106 research outputs found
HEAD IMPACT FREQUENCY IN YOUTH AMERICAN FOOTBALL, AGES 9-13
The objective of this study was to quantify head impact frequency in youth American football players, ages 9-13. Kinematic data from head impacts were collected from 25 players on two teams (11.7 Β± 1.2 years) using a helmet-mounted accelerometer system. A total of 4432 head impacts were recorded, including 1800 during 265 practice sessions and 2632 during 175 game sessions. Most peak linear acceleration magnitudes were less than 20 g in practices (60%) and games (55%). For impacts greater than or equal to 60 g, players sustained 122% more in games than practices. Both teams played in leagues that limited full-contact practice time, which likely contributed to lower impact frequencies in practices. Interventions to further reduce head impact frequency in youth football should include measures which affect in-game exposure
Π¦-ΡΠ΅Π°ΠΊΡΠΈΠ²Π΅Π½ ΠΏΡΠΎΡΠ΅ΠΈΠ½ ΠΈ cΠΎΠΎΠ΄Π½ΠΎΡΠΎΡ Π½Π° Π½Π΅ΡΡΡΠΎΡΠΈΠ»ΠΈ-Π»ΠΈΠΌΡΠΎΡΠΈΡΠΈ ΠΊΠ°ΠΊΠΎ ΡΠ°ΠΊΡΠΎΡΠΈ Π·Π° ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΈΠ²Π½ΠΎΡΡ Π½Π° ΡΠ΅ΠΆΠΈΠ½Π°ΡΠ° Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠ°ΡΠ° ΡΠ»ΠΈΠΊΠ° ΠΊΠ°Ρ COVID-19
COVID-19 is an infectious disease that can manifest quite differently. In this study we examined the relationship between the value of serum CRP(C-reactive protein) andneutrophil-lymphocyte ratio (NLR) as predictor factors for the development of a severe clinical manifestation in COVID19 patients. Materials and methods: We followed 95 COVID-19 positive patients who were hospitalized at the University Clinic for Eye Diseases - COVID Center. We analyzed the initial laboratory parameters of white blood cells and CRP on admission of the patients and the results of laboratory analyses performed before they left the Clinic, or the last parameters before the lethal outcome in those patients who died. Several models of logistic regression were tested to analyze the predictive value of these markers of inflammation for lethal outcome in patients hospitalized for COVID-19. Results: Bivariate analysis demonstrated that the