Association of Sport Helmet Status on Concussion Presentation and Recovery in Male Collegiate Student-Athletes.
Mild traumatic brain injury
NCAA-DOD CARE consortium
Sport equipment
Journal
Annals of biomedical engineering
ISSN: 1573-9686
Titre abrégé: Ann Biomed Eng
Pays: United States
ID NLM: 0361512
Informations de publication
Date de publication:
08 Jul 2024
08 Jul 2024
Historique:
received:
16
10
2023
accepted:
30
06
2024
medline:
9
7
2024
pubmed:
9
7
2024
entrez:
8
7
2024
Statut:
aheadofprint
Résumé
Sporting helmets contain force attenuating materials which reduce traumatic head injury risk and may influence sport-related concussion (SRC) sequelae. The purpose of this study was to examine the association of sport helmet status with SRC-clinical presentation and recovery trajectories in men's collegiate athletes. Sport helmet status was based on the nature of sports being either helmeted/non-helmeted. 1070 SRCs in helmeted (HELM) sports (Men's-Football, Ice Hockey, and Lacrosse), and 399 SRCs in non-helmeted (NOHELM) sports (Men's-Basketball, Cheerleading, Cross Country/Track & Field, Diving, Gymnastics, Soccer, Swimming, Tennis, and Volleyball) were analyzed. Multivariable negative binomial regression models analyzed associations between sport helmet status and post-injury cognition, balance, and symptom severity, adjusting for covariate effects (SRC history, loss of consciousness, anterograde/retrograde amnesia, event type). Kaplan-Meier curves evaluated median days to: initiation of return to play (iRTP) protocol, and unrestricted RTP (URTP) by sport helmet status. Log-rank tests were used to evaluate differential iRTP/URTP between groups. Two independent multivariable Weibull accelerated failure time models were used to examine differential iRTP and URTP between groups, after adjusting for aforementioned covariates and symptom severity score. Overall, the median days to iRTP and URTP was 6.3 and 12.0, respectively, and was comparable across NOHELM- and HELM-SRCs. Post-injury symptom severity was lower (Score Ratio 0.90, 95%CI 0.82, 0.98), and cognitive test performance was higher (Score Ratio 1.03, 95%CI 1.02, 1.05) in NOHELM-compared to HELM-SRCs. Estimated time spent recovering to iRTP/URTP was comparable between sport helmet status groups. Findings suggest that the grouping of sports into helmeted and non-helmeted show slight differences in clinical presentation but not recovery.
Identifiants
pubmed: 38977528
doi: 10.1007/s10439-024-03575-0
pii: 10.1007/s10439-024-03575-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : U.S. Department of Defense
ID : W81XWH-14-2-0151
Investigateurs
Louise Kelly
(L)
Justus Ortega
(J)
Nicholas Port
(N)
James T Eckner
(JT)
Patrick O'Donnell
(P)
Christopher D'Lauro
(C)
Adam Susmarski
(A)
Holly Benjamin
(H)
Christopher Giza
(C)
Thomas Kaminski
(T)
Thomas Buckley
(T)
James Clugston
(J)
Joseph Hazzard
(J)
Luis Feigenbaum
(L)
Kristy Arbogast
(K)
Christina Master
(C)
Anthony Kontos
(A)
Alison Brooks
(A)
Informations de copyright
© 2024. The Author(s) under exclusive licence to Biomedical Engineering Society.
Références
Arbogast, K. B., J. B. Caccese, T. A. Buckley, A. S. McIntosh, K. Henderson, B. D. Stemper, G. Solomon, S. P. Broglio, J. R. Funk, and J. R. Crandall. Consensus head acceleration measurement practices (CHAMP): origins, methods, transparency and disclosure. Ann. Biomed. Eng. 50:1317–1345, 2022.
doi: 10.1007/s10439-022-03025-9
pubmed: 35920964
pmcid: 9652170
Barr, W. B., and M. McCREA. Sensitivity and specificity of standardized neurocognitive testing immediately following sports concussion. J. Int. Neuropsychol. Soc. 7:693–702, 2001.
doi: 10.1017/S1355617701766052
pubmed: 11575591
Baugh, C. M., W. P. Meehan, E. Kroshus, T. G. McGuire, and L. A. Hatfield. College football players less likely to report concussions and other injuries with increased injury accumulation. J. Neurotrauma. 36:2065–2072, 2019.
doi: 10.1089/neu.2018.6161
pubmed: 30688141
pmcid: 6602107
Brett, B. L., et al. Investigating the range of symptom endorsement at initiation of a graduated return-to-play protocol after concussion and duration of the protocol: a study from the national collegiate athletic association-department of defense concussion, assessment, research, and education (CARE) consortium. Am. J. Sports Med. 48:1476–1484, 2020.
doi: 10.1177/0363546520913252
pubmed: 32298132
Broglio, S. P., et al. The natural history of sport-related concussion in collegiate athletes: findings from the NCAA-DoD CARE consortium. Sports Med. 52:403–415, 2022.
