The Natural History of Sport-Related Concussion in Collegiate Athletes: Findings from the NCAA-DoD CARE Consortium

Broglio, Steven P.; McAllister, Thomas W.; Katz, Barry P.; LaPradd, Michelle; Zhou, Wenxian; McCrea, Michael

doi:10.1007/s40279-021-01541-7

Cited by 89 publications

(50 citation statements)

References 34 publications

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“…For example, results of a recent study suggest that among former collegiate football players, with no professional football exposure, a history of three or more prior concussions, but not a prior history of only one or two concussions, was associated with worse health outcomes (e.g., physical pain, depressive symptomatology, general health) 15 years after the conclusion of their athletic careers [ 42 ]. This apparent threshold of three or more prior concussions, versus only one or two, has been cited as a prognostic indicator for worse clinical outcomes in other studies as well [ 11 , 23 , 42 , 43 ]. Additionally, a study conducted across 3 university-affiliated specialty clinics, comprised of 270 adolescents, reported that a history of 3 or more prior concussions increased risk for experiencing persistent postconcussion symptoms.…”

Section: Discussionmentioning

confidence: 89%

“…Evolving methodological advancements in the study of concussion history, such as considering the exact number of prior concussions, rather than studying concussion history as a dichotomous variable (i.e., any prior concussions: yes/no), has begun to yield more nuanced insights. For example, a recent study of collegiate athletes reported that a history of three or more prior concussions was associated with longer clinical recoveries; however, this association was not detected in athletes with only one or two prior concussions [ 11 ]. Moreover, concussion history is a complex variable, and its prognostic utility may be reduced if it is measured in a binary fashion (i.e., yes or no).…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcome Following Concussion Among College Athletes with a History of Prior Concussion: A Systematic Review

et al. 2022

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Background There is long-standing interest in, and concern about, whether collegiate athletes with a history of concussion will experience worse clinical outcomes, or prolonged recovery, should they sustain a subsequent concussion. Objectives This systematic review examined the association between prior concussion history and clinical outcomes following a subsequent sport-related concussion among college-age student athletes. Study Design Systematic review. Methods We screened 5,118 abstracts and 619 full-text articles that were appraised to determine whether they met inclusion criteria. We utilized a likelihood heuristic to assess the probability of observing a specific number of statistically significant and nonsignificant studies reporting an association between concussion history and clinical outcomes. We conducted a narrative synthesis of the study findings. Results Sixteen studies met the inclusion criteria. Thirteen studies reported the number of participants with a history of prior concussions (≥ 1), which totaled 1690 of 4573 total participants (on average 37.0% of study participants; median = 46.0%, range 5.6–63.8%). On the Newcastle–Ottawa Quality Assessment Scale, the risk of bias ratings ranged from 3 to 9 (mean = 5.4, SD = 1.4). Across all studies, 43.8% (k = 7/16) reported at least one statistically significant result among primary analyses showing an association between concussion history and worse clinical outcome. A minority of studies reporting on symptom duration (4/13, 30.8%) and time to return to play (2/7, 28.6%) found an association between concussion history and worse outcome. Studies included in the review reported limited information pertaining to the characteristics of prior concussions, such as presence or duration of loss of consciousness or posttraumatic amnesia, age at first lifetime concussion, time since most recent past concussion, or length of recovery from prior concussions. Conclusion The question of whether college athletes with a prior history of concussion have worse clinical outcome from their next sport-related concussion remains unresolved. The published results are mixed and in aggregate show modest evidence for an association. Many studies have small samples, and only three studies were designed specifically to address this research question. Important outcomes, such as time to return to academics, have not been adequately studied. Larger hypothesis-driven studies considering the number of prior concussions (e.g., 3 or more) are needed. Trial registration: PROSPERO CRD42016041479, CRD42019128300.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Clinical Outcome Following Concussion Among College Athletes with a History of Prior Concussion: A Systematic Review

et al. 2022

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“…For most athletes, acute postconcussion symptoms resolve within 10–15 days; however, some athletes demonstrate prolonged symptom resolution well past a 2-week recovery period (Barr et al, 2018; Belanger & Vanderploeg, 2005). Additionally, some emerging evidence suggests a longer recovery time of 3–4 weeks as standard for adolescent athletes (Broglio et al, 2022; Ledoux et al, 2019).…”

Section: Previous Systematic Reviewsmentioning

confidence: 99%

A systematic review and meta-analysis of factors influencing ImPACT concussion testing in high school and collegiate athletes with self-reported ADHD and/or LD.

