Abstract

Original Article

Parents Take-On Concussion: Advances in Sideline Research and Culture in Youth Sports

Arlene Silverio, Scott Briggs, Lisena Hasanaj, Jeffrey Hurd Jr, Max Lahn, Liliana Serrano, Lucy Cobbs, Jenelle Raynowska, Rachel Nolan, Joel Birkemeier, Dennis Cardone, Steven L Galetta and Laura J Balcer*

Published: 16 March, 2017 | Volume 2 - Issue 1 | Pages: 009-019

Identifying concussion and initiating removal from play is challenging for even the most diligent youth sports organizations. Empowering parents to implement removal from play protocols and sideline testing may be the most practical plan at community levels to protect young athletes. We developed paradigms for community-based youth sports teams that incorporated both standard concussion protocols and research investigations. The research studies were designed to determine how sideline tests of vision, cognition and balance augment the capacity for parents and other responsible adults to identify youth athletes with concussion in ice hockey, football, lacrosse and cheerleading. Research-based sideline tests were performed at pre-season baseline sessions and during the season at the time of injury or as soon as symptoms were recognized by trained volunteer parent team testers. The combination of standard concussion protocols and research studies were performed for 510 athletes, aged 5-17 years, over 2.5 years through 5 athletic seasons. To implement the protocols and studies, approximately 80 student volunteers and parents were educated and trained on early concussion recognition and on baseline and sideline test administration. Over 80% of parent-identified head injuries were physician-confirmed concussions. Of the sideline tests performed, over two-thirds were administered within 24 hours of injury; the rest were performed within an average of 2.6 days post-injury since some athletes had delayed development of symptoms. Removal from play guidelines and standard concussion evaluation protocols were maintained in the context of the sideline testing research investigations. Based on this observational study, parents of youth athletes can be successfully empowered to perform rapid sideline tests in the context of existing concussion protocols. Implementation of objective testing may improve concussion identification and shift the culture of advocacy and responsibility towards parent groups to promote safety of young athletes. Ongoing investigations will further examine the impact of these programs on concussion management in youth sports.

Read Full Article HTML DOI: 10.29328/journal.jsmt.1001003 Cite this Article Read Full Article PDF

Keywords:

