The severity of injury associated with sport concussions that present with a loss of consciousness or impact seizures is ambiguous. A disconnect between the clinical and biomechanical aspect can be observed throughout the literature pertaining to loss of consciousness and impact seizures. Clinicians have dismissed a loss of consciousness or the presence of impact seizures as an indicator of severity. However, early biomechanical research suggests that loss of consciousness is caused by greater magnitudes of impacts and damage to more vulnerable brain regions. However, this research was conducted on animal and cadaver models and may not adequately represent sport-related concussions. Recent methodologies such as laboratory reconstructions of head impacts and finite element modeling can provide new information on the severity of impact associated with these signs of concussions. Study One compared the magnitudes of head dynamic response and brain tissue deformation between impact representations of punches that lead or do not lead to LOC in boxing. The main findings of this study revealed knockout punches were the result of by unprotected hooks to the mandibular angle resulting in greater brain tissue trauma. Study Two compared cases of concussions with and without LOC in American football. Head dynamic response and brain tissue deformation was also greater in the LOC group in this sport, consistent with boxing impacts. The main predictor of LOC was found to be impact velocity which has implications in terms of prevention. Study Three compared the magnitudes of head dynamic response and brain tissue deformation between cases of concussions with a loss of consciousness and cases of concussion with impact seizures in American football. The two types of clinical presentations had similar severities of brain tissue deformation with the exception of strain rate in the white matter being smaller in cases of impact seizures. The findings of this thesis support the notion that concussions with loss of consciousness or impact seizure represent a more severe injury than concussions without these signs. It may be appropriate to address these signs of injury differently in return to sport protocols to reflect their severity. The findings also suggests that prevention of loss of consciousness should be sport specific. Hooks to the side of the jaw were the primary cause in boxing, whereas LOC could be caused by different event types in American football. However, in both sports, impact velocity and impact location played an important role in the risk for loss of consciousness.

No description available.

Social interest and recent advance in technology have made concussions on the largest topics is scientific research today. Knowledge continues to be uncovered and more data and information is studied on the effects of concussions and links to later in life cognitive decline. Dementia and Alzheimer’s disease have been known consequences of chronic traumatic encephalopathy but with recent findings in retired football players, more research is needed to show the correlation between concussions and the effects on cognition. Furthermore, with millions of youth athletes participating in sports each year, the impact of concussions on development and maturation need to be further researched. Initial retrospective studies seem to show the correlation between early in life concussions and decreased cognitive function later in life but longitudinal studies are lacking. Cognitive function data collected in longitudinal studies may help to show how early changes in function may be able to be identified and prevent further decline from repetitive impacts. Studies such as this would help fill the gap in research that could change youth sports as well as medical treatment and prevention to youth concussions.

Shoulder-to-helmet (STH) impacts have been shown to cause approximately twenty percent of concussions in football, yet little research has investigated shoulder pad design and STH impacts. While shoulder pads are designed to protect the player wearing them, they have the potential to better protect the struck player in STH collisions. This study aimed to characterize STH impacts and identify the effect of shoulder pad stiffness on the struck head kinematics. Additional padding was added to a shoulder pad as means to reduce the overall stiffness of the system, and an unmodified shoulder pad acted as the control. Participants performed a series of impact tests with two shoulder pad variations to identify if additional padding in the shoulder pads could reduce head kinematics. Participants struck a helmeted Hybrid III dummy with a National Operating Committee on Standards for Athletic Equipment (NOCSAE) on the side, replicating a lateral STH impact. Linear and rotational kinematics of the struck head were recorded for each impact, and impact speed was derived from high-speed video. Peak kinematics were compared between shoulder pad configurations to identify differences in pad performance. Impact response corridors were developed from this study that could be used to inform future controlled laboratory test setups that replicate STH impacts. A controlled test setup would allow for future testing at higher impacts speeds to evaluate concussive level impacts. Overall, this study aimed to identify if shoulder pad design can affect the struck head kinematics in STH impacts, which would open a new avenue of player safety research and development. / Master of Science / Shoulder-to-helmet (STH) impacts have been shown to cause approximately twenty percent of concussions in football, yet little research has investigated shoulder pad design and STH impacts. While shoulder pads are designed to protect the player wearing them, they have the potential to better protect the struck player in STH collisions. This study aimed to characterize STH impacts and identify the effect of shoulder pad stiffness on the struck head kinematics. Participants performed a series of impact tests with two shoulder pad variations to identify if additional padding in the shoulder pads could reduce head kinematics. Participants struck the side of a crash test dummy head with their shoulder to replicate a STH impact. Linear and rotational kinematics were recorded for each impact, and impact speed was derived from high-speed video. Values that are used to quantify head injury were compared between shoulder pad configurations to identify differences in pad performance. This study defined impact response corridors that could be used to inform future controlled lab test setups that replicate STH impacts. A controlled test setup would allow for future testing at higher impacts speeds to evaluate concussive level impacts. Overall, this study aimed to identify if shoulder pad design can affect the struck head kinematics in STH impacts, which would open a new avenue of player safety research and development.

