Yes / ... Sustaining a sport-related concussion (SRC) has been associated with negative consequences to emotion and cognition in recent years,4,5 and head impacts are no different.1 Moreover, there is a consistent link reported with neurodegenerative diseases such as motor-neuron disease, Parkinson’s disease, and dementia. Although this is well-known within the scientific community, and becoming so in the general population, we still place children at risk. Promoting attitude change toward SRC and head impacts in sport is difficult enough with adults as many are accustomed to the way their contact sports are played and spectated. However, a redeeming feature for many researchers is that the evidence is there, and the rhetoric is being discussed in the mainstream media across the world.

Incidents and awareness of sports-related concussion have grown in recent years, attracting attention in both the academic and popular press. These concussions can lead to the rapid onset of neurological dysfunctions, as well as a variety of subjective symptoms. Although concussive sequelae are typically considered transient, debate remains about the persistent effects of repeated traumatic contact during sport participation. Although research has examined the complications of head trauma found in traditionally popular sports (e.g., football, soccer, boxing), little research has focused on the growing sport of mixed-martial-arts (MMA). Research specifically pertaining to MMA is in nascent stages, but to-date studies suggest that concussive injuries for this sport are prevalent and the training regimens of these athletes may place them at a high risk for concussive or subconcussive head traumas—as well as the accompanying neurological difficulties. The current study is the first to assess cognitive profiles of MMA athletes using an objective neuropsychological assessment instrument. Among 56 athletes (28 MMA athletes and 28 athletes not exposed to head traumas), no neuropsychological differences were found between groups of athletes. Additionally, no aspects of MMA training regimen shared a reliable relationship with neuropsychological performance or subjective concussive symptoms. This suggests non-professional participation in MMA may not typically pose a significant risk for cumulative concussions and associated adverse neuropsychological consequences.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

M.A. / A review of existing relevant literature and research confirms that there is not always unanimity about the diagnosis and classification of the Post-concussion syndrome (PCS). This controversy arising from the diagnosis results in the failure to inform, prepare and equip the patient and his family adequately for the effects of PCS. This influences the treatment and eventual rehabilitation of a patient who has a light head injury. It is, therefore, essential that the medical field, over the whole spectrum of medical disciplines, should fully understand PCS and the patient, and should also provide the patient's support system with the necessary information with regard to the effects of PCS. This will, in truth, affect the rehabilitation of this patient. An investigation of the literature showed that most light head injuries are the result of road accidents, followed by industrial and factory accidents. Other types of head injuries and alcohol abuse play a further role in the appearance and degree of seriousness of light head injuries. The effect of PCS symptoms range from physical discomforts such as headaches to more emotional problems such as depression, fatigue, anxiety and concentration problems. Primary symptoms fade with the passing of time while secondary symptoms increase after the first few months after the head injury. The experience of PCS symptoms can be influenced by different factors such as pre-trauma personality traits, accident neurosis and compensations. It is postulated that the experience of typical PCS symptoms can be mediated by sufficient understanding, knowledge and realistic expectations on the part of the light head injured patient. The aim of the study was to address the problem of insufficient information provided to patients suffering from PCS regarding the symptoms they are likely to suffer. This was done by creating a post-trauma information program consisting of an attractive and multicoloured booklet with easy access to various issues such as explanation of terminology, the neurology of concussion, likely symptoms, prognosis and recovery time. The booklet was complemented with a casette recording of relevant issues, presented in different voices, with a calming musical background. The patients who were selected to participate in the evaluation of the program had all presented at the 1 Military Hospital over a period of 18 months with firmly diagnosed PCS based on scores obtained on the Galveston Orientation and Amnesia Test (GOAT) and the Glasgow Coma Scale (GCS). A total of 81 white, male subjects were selected. All the subjects complied with certain criteria such as Afrikaans or English language proficiency, falling within a particular age group (16 - 35 years) and with no prior neurological or psychiatric disease. The 81 patients were randomly divided into groups according to the Solomon fourgroup design. Pre tests were administered to the two experimental groups. The pre tests consisted of four subscales of the Profile of Mood States (POMS) and four subscales of the Personal, Home, Social and Formal Relations Questionnaire (PHSF). The validities and reliabilities of these scales are wel documented. The four selected POMS subscales were: Tension-anxiety Depression-dejection Anger-hostility Fatigue-inertia The four selected PHSF subscales were: Self-esteem Self-control Health Formal Relations One experimental and one control group now received the intervention program.

