Management of cervical spine injuries in athletes.

Objective: Although the incidence of catastrophic cervical spine injury in sport has been significantly reduced over the past 3 decades, the injury warrants continued attention because of the altered quality of life that often accompanies such an injury. The purpose of our literature review was to provide athletic trainers with an understanding of the mechanisms, anatomical structures, and complications often associated with sport-related cervical spine injury. We also present the most current recommendations for management and treatment of these potentially catastrophic injuries.

Neuropsychological performance, postural stability, and symptoms after dehydration.

Context: Dehydration and concussion are common in athletic performance. Some experts have speculated that dehydration may negatively influence performance on tests commonly used for concussion assessment.

Objective: To determine how the signs and symptoms, neuropsychological performance, and postural stability are affected by dehydration.

Recurrent concussion and risk of depression in retired professional football players.

Purpose: The purpose of our study was to investigate the association between prior head injury and the likelihood of being diagnosed with clinical depression among retired professional football players with prior head injury exposure.

Methods: A general health questionnaire, including information about prior injuries, the SF-36 (Short Form 36), and other markers for depression, was completed by 2552 retired professional football players with an average age of 53.8 (+/-13.

Psychometric and measurement properties of concussion assessment tools in youth sports.

Context: Establishing psychometric and measurement properties of concussion assessments is important before these assessments are used by clinicians. To date, data have been limited regarding these issues with respect to neurocognitive and postural stability testing, especially in a younger athletic population.

Objective: To determine the test-retest reliability and reliable change indices of concussion assessments in athletes participating in youth sports.

Functional balance training, with or without exercise sandals, for subjects with stable or unstable ankles.

Context: Improving postural stability through balance training may prevent ankle sprains. Exercise Sandals may increase the demands placed on ankle muscles during rehabilitation, which could improve postural stability.

Objective: To examine the effects of functional balance training, with and without the use of Exercise Sandals, on postural stability in subjects with stable or unstable ankles.

Effectiveness of mouthguards in reducing neurocognitive deficits following sports-related cerebral concussion.

Although it is widely accepted that mouthguards decrease the incidence of dental injuries, there is a controversy among sports medicine professionals as to the effectiveness of mouthguards in decreasing the incidence or severity of sports-related cerebral concussion (SRCC). While some experimental data suggest that this may be the case, there exist a number of reports suggesting that mouthguards do not serve this purpose. These conclusions have been drawn, however, without actually measuring the extent of neurocognitive dysfunction in athletes following sports-related concussion.

Recovery of postural control after cerebral concussion: new insights using approximate entropy.

Context: The return-to-play decision after sport-related cerebral concussion depends in part on knowing when an athlete has fully recovered postural control after injury.

Objective: To describe the postconcussion recovery of postural control using approximate entropy (ApEn), a regularity statistic from nonlinear dynamics.

Design: Retrospective case series analysis.

Sport-related concussion in the young athlete.

Purpose Of Review: The purpose of this review is to present an overview of sport-related concussion in the young athlete and review recent publications of clinical and scientific importance.

Recent Findings: Recent findings show that young athletes are more susceptible to concussions than older athletes and more likely to develop second impact syndrome, as well as long-term negative cumulative consequences. Further, ongoing research suggests a more prolonged disturbance of brain function following a concussion than previously believed.

Effect of coordination training with and without stochastic resonance stimulation on dynamic postural stability of subjects with functional ankle instability and subjects with stable ankles.

Objective: To examine the effects of coordination training with and without stochastic resonance (SR) stimulation on dynamic postural stability.

Design: Experimental with repeated measures.

Setting: Research Laboratory.

Issues in estimating risks and rates in sports injury research.

Objective: To describe 3 measures of incidence used in sports injury epidemiology.

Background: To promote safety in sports, athletic trainers must be able to accurately interpret and apply injury data and statistics. Doing so allows them to more efficiently articulate this information to school administrators in recommending increases in medical resources, such as more personnel, better services, and safer facilities and equipment.

Current trends in athletic training practice for concussion assessment and management.

Context: Athletic trainers surveyed in 1999 demonstrated little consensus on the use of concussion grading scales and return-to-play criteria. Most relied on clinical examination or symptom checklists to evaluate athletes with concussion.

Objective: To investigate the current trends of certified athletic trainers in concussion assessment and management.

Single-leg jump-landing stabilization times in subjects with functionally unstable ankles.

Context: Factors contributing to functional ankle instability may cause individuals with the condition to land from a jump differently than those with stable ankles.

Objective: To determine stabilization time differences during single-leg jump landings between stable and unstable ankle groups and to report the reliability and precision of time-to-stabilization measures.

Design: A mixed design with 1 between factor (ankle group) and 1 within factor (direction) was used to analyze the comparison between our 10 subjects with functional ankle instability and 10 subjects with stable ankles.

