Youth Sports Concussions, An Issue of Physical Medicine and Rehabilitation Clinics

Kathleen R. Bell, Stanley A. Herring

Description

Epidemiology of Sports Concussions, Pathophysiology of Concussion in Youth, On the Field Identification and Sideline Management of Concussion, Return to Play Decisions, Diagnosis of Concussion: The Role of Imaging Now and In Future, Use of Neuropsychological Examinations, Subacute Management of Concussion Related Symptoms, Long Term Consequences: Effects on Normal Development Profile After Concussion, School and the Concussed Youth, Community Response to Concussion: Legislative Updates, Best Practices in Concussion Education and PreventionEpidemiology of Sports Concussions, Pathophysiology of Concussion in Youth, On the Field Identification and Sideline Management of Concussion, Return to Play Decisions, Diagnosis of Concussion: The Role of Imaging Now and In Future, Use of Neuropsychological Examinations, Subacute Management of Concussion Related Symptoms, Long Term Consequences: Effects on Normal Development Profile After Concussion, School and the Concussed Youth, Community Response to Concussion: Legislative Updates, Best Practices in Concussion Education and Prevention

Sujets

• Physical Medicine
• Medical
• Médecine
• Rehabilitation

Informations

• Publié par: Saunders
• Date de parution: 28 novembre 2011
• Nombre de lectures: 0
• EAN13: 9781455709472
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Physical Medicine and Rehabilitation Clinics of North America , Vol. 22, No. 4, November 2011
ISSN: 1047-9651
doi: 10.1016/S1047-9651(11)00088-X

Contributors
Physical Medicine and Rehabilitation Clinics of North America
Youth Sports Concussions
GUEST EDITORS: Kathleen R. Bell, MD
Department of Rehabilitation Medicine, University of Washington, Traumatic Brain Injury Model Systems, 1959 NE Pacific Street, Seattle, WA 98195, USA
Stanley A. Herring, MD
Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine and Neurological Surgery, University of Washington, 4225 Roosevelt Way, NE, Seattle, WA 98105, USA
CONSULTING EDITORS: George H. Kraft, MD, MS
ISSN  1047-9651
Volume 22 • Number 4 • November 2011

Contents
Cover
Contributors
Forthcoming Issues
Preface
Dedication
Epidemiology of Youth Sports Concussion
The Pathophysiology of Concussions in Youth
Sport-Related Concussion: On-Field and Sideline Assessment
Return-to-Play Decisions
Diagnosis of Concussion: The Role of Imaging Now and in the Future
Use of Neuropsychological Evaluations
Subacute Concussion-Related Symptoms in Youth
Long-Term Consequences: Effects on Normal Development Profile After Concussion
School and the Concussed Youth: Recommendations for Concussion Education and Management
Youth Sports and Concussions: Preventing Preventable Brain Injuries. One Client, One Cause, and A New Law
Index
Physical Medicine and Rehabilitation Clinics of North America , Vol. 22, No. 4, November 2011
ISSN: 1047-9651
doi: 10.1016/S1047-9651(11)00090-8

Forthcoming Issues
Physical Medicine and Rehabilitation Clinics of North America , Vol. 22, No. 4, November 2011
ISSN: 1047-9651
doi: 10.1016/j.pmr.2011.08.011

Preface

Kathleen R. Bell, MD
Department of Rehabilitation Medicine, University of Washington Traumatic Brain Injury Model Systems, 1959 NE Pacific Street, Seattle, WA 98195, USA
E-mail address: [e-mail]
E-mail address: [e-mail]

Stanley A. Herring, MD
Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine and Neurological Surgery, University of Washington, 4225 Roosevelt Way, NE, Seattle, WA 98105, USA
E-mail address: [e-mail]
E-mail address: [e-mail]