length of hospital stay was significantly shorter in patients with lethal outcome (p=0.001). The NLR was significantly higher in patients with lethal outcome at both times (p=0.005; and p=0.017). Leukocyteβs count (p=0.046, and p<0.001) and CRP (p=0.013,and p=0.005) were also significantly higher in patients with lethal outcome at both times. The increase on the NLR scale both at hospitalization and at discharge (or the last analysis before death) leads to increase in the odds of lethal outcome (T1:40.4% increased odds; T2:36% increased odds). Conclusion: CRP and NLR are laboratory parameters that can predict the severity of the clinical manifestation in patients with COVID-19.COVID-19 Π΅ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎ Π·Π°Π±ΠΎΠ»ΡΠ²Π°ΡΠ΅ ΠΊΠΎΠ΅ ΠΌΠΎΠΆΠ΅ Π΄Π° ΡΠ΅ ΠΌΠ°Π½ΠΈΡΠ΅ΡΡΠΈΡΠ° Π΄ΠΎΡΡΠ° ΡΠ°Π·Π»ΠΈΡΠ½ΠΎ. ΠΠΎ ΠΎΠ²Π°Π° ΡΡΡΠ΄ΠΈΡΠ° Π½ΠΈΠ΅ ΡΠ° ΠΈΡΠΏΠΈΡΡΠ²Π°Π²ΠΌΠ΅ ΠΏΠΎΠ²ΡΠ·Π°Π½ΠΎΡΡΠ° ΠΏΠΎΠΌΠ΅ΡΡ Π²ΡΠ΅Π΄Π½ΠΎΡΡΠΈΡΠ΅ Π½Π° CRP (Π¦-ΡΠ΅Π°ΠΊΡΠΈΠ²Π΅Π½ ΠΏΡΠΎΡΠ΅ΠΈΠ½) ΠΈ ΡΠΎΠΎΠ΄Π½ΠΎΡΠΎΡ Π½Π΅ΡΡΡΠΎΡΠΈΠ»ΠΈ-Π»ΠΈΠΌΡΠΎΡΠΈΡΠΈ (NLR) ΠΊΠ°ΠΊΠΎ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΈΠ²Π½ΠΈ ΡΠ°ΠΊΡΠΎΡΠΈ Π·Π° ΡΠ°Π·Π²ΠΎΡ Π½Π° ΡΠ΅ΡΠΊΠ° ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠ° ΡΠ»ΠΈΠΊΠ° ΠΊΠ°Ρ ΠΏΠ°ΡΠ΅Π½ΡΠΈΡΠ΅ ΡΠΎ COVID-19. ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π»ΠΈ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ:Π‘Π»Π΅Π΄Π΅Π²ΠΌΠ΅ 95 COVID-19 ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΠΊΠΎΠΈ Π±Π΅Π° Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠ°Π½ΠΈ Π²ΠΎ Π£Π Π·Π° ΠΎΡΠ½ΠΈ Π±ΠΎΠ»Π΅ΡΡΠΈ - COVID ΡΠ΅Π½ΡΠ°Ρ Π²ΠΎ Π‘ΠΊΠΎΠΏΡΠ΅. ΠΠΈ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠ°Π²ΠΌΠ΅ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠΈΡΠΊΠΈΡΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈ Π½Π° Π»Π΅ΡΠΊΠΎΡΠΈΡΠΈΡΠ΅ ΠΈ CRP ΠΏΡΠΈ ΠΏΡΠΈΠ΅ΠΌ Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Π²ΠΎ ΠΠ»ΠΈΠ½ΠΈΠΊΠ°ΡΠ° ΠΈ ΡΠ΅Π·ΡΠ»ΡΠ°ΡΠΈΡΠ΅ ΠΎΠ΄ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠΈΡΠΊΠΈΡΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈ ΠΈΠ·Π²Π΅Π΄Π΅Π½ΠΈ ΠΏΡΠ΅Π΄ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Π΄Π° ΡΠ° Π½Π°ΠΏΡΡΡΠ°Ρ ΠΠ»ΠΈΠ½ΠΈΠΊΠ°ΡΠ° ΠΈΠ»ΠΈ ΠΏΡΠ΅Π΄ Π½ΠΈΠ²Π½ΠΈΠΎΡ Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄, ΠΊΠ°Ρ ΠΎΠ½ΠΈΠ΅ ΡΡΠΎ ΠΏΠΎΡΠΈΠ½Π°Π°. ΠΠ΅Π° ΡΠ΅ΡΡΠΈΡΠ°Π½ΠΈ Π½Π΅ΠΊΠΎΠ»ΠΊΡ ΠΌΠΎΠ΄Π΅Π»ΠΈ Π½Π° Π»ΠΎΠ³ΠΈΡΡΠΈΡΠΊΠ° ΡΠ΅Π³ΡΠ΅ΡΠΈΡΠ° ΡΠΎ ΡΠ΅Π» Π΄Π° ΡΠ΅ ΡΡΠ²ΡΠ΄ΠΈ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΈΠ²Π½Π°ΡΠ° Π²ΡΠ΅Π΄Π½ΠΎΡΡ Π½Π° ΠΎΠ²ΠΈΠ΅ ΠΌΠ°ΡΠΊΠ΅ΡΠΈ Π½Π° ΠΈΠ½ΡΠ»Π°ΠΌΠ°ΡΠΈΡΠ° Π·Π° Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠ°Π½ΠΈ ΠΎΠ΄ COVID-19. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: ΠΠ½Π°Π»ΠΈΠ·Π°ΡΠ° ΠΏΠΎΠΊΠ°ΠΆΠ° Π΄Π΅ΠΊΠ° Π΄ΠΎΠ»ΠΆΠΈΠ½Π°ΡΠ° Π½Π° ΠΏΡΠ΅ΡΡΠΎΡ Π²ΠΎ Π±ΠΎΠ»Π½ΠΈΡΠ° Π±Π΅ΡΠ΅ Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ ΠΏΠΎΠΊΡΠ°ΡΠΊΠ° ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΡΠΎ Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄ (=0,001). NLR Π±Π΅ΡΠ΅ Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ ΠΏΠΎΠ²ΠΈΡΠΎΠΊ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄ ΠΈ Π²ΠΎ Π΄Π²Π΅ΡΠ΅ Π²ΡΠ΅ΠΌΠΈΡΠ° (p = 0,005; ΠΈ p = 0,017). ΠΡΠΎΡΠΎΡ Π½Π° Π»Π΅ΡΠΊΠΎΡΠΈΡΠΈΡΠ΅ (p = 0,046, ΠΈ p <0.001) ΠΈ CRP (p = 0,013, ΠΈ p = 0,005), ΠΈΡΡΠΎ ΡΠ°ΠΊΠ°, Π±Π΅Π° Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ ΠΏΠΎΠ²ΠΈΡΠΎΠΊΠΈ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄ Π²ΠΎ Π΄Π²Π΅ΡΠ΅ Π²ΡΠ΅ΠΌΠΈΡΠ°. ΠΠΎΠ²ΠΈΡΠΎΠΊΠΈ Π²ΡΠ΅Π΄Π½ΠΎΡΡΠΈ Π½Π° NLR ΠΈ ΠΏΡΠΈ Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡΠ° ΠΈ ΠΏΡΠΈ ΠΎΡΠΏΡΡΡΠ°ΡΠ΅ (ΠΈΠ»ΠΈ ΠΏΠΎΡΠ»Π΅Π΄Π½Π° Π°Π½Π°Π»ΠΈΠ·Π° ΠΏΡΠ΅Π΄ Π½Π°ΡΡΠ°ΠΏΡΠ²Π°ΡΠ΅ Π½Π° ΡΠΌΡΡΡΠ°) Π΄ΠΎΠ²Π΅Π΄ΡΠ²Π° Π΄ΠΎ Π·Π³ΠΎΠ»Π΅ΠΌΡΠ²Π°ΡΠ΅ Π½Π° ΡΠ°Π½ΡΠΈΡΠ΅ Π·Π° Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄ (Π’1: 40,4% Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ΠΈ ΡΠ°Π½ΡΠΈ; Π’2: 36% Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ΠΈ ΡΠ°Π½ΡΠΈ). ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: CRP ΠΈ NLR ΡΠ΅ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠΈΡΠΊΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈ ΠΊΠΎΠΈ ΠΌΠΎΠΆΠ°Ρ Π΄Π° ΡΠ° ΠΏΡΠ΅Π΄Π²ΠΈΠ΄Π°Ρ ΡΠ΅ΡΠΈΠΎΠ·Π½ΠΎΡΡΠ° Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠ°ΡΠ° ΡΠ»ΠΈΠΊΠ° ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ COVID-19.
