Mechanisms of Injury Leading to Concussions in Collegiate Soccer Players: A CARE Consortium Study.

outcome return to play soccer sport-related concussion

Journal

The American journal of sports medicine
ISSN: 1552-3365
Titre abrégé: Am J Sports Med
Pays: United States
ID NLM: 7609541

Informations de publication

Date de publication:
24 Apr 2024
Historique:
medline: 24 4 2024
pubmed: 24 4 2024
entrez: 24 4 2024
Statut: aheadofprint

Résumé

Few previous studies have investigated how different injury mechanisms leading to sport-related concussion (SRC) in soccer may affect outcomes. To describe injury mechanisms and evaluate injury mechanisms as predictors of symptom severity, return to play (RTP) initiation, and unrestricted RTP (URTP) in a cohort of collegiate soccer players. Cohort study; Level of evidence, 2. The Concussion Assessment, Research and Education (CARE) Consortium database was used. The mechanism of injury was categorized into head-to-ball, head-to-head, head-to-body, and head-to-ground/equipment. Baseline/acute injury characteristics-including Sports Concussion Assessment Tool-3 total symptom severity (TSS), loss of consciousness (LOC), and altered mental status (AMS); descriptive data; and recovery (RTP and URTP)-were compared. Multivariable regression and Weibull models were used to assess the predictive value of the mechanism of injury on TSS and RTP/URTP, respectively. Among 391 soccer SRCs, 32.7% were attributed to a head-to-ball mechanism, 27.9% to a head-to-body mechanism, 21.7% to a head-to-head mechanism, and 17.6% to a head-to-ground/equipment mechanism. Event type was significantly associated with injury mechanism [χ The mechanism of injury differed by event type and primary position, and LOC and AMS were different across mechanisms. Even though the mechanism of injury was not a significant predictor of acute symptom burden or time until RTP initiation, those with head-to-equipment/ground injuries spent the shortest time until URTP, and those with head-to-ball injuries had the longest time until URTP.

Sections du résumé

BACKGROUND UNASSIGNED
Few previous studies have investigated how different injury mechanisms leading to sport-related concussion (SRC) in soccer may affect outcomes.
PURPOSE UNASSIGNED
To describe injury mechanisms and evaluate injury mechanisms as predictors of symptom severity, return to play (RTP) initiation, and unrestricted RTP (URTP) in a cohort of collegiate soccer players.
STUDY DESIGN UNASSIGNED
Cohort study; Level of evidence, 2.
METHODS UNASSIGNED
The Concussion Assessment, Research and Education (CARE) Consortium database was used. The mechanism of injury was categorized into head-to-ball, head-to-head, head-to-body, and head-to-ground/equipment. Baseline/acute injury characteristics-including Sports Concussion Assessment Tool-3 total symptom severity (TSS), loss of consciousness (LOC), and altered mental status (AMS); descriptive data; and recovery (RTP and URTP)-were compared. Multivariable regression and Weibull models were used to assess the predictive value of the mechanism of injury on TSS and RTP/URTP, respectively.
RESULTS UNASSIGNED
Among 391 soccer SRCs, 32.7% were attributed to a head-to-ball mechanism, 27.9% to a head-to-body mechanism, 21.7% to a head-to-head mechanism, and 17.6% to a head-to-ground/equipment mechanism. Event type was significantly associated with injury mechanism [χ
CONCLUSION UNASSIGNED
The mechanism of injury differed by event type and primary position, and LOC and AMS were different across mechanisms. Even though the mechanism of injury was not a significant predictor of acute symptom burden or time until RTP initiation, those with head-to-equipment/ground injuries spent the shortest time until URTP, and those with head-to-ball injuries had the longest time until URTP.