Concussion; Parents; Youth sports; Baseline testing; Sideline testing

References

  1. Bryan MA, Rowhani-Rahbar A, Comstock RD, Rivara F, Seattle Sports Concussion Research Collaborative. Sports- and recreation-related concussions in US youth. Pediatrics. 2016; 138. Ref.: https://goo.gl/pWaVrr
  2. McCrory P, Collie A, Anderson V, Davis G. Can we manage sport related concussion in children the same as in adults? Br J of Sports Med. 2004; 38: 516-519. Ref.: https://goo.gl/bjsSFT
  3. Sady MD, Vaughan CG, Gioia GA. School and the concussed youth: recommendations for concussion education and management. Phys Med Rehab Clin N Am. 2011; 22: 701-719. Ref.: https://goo.gl/NO3QBc
  4. Carman AJ, Ferguson R, Cantu R, Comstock RD, Dacks PA, et al. Expert consensus document: mind the gaps—advancing research into short-term and long-term neuropsychological outcomes of youth sports-related concussions. Nat Rev Neurol. 2015; 11: 230-244. Ref.: https://goo.gl/XDI4DX
  5. Centers for Disease Control and Prevention. Report to Congress on Traumatic Brain Injury in the US: Epidemiology and Rehabilitation. Atlanta, GA: National Center for Injury Prevention and Control; Division of Unintentional Injury Prevention, 2015.
  6. Toledo E, Lebel A, Becerra L, Minster A, Linnman C, et al. The young brain and concussion: imaging as a biomarker for diagnosis and prognosis. Neurosci Biobehav Rev. 2012; 36: 1510-1531. Ref.: https://goo.gl/tE7xej
  7. Rivara FP, Graham R. Sports-related concussions in Youth. JAMA. 2014; 311: 239-240. Ref.: https://goo.gl/PzOXiV
  8. Meehan WP, Mannix RC, OʼBrien MJ, Collins MW. The prevalence of undiagnosed concussions in athletes. Clin J of Sport Med. 2013; 23: 339-342. Ref.: https://goo.gl/61ayvM
  9. McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players. Clin J of Sport Med. 2004; 14: 13-17. Ref.: https://goo.gl/hfxcy4
  10. Chrisman SP, Quitiquit C, Rivara FP. Qualitative study of barriers to concussive symptom reporting in high school athletics. J Adolesc Health. 2013; 52: 330-335. Ref.: https://goo.gl/LcgvsZ
  11. Kroshus E, Garnett B, Hawrilenko M, Baugh CM, Calzo JP. Concussion under-reporting and pressure from coaches, teammates, fans, and parents. Soc Sci Med. 2015; 134: 66-75. Ref.: https://goo.gl/aJYKyy
  12. Pryor RR, Casa DJ, Vandermark LW, Stearns RL, Attanasio SM, et al. Athletic training services in public secondary schools: a benchmark study. J Athl Train. 2015; 50: 156-162. Ref.: https://goo.gl/Hwa8sU
  13. Chrisman SP, Schiff MA, Chung SK, Herring SA, Rivara FP. Implementation of concussion legislation and extent of concussion education for athletes, parents, and coaches in Washington State. Am J Sports Med. 2014; 42: 1190-1196. Ref.: https://goo.gl/Tzdl9r
  14. Rivara FP, Schiff MA, Chrisman SP, Chung SK, Ellenbogen RG, et al. The effect of coach education on reporting of concussions among high school athletes after passage of a concussion law. Am J Sports Med. 2014; 42: 1197-1203. Ref.: https://goo.gl/XRA32o
  15. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington, DC: Sports-Related Concussions in Youth: Improving the Science. Changing the Culture. 2015; 180: 123-125. Ref.: https://goo.gl/ojzLyG
  16. Coghlin CJ, Myles BD, Howitt SD. The ability of parents to accurately report concussion occurrence in their bantam-aged minor hockey league children. J Can Chiropr Assoc. 2009; 53: 233-250. Ref.: https://goo.gl/YGUzWK
  17. Bloodgood B, Inokuchi D, Shawver W, Olson K, Hoffman R, et al. Exploration of awareness, knowledge, and perceptions of traumatic brain injury among American youth athletes and their parents. J Adolesc Health. 2013; 53: 34-39. Ref.: https://goo.gl/028syZ
  18. Lin AC, Salzman GA, Bachman SL, Burke RV, Zaslow T, et al. Assessment of parental knowledge and attitudes toward pediatric sports-related concussions. Sports Health. 2015; 7: 124-129. Ref.: https://goo.gl/VpGhgk
  19. Sullivan SJ, Bourne L, Choie S, Eastwood B, Isbister S, et al. Understanding of sport concussion by the parents of young rugby players: a pilot study. Clin J Sport Med. 2009; 19: 228-230. Ref.: https://goo.gl/2VwEVQ
  20. General Info on Concussion. Reston Raiders Hockey Club. 2016. Ref.: https://goo.gl/0eQBzf
  21. Ventura RE, Jancuska JM, Balcer LJ, Galetta SL. Diagnostic tests for concussion. J Neuroophthalmol. 2015; 35: 73-81. Ref.: https://goo.gl/2FDrSy
  22. Leong DF, Balcer LJ, Galetta SL, Liu Z, Master CL. The King-Devick test as a concussion screening tool administered by sports parents. J Sports Med Phys Fitness. 2014; 54: 70-77. Ref.: https://goo.gl/GMxVIJ
  23. The University of the State of New York. Guidelines for Concussion Management in the School Setting. 2016. Ref.: https://goo.gl/lQxNf6
  24. New York State Department of Health. When in Doubt Take Them Out! Fact Sheet for Coaches and Sports Officials. 2016. Ref.: https://goo.gl/Uu3AS4
  25. S. Department of Health and Human Services Centers for Disease Control and Prevention. Heads up Schools, A Fact Sheet for Parents. 2016. Ref.: https://goo.gl/wA1Dcw
  26. Galetta KM, Morganroth J, Moehringer N, Mueller B, Hasanaj L, et al. Adding vision to concussion testing: a prospective study of sideline testing in youth and college athletes. J Neuroophthalmol. 2015; 35: 235-241. Ref.: https://goo.gl/htyb0G
  27. Galetta KM, Liu M, Leong DF, Ventura RE, Galetta SL, Balcer LJ. The King-Devick test of rapid number naming for concussion detection: meta-analysis and systematic review of the literature. Concussion. 2016; 1. Ref.: https://goo.gl/lcuq6y
  28. Mrazik M, Dennison CR, Brooks BL, Yeates KO, Babul S, et al. A qualitative review of sports concussion education: prime time for evidence-based knowledge translation. Br J Sports Med. 2015; 49: 1548-1553. Ref.: https://goo.gl/nP7Pr5
  29. Chrisman SP, Schiff MA, Chung SK, Herring SA, Rivara FP. Implementation of concussion legislation and extent of concussion education for athletes, parents, and coaches in Washington State. Am J Sports Med. 2014; 42: 1190-1196. Ref.: https://goo.gl/yYksMG
  30. Newton JD, White PE, Ewing MT, Makdissi M, Davis GA, et al. Intention to use sport concussion guidelines among community-level coaches and sports trainers. J Sci Med Sport. 2014; 17: 469-473. Ref.: https://goo.gl/8Ek1WP
  31. Tjoumakaris FP, Eck B, Freedman KB, Pepe MD, Austin L, et al. Cost benefit analysis of sports medicine team coverage: is it worth our while? Orthop J Sports Med. 2013; 1.
  32. USA Hockey Concussion Management Program. USA Hockey. 2016. Ref.: https://goo.gl/dv0puj
  33. US Lacrosse Concussion Management Plan Guidelines for U-19 Programs. US Lacrosse. 2016.
  34. Youth Football Rules Book 2014. USA Football, Inc.
  35. Galetta KM, Brandes LE, Maki K, Dziemianowicz MS, Laudano E, et al. The King-Devick test and sports-related concussion: study of a rapid visual screening tool in a collegiate cohort. J Neurol Sci. 2011; 309: 34-39. Ref.: https://goo.gl/Rw9Fco
  36. Galetta KM, Barrett J, Allen M, Madda F, Delicata D, et al. The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters. Neurology. 2011; 76: 1456-1472. Ref.: https://goo.gl/pcvNIN

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?