, division of competition, player position, and average length of ice hockey career. Players also completed scales assessing concussion knowledge, attitudes and prior reporting behavior for suspected concussions.Results: 65.3% of athletes affirmed that they received pre-season concussion education. Lecture by an athletic trainer was the most common modality. There were no differences in concussion knowledge or attitudes by concussion education status, NCAA division of competition, or year in school. Players with higher knowledge scores were more likely than their peers to have experienced a suspected concussion and to have not reported it (p = 0.056).Conclusions: Not all NCAA women's ice hockey players are receiving (or recall receiving) mandated concussion education from their institution. The inverse association between concussion knowledge and concussion reporting behavior, while not statistically significant, is concerning and warrants further study. More work is needed to develop educational materials about concussion that are acceptable and memorable to this population, and that help increase concussion care-seeking behaviors.


Assuntos
Traumatismos em Atletas/prevenção & controle , Concussão Encefálica/prevenção & controle , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Hóquei , Universidades , Adolescente , Adulto , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/epidemiologia , Concussão Encefálica/diagnóstico , Concussão Encefálica/epidemiologia , Feminino , Humanos , Incidência , Adulto Jovem
14.
Ann Emerg Med ; 75(4): 471-482, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31326205

RESUMO

Sport-related concussion refers to the subset of concussive injuries occurring during sport activities. Similar to concussion from nonsport mechanisms, sport-related concussion is associated with significant morbidity, including migrainous headaches, disruption in normal daily activities, and long-term depression and cognitive deficits. Unlike nonsport concussions, sport-related concussion may be uniquely amenable to prevention efforts to mitigate these problems. The emergency department (ED) visit for sport-related concussion represents an opportunity to reduce morbidity by timely diagnosis and management using best practices, and through education and counseling to prevent a subsequent sport-related concussion. This article provides recommendations to reduce sport-related concussion disability through primary, secondary, and tertiary preventive strategies enacted during the ED visit. Although many recommendations have a solid evidence base, several research gaps remain. The overarching goal of improving sport-related concussion outcome through enactment of ED-based prevention strategies needs to be explicitly studied.


Assuntos
Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Medicina de Emergência , Sumários de Alta do Paciente Hospitalar , Traumatismos em Atletas/complicações , Traumatismos em Atletas/terapia , Concussão Encefálica/complicações , Concussão Encefálica/prevenção & controle , Concussão Encefálica/terapia , Medicina de Emergência/métodos , Serviço Hospitalar de Emergência , Humanos
15.
Br J Sports Med ; 54(7): 414-420, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31492676

RESUMO

OBJECTIVE: To compare rates of injury and concussion among non-elite (lowest 60% by division of play) Bantam (ages 13-14 years) ice hockey leagues that disallow body checking to non-elite Bantam leagues that allow body checking. METHODS: In this 2-year cohort study, Bantam non-elite ice hockey players were recruited from leagues where policy allowed body checking in games (Calgary/Edmonton 2014-2015, Edmonton 2015-2016) and where policy disallowed body checking (Kelowna/Vancouver 2014-2015, Calgary 2015-2016). All ice hockey game-related injuries resulting in medical attention, inability to complete a session and/or time loss from hockey were identified using valid injury surveillance methodology. Any player suspected of having concussion was referred to a study physician for diagnosis and management. RESULTS: 49 body checking (608 players) and 33 non-body checking teams (396 players) participated. There were 129 injuries (incidence rate (IR)=7.98/1000 hours) and 54 concussions (IR=3.34/1000 hours) in the body checking teams in games. After policy change, there were 31 injuries (IR=3.66/1000 hours) and 17 concussions (IR=2.01/1000 hours) in games. Policy disallowing body checking was associated with a lower rate of all injury (adjusted incidence rate ratio (IRR)=0.44; 95% CI: 0.27 to 0.74). The point estimate showed a lower rate of concussion (adjusted IRR=0.6; 95% CI: 0.31 to 1.18), but this was not statistically significant. CONCLUSION: Policy change disallowing body checking in non-elite Bantam ice hockey resulted in a 56% lower rate of injury. There is growing evidence that disallowing body checking in youth ice hockey is associated with fewer injuries.


Assuntos
Concussão Encefálica/epidemiologia , Concussão Encefálica/prevenção & controle , Hóquei/lesões , Políticas , Adolescente , Canadá/epidemiologia , Estudos de Coortes , Feminino , Hóquei/legislação & jurisprudência , Humanos , Incidência , Masculino , Destreza Motora , Estudos Prospectivos , Fatores de Risco
17.
Br J Sports Med ; 54(7): 408-413, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31088784

RESUMO

BACKGROUND: There have been no large randomised controlled trials to determine whether soccer headgear reduces the incidence or severity of sport-related concussion (SRC) in US high school athletes. OBJECTIVE: We aimed to determine whether headgear reduces the incidence or severity (days out from soccer) of SRCs in soccer players. METHODS: 2766 participants (67% female, age 15.6±1.2) (who undertook 3050 participant years) participated in this cluster randomised trial. Athletes in the headgear (HG) group wore headgear during the season, while those in the no headgear (NoHG) group did not. Staff recorded SRC and non-SRC injuries and soccer exposures. Multivariate Cox proportional hazards models were used to examine time-to-SRC between groups, while severity was compared with a Wilcoxon rank-sum test. RESULTS: 130 participants (5.3% female, 2.2% male) sustained an SRC. The incidence of SRC was not different between the HG and NoHG groups for males (HR: 2.00 (0.63-6.43) p=0.242) and females (HR: 0.86 (0.54-1.36) p=0.520). Days lost from SRC were not different (p=0.583) between the HG group (13.5 (11.0-018.8) days) and the NoHG group (13.0 (9.0-18.8) days). CONCLUSIONS: Soccer headgear did not reduce the incidence or severity of SRC in high school soccer players. TRIAL REGISTRATION NUMBER: NCT02850926.


