This thesis investigates head injuries (HIs) occurring in sports and recreation (SR) that presented to emergency departments (EDs) in Edmonton, Alberta, from April 1st, 1997 to March 31st, 2008. There were 4,950 SR HIs identified over the 11 years (5.13 HIs per 1,000 ED injury visits). Individuals less than 18 years old were 3.4 times more likely, and males were 1.25 times more likely to present with a head injury from SR (p < 0.0001). A history of one or two previous SR HIs increased the odds of subsequent HI by 2.62 and 5.94 times, respectively, while children aged 7 13 and 14 17 were more than four times more likely to sustain a HIs from SR (p < 0.001). The effects of multiple HIs occurring in children participating in SR activities needs to be addressed, due to the chronic neurobehavioral effects of HIs. / Epidemiology

Η υψηλή συχνότητα εμφάνισης του μεταδιασεισικού συνδρόμου μετά από ελαφριές κρανιοεγκεφαλικές κακώσεις έχει σοβαρό κοινωνικό και οικονομικό αντίκτυπο. Σκοπός της παρούσας έρευνας είναι να προσδιοριστούν οι προγνωστικοί παράγοντες του μεταδιασεισικού συνδρόμου. Για τον λόγο αυτό, συγκεντρώθηκαν έρευνες που έχουν γίνει κατά το παρελθόν στο εξωτερικό και στην Ελλάδα. Για κάθε έρευνα προσδιορίστηκαν κάποια στοιχεία όπως: η χώρα στην οποία έγινε η έρευνα, η χρονολογία, ο αριθμός των ασθενών που έλαβαν μέρος, η μέθοδος στατιστικής ανάλυσης καθώς και τα αποτελέσματα που καταλήγει η καθεμία. Όλα αυτά τα στοιχεία συγκεντρώθηκαν σε ένα πίνακα για καλύτερη ανάλυση. Το συμπέρασμα της έρευνας είναι ότι οι προγνωστικοί παράγοντες ποικίλουν από έρευνα σε έρευνα. Αυτό οφείλεται σε πολλούς λόγους όπως : οι πολιτιστικές διαφορές κάθε χώρας, οι διαφορετικοί ορισμοί της διάσεισης καθώς και οι διαφορετικοί τρόποι στατιστικής ανάλυσης. / The high incidence of postconcussion syndrome following mild traumatic brain injury hαs severe social and economic impact. The purpose of this study is to identify predictors of postconcussion syndrome. For this reason, gathered studies done in the past in Greece and abroad. For each study identified some elements such as the country in which the research took place, the date, the number of patients included in, the statistical analysis method and the results that ends each. All these elements were gathered together in one table for better analysis. The conclusion of the research is that the predictors vary from study to study. This is due to many reasons such as: the cultural differences of each country, different definitions of concussion and the different modes of statistical analysis.

Les traumatismes crâniens demeurent une cause de mortalité importante et entraînent des incapacités graves. La modélisation numérique est un outil moderne pour étudier la biomécanique des chocs crâniens. L’objectif principal de cette thèse a été l’évaluation biomécanique d’un casque de cycliste issu du commerce. Des tests de caractérisation ainsi que des campagnes de chocs normatifs et tangentiels ont permis le développement d’un modèle éléments-finis du casque et sa validation. Afin d’estimer le risque lésionnel encouru lors de chocs réalistes, le modèle de casque a été couplé à un modèle de tête anatomique et différents paramètres intracrâniens ont été calculés. Les valeurs obtenues pour ces paramètres se sont révélées supérieures aux limites de tolérance. Fort de ces constats, une réflexion en profondeur sur la norme EN1078 actuelle a été menée et pour laquelle des modifications ont été proposées afin que le casque protège la tête de façon optimale vis-à-vis de critères biomécaniques. / Traumatic head injuries remain a common cause of death and severe disabilities worldwide. FE modeling of the head is a well accepted tool to study head impact biomechanics. The objective of this PhD thesis was to evaluate the head protection capability offered by a commercial bicycle helmet. Experimental characterization tests, standard and tangential impacts were performed to develop and validate the finite element helmet model. In order to estimate the injury risk sustained in case of realistic head impacts, the helmet model has been coupled to an anatomical head and intracranial parameters were computed. Calculated values were higher than published tolerance limits. An in-deep investigation of the current EN1078 European standard was then carried out and relevant modifications were proposed to assess and optimize bicycle helmets against biomechanical criteria.

This study investigated the use of biofeedback as part of stress-management training program with head injured adults. The single cases examined were four males with head injuries of moderate severity who were in the post-acute stages of recovery. Treatment involved bi-weekly relaxation training, using EMG biofeedback in combination with deep breathing, autogenic training and/or imagery. Individual subject response to relaxation training was examined during treatment sessions, as was the frequency of stress-related symptomatology outside of sessions, and overall functional adaptation. While all subjects showed evidence of relaxation during treatment sessions, such factors as the nature of the functional disturbance and personal motivation appear to be related to the degree of carryover to the external environment.