The Association Between Persistent White-Matter Abnormalities and Repeat Injury After Sport-Related Concussion
Objective: A recent systematic review determined that the physiological effects of concussion may persist beyond clinical recovery. Preclinical models suggest that ongoing physiological effects are accompanied by increased cerebral vulnerability that is associated with risk for subsequent, more severe injury. This study examined the association between signal alterations on diffusion tensor imaging following clinical recovery of sport-related concussion in athletes with and without a subsequent second concussion. Methods: Average mean diffusivity (MD) was calculated in a region of interest (ROI) in which concussed athletes (n = 82) showed significantly elevated MD acutely after injury (<48 h), at an asymptomatic time point, 7 days post-return to play (RTP), and 6 months relative to controls (n = 69). The relationship between MD in the identified ROI and likelihood of sustaining a subsequent concussion over a 1-year period was examined with a binary logistic regression (re-injured, yes/no). Results: Eleven of 82 concussed athletes (13.4%) sustained a second concussion within 12 months of initial injury. Mean MD at 7 days post-RTP was significantly higher in those athletes who went on to sustain a repeat concussion within 1 year of initial injury than those who did not (p = 0.048; d = 0.75). In this underpowered sample, the relationship between MD at 7 days post-RTP and likelihood of sustaining a secondary injury approached significance [Ο2 (1) = 4.17, p = 0.057; B = 0.03, SE = 0.017; OR = 1.03, CI = 0.99, 1.07]. Conclusions: These preliminary findings raise the hypothesis that persistent signal abnormalities in diffusion imaging metrics at RTP following concussion may be predictive of a repeat concussion. This may reflect a window of cerebral vulnerability or increased susceptibility following concussion, though understanding the clinical significance of these findings requires further study
Head Impact Exposure in Youth Football: Elementary School Ages 9β12Β Years and the Effect of Practice Structure
Head impact exposure in youth football has not been well-documented, despite children under the age of 14 accounting for 70% of all football players in the United States. The objective of this study was to quantify the head impact exposure of youth football players, age 9β12, for all practices and games over the course of single season. A total of 50 players (ageΒ =Β 11.0Β Β±Β 1.1Β years) on three teams were equipped with helmet mounted accelerometer arrays, which monitored each impact players sustained during practices and games. During the season, 11,978 impacts were recorded for this age group. Players averaged 240Β Β±Β 147 impacts for the season with linear and rotational 95th percentile magnitudes of 43Β Β±Β 7Β g and 2034Β Β±Β 361Β rad/s(2). Overall, practice and game sessions involved similar impact frequencies and magnitudes. One of the three teams however, had substantially fewer impacts per practice and lower 95th percentile magnitudes in practices due to a concerted effort to limit contact in practices. The same team also participated in fewer practices, further reducing the number of impacts each player experienced in practice. Head impact exposures in games showed no statistical difference. While the acceleration magnitudes among 9β12Β year old players tended to be lower than those reported for older players, some recorded high magnitude impacts were similar to those seen at the high school and college level. Head impact exposure in youth football may be appreciably reduced by limiting contact in practices. Further research is required to assess whether such a reduction in head impact exposure will result in a reduction in concussion incidence
Rotational Head Kinematics in Football Impacts: An Injury Risk Function for Concussion
Recent research has suggested a possible link between sports-related concussions and neurodegen-erative processes, highlighting the importance of developing methods to accurately quantify head impact tolerance. The use of kinematic parameters of the head to predict brain injury has been sug-gested because they are indicative of the inertial response of the brain. The objective of this study is to characterize the rotational kinematics of the head associated with concussive impacts using a large head acceleration dataset collected from human subjects. The helmets of 335 football players were instrumented with accelerometer arrays that measured head acceleration following head impacts sustained during play, resulting in data for 300,977 subconcussive and 57 concussive head impacts. The average subconcussive impact had a rotational acceleration of 1230 rad/s2 and a rotational ve-locity of 5.5 rad/s, while the average concussive impact had a rotational acceleration of 5022 rad/s2 and a rotational velocity of 22.3 rad/s. An injury risk curve was developed and a nominal injury value of 6383 rad/s2 associated with 28.3 rad/s represents 50% risk of concussion. These data provide an increased understanding of the biomechanics associated with concussion, and they provide critical insight into injury mechanisms, human tolerance to mechanical stimuli, and injury prevention tech-niques
Rotational Head Kinematics in Football Impacts: An Injury Risk Function for Concussion
