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  • Ovid Technologies (Wolters Kluwer Health)  (4)
  • McCrea, Michael  (4)
  • English  (4)
  • 1
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    Online Resource
    Postinjury Alcohol Use Is Associated With Prolonged Recovery After Concussion in NCAA Athletes
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Clinical Journal of Sport Medicine ( 2023-7-6)
    Details
    In: Clinical Journal of Sport Medicine, Ovid Technologies (Wolters Kluwer Health), ( 2023-7-6)
    Abstract: To determine whether alcohol use leads to prolonged clinical recovery or increased severity of concussion symptoms in National Collegiate Athletic Association (NCAA) athletes. Design: Prospective observational study. Setting: Clinical institutions. Participants: Athletes from the NCAA Concussion Assessment Research and Education consortium who sustained a concussion from 2014 to 2021. Interventions: Athletes were divided into 2 groups, those reporting alcohol use postinjury and those reporting no alcohol use postinjury. Main Outcome Measures: Symptom recovery was evaluated as time (in days) from injury to clearance to return to unrestricted play (days until URTP). Severity of concussion symptoms was assessed using the Standardized Sport Concussion Assessment Tool (SCAT3) symptom severity, headache severity, difficulty concentrating, and difficulty remembering scores. These scores were taken a median of 6.6 [interquartile range (IQR) = 4.0-10] and 6 (IQR = 4.0-9.0) days after injury for those who did and did not consume alcohol postinjury respectively and compared with baseline SCAT3 scores. Results: Four hundred eighty four athletes from the data set had complete data for exposure and outcome. The adjusted mean number of days until URTP for athletes reporting alcohol use postinjury [23.3; 95% confidence interval (CI), 20.0-27.2; days] was incidence rate ratio (IRR) 1.32 (95% CI, 1.12-1.55; P 〈 0.001) times higher than for athletes who reported no alcohol use postinjury [17.7 (95% CI, 16.1-19.3) days]. Postinjury alcohol was not associated with severity of concussion symptoms ( P 's 〈 0.05). Conclusion: Self-reported postinjury alcohol use is associated with prolonged recovery but not severity of concussion symptoms in collegiate athletes. This may inform future clinical recommendations regarding alcohol consumption after concussion.
    Type of Medium: Online Resource
    ISSN: 1050-642X
    URL: Article
    DOI: 10.1097/JSM.0000000000001165
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2045233-0
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  • 2
    Online Resource
    Online Resource
    Influence of Postconcussion Sleep Duration on Concussion Recovery in Collegiate Athletes
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Clinical Journal of Sport Medicine Vol. 30, No. 1 ( 2020-03), p. S29-S35
    Details
    In: Clinical Journal of Sport Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 1 ( 2020-03), p. S29-S35
    Abstract: To determine whether decreased sleep duration postconcussion influences days to asymptomatic and assessment of performance throughout recovery. Design: Prospective. Setting: Institutional Clinical Research Laboratory. Patients: Four hundred twenty-three collegiate athletes were diagnosed with concussion. Interventions: Multidimensional concussion assessment battery was conducted at baseline, within 24 to 48 hours, daily [2-4 days postinjury (PI); symptoms only], once asymptomatic, and after return-to-play. The battery included the following: 22-item symptom checklist, Standardized Assessment of Concussion (SAC), Balance Error Scoring System (BESS), and computerized neurocognitive test [Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)] . Main Outcome Measures: We subtracted baseline sleep duration from 24 to 48 hours postconcussion sleep duration and categorized athletes into the following groups: shorter sleep (≤−1 hour), no change ( 〉 −1 hour, 〈 +1 hour), and longer sleep (≥+1 hour). A 1-way analysis of variance (ANOVA) was conducted to compare days to asymptomatic and separate mixed-model ANOVAs to compare total symptom scores, SAC total scores, BESS total error scores, and ImPACT composite scores between sleep categories across time points (α = 0.05). Results: Sleep groups did not differ in days to asymptomatic. The shorter sleep group had greater symptom severity than no sleep change and longer sleep groups at 24 to 48 hours (shorter: 39.1 ± 20.7; no change: 25.1 ± 18.4, P = 0.007; longer: 25.7 ± 21.8, P = 0.004), and at 2 to 4 days PI (shorter: 21.8 ± 21.8; no change: 10.5 ± 10.8, P = 0.013; longer: 11.9 ± 14.2, P = 0.007), but did not differ at other time points (ie, asymptomatic and return-to-play). Participants with shorter sleep exhibited slower ImPACT reaction times at 24 to 48 hours (shorter: 0.68 ± 0.14; no change: 0.61 ± 0.09, P = 0.016; and longer: 0.62 ± 0.12, P = 0.028) and asymptomatic time points (shorter: 0.62 ± 0.11; no change: 0.56 ± 0.05; P = 0.015). Conclusion: Postinjury sleep declines may be associated with symptom severity and worsened reaction time during initial stages of recovery or may be the result of the concussion itself. Clinicians should be aware of alterations in sleep duration and manage appropriately to mitigate initial symptom burden postconcussion.