The goals of this study were to measure the ability of catcher's masks to attenuate head accelerations upon impact with a baseball, and to compare these head accelerations to established injury thresholds for concussions. Testing involved using a pneumatic cannon to shoot baseballs at an instrumented (3-2-2-2 accelerometer array) Hybrid III headform (a 50th percentile male head and neck) with and without a catcher's mask on the head. The ball speed was controlled from approximately 26.8 – 35.8 m/s (60 – 80 mph) and regulation NCAA baseballs were used. Peak linear resultant acceleration was 140 – 180 g without a mask and 16 – 30 g with a mask over the range of balls speeds investigated. Peak angular resultant acceleration was 19500 – 25700 rad/sec2 without a mask and 2250 – 3230 rad/sec2 with a mask. The Head Injury Criterion was 93 – 181 without a mask and 3 – 13 with a mask and the Severity index was 110 – 210 without a mask and 3 – 15 with a mask. Catcher's masks reduced head acceleration metrics by approximately 85% when baseballs were impacted with just the headform. Head accelerations with a catcher's mask were substantially lower than contemporary injury thresholds, yet evidence indicates that baseball impacts to the mask still result in concussions. / Master of Science

Background: Despite the increased awareness and education to the public, concussions in children continue to ensue without proper concussion education and management in school systems. Whether the child suffers a concussion in school or at home, it is essential for school nurses to have proper concussion education and evidence based management strategies to further monitor post-concussive symptoms in the school setting. Concussion symptoms can affect the student up to 7-10 days following the injury. Concussions can range from mild to severe, with symptoms lasting hours, days, months or longer. Children who experience a concussion can experience academic challenges that will affect them in the classroom. Without proper concussion education for school nurses, concussed youth may experience post-concussive symptoms. School nurses have a significant role, collaborating with the parents, providers, and the student in providing accommodations and support while transitioning back into the classroom. Purpose: To assess the knowledge of Utah school nurses regarding concussion education and management of the concussed student. In addition evaluating the educational intervention, which changed the knowledge base of the participants. Methods: A one group pre-test and post-test design was used. Study materials were emailed via the Utah School Nurse Association listserv to all Utah school nurses. A concussion educational power point was provided to these nurses before having them complete the post-test. Results: The results of the paired sample t-test revealed that there was a significant difference (p= .000) in comparison of the pre-test and post-test results after viewing the concussion educational power point. Conclusion: The results of this study showed that there was a significant difference between pre-test and post-test results after viewing the concussion educational power point. Therefore it can be concluded that providing education and awareness regarding concussion and its management will increase the knowledge and ultimately may change practice which in turn may improve patient outcomes.