Structural validity of a self-report concussion-related symptom scale.

Purpose: This study evaluated the factorial validity of a self-report measure of concussion-related symptom severity among a large sample of male, high-school athletes.

Methods: Participants (N = 1089) were nonconcussed, male, high-school football players. All participants completed a single baseline self-report measure of concussion-related symptom severity, namely the graded symptom checklist (GSC).

A nonlinear dynamic approach for evaluating postural control: new directions for the management of sport-related cerebral concussion.

Recent research suggests that traditional biomechanical models of postural stability do not fully characterise the nonlinear properties of postural control. In sports medicine, this limitation is manifest in the postural steadiness assessment approach, which may not be sufficient for detecting the presence of subtle physiological change after injury. The limitation is especially relevant given that return-to-play decisions are being made based on assessment results.

Association between recurrent concussion and late-life cognitive impairment in retired professional football players.

Objective: Cerebral concussion is common in collision sports such as football, yet the chronic neurological effects of recurrent concussion are not well understood. The purpose of our study was to investigate the association between previous head injury and the likelihood of developing mild cognitive impairment (MCI) and Alzheimer's disease in a unique group of retired professional football players with previous head injury exposure.

Methods: A general health questionnaire was completed by 2552 retired professional football players with an average age of 53.

Comparison of triceps surae structural stiffness and material modulus across sex.

Background: Dynamic joint stability is derived, in part, from active muscle stiffness. Previous research has identified greater structural musculotendinous stiffness in males than in females, suggesting potential sex differences in joint stability. However, structural stiffness is influenced by anthropometrics, and it is currently unclear if sex differences in musculotendinous stiffness are purely functions of anthropometrics or related to additional factors.

Influences of experimental factors on spinal stretch reflex latency and amplitude in the human triceps surae.

The spinal stretch reflex (SSR) is commonly assessed via electromyographic (EMG) analysis of joint perturbations inducing changes in muscle length. Previous literature indicates that when large experimental changes in magnitude of agonist background EMG, perturbation velocity, and perturbation amplitude are employed, SSR latency and amplitude are significantly altered. The purpose of this investigation was to evaluate the relative dependence of SSR latency and amplitude on inherent variability in these experimental variables.

Age and gender effects on lower extremity kinematics of youth soccer players in a stop-jump task.

Background: Gender differences in lower extremity motion patterns were previously identified as a possible risk factor for non-contact anterior cruciate ligament injuries in sports.

Hypothesis: Gender differences in lower extremity kinematics in the stop-jump task are functions of age for youth soccer players between 11 and 16 years of age.

Study Design: Descriptive laboratory study.

Instruction of jump-landing technique using videotape feedback: altering lower extremity motion patterns.

Background: Anterior cruciate ligament injury prevention programs have used videotapes of jump-landing technique as a key instructional component to improve landing performance.

Hypothesis: All videotape feedback model groups will increase knee flexion angles at initial contact and overall knee flexion motion and decrease peak vertical ground reaction forces and peak proximal anterior tibial shear forces to a greater extent than will a nonfeedback group. The secondary hypothesis is that the videotape feedback using the combination of the expert and self models will create the greatest change in each variable.

Standard regression-based methods for measuring recovery after sport-related concussion.

Clinical decision making about an athlete's return to competition after concussion is hampered by a lack of systematic methods to measure recovery. We applied standard regression-based methods to statistically measure individual rates of impairment at several time points after concussion in college football players. Postconcussive symptoms, cognitive functioning, and balance were assessed in 94 players with concussion (based on American Academy of Neurology Criteria) and 56 noninjured controls during preseason baseline testing, and immediately, 3 hr, and 1, 2, 3, 5, and 7 days postinjury.

Examination of static and dynamic postural stability in individuals with functionally stable and unstable ankles.

Objective: To determine static and dynamic postural stability differences between functional ankle instability and stable ankle groups.

Design: Subjects were required to balance on a single leg and remain motionless for 20 seconds. After completing 3 trials, they performed a jump-landing test, which required them to jump 50% to 55% of their maximum vertical jump height.

The relationships between active extensibility, and passive and active stiffness of the knee flexors.

Insufficient active knee flexor stiffness may predispose the anterior cruciate ligament to injury. Insufficient passive stiffness may result in insufficient active stiffness. Similarly, higher levels of musculotendinous extensibility may inhibit active and passive muscle stiffness, potentially contributing to an increased risk of injury.

Serial administration of clinical concussion assessments and learning effects in healthy young athletes.

Objective: To determine if serial administration of the Standardized Assessment of Concussion (SAC) and Balance Error Scoring System (BESS) would elicit a learning effect in young athletes and to determine the intratester reliability of scoring the BESS.

Design: A prospective study of 50 healthy young athletes who were assigned to either the control or practice group. All subjects were administered the assessments on 2 occasions, 60 days apart.