No abstract

This study provides preliminary evidence to suggest that athletes with multiple concussions might have cumulative effects.

The purpose of this study was to examine the relation between the subjective report of feeling foggy at one-week post concussion and acute neuropsychological outcome. The outcome variables were derived from a computerized neuropsychological screening battery, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Participants were 110 high school students who sustained a sports-related concussion and were evaluated 5-10 days post injury (M 5 6.8 days). Athletes were divided into two groups on the basis of self-reported fogginess. The first group reported no fogginess (n 5 91), whereas the second group reported experiencing some degree of fogginess (n 5 19) on a 6-point scale. The athletes with persistent fogginess experienced a large number of other post-concussion symptoms, compared to the athletes with no reported fogginess. In addition, the athletes with persistent fogginess had significantly slower reaction times, reduced memory performance, and slower processing speed. Thus, athletes with any degree of self-reported fogginess at one-week post injury are likely to have adverse effects from their concussions in multiple domains. (JINS, 2004, 10, 904-906.)

The purpose of this study was to investigate the effectiveness of instability training in the recruitment of core stabilizing muscles during dynamic multijoint movement. Surface electromyography (EMG) was measured from 6 muscles (latissimus dorsi, rectus abdominus, internal obliques, erector spinae, and soleus) while subjects performed a 9.1-kg bench press on stable and unstable surfaces. There were 4 exercises in total: (a) stable surfaces for shoulders and feet, (b) upper-body instability, (c) lower-body instability, and (d) dual instability. Five seconds of EMG were recorded during each bench press and were subsequently smoothed with root mean squares calculated for the entire time-series. A repeated-measures analysis of variance (ANOVA) was used to test overall differences between exercise conditions for each muscle. Paired equal variance t-tests with a stepwise Bonferroni correction for multiple contrasts (alpha = 0.05/total number of contrasts) were performed for muscles with significant repeated-measures ANOVA results. The results show significant increases in EMG with increasing instability. Specifically, the dual instability bench press resulted in the greatest mean muscle activation of the 3 stability conditions, with single instability conditions being significantly greater than the stable condition. This pattern of results is consistent with the position that performing the bench press in a progressively unstable environment may be an effective method to increase activation of the core stabilizing musculature, while the upper- and lower-body stabilizers can be activated differentially depending on the mode of instability.

Background. The literature on lingering or “cumulative” effects of multiple concussions is mixed. The purpose of this study was to examine whether athletes with a history of three or more concussions perform more poorly on neuropsychological testing or report more subjective symptoms during a baseline, preseason evaluation.Hypothesis. Athletes reporting three or more past concussions would perform more poorly on preseason neurocognitive testing.Study Design. Case-control study.Methods. An archival database including 786 male athletes who underwent preseason testing with a computerized battery (ImPACT) was used to select the participants. Twenty-six athletes, between the ages of 17 and 22 with a history of three or more concussions, were identified. Athletes with no history of concussion were matched, in a case-control fashion, on age, education, self-reported ADHD, school, sport, and, when possible, playing position and self-reported academic problems.Results. The two groups were compared on the four neuropsychological composite scores from ImPACT using multivariate analysis of variance followed by univariate ANOVAs. MANOVA revealed no overall significant effect. Exploratory ANOVAs were conducted using Verbal Memory, Visual Memory, Reaction Time, Processing Speed, and Postconcussion Scale composite scores as dependent variables. There was a significant effect for only the Verbal Memory composite.Conclusions. Although inconclusive, the results suggest that some athletes with multiple concussions could have lingering memory deficits.

The primary recommendation to reduce the number and severity of concussions is to eliminate plays where there is a demonstrable intent to injure another player. Concussions in hockey are of considerable concern; however, there is now encouraging information with respect to the treatment of these injuries.

The following conclusions are offered: (1) standard clinical EEG is not useful; however, newer analytical procedures may be proven valuable; (2) consistent with current theory of MTBI, cognitive ERPs seem to be more sensitive to injury than EPs; (3) development of an assessment battery that may include EEG, EPs, ERPs, and neuropsychologic testing is advocated.

BackgroundRecent literature states that many necessary skills of CPR and first aid are forgotten shortly after certification. The purpose of this study was to determine the skill and knowledge decay in first aid in those who are paid to respond to emergency situations within a workplace.MethodsUsing a choking victim scenario, the sequence and accuracy of events were observed and recorded in 257 participants paid to act as first responders in large industrial or service industry settings. A multiple choice exam was also written to determine knowledge retention.ResultsFirst aid knowledge was higher in those who were trained at a higher level, and did not significantly decline over time. Those who had renewed their certificate one or more times performed better than those who had learned the information only once. During the choking scenario many skills were performed poorly, regardless of days since last training, such as hand placement and abdominal thrusts. Compressions following the victim becoming unconscious also showed classic signs of skill deterioration after 30 days.ConclusionsAs many skills deteriorate rapidly over the course of the first 90 days, changing frequency of certification is not necessarily the most obvious choice to increase retention of skill and knowledge. Alternatively, methods of regularly "refreshing" a skill should be explored that could be delivered at a high frequency - such as every 90 days.