Thesis advisor: Stephanie Greene / This paper addresses the recent concerns about concussions in the sport of football and elaborates on the medical findings, litigation, and ethical questions that have surrounded the issue. The goal is to present a compelling case for change in how concussions are viewed and handled in the sport. By using concrete examples to explain the lasting effects concussions have had on players after their careers have ended, I hope to show the need for change. I will explore the most recent developments of chronic traumatic encephalopathy in order to show its harmful reach and will touch upon litigation that has been filed by players who experienced post career problems. In addition, through the insight of current college players as well as referencing my own experience as a Division I College Football player, I wish to establish an emotional connection in the paper and unveil the roots of the problem – the toxic nature of the football culture. I am optimistic that this inquiry will help cultivate a culture change through a variety of approaches. First, I indicate the need for a transformation of the football culture. Second, I suggest a formal, mandatory education to inform players at all levels about concussions, subconcussive hits, and the potential diseases that can stem from. Third, I propose new penalties for players, coaches, support staff, and all involved in player safety in an attempt to further prevent head injuries. This thesis attacks the issue of concussions in football from all angles. It calls for the football community to accept the severity of concussions, educate on concussions, and prevent repeated concussions in order to prompt action. / Thesis (BS) — Boston College, 2016. / Submitted to: Boston College. Carroll School of Management. / Discipline: Departmental Honors. / Discipline: Other.

Experiences of Youth Recreation Sport Organizations' Administrators with Implementation of Maryland Concussion Law by Donelle Damali Ainsworth-McKenna MHSA, The George Washington University, 2004 BS, Morgan State University, 2000 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University September 2015 There have been statewide concussion policies implemented in all 50 states and the District of Columbia to address the problem of sports-related concussions in youth athletes. The efforts to implement the requirements of these laws have mainly focused on high school athletics, despite evidence that pre-high school youth athletes who participate in organized community sports through recreation sport organizations are sustaining concussions at a similar rate as high school athletes. Thus, this study explored the implementation of the Maryland concussion law in youth sports recreation organizations in Laurel, Maryland that serve pre-high school youth athletes aged 5-14 years. A qualitative approach was utilized to conduct this study. Administrators of such youth sports and recreation organizations were interviewed to answer the central research question about how the Maryland concussion law is being implemented in youth sport recreation organizations in the state. The diffusion of innovations theory was the theoretical framework used to guide this study as well as to explore barriers to and facilitators of implementing this policy. NVivo software was used to analyze the data, and the results identified concussion training, guidelines, resources, and policing as integral to implementation of the policy. These findings can be used to inform policies, implementation, and best practices for this policy. Thus the individual and community implications for positive social change include behavior change to prevent, identify, and manage concussions in youth athletes to reduce the potential impact of concussions in youth athletes.

Thesis (M.A.)--Miami University, Dept. of Speech Pathology and Audiology, 2009. / Title from first page of PDF document. Includes bibliographical references (p. 29-32).

While participation in youth sports bolster a myriad of health benefits, it can also pose a risk to the athlete's health from the increasing prevalence of repetitive mild traumatic brain injuries (TBI), often referred to as concussions. The adverse effects from repeated traumatic blows give a combination of acute symptoms, which may potentially develop into long-term complications. There is little known about the epidemiology of concussions, and thus the development of an animal model would help enhance our understanding of this potentially debilitating injury. An appropriate animal model should mimic the conditions of how concussions occur, in that there is not an invasive method to induce the injury and follows the same biomechanics. In our adolescent repetitive mild TBI model, we utilized a free-falling weight to deliver the traumatic blow to anesthetized mice that allowed free head rotation after impact. The injured group received one hit daily over the course of three days. The mice then underwent several behavioral tests to analyze the cognitive deficits, and the pathology of the tissue was analyzed via silver, Hematoxylin and Eosin (H&E), and Fluoro Jade-B staining. The injured mice developed both short- and long-term memory and spatial learning deficits, symptoms commonly found in concussed athletes, but failed to show deficits in anxiety and depression tests. The Fluoro Jade-B, silver and H&E staining resulted in negative signals for cell death. This study properly demonstrates repetitive mild TBIs in an adolescent mice model.