Maietta¹,

Renn²,

Goodwin³

et al. 2023

Neuropsychology

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Objective: Sport concussion is a common injury, and athletes with attention-deficit/hyperactivity disorder (ADHD) and/or learning disorder (LD) are at increased risk and require specialized attention in clinical settings. Although systematic reviews of the relationship between ADHD/LD and concussion are reported in the literature, these reviews do not include quantitative syntheses. Additionally, no reviews have focused on the most commonly utilized concussion assessment, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The current review provides an update of sport concussion assessment in athletes with ADHD and/or LD from 2000 to 2021 on these topics: baseline and postconcussion performance on ImPACT, baseline and postconcussion symptom reporting using the Postconcussion Symptom Scale, invalid baseline classification on ImPACT, and self-reported history of concussion. Method: Meta-analyses were conducted on baseline ImPACT performance, symptom reporting, invalid baseline classification, and concussion rates. Thirty-four studies were included in systematic review and 19 were included in meta-analyses. Results: Decreased baseline performance was found for athletes with ADHD (trivial to small effects), LD (small-to-medium effects), and ADHD/LD (small-to-medium effects). Increased baseline symptom reporting was found for athletes with ADHD (small effect). Increased odds of invalid baseline performance (trivial effect) and self-reported concussion history (small effect) were found in ADHD. Conclusions: These results provide the first quantitative synthesis of the literature in this area. It is recommended that future research further examines these topics in athletes with LD and co-occurring ADHD/LD (given the focus on ADHD), as well as the effects that all of these conditions may have on concussion recovery and return-to-play decision-making. Key PointsQuestion: This systematic review and meta-analysis synthesize the sport concussion ImPACT literature in high school and collegiate athletes with self-reported attention-deficit/hyperactivity disorder (ADHD) and/or learning disorder (LD) with topics including baseline and postconcussion cognitive differences, symptom differences, invalid performance, and self-reported concussion rates. Findings: Meta-analysis results indicated that athletes with ADHD and/or LD had poorer cognitive performance and that those with ADHD had increased symptom reporting and were at higher risk for concussion and invalid baseline performance. Importance: Athletes with ADHD and/or LD may require increased attention in sport concussion assessment due to differences in cognitive performance and symptom reporting as well as higher rates of self-reported concussion history, particularly for athletes with ADHD. Next Steps:Neuropsychology

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“…According to the Sports Injury Monitoring system [ 1 , 2 , 3 ], student athletes have a high incidence of sports injuries. The occurrence of repeated and serious injury not only affects their development and causes a heavy physical and mental burden, but may also lead to the premature end of their sports career [ 4 , 5 ]. Therefore, the identification of sports injuries, their risk factors, and targeted interventions are important strategies for prevention [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Yoga Intervention on Functional Movement Patterns and Mindfulness in Collegiate Athletes: A Quasi-Experimental Study

Ruan

et al. 2022

IJERPH

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High-quality movement patterns and high levels of mindfulness are thought to be beneficial in preventing sports injuries. Yoga is recommended in the field of athlete rehabilitation. This study investigated the effects of yoga intervention on functional movement patterns and mindfulness in collegiate athletes. It is a quasi-experimental study with a pre/post-test control design. The participants were divided into a yoga group and a control group. A Functional Movement Screen and the Mindful Attention Awareness Scale were used to assess participants’ basic movement patterns and mindfulness before and after 12 weeks of yoga intervention (two classes per week, 90 min per class). The results show that the yoga group’s FMS scores improved more compared to the control group [F(1,78) = 29.08, p < 0.001, ŋp2 = 0.27], and that the scores for the deep squat (ŋp2 = 0.4), shoulder mobility (ŋp2 = 0.17), and trunk stability pushup (ŋp2 = 0.36) improved substantially. The dysfunctional score ratio for deep squats (χ2 = 18.57, p < 0.001), shoulder mobility (χ2 = 26.90, p < 0.001), trunk stability pushup (χ2 = 17.07, p < 0.001), and rotatory stability (χ2= 38.29, p <0.001) decreased significantly compared with the control group, but there was no significant improvement in asymmetric movement patterns (χ2 = 0.75, p = 0.39). The mindfulness scores in the yoga group significantly exceeded those of the control group [F(1,78) = 13.56, p < 0.001, ŋp2 = 0.15]. These results suggest that yoga intervention can improve functional movement patterns and mindfulness levels, but further evidence is needed to determine whether yoga could positively influence sports injuries.

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The Natural History of Sport-Related Concussion in Collegiate Athletes: Findings from the NCAA-DoD CARE Consortium

Cited by 89 publications

References 34 publications

Clinical Outcome Following Concussion Among College Athletes with a History of Prior Concussion: A Systematic Review

Clinical Outcome Following Concussion Among College Athletes with a History of Prior Concussion: A Systematic Review

A systematic review and meta-analysis of factors influencing ImPACT concussion testing in high school and collegiate athletes with self-reported ADHD and/or LD.

Effects of Yoga Intervention on Functional Movement Patterns and Mindfulness in Collegiate Athletes: A Quasi-Experimental Study

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