Removal From Play Following Concussions In Pediatric Soccer Athletes

Participation in youth soccer and sport-related concussion incidence has increased dramatically over the last decade. Established medical guidelines and Texas state law require immediate removal from play and prohibit athletes from same-day return to play if a concussion is suspected. However, there is limited literature examining the rate at which immediate removal from play is occurring. PURPOSE: To identify the frequency of immediate removal from play in pediatric soccer players with sport-related concussions. METHODS: A retrospective review was performed of 41 athletes diagnosed with a concussion sustained while playing soccer seen consecutively over a one year period. All patients were seen at a pediatric sports medicine center by a single provider. Medical records were reviewed for patient reported symptoms, as identified on the SCAT-3, and patient reported removal from play on the same day as the mechanism of injury. Demographics, previous history of concussion, soccer position, location of head impact, loss of consciousness, memory loss, and mechanism of injury were also reviewed when available. RESULTS: Of 41 patients treated for a soccer-related concussion, 14 were males and 27 were females, with a mean age of 14 (range 7-18). 16 (39%) patients reported delayed removal from play on the same day as initial injury. Although not considered statistically significant, 13 out of 27 females (48.1%) reported delayed removal from play after initial injury as compared to only 3 out of 14 males (21.4%). Additionally, no significant differences were noted in age, previous history of concussion, position, mechanism of injury, or impact location between those who were removed from play immediately and those who had delayed removal. Patients who experienced a loss of consciousness on day of injury were statistically more likely to experience immediate removal from play (p\u3c.05). There were no statistically significant differences noted in severity of symptoms between groups on the day of injury. Patients who were delayed in their removal from play reported a more severe symptom of “not feeling right” (p=.026) on the day of initial clinic visit. CONCLUSION: With a goal of immediate removal from play and no same-day return to play, increased education may help athletes and coaches better identify concussion symptoms and comply with current medical guidelines and applicable Texas state law. In the future, reviewing a larger sample size may improve understanding of the impact of delayed removal from play on recovery patterns and return to play

Poster 121: Properties of Wrist‐Worn Accelerometers in Individuals with Spinal Cord Injury

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147132/1/pmr2s173b.pd

Continued Play Following Sport-Related Concussion in United States Youth Soccer

International Journal of Exercise Science 13(6): 87-100, 2020. Medical guidelines and legislation in the US call for immediate removal from play and prohibit continued play on the same day if a concussion is suspected. However, there is limited literature examining whether these guidelines and laws are being followed in youth soccer. The purpose of this study was to identify the frequency at which youth soccer players continued play on the same day following sport-related concussion and factors that may be associated with this behavior. A retrospective review of youth soccer players diagnosed at the initial clinic visit with a sport-related concussion was performed. Participants were categorized into groups, those who continued play on the same day as their concussion (PLAY) and those who did not (NO PLAY). Records were reviewed for demographics, injury characteristics, SCAT3™ symptoms, mBESS and ImPACT® results, symptom resolution and return to play protocol initiation. Fifty-eight girls (mean age: 14 years, range: 7-18 years) and 29 boys (mean age: 14.4 years, range: 6-18 years) participated in this study. Thirty of 58 girls (51.7%) continued play the same day compared to only 5 of 29 boys (17.2%; p=0.002). The odds of continued play in girls were 5 times as high as the odds of continued play in boys (OR=5.05; 95% CI, 1.59-19.3). Overall, 35 (40.2%) soccer players continued play on the same day following a concussion. In conclusion, approximately 40% of youth soccer players continued play on the same day as their concussion. Girl soccer players demonstrated a significantly higher frequency of continued play than boys

A deep learning-based approach to diagnose mild traumatic brain injury using audio classification

Mild traumatic brain injury (mTBI or concussion) is receiving increased attention due to the incidence in contact sports and limitations with subjective (pen and paper) diagnostic approaches. If an mTBI is undiagnosed and the athlete prematurely returns to play, it can result in serious short-term and/or long-term health complications. This demonstrates the importance of providing more reliable mTBI diagnostic tools to mitigate misdiagnosis. Accordingly, there is a need to develop reliable and efficient objective approaches with computationally robust diagnostic methods. Here in this pilot study, we propose the extraction of Mel Frequency Cepstral Coefficient (MFCC) features from audio recordings of speech that were collected from athletes engaging in rugby union who were diagnosed with an mTBI or not. These features were trained on our novel particle swarm optimised (PSO) bidirectional long short-term memory attention (Bi-LSTM-A) deep learning model. Little-to-no overfitting occurred during the training process, indicating strong reliability of the approach regarding the current test dataset classification results and future test data. Sensitivity and specificity to distinguish those with an mTBI were 94.7% and 86.2%, respectively, with an AUROC score of 0.904. This indicates a strong potential for the deep learning approach, with future improvements in classification results relying on more participant data and further innovations to the Bi-LSTM-A model to fully establish this approach as a pragmatic mTBI diagnostic tool

Bi-LSTM-A model architecture.

Bi-LSTM-A model architecture.</p

Confusion matrix of the Bi-LSTM-A model classification.

Confusion matrix of the Bi-LSTM-A model classification.</p

Participant inclusion and exclusion criteria.

Participant inclusion and exclusion criteria.</p

Four main steps of the MFCC feature extraction process.

Four main steps of the MFCC feature extraction process.</p

Bi-LSTM-A model optimised hyper-parameters.

Bi-LSTM-A model optimised hyper-parameters.</p

Bi-LSTM-A training and validation loss.

Bi-LSTM-A training and validation loss.</p