Kathleen R. Bell, MD, Guest Editor

Stanley A. Herring, MD, Guest Editor

A teacher affects eternity; he can never tell where his influence stops.
—Adams, Henry. The Education of Henry Adams, 1918.
First things first. We are honored to have been asked to guest edit this volume of Physical Medicine and Rehabilitation of North America , the final issue directed by George H. Kraft, MD, our friend and teacher. Dr Kraft has been the consulting editor for this esteemed journal since 1990 and, in doing so, has extended his teaching and influence to a national and international audience. We cannot thank him enough for his mentoring and guidance throughout the years.
We were excited at the opportunity to develop this volume addressing Youth Sports Concussion. As physiatrists, we are devoted to caring for people with acute and chronic disorders that affect daily abilities, including work, school, family life, and yes, sports. Often the topic of sports-related concussion is narrowly addressed. With the backdrop of our training in physical medicine and rehabilitation, and our individual practices as a sports physician and a brain injury specialist, we tried to bring together the experts who could discuss the full spectrum of sports-related concussions in youth athletes, from on the field management to school performance to ongoing health problems. It is important for athletes, parents, coaches, athletic trainers, physicians, and others to understand that concussion may not only be a single event. Recovery from concussion, especially repeated insults, is an ongoing process that may require expert management over a more extended period of time than is often considered.
Taking into account these issues, we gathered authorities from many venues. Drs Thomas Jinguji and colleagues review the epidemiology of youth sports concussions, and Dr Christopher Giza and his group explore how the pathophysiology of concussion is different in the developing brain. Acute management of concussion and return to play decisions are discussed by Drs Kevin Guskiewicz, Steven Broglio, and Scott Laker. The third section of this volume covers the current state of diagnosis for concussion with articles on neuroimaging by Drs McCullough and Jarvik and neuropsychological testing by Dr Coppel. The longer term consequences of concussion in children form the fourth section. Drs Blume, Lucas, and Bell discuss the subacute medical problems in children and Dr Cantu and his colleagues review the long-term neuropathologic consequences of concussion on the young brain. Finally, our last section examines community responses to youth sports concussion. Dr Goia and associates review how concussion might affect school performance and the need for educational management. A blueprint for legislative action, as exemplified by the Washington state Lystedt law regulating early management of youth sports-related concussion, is given by Mr Richard Adler. Thank you to all authors for finding the time in unforgiving schedules to produce such quality work.
We are encouraged and gratified by the attention and enthusiasm of the medical and public community to addressing this preventable and treatable disorder, and we offer our thanks to Zackery Lystedt and his parents, Victor and Mercedes, for their endless courage and determination, a sustaining source of inspiration for us all.
Physical Medicine and Rehabilitation Clinics of North America , Vol. 22, No. 4, November 2011
ISSN: 1047-9651
doi: 10.1016/j.pmr.2011.09.001

Dedication


George Kraft
Elsevier would like to thank Dr George Kraft for his more than twenty years serving as the Consulting Editor for Physical Medicine and Rehabilitation Clinics of North America . This is Dr Kraft’s final issue as Consulting Editor for the Clinics. His time and effort have been paramount to our growth over the years, and we wish him all the best in his future endeavors.
Physical Medicine and Rehabilitation Clinics of North America , Vol. 22, No. 4, November 2011
ISSN: 1047-9651
doi: 10.1016/j.pmr.2011.08.001

Epidemiology of Youth Sports Concussion

Thomas M. Jinguji, MD a , b , * , Brian J. Krabak, MD, MBA c , d , e , Emma K. Satchell b
a Department of Orthopedics and Sports Medicine, University of Washington, Seattle, WA, USA
b Seattle Children’s, W-7706 - Orthopedics Administration, 4800 And Point Way NE, Seattle, WA 98105, USA
c University of Washington and Seattle Children’s Sports Medicine, Seattle, WA, USA
d University of Washington and Seattle University Athletics, Seattle, WA, USA
e RacingThePlanet Ultramarathons, Seattle, WA, USA
* Corresponding author. Seattle Children’s, W-7706 - Orthopedics Administration, 4800 And Point Way NE, Seattle, WA 98105.
E-mail address: [e-mail]

Abstract
The overall prevalence of concussion is high school sports is unknown. In general, concussions in this age range occur much more frequently in games than in practice. Also for sports in which both sexes participate, reported concussion rates are higher for female than male high school athletes. Recent data show that the time required for return to play and resolution of symptoms is similar for women and men. Very little is known about the epidemiology of concussions in middle school–aged athletes and younger children.

Keywords
• Concussion • High school athletes • Head injury • Youth

Sports concussion
Estimates of the frequency of sports concussion are truly estimates. Before 2006, an often quoted number for total sports-related concussion in the United States was 300,000 per year. This number is based on data from 1991 National Health Interview Survey in which 46,700 households (120,000 persons) were interviewed, and, from these data, it was estimated that 1.54 million mild head injuries occurred in the year 1990 in the United States. Around 20% of these injuries occurred during sports or physical activity. To be counted as mild, the head injury had to involve loss of consciousness but did not have to be severe enough to cause death or long-term institutionalization. 1 Estimates of sports concussion causing loss of consciousness range between 8% and 19.2%. 2, 3 Based on these data, Langlois and colleagues 4 estimated sports concussion at 1.6 million to 3.8 million events per year in the United States. This is an estimate of all sports concussion in the United States and does not address any specific age group.

Youth sports concussion
On May 20, 2010 the US Government Accountability Office (GAO) gave testimony before the House Committee on Education and Labor regarding the occurrence of concussion in high school sports. The GAO believed that the “overall estimate of occurrence is not available.” 5 Multiple definitions for concussion, poor recognition of this condition, and underreporting in the high school setting lead to the assumption that concussion is probably underestimated in youth sports. 6
Yard and Comstock 7 studied 100 high schools for more than 3 years and found 1308 concussions during 5,627,921 athletic exposures (AE).