    Type of Medium: Online Resource
    ISSN: 1050-642X
    URL: Article
    DOI: 10.1097/JSM.0000000000000538
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2045233-0
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  • 3
    Online Resource
    Online Resource
    Test–Retest Reliability and Efficacy of Individual Symptoms in Concussion Management
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Clinical Journal of Sport Medicine Vol. 33, No. 1 ( 2023-01), p. 52-60
    Details
    In: Clinical Journal of Sport Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 1 ( 2023-01), p. 52-60
    Abstract: (1) To determine test–retest reliability of individual Sport Concussion Assessment Tool—Third Edition (SCAT-3) symptom scores and symptom severity scores, (2) to examine the specificity/sensitivity of individual SCAT-3 symptom severity scores acutely (24-48 hours) postconcussion, and (3) to develop a model of symptoms best able to differentiate concussed from nonconcussed student athletes and cadets. Design: Prospective, longitudinal, and cross-sectional. Setting: Twenty-six civilian schools and 3 US service academies. Participants: Collegiate student athletes (n = 5519) and cadets (n = 5359) from the National Collegiate Athletic Association–Department of Defense Grand Alliance: Concussion Assessment, Research and Education Consortium, including 290 student athletes and 205 cadets, assessed 24 to 48 hours postconcussion. Independent Variables: Concussed and nonconcussed student athlete and cadet groups. Main Outcome Measures: Sport Concussion Assessment Tool—Third Edition individual symptom severity scores, total symptom scores, and symptom severity scores. Results: Results indicated poor test–retest reliability across all symptom scores (intraclass correlation coefficient = 0.029-0.331), but several individual symptoms had excellent predictive capability in discriminating concussed from nonconcussed participants (eg, headache, pressure in the head, and don't feel right had area under the curve 〉 0.8, sensitivity 〉 70%, and specificity 〉 85%) regardless of baseline testing. These symptoms were consistent with Chi-square Automatic Interaction Detector classification trees with the highest mean probability. Conclusions: Findings support the excellent diagnostic accuracy of honest symptom reporting, notwithstanding the known limitations in symptom underreporting, and suggest that there may be added value in examining individual symptoms rather than total symptom scores and symptom severity scores alone. Finally, findings suggest that baseline testing is not necessary for interpreting postconcussion symptom scores.
    Type of Medium: Online Resource
    ISSN: 1050-642X
    URL: Article
    DOI: 10.1097/JSM.0000000000001084
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2045233-0
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  • 4
    Online Resource
    Online Resource
    Estimated age of first exposure to American football and outcome from concussion
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Neurology Vol. 95, No. 21 ( 2020-11-24), p. e2935-e2944
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 95, No. 21 ( 2020-11-24), p. e2935-e2944
    Abstract: To examine the association between estimated age at first exposure (eAFE) to American football and clinical measures throughout recovery following concussion. Methods Participants were recruited across 30 colleges and universities as part of the National Collegiate Athletic Association (NCAA)–Department of Defense Concussion Assessment, Research and Education Consortium. There were 294 NCAA American football players (age 19 ± 1 years) evaluated 24–48 hours following concussion with valid baseline data and 327 (age 19 ± 1 years) evaluated at the time they were asymptomatic with valid baseline data. Participants sustained a medically diagnosed concussion between baseline testing and postconcussion assessments. Outcome measures included the number of days until asymptomatic, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) composite scores, Balance Error Scoring System (BESS) total score, and Brief Symptom Inventory 18 (BSI-18) subscores. The eAFE was defined as participant's age at the time of assessment minus self-reported number of years playing football. Results In unadjusted regression models, younger eAFE was associated with lower (worse) ImPACT Visual Motor Speed ( R 2 = 0.031, p = 0.012) at 24–48 hours following injury and lower (better) BSI-18 Somatization subscores ( R 2 = 0.014, p = 0.038) when the athletes were asymptomatic. The effect sizes were very small. The eAFE was not associated with the number of days until asymptomatic, other ImPACT composite scores, BESS total score, or other BSI-18 subscores. Conclusion Earlier eAFE to American football was not associated with longer symptom recovery, worse balance, worse cognitive performance, or greater psychological distress following concussion. In these NCAA football players, longer duration of exposure to football during childhood and adolescence appears to be unrelated to clinical recovery following concussion.
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.0000000000010672
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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