SyfteSyftet med studien är att undersöka translationella accelerationer och rotationsaccelerationer hos huvudet vid lätt sparring hos manliga ungdomsboxare samt hur dessa påverkas av slagens acceleration, hastighet, slagteknik, träffområde och blockerande guard.MetodUrvalet baserades på fyra manliga ungdomsboxare tillhörande viktklass -60 kg och -77 kg. Tandskyddssensorer (Hybrid Mouthguard, Prevent Biometrics, USA) och handledsaccelerometrar (Corner Wearables Ltd. U.K.) användes för att mäta accelerationer i huvudet respektive slaghastighet och slagacceleration. Testupplägget bestod av 15 minuter individuell uppvärmning och två ronder a’ 3 minuter per rond på 50 % intensitetsnivå. Pearsons korrelationstest har använts för att undersöka samband och independent-samples t-test har använts för att mäta skillnader.ResultatEtt starkt positivt samband uppmättes mellan translationell acceleration och rotationsacceleration (r = 0,75; p &lt; 0,001) hos huvudet. Inget signifikant samband upptäcktes mellan träff med/utan blockerande guard gällande translationella accelerationer (t = -0,09; p = 0,93) eller rotationsaccelerationer (t = -0,80; p = 0,43) hos huvudet.SlutsatserInget signifikant samband upptäcktes mellan uppmätt slaghastighet och translationella accelerationer hos huvudet eller mellan slaghastighet och rotationsaccelerationer hos huvudet. Ett starkt signifikant samband mellan translationella accelerationer och rotationsaccelerationer hos huvudet. Kollisionerna kännetecknades av de kinematiska egenskaperna som indikerar potentiella skaderisker. Det krävs mätningar i större omfattning för att undersöka de potentiella effekterna av upprepade subkonkusiva slag, då samtliga kollisioner låg under de tidigare uppsatta gränsvärderna för milda hjärnskador. / PurposeThe purpose of this study was to examine the translational and rotational accelerations from head impacts during low intensity sparring bouts among competitive teen boxers and how they are affected by punch velocity, acceleration, punch type, impact locations and a defending guard.MethodsFour male competitive teen boxers in the -60 kg and -77 kg weight classes participated in the study. Mouthguard accelerometers (Hybrid Mouthguard, Prevent Biometrics, USA) and wrist accelerometers (Corner Wearables Ltd. U.K.) were equipped to measure the accelerations to the head as well as the punch velocity and punch accelerations. The test battery included 15 minutes of individually chosen warm-ups and two sparring rounds at three minutes each at an intensity of 50 %. Pearson’s correlation test was used to examine the relationships between variables and independent-samples t-test was used to compare means.ResultsA strong correlation was found between translational acceleration and rotational acceleration (r = 0,750) (p &lt; 0,001). No significant relationship was found between the translational and rotational accelerations of a clean punch to the head and a punch to the guard (t = -0,09, p = 0,93 (t = -0,80, p = 0,43).ConclusionsNo significant relationship between punch velocity and translational accelerations or between punch velocity and rotational accelerations of punches to the head. This result emphasizes the need of defensive movements to further avoid the risks of punches to the head. There was a strong correlation between translational accelerations and rotational acceleration. The kinematic properties of the head impacts could indicate potential injuries to the head during sparring even at lower intensities. Even though none of the impacts surpassed the 25 % probability threshold for brain injury, more extensive research is needed to evaluate the potential risks of sub concussive impacts.

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Inledning: Krig och materiel utvecklas konstant. Detta resulterar i olika typer av skador. Tidigare litteraturstudier uppvisar en prevalens av huvud-, ansikts- och halsskador (HAHS) under 1900-talet på mellan 16% och 43% i krig och krigsliknande situationer. Ytan av huvudet, ansiktet och halsen är dock inte mer än cirka 9% av den totala kroppsytan. På senare år har en ökning i användandet av hemmagjorda bomber, eller “improvised explosive devices” (IED), påvisat en uppgång av prevalensen gällande HAHS.Syfte: Att undersöka andelen HAHS i det totala skadepanoramet i krig och krigsliknande situationer från år 2000 till 2010. Metod: En systematisk litteratursökning genomfördes. Resultat: Tio artiklar inkluderades. Dessa redovisade resultat från konflikter och attacker i Afghanistan, Israel, Irak och London och andelen HAHS sträckte sig mellan 6,4% och 39,4% och resulterade i en genomsnittlig prevalens på 25%. Den stora spridningen i resultatet är troligtvis ett tecken på svårigheterna att jämföra olika konflikter med varandra. Olika anatomiska inklusioner och exklusioner gör det svårt att jämföra resultat. Den riktiga prevalensen av dessa typer av skador är därför, troligen, högre. Vanliga och specifika maxillofaciala skador presenteras även.Slutsatser: Explosioner är den vanligaste oraken till maxillofaciala skador. Mjukvävnadsskador i ansiktet är den vanligaste skadan och den vanligaste hårdvävnadsskadan är fraktur i den nedre tredjedelen av ansiktet. Då användandet av IED ökar är det troligt att prevalensen av HAHS ökar i framtiden. / Introduction: War, weaponry and armour are constantly evolving. This results in variations in types of injuries occurring. Previous reviews show an incidence of head, face, and neck injuries (HFNI) during the 20th century ranging from 16% to 43% in war and war type situations but, anatomically, the head, face, and neck accounts for approximately 9% of the total body area. In recent years the use of Improvised Explosive Devices (IED) in terrorist conflict has risen and this has been shown to give a rise in the prevalence of HFNI.Aim: To examine the proportion of HFNI in the total injury panorama of soldiers and civilians wounded in war type situations from 2000 to 2010. Methods: A systematic literature search was conducted according to Goodman. Results: Ten articles concerning conflicts and attacks in Afghanistan, Israel, Iraq and London were included and presented an incidence of HFNI on 25% (mean, range 6.4-39.4%).The wide spread in results is caused of different anatomical exclusions and inclusions but also because of the difficulties in comparing different conflicts to each other. The real mean incidence is therefore, most likely, higher. Common and particular maxillofacial war injuries are also discussed.Conclusion: Explosive devices account for the bulk of injury mechanism. Facial lacerations are the most common HFNI and the majority of fractures occur in the lower third of the face. A rise in the use of IED will mostly likely cause an increase in the prevalence of HFNI in the future.

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No description available.