Identifiants

DOI: 10.1177/03635465241240789 PMID: 38656160
pubmed: 38656160
doi: 10.1177/03635465241240789
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3635465241240789

Déclaration de conflit d'intérêts

One or more of the authors has declared the following potential conflict of interest or source of funding: This project was supported, in part, by the Grand Alliance Sport-Related Concussion Assessment, Research, and Education (CARE) Consortium, funded, in part by the National Collegiate Athletic Association (NCAA) and the DoD. The U.S. Army Medical Research Acquisition Activity is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program under award No. W81XWH-14-2-0151. A.J.B. has been part of projects that have received funding from the DoD, the National Operating Committee on Standards from Athletic Equipment, the National Athletic Trainer's Association (NATA) Research and Education Foundation, and the NCAA. P.F.P. is an employee of the DoD and has previously received other DoD-related grants. T.W.M. has received research support from the NCAA, the US DoD, and the National Institutes of Health (NIH). He also reports textbook royalties from American Psychiatric Press Publishing Inc and serves on the Concussion Committee Scientific Advisory Board for the Australian Football League. M.A.M. has received research funding from the NIH, the Centers for Disease Control and Prevention (CDC), the DoD, the NCAA, the National Football League (NFL), and Abbott Laboratories. S.P.B. has received research funding from the NIH, the CDC, the DoD-USA Medical Research Acquisition Activity, the NCAA, the NATA Research and Education Foundation, the NFL/Under Armour/GE, Simbex, and ElmindA. He has consulted for US Soccer, US Cycling, the University of Calgary SHRed Concussions external advisory board, and medicolegal litigation. S.L.Z. is a member of the NFL Head, Neck, and Spine Committee. D.P.T. serves as a scientific advisor for HitIQ. He previously consulted for REACT Neuro Inc. He has a consulting practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained mild traumatic brain injury (including former athletes). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Auteurs

Jacob Jo (J)

Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.
ORCID: 0000-0002-0424-3507

Adrian J Boltz (AJ)

Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Kristen L Williams (KL)

Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Paul F Pasquina (PF)

Department of Physical Medicine and Rehabilitation at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Thomas W McAllister (TW)

Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Michael A McCrea (MA)

Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Steven P Broglio (SP)

Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Scott L Zuckerman (SL)

Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Douglas P Terry (DP)

Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Kristy Arbogast (K)

University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Holly J Benjamin (HJ)

University of Chicago, Chicago, Illinois, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Alison Brooks (A)

University of Wisconsin-Madison, Madison, Wisconsin, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Kenneth L Cameron (KL)

United States Military Academy, West Point, New York, USA).
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Sara P D Chrisman (SPD)

University of Washington, Seattle, Washington, USA).
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

James R Clugston (JR)

University of Florida, Gainesville, Florida, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Micky Collins (M)

University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

John DiFiori (J)

Hospital for Special Surgery, New York, New York, USA).
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

James T Eckner (JT)

University of Michigan, Michigan, USA).
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Carlos Estevez (C)

United States Coast Guard Academy, New London, Connecticut, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Luis A Feigenbaum (LA)

University of Miami, Coral Gables, Florida, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Joshua T Goldman (JT)

University of California, Los Angeles, Los Angeles, California, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

April Hoy (A)

Azusa Pacific University, Azusa, California, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Thomas W Kaminski (TW)

University of Delaware, Newark, Delaware, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Louise A Kelly (LA)

California Lutheran University, Thousand Oaks, California, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Anthony P Kontos (AP)

University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Dianne Langford (D)

Temple University, Philadelphia, Pennsylvania, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Laura J Lintner (LJ)

Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Christina L Master (CL)

University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Jane McDevitt (J)

Temple University, Philadelphia, Pennsylvania, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Gerald McGinty (G)

United States Air Force Academy, El Paso, Colorado, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Chris Miles (C)

Wake Forest University, Winston-Salem, North Carolina, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Justus Ortega (J)

California State Polytechnic University, Pomona, California, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Nicholas Port (N)

Indiana University, Bloomington, Indiana, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Steve Rowson (S)

Virginia Tech, Blacksburg, Virginia, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Julianne Schmidt (J)

University of Georgia, Athens, Georgia, USA).
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Adam Susmarski (A)

United States Naval Academy, Annapolis, Maryland, USA).
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Steven Svoboda (S)

MedStar Health, Columbia, Maryland, USA.
Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Classifications MeSH