Background
Laboratory-based studies on neuromuscular control after concussion and epidemiological studies suggest that concussion may increase the risk of subsequent musculoskeletal injury.
Objective
The purpose of this study was to determine if athletes have an increased risk of lower extremity musculoskeletal injury after return-to-play from a concussion.
Methods
Injury data were collected from 2006–2013 for men’s football and women’s basketball, soccer, and lacrosse at a NCAA Division I university. Ninety cases in 73 athletes (52 Male, 21 Female) of in-season concussion with return-to-play at least 30 days prior to the end of the season were identified. A period of up to 90 days of in-season competition following return-to-play was reviewed for time-loss injury. The same period was studied in up to two control athletes who were without a concussion within the prior year and were matched on sport, starting status, and position.
Results
Lower extremity musculoskeletal injuries occurred at a higher rate in the concussed athletes (45/90 or 50%) compared to the non-concussed athletes (30/148 or 20%) (p < 0.01). The odds of sustaining a musculoskeletal injury were 3.39 times higher in the concussed athletes (95% CI = 1.90, 6.05; p < 0.01). Overall, the number of days lost due to injury was similar between concussed and non-concussed athletes (Median = 9 vs 15, p = 0.41).
Conclusions
The results of this study demonstrate a relationship between concussion and an increased risk of lower extremity musculoskeletal injury after return to play, and may have implications for current medical practice standards regarding the evaluation and management of concussion injuries.
Purpose
Recent research indicates that a concussion increases risk of musculoskeletal injury. Neuromuscular changes following concussion might contribute to the increased risk of injury. Many studies have examined gait post-concussion, but few studies have examined more demanding tasks. This study compared changes in stiffness across the lower extremity, a measure of neuromuscular function, during a jump-landing task in athletes with a concussion (CONC) to uninjured athletes (UNINJ).
Methods
Division I football players (13 CONC, 26 UNINJ) were tested pre- and post-season. A motion-capture system recorded subjects jumping on one limb from a 25.4 cm step onto a force plate. Hip, knee, and ankle joint stiffness were calculated from initial contact to peak joint flexion using the regression line slopes of the joint moment versus joint angle plots. Leg stiffness was (peak vertical ground reaction force (PVGRF)/lower extremity vertical displacement) from initial contact to PVGRF. All stiffness values were normalized to bodyweight. Values from both limbs were averaged. General linear models compared group (CONC, UNINJ) differences in the changes of pre- and post-season stiffness values.
Results
Average time from concussion to post-season testing was 49.9 days. The CONC group showed an increase in hip stiffness (p=0.03), a decrease in knee (p=0.03) and leg stiffness (p=0.03), but no change in ankle stiffness (p=0.65) from pre- to post-season.
Conclusion
Lower extremity stiffness is altered following concussion, which could contribute to an increased risk of lower extremity injury. These data provide further evidence of altered neuromuscular function after concussion.
We investigated a cluster of methicillin-resistant Staphylococcus aureus infections in college football players. Risk factors included a history of recurrent skin infections and contact with the skin lesions of persons outside college. The infections were controlled through treatment of carriers with topical mupirocin, chlorhexidine body washes, and enhancement of personal hygiene practices. Varsity and professional teams need to consider similar preventive measures.
ObjectiveTo assess the diagnostic accuracy of antigen compared with reverse transcriptase (RT)-PCR testing in an asymptomatic athlete screening programme and to monitor infection in college athletes.MethodsQuidel Sofia-2 SARS-CoV-2 Antigen Tests were performed daily before sports participation for football, basketball, wrestling and water polo from 29 September 2020 to 28 February 2021. Paired RT-PCR and antigen tests were performed at least once a week. Positive antigen tests were confirmed with RT-PCR.Results81 175 antigen and 42 187 RT-PCR tests were performed, including 23 462 weekly paired antigen/RT-PCR screening tests in 1931 athletes. One hundred and seventy-two athletes had a positive screening RT-PCR (0.4%), of which 83 (48%) occurred on paired testing days. The sensitivity of antigen tests varied with the frequency of RT-PCR testing and prevalence of COVID-19. The sensitivity of antigen testing was 35.7% (95% CI: 17% to 60%) and specificity 99.8% (95% CI: 99.7% to 99.9%) with once-a-week RT-PCR testing after adjusting for school prevalence. Daily antigen testing was similar to RT-PCR testing two to three times a week in identifying infection. Antigen testing identified infection before the next scheduled PCR on 89 occasions and resulted in 234 days where potentially infectious athletes were isolated before they would have been isolated with RT-PCR testing alone. Two athletic-related outbreaks occurred; 86% of total infections were community acquired.ConclusionAntigen testing has high specificity with a short turnaround time but is not as sensitive as RT-PCR. Daily antigen testing or RT-PCR testing two to three times a week is similar. There are benefits and drawbacks to each testing approach.
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