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Introduktion: Handboll är en populär lagsport som innehåller kroppskontakt, hopp och sprints. Det är dock även en skadedrabbad sport, där bla huvudskador är vanligt. Huvudskador, eller sport related concussion (SRC), är en allvarlig skada som kan leda till komplikationer senare i livet. Tidigare forskning, gällande risken av att drabbas av SRC, har visat skillnader mellan kön samt positioner. Inom svensk handboll är de flesta SRC studier utförda på högsta eliten. Syftet med denna studie var därför att kartlägga förekomsten av SRC, eventuella skillnader mellan positioner, kön, samt symtom och metod för återgång till träning bland division 1 spelare och NIU/RIG-elever. Metod: En online enkät med 22 frågor uppdelat i tre delar skapades. Frågorna validerades genom face-validity samt en pilotstudie. Enkäten skickades sedan ut till alla division 1 klubbar och NIU/RIG-gymnasier, där tränarna/lärarna själva fick distribuera enkäten till sina elever/spelare. Resultat: Förekomsten av SRC av de som svarade i division 1 och NIU/RIG var 34,9%. Resultatet visade att gruppen målvakter rapporterade flest SRC av alla positioner. Kvinnliga spelare rapporterade signifikant fler antal SRC jämfört med herrspelare (58 vs 30, p=0,018) samt även fler olika symtom efter skada jämfört med herrspelarna. Vanligaste strategin för återgång till idrott oavsett kön och position var hjärntrappan. Konklusion: Sammanfattningsvis visade vår data att förekomsten av SRC bland handbollsspelare på div 1 och NIU/RIG är något lägre än tidigare studier på elitspelare. Resultatet att damspelarna rapporterade fler antal SRC, samt fler och mer varierade symtom än herrspelarna stämmer överens med flera tidigare studier. Den vanligaste vägen tillbaka till handbollen var via hjärntrappan. Vår undersökning bidrar till att öka kunskapen om SRC:s inom handbollen och förhoppningsvis kan den bidra till att förebygga denna typ av skada i framtiden. / Introduction: Handball is a popular sport that contains a lot of body contact, jumps and sprints. It is also an injury-prone sport, where head injuries are common. Head injuries, or sport related concussion (SRC), is a serious injury that may cause complications later in life. Previous research on the risk of SRC have shown differences between gender and within player position. In Swedish handball, available studies on SRC:s include mostly the highest elite. Thus, we aimed to study the prevalence of SRC, differences between positions, gender, symptoms and method of return to training among Division 1 players and NIU/RIG-students. Method: An online survey with 22 questions divided into three parts was created. The questions were validated through face validity and a pilot study. The survey was then distributed to all division 1 clubs and NIU/RIG high schools, where coaches/teachers were responsible for distributing the survey to their students. Results: The SRC prevalence among the Division 1 and NIU/RIG-student respondents, was 34.9%. Goalkeepers reported the highest incidence of SRC of all positions. Female players reported a significantly higher number of SRC compared to males (58 vs. 30, p=0.018). Furthermore, females reported a more diverse range of post-injury symptoms. The most frequently used return-to-play strategy was the brain-ladder, regardless of gender or position. Conclusion: Our data revealed that the prevalence of SRC among division 1 and NIU/RIG handball players is slightly lower than previous studies on elite handball players. The result that female players reported a higher number of SRC and more varied symptoms than male players, aligns with several previous studies. The most common pathway back to handball was through the brain-ladder protocol. Our study contributes to increasing knowledge about SRC in handball and hopefully can help prevent this type of injury in the future.

Background: To reduce the reliance on clinical judgment for the regulation of sports-related traumatic brain injury, identifying and measuring objective to biofluid biomarkers can provide important insight into the diagnosis (Determining the type and origin of a disorder) and prognosis (Determining the chance of survival of a disorder) of SR-TBIs. A biomarker is a qualitative or quantitative measurement that provides a measure of a subject’s physiological or pathological condition at a specific time or during a disease state. Recent literature has suggested that biomarkers can help in the screening of patients exhibiting symptoms of mild traumatic brain injury (mTBI). Despite insights from recent research, it is not clear whether biomarkers and assessments of sports-related TBI are well-aligned. The objective of this study sought to review the current literature on predictive values of biomarkers: glial fibrillary acidic protein (GFAP), calcium channel binding protein S100 subunit beta (S100β), total-tau and neuron-specific enolase (NSE) for sports-related Traumatic Brain Injuries (SR-TBIs) to improve comprehension of biological and clinical contexts that can help evaluate the use of these biomarkers in sports-related TBIs and their potential function. Methods: The study was reported based on guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA: 2020 Edition) of 8 studies related to the assessment of biomarkers concerning SR-TBI. Literature searches were carried out on PubMed, Google Scholar, ScienceDirect, and ResearchGate. With an evidentiary table, the characteristics of the studies included in the meta-analysis (n = 14 studies) were presented. A significant role for biomarkers in the management of mild traumatic brain injury is suggested by the results of this analysis. From the literature, the significance of biomarkers in SR-TBI was identified along with the biomarkers that can facilitate more accurate clinical decision-making. Results:The initial search resulted in 73 articles, and the application of exclusion criteria and removal of duplicates resulted in the inclusion of 14 articles. Eight of the included studies were ([26], [27], [28], [30], [34], [39], [40], [41]), three were cohort studies ([25], [37], [45]) one was a pilot study [32], one interview, and an observational study [44]. The review was carried out to determine the efficacy of Biomarkers GFAP, S100β, Total-tau, and NSE to help in the screening of mild traumatic brain injury (mTBI) in patients showing symptoms. The focus is on athletes presenting at an emergency department with possible mTBI requiring a CT scan based on the application of a clinical algorithm. A forest plot was utilized, and the studies had low heterogeneity or variability (P Conclusions: It was established that the utility of biofluid biomarkers in the prediction of mild traumatic brain injury due to SRC is significant when the markers are used in large combinations. The four biofluid biomarkers (S100β, total-tau, GFAP, NSE) under study have strong predictive ability for mTBI, and their use can reduce the number of CT scans among TBI patients participating in athletic activities. Although preliminary evidence shows that other diagnostic treatments may help to mitigate traumatic brain injury sequelae, clinical trials are needed to further test their efficacy, specifically with diverse and high-risk populations. Luckily, the research on mTBI biomarkers is rapidly advancing, and should these biomarkers be better established clinically, they could easily hold many important roles.

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