Jan 29, 2015
Bulletin Board

Predicting Concussion Recovery

Using a national high school athlete injury database, researchers have identified specific concussion symptoms that, when present at initial injury, predict the athlete will struggle with concussive symptoms for longer than one week. Their study appeared in the January issue of Brain Injury.

Researchers from the University of Washington, Harborview Injury Prevention and Research Center, Seattle Children’s Research Institute, and the Center for Injury Research and Policy at Nationwide Children’s Hospital found that drowsiness, nausea, and difficulty concentrating at the time of the concussion were associated with lingering symptoms for athletes in all sports. And for male athletes, amnesia was associated with lasting symptoms. Loss of consciousness did not play a role in prolonged symptoms.

In addition, the study found that athletes in all sports who displayed more than three concussion symptoms at the time of injury were at double the risk for the injury to linger for more than a week. And for football players only, a history of prior concussion put them at twice the risk for symptoms to continue past the one-week mark.

The findings could have an impact on return to play guidelines following a concussion. “The medical community is becoming more aware that concussions may not be a minor injury and may result in prolonged symptoms,” Sara Chrisman, MD, an adolescent medicine fellow at UW and lead author of the study, said in a press release. “This is a step towards developing evidence-based return to play guidelines.”

To view a summary of the study, search its title, “Risk factors for concussive symptoms 1 week or longer in high school athletes,” at: http://informahealthcare.com/loi/bij.

Division III Passes Sickle Cell Legislation NCAA Division III schools will begin testing athletes for the sickle cell trait this fall, joining their counterparts in Division I and II. The rule requiring testing was approved at the NCAA Convention in January and goes into effect Aug. 1, when incoming student-athletes will be tested. Schools are required to finalize confirmation of sickle cell trait status for the rest of their student-athletes no later than the 2014-15 academic year.

Division III schools can confirm the sickle cell trait status of student-athletes in one of two ways: Athletes can be tested or provide documentation of a previous test. They can also choose to sign a waiver declining to be tested. If an athlete chooses the third option, the school is required to educate that athlete about the condition and possible ramifications of not being tested.

An educational component of Division III’s rule makes it unique from Divisions I and II. All D-III athletes are required to be educated about the condition, even if they’re not at risk. It is the NCAA’s hope that this component will ease student-athletes’ fears about the ramifications of a positive test. Contrary to some athletes’ beliefs, those who carry the sickle cell trait are not barred from athletic participation. Instead, athletic trainers and coaches can take steps to properly manage the condition that will allow athletes to continue in their sport.

To help defray testing costs, the Division III Presidents Council authorized a one-time allocation of $220,000, awarding each school $500. The additional funding augments a deal the NCAA has struck with Quest Diagnostics, a national lab service, to provide testing and results in a timely fashion at a reduced rate. The NCAA estimates that for as low as $8.50 (and up to $32.50 depending on the process), a student-athlete’s results can be available in a matter of days.

For more information about the sickle cell trait, the testing process, and educating student-athletes, go to: www.ncaa.org and search “sickle cell.”

To read a T&C article written by Scott Anderson, ATC, Head Athletic Trainer at the University of Oklahoma, about testing student-athletes for the sickle cell trait, search “Testing for SCT” at: www.Training-Conditioning.com.

Warding Off Overuse Numerous studies have found that sport specialization may increase an athlete’s risk of injury, especially overuse injuries. New research presented at the Society for Tennis Medicine and Science meeting, and the United States Tennis Association-Tennis Medicine & Injury Prevention Conference has found that the solution may be as simple as having athletes spend more time playing various recreational sports for fun in a non-organized setting.

Researchers from Loyola University (Ill.) studied the records of 618 young athletes who were treated at the Loyola University Health System and Lurie Children’s Hospital of Chicago clinics for various injuries. For comparison, they also included 273 uninjured athletes who were seen for sports physicals. This pool of 891 athletes included 124 who played tennis, 74 of whom participated in tennis exclusively.

The injured athletes who played tennis exclusively spent an average of 12.6 hours per week participating in organized tennis and 2.4 hours per week playing other sports in a recreational setting. The uninjured tennis players spent an average of 9.7 hours per week playing tennis and 4.3 hours per week playing various sports for fun. “Our findings suggest that more participation in a variety of unorganized sports and free play may be protective of injury, particularly among tennis players,” Neeru Jayanthi, MD, Associate Professor at Loyola and Medical Director of the school’s athletic center and primary care sports medicine facility, said in a press release.

Position Determines Muscle Response

A study published in the December issue of the Journal of Electromyography and Kinesiology found that soccer players’ muscle responses differ depending on the position they play. The authors, from the University of Vigo in Spain, concluded that their findings–and the measuring technique they used–may be able to help players optimize their training and recovery process.

The researchers used tensiomyography, a non-invasive method of neuromuscular assessment, to measure the rectus femoris and biceps femoris of 78 professional soccer players. (The players’ average age was 26.6 years old, average weight was 75.8 kilograms, and average height was 179.2 centimeters.) The following tensiomyography measurements were taken after the players had two days of rest with no practices or training sessions:

– Maximal displacement – Contraction time – Sustain time – Delay time – Half-relaxation time.

While no significant differences were found in the players’ biceps femoris, significant differences were observed between contraction time, sustain time, and half-relaxation time in the players’ rectus femoris muscles based on their playing position. Central defenders and goalkeepers showed lower contraction time when compared to side defenders. “This is because central defenders and goalkeepers need higher levels of explosive force in the knee extension muscles to jump, stop, and head the ball effectively,” Ezequiel Rey, PhD, a Professor in Vigo’s Physical Education department and lead researcher, told Medical News Today.

The tensiomyography technique allowed researchers to “obtain information on the acute and chronic effects of training on a muscular level, prevent injuries, detect muscle imbalance and muscular asymmetry, and assess the state of muscle fatigue after training,” Rey added. “[The study] provides values that can be used when prescribing the training loads in elite football and to reduce the risk of injury in the different specific positions.”

To view the abstract of the study, search its title, “Tensiomyography of selected lower-limb muscles in professional soccer players,” at: www.sciencedirect.com.


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