doi: 10.1007/s40279-021-01541-7
pubmed: 34427877
Broglio, S. P., R. C. Cantu, G. A. Gioia, K. M. Guskiewicz, J. Kutcher, M. Palm, T. C. Valovich McLeod, National Athletic Trainer’s Association. National athletic trainers’ Association position statement: management of sport concussion. J. Athl. Train. 49:245–265, 2014.
doi: 10.4085/1062-6050-49.1.07
pubmed: 24601910
pmcid: 3975780
Broglio, S. P., J. T. Eckner, T. Surma, and J. S. Kutcher. Post-concussion cognitive declines and symptomatology are not related to concussion biomechanics in high school football players. J. Neurotrauma. 28:2061–2068, 2011.
doi: 10.1089/neu.2011.1905
pubmed: 21644811
pmcid: 4346373
Broglio, S. P., A. Lapointe, K. L. O’Connor, and M. McCrea. Head impact density: a model to explain the elusive concussion threshold. J. Neurotrauma. 34:2675–2683, 2017.
doi: 10.1089/neu.2016.4767
pubmed: 28381134
pmcid: 5647505
Broglio, S. P., M. McCrea, T. McAllister, J. Harezlak, B. Katz, D. Hack, B. Hainline, CARE Consortium Investigators. A national study on the effects of concussion in collegiate athletes and us military service academy members: the NCAA-DoD concussion assessment, research and education (CARE) consortium structure and methods. Sports Med. Auckl. NZ. 47:1437–1451, 2017.
doi: 10.1007/s40279-017-0707-1
Broshek, D. K., J. E. Pardini, and S. A. Herring. Persisting symptoms after concussion: time for a paradigm shift. Pm R. 14:1509–1513, 2022.
doi: 10.1002/pmrj.12884
pubmed: 36152344
pmcid: 10087676
Campolettano, E. T., R. A. Gellner, D. W. Sproule, M. T. Begonia, and S. Rowson. Quantifying youth football helmet performance: assessing linear and rotational head acceleration. Ann. Biomed. Eng. 48:1640–1650, 2020.
doi: 10.1007/s10439-020-02505-0
pubmed: 32266597
pmcid: 7494015
Chandran, A., A. J. Boltz, B. L. Brett, S. R. Walton, H. J. Robison, C. L. Collins, J. K. Register-Mihalik, and J. P. Mihalik. Patterns and predictors of concussion symptom presentations in NCAA athletes. Res. Sports Med. 32:1–15, 2022.
Chandran, A., A. J. Boltz, S. N. Morris, H. J. Robison, A. K. Nedimyer, C. L. Collins, and J. K. Register-Mihalik. Epidemiology of concussions in national collegiate athletic association (NCAA) sports: 2014/15-2018/19. Am. J. Sports Med. 50:526–536, 2022.
doi: 10.1177/03635465211060340
pubmed: 34898299
Chandran, A., L. DiPietro, H. Young, and A. Elmi. Modeling time loss from sports-related injuries using random effects models: an illustration using soccer-related injury observations. J. Quant. Anal. Sports. 16:221–235, 2020.
doi: 10.1515/jqas-2019-0030
Guskiewicz, K. M., J. P. Mihalik, V. Shankar, S. W. Marshall, D. H. Crowell, S. M. Oliaro, M. F. Ciocca, and D. N. Hooker. Measurement of head impacts in collegiate football players: relationship between head impact biomechanics and acute clinical outcome after concussion. Neurosurgery. 61:1244, 2007.
doi: 10.1227/01.neu.0000306103.68635.1a
pubmed: 18162904
Lempke, L. B., J. D. Schmidt, and R. C. Lynall. Athletic trainers’ concussion-assessment and concussion-management practices: an update. J. Athl. Train. 55:17–26, 2020.
doi: 10.4085/1062-6050-322-18
pubmed: 31855075
pmcid: 6961637
Lin, A. P., S. Ramadan, R. A. Stern, H. C. Box, C. J. Nowinski, B. D. Ross, and C. E. Mountford. Changes in the neurochemistry of athletes with repetitive brain trauma: preliminary results using localized correlated spectroscopy. Alzheimers Res. Ther. 7:13, 2015.
doi: 10.1186/s13195-015-0094-5
pubmed: 25780390
pmcid: 4361214
Lynall, R. C., M. D. Clark, E. E. Grand, J. C. Stucker, A. C. Littleton, A. J. Aguilar, M. A. Petschauer, E. F. Teel, and J. P. Mihalik. Head impact biomechanics in women’s college soccer. Med. Sci. Sports Exerc. 48:1772–1778, 2016.
doi: 10.1249/MSS.0000000000000951
pubmed: 27187102
Mainwaring, L., K. M. Ferdinand Pennock, S. Mylabathula, and B. Z. Alavie. Subconcussive head impacts in sport: a systematic review of the evidence. Int. J. Psychophysiol. 132:39–54, 2018.
doi: 10.1016/j.ijpsycho.2018.01.007
pubmed: 29402530
McAllister, T. W., S. P. Broglio, B. P. Katz, S. M. Perkins, M. LaPradd, W. Zhou, M. A. McCrea, On behalf of Concussion Assessment, Research and Education (CARE) Consortium. Characteristics and outcomes of athletes with slow recovery from sports-related concussion: a CARE consortium study. Neurology. 100:e1510–e1519, 2023.
doi: 10.1212/WNL.0000000000206853
pubmed: 36653178
pmcid: 10104617
McCrory, P., et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br. J. Sports Med. 51:838–847, 2017.
doi: 10.1136/bjsports-2017-097699
pubmed: 28446457
McCrory, P., W. H. Meeuwisse, M. Aubry, B. Cantu, J. Dvořák, R. J. Echemendia, L. Engebretsen, K. Johnston, J. S. Kutcher, M. Raftery, A. Sills, B. W. Benson, G. A. Davis, R. G. Ellenbogen, K. Guskiewicz, S. A. Herring, G. L. Iverson, B. D. Jordan, J. Kissick, M. McCrea, A. S. McIntosh, D. Maddocks, M. Makdissi, L. Purcell, M. Putukian, K. Schneider, C. H. Tator, and M. Turner. Consensus statement on concussion in sport: the 4th international conference on concussion in sport held in Zurich. Br. J. Sports Med. 47:250–258, 2013.
doi: 10.1136/bjsports-2013-092313
pubmed: 23479479
Mihalik, J. P., S. A. Amalfe, P. R. Roby, C. B. Ford, R. C. Lynall, K. E. Riegler, E. F. Teel, E. B. Wasserman, and M. Putukian. Sex and sport differences in college lacrosse and soccer head impact biomechanics. Med. Sci. Sports Exerc. 52:2349–2356, 2020.
doi: 10.1249/MSS.0000000000002382
pubmed: 33064408
Mihalik, J. P., A. Chandran, J. R. Powell, P. R. Roby, K. M. Guskiewicz, B. D. Stemper, A. S. Shah, S. Rowson, S. Duma, J. Harezlak, L. Riggen, S. P. Broglio, T. W. McAllister, and M. McCrea. Do head injury biomechanics predict concussion clinical recovery in college American football players? Ann. Biomed. Eng. 48:2555–2565, 2020.
doi: 10.1007/s10439-020-02658-y
pubmed: 33136240
Miller, J. H., C. Gill, E. N. Kuhn, B. G. Rocque, J. Y. Menendez, J. A. O’Neill, B. S. Agee, S. T. Brown, M. Crowther, R. D. Davis, D. Ferguson, and J. M. Johnston. Predictors of delayed recovery following pediatric sports-related concussion: a case-control study. J. Neurosurg. Pediatr. 17:491–496, 2016.
doi: 10.3171/2015.8.PEDS14332
pubmed: 26684762
O’Connor, K. L., S. Rowson, S. M. Duma, and S. P. Broglio. Head-impact-measurement devices: a systematic review. J. Athl. Train. 52:206–227, 2017.
doi: 10.4085/1062-6050.52.2.05
pubmed: 28387553
pmcid: 5384819
Van Pelt, K. L., T. Puetz, J. Swallow, A. P. Lapointe, and S. P. Broglio. Data-driven risk classification of concussion rates: a systematic review and meta-analysis. Sports Med. Auckl. NZ. 51:1227–1244, 2021.
doi: 10.1007/s40279-021-01428-7
Rice, S. G., American Academy of Pediatrics Council on Sports Medicine and Fitness. Medical conditions affecting sports participation. Pediatrics. 121:841–848, 2008.
doi: 10.1542/peds.2008-0080
pubmed: 18381550
Rowson, S., and S. M. Duma. Brain injury prediction: assessing the combined probability of concussion using linear and rotational head acceleration. Ann. Biomed. Eng. 41:873–882, 2013.
doi: 10.1007/s10439-012-0731-0
pubmed: 23299827
pmcid: 3624001
Rowson, B., S. Rowson, and S. M. Duma. Hockey STAR: a methodology for assessing the biomechanical performance of hockey helmets. Ann. Biomed. Eng. 43:2429–2443, 2015.
doi: 10.1007/s10439-015-1278-7
pubmed: 25822907
pmcid: 4569651
Saunders, T. D., R. K. Le, K. M. Breedlove, D. A. Bradney, and T. G. Bowman. Sex differences in mechanisms of head impacts in collegiate soccer athletes. Clin. Biomech. 74:14–20, 2020.
doi: 10.1016/j.clinbiomech.2020.02.003
Schneider, D. K., R. Galloway, J. J. Bazarian, J. A. Diekfuss, J. Dudley, J. L. Leach, R. Mannix, T. M. Talavage, W. Yuan, and G. D. Myer. Diffusion tensor imaging in athletes sustaining repetitive head impacts: a systematic review of prospective studies. J. Neurotrauma. 36:2831–2849, 2019.
doi: 10.1089/neu.2019.6398
pubmed: 31062655
Zuckerman, S. L., Y. M. Lee, M. J. Odom, J. A. Forbes, G. S. Solomon, and A. K. Sills. Sports-related concussion in helmeted versus unhelmeted athletes: who fares worse? Int. J. Sports Med. 36:419–425, 2015.
doi: 10.1055/s-0034-1395587
pubmed: 25664998