Assuntos
Concussão Encefálica/epidemiologia , Concussão Encefálica/prevenção & controle , Dispositivos de Proteção da Cabeça , Futebol/lesões , Adolescente , Feminino , Humanos , Incidência , Masculino , Modelos de Riscos Proporcionais , Índices de Gravidade do Trauma , Estados Unidos/epidemiologia
18.
Sports Biomech ; 19(5): 678-700, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30274537

RESUMO

Professional American football games are recorded in digital video with multiple cameras, often at high resolution and high frame rates. The purpose of this study was to evaluate the accuracy of a videogrammetry technique to calculate translational and rotational helmet velocity before, during and after a helmet impact. In total, 10 football impacts were staged in a National Football League (NFL) stadium by propelling helmeted 50th percentile male crash test dummies into each other or the ground at speeds and orientations representative of concussive impacts for NFL players. The tests were recorded by experienced sports film crews to obtain video coverage and quality typically available for NFL games. A videogrammetry procedure was used to track the position and rotation of the helmet throughout the relevant time interval of the head impact. Compared with rigidly mounted retroreflective marker three dimensional (3-D) motion tracking that was concurrently collected in the experiments, videogrammetry accurately calculated changes in translational and rotational velocity of the helmet using high frame rate (two cameras at 240 Hz) video (7% and 15% error, respectively). Low frame rate (2 cameras at 60 Hz) video was adequate for calculating pre-impact translational velocity but not for calculating the translational or rotational velocity change of the helmet during impact.


Assuntos
Futebol Americano , Dispositivos de Proteção da Cabeça , Gravação em Vídeo/métodos , Aceleração , Fenômenos Biomecânicos , Concussão Encefálica/fisiopatologia , Concussão Encefálica/prevenção & controle , Futebol Americano/lesões , Cabeça/fisiopatologia , Humanos , Masculino , Manequins , Rotação , Estudos de Tempo e Movimento
19.
Sports Biomech ; 19(4): 510-531, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30274550

RESUMO

Goaltenders in the sport of ice hockey are at high risk for concussions from falls to the ice, player collisions and puck impacts. However, current methods used to certify helmets only consider head accelerations for drop tests which may not describe all common injury mechanisms relating to concussion. The purpose of this study was to describe the characteristics of 3 events associated with concussions for ice hockey goaltenders. A helmeted medium National Operating Committee on Standards for Athletic Equipment (NOCSAE) headform was impacted under conditions representing 3 injury events. Three impact locations' velocities were selected for each event based on video analysis of real-world concussive events. Peak resultant linear acceleration, rotational acceleration and rotational velocity of the headform were measured. The University College Dublin Brain Trauma Model (UCDBTM) was used to calculate maximum principal strain (MPS) and von Mises stress in the cerebrum. Each impact event produced a unique dynamic response and brain stress and strain values. This demonstrates that a single impact event (i.e. falls) cannot adequately describe all impact events. As a result, impact protocols which assess multiple impact events such as the protocol described in this study should be used to evaluate ice hockey goaltender masks.


Assuntos
Concussão Encefálica/prevenção & controle , Concussão Encefálica/fisiopatologia , Encéfalo/fisiopatologia , Dispositivos de Proteção da Cabeça/normas , Hóquei/lesões , Máscaras/normas , Equipamentos Esportivos/normas , Aceleração , Fenômenos Biomecânicos , Desenho de Equipamento , Análise de Elementos Finitos , Humanos , Manequins , Rotação , Estudos de Tempo e Movimento , Gravação em Vídeo
20.
Clin J Sport Med ; 30(4): 366-371, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-29952843

RESUMO

OBJECTIVE: Evaluate the rate of concussions across Big 12 Conference football programs based on (1) equipment worn, (2) contact level, (3) preseason practice versus in-season practice versus games, and (4) mechanism of injury for concussion. DESIGN: Descriptive epidemiology study. SETTING: Big 12 Conference football practices and competitions. PATIENTS (OR PARTICIPANTS): Big 12 Conference football teams. ASSESSMENT OF RISK FACTORS: All Big 12 Conference institutions collected data on practice types, equipment worn, practice and game participation, and concussions during the fall, preseasons and regular seasons, from 2013 to 2016. MAIN OUTCOME MEASURES: Injury rates and injury rate ratios were reported with 95% confidence intervals (CIs). RESULTS: From 2013 to 2016, there were 375 concussions reported [0.98/1000 athlete exposures (AEs) (95% CI, 0.88-1.08)], an average of approximately 9 concussions per team per year. Concussion rates were highest in games (5.73/1000 AE), but among practices, concussion rates were highest in full-pad (1.18/1000 AEs) and live-contact (1.28/1000 AEs) practices. Concussion rates increased with increasing contact and equipment worn. Concussion rates were higher in the preseason than in the regular season, even when stratifying by contact level and equipment worn. CONCLUSIONS: Practice concussion rates are highest during fully padded and live-contact practices, supporting limitations on practice contact and equipment worn to reduce the risk associated with head-impact exposure. Higher concussion rates in the preseason and during games indicate an effect of play intensity on concussion risk, and further research is needed to evaluate the direct effect of practice contact level and equipment guidelines and restrictions on concussion incidence.


Assuntos
Concussão Encefálica/epidemiologia , Comportamento Competitivo , Futebol Americano/lesões , Condicionamento Físico Humano/efeitos adversos , Equipamentos de Proteção , Concussão Encefálica/etiologia , Concussão Encefálica/prevenção & controle , Humanos , Incidência , Masculino , Fatores de Risco , Estados Unidos/epidemiologia
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