Recent research has suggested a possible link between sports-related concussions and neurodegen-erative processes, highlighting the importance of developing methods to accurately quantify head impact tolerance. The use of kinematic parameters of the head to predict brain injury has been sug-gested because they are indicative of the inertial response of the brain. The objective of this study is to characterize the rotational kinematics of the head associated with concussive impacts using a large head acceleration dataset collected from human subjects. The helmets of 335 football players were instrumented with accelerometer arrays that measured head acceleration following head impacts sustained during play, resulting in data for 300,977 subconcussive and 57 concussive head impacts. The average subconcussive impact had a rotational acceleration of 1230 rad/s2 and a rotational ve-locity of 5.5 rad/s, while the average concussive impact had a rotational acceleration of 5022 rad/s2 and a rotational velocity of 22.3 rad/s. An injury risk curve was developed and a nominal injury value of 6383 rad/s2 associated with 28.3 rad/s represents 50% risk of concussion. These data provide an increased understanding of the biomechanics associated with concussion, and they provide critical insight into injury mechanisms, human tolerance to mechanical stimuli, and injury prevention tech-niques
Testβretest, retest, and retest: Growth curve models of repeat testing with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)
Computerized neuropsychological testing has become an important tool in the identification and management of sports-related concussions; however, the psychometric effect of repeat testing has not been studied extensively beyond testβretest statistics. The current study analyzed data from Division I collegiate athletes who completed Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baseline assessments at four sequential time points that varied over the course of their athletic careers. Administrations were part of a larger National Institutes of Health (NIH) study. Growth curve modeling showed that the two memory composite scores increased significantly with successive administrations: Change in Verbal Memory was best represented with a quadratic model, while a linear model best fit Visual Memory. Visual Motor Speed and Reaction Time composites showed no significant linear or quadratic growth. The results demonstrate the effect of repeated test administrations for memory composite scores, while speed composites were not significantly impacted by repeat testing. Acceptable testβretest reliability was demonstrated for all four composites as well
Cognitive effects of one season of head impacts in a cohort of collegiate contact sport athletes
Objective: To determine whether exposure to repetitive head impacts over a single season negatively affects cognitive performance in collegiate contact sport athletes.
Methods: This is a prospective cohort study at 3 Division I National Collegiate Athletic Association athletic programs. Participants were 214 Division I college varsity football and ice hockey players who wore instrumented helmets that recorded the acceleration-time history of the head following impact, and 45 noncontact sport athletes. All athletes were assessed prior to and shortly after the season with a cognitive screening battery (ImPACT) and a subgroup of athletes also were assessed with 7 measures from a neuropsychological test battery.
Results: Few cognitive differences were found between the athlete groups at the preseason or postseason assessments. However, a higher percentage of the contact sport athletes performed more poorly than predicted postseason on a measure of new learning (California Verbal Learning Test) compared to the noncontact athletes (24% vs 3.6%; p \u3c 0.006). On 2 postseason cognitive measures (ImPACT Reaction Time and Trails 4/B), poorer performance was significantly associated with higher scores on several head impact exposure metrics.
Conclusion: Repetitive head impacts over the course of a single season may negatively impact learning in some collegiate athletes. Further work is needed to assess whether such effects are short term or persistent
Head Impact Exposure in Youth and Collegiate American Football
The relationship between head impact and subsequent brain injury for American football players is not well defined, especially for youth. The objective of this study is to quantify and assess Head Impact Exposure (HIE) metrics among youth and collegiate football players. This multiseason study enrolled 639 unique athletes (354 collegiate; 285 youth, ages 9β14), recording 476,209 head impacts (367,337 collegiate; 108,872 youth) over 971 sessions (480 collegiate; 491 youth). Youth players experienced 43 and 65% fewer impacts per competition and practice, respectively, and lower impact magnitudes compared to collegiate players (95th percentile peak linear acceleration (PLA, g) competition: 45.6 vs 61.9; 95th percentile PLA practice: 42.6 vs 58.8; 95th percentile peak rotational acceleration (PRA, radβsβ2) competition: 2262 vs 4422; 95th percentile PRA practice: 2081 vs 4052; 95th percentile HITsp competition: 25.4 vs 32.8; 95th percentile HITsp practice: 23.9 vs 30.2). Impacts during competition were more frequent and of greater magnitude than during practice at both levels. Quantified comparisons of head impact frequency and magnitude between youth and collegiate athletes reveal HIE differences as a function of age, and expanded insight better informs the development of age-appropriate guidelines for helmet design, prevention measures, standardized testing, brain injury diagnosis, and recovery management
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