Mechanism of Injury and Clinical Recovery Outcomes Following Pediatric Concussion.

Children with concussion are injured through a variety of mechanisms, but the relationship between mechanism of injury (MOI) and recovery outcomes is unclear due to small sample sizes and varied methodological designs. Our objective was to examine the association of MOI and clinical recovery in youth with concussion using a large dataset collated from a single, multisite study. We hypothesized that sport-related concussion would be related to better clinical presentation and faster recovery trajectories compared to other mechanisms of concussion.

5P Risk Classification Predicts Performance on Self-reported but Not Objective Clinical Outcomes at 4 Weeks Postconcussion in Children.

Objective: To determine if performance on symptom, cognitive, balance, fatigue, physical activity, and quality of life outcomes at 4 weeks postinjury in children with concussion differs based on acute Predicting and Preventing Postconcussive Problems in Pediatrics (5P) risk classification.

Design: Prospective cohort.

Setting: Laboratory.

A Concussion Management Policy Change Promoted Earlier Initiation of Rehabilitation Services and Improved Clinical Recovery Outcomes in Concussion.

Context: In line with emerging research, an interprofessional specialty concussion clinic instituted a policy change permitting earlier physiotherapy-based treatment entry. Our objective was to determine the effect of this policy change on concussion recovery outcomes.

Design: Secondary analysis of prospectively collected clinical data.

Parent and Youth Athlete Perceptions of Concussion Injury: Establishing a Factor Structure.

Objective: The first objective was to establish the respective factor structures of a concussion perceptions inventory that was adapted for youth athletes (ages 8-14 years) and their parents from the Perceptions of Concussion Inventory for Athletes. The second objective was to understand the associations between the concussion perceptions of youth athlete-parent dyads.

Method: In this cross-sectional study, 329 parent-youth athlete dyads completed a respective concussion perception inventory.

An At-Home, Virtually Administered Graded Exertion Protocol for Use in Concussion Management: Preliminary Evaluation of Safety and Feasibility for Determining Clearance to Return to High-Intensity Exercise in Healthy Youth and Children With Subacute Concussion.

Graded exertion testing (GXT) is an important tool for concussion management, as it is used to personalize post-concussion exercise prescription and return athletes to sport. However, most GXT requires expensive equipment and in-person supervision. Our objective was to assess the safety and feasibility of the ntreal irtual xertion (MOVE) protocol, a no-equipment, virtually compatible GXT, in healthy children and children with subacute concussion.

Early Exercise is Associated with Faster Concussion Recovery Among Collegiate Athletes: Findings from the NCAA-DoD CARE Consortium.

Background: Growing evidence indicates early exercise may improve symptoms and reduce clinical recovery time after concussion, but research examining collegiate student-athletes is scarce.

Objective: The aim of this study was to compare symptom recovery time, clinical recovery time, and persisting post-concussion symptom (i.e.

Electroencephalographic characteristics of children and adolescents with chronic musculoskeletal pain.

Introduction: The pathophysiology of pediatric musculoskeletal (MSK) pain is unclear, contributing to persistent challenges to its management.

Objectives: This study hypothesizes that children and adolescents with chronic MSK pain (CPs) will show differences in electroencephalography (EEG) features at rest and during thermal pain modalities when compared with age-matched controls.

Methods: One hundred forty-two CP patients and 45 age-matched healthy controls (HCs) underwent a standardized thermal tonic heat and cold stimulations, while a 21-electrode headset collected EEG data.

Test-Retest reliability and preliminary reliable change estimates for Sway Balance tests administered remotely in community-dwelling adults.

Objective: Impaired balance and postural stability can occur with advanced age, following traumatic brain injury, in association with neurological disorders and diseases, and as the result of acute or chronic orthopedic problems. The remote assessment of balance and postural stability could be of value in clinical practice and research. We examined the test-retest reliability and reliable change estimates for Sway Balance Mobile Application tests (Sway Medical, Tulsa OK, USA) administered remotely from the participant's home.

Accurate classification of pain experiences using wearable electroencephalography in adolescents with and without chronic musculoskeletal pain.

Objective: We assessed the potential of using EEG to detect cold thermal pain in adolescents with and without chronic musculoskeletal pain.

Methods: Thirty-nine healthy controls (15.2 ± 2.

The magnitude of parental stress is highly variable following pediatric concussion: using the transactional model of stress to understand parent experiences.

Objectives: To use the Transactional Model of Stress to understand variations in parental stress following pediatric concussion.

Methods: Mixed-methods design. 49 (13.

Developing a conceptual framework to identify and classify sources of parental stress following pediatric concussion.

Objectives: To create a conceptual framework that classifies the various stresses parents experience following their child's concussion.

Methods: Twelve parents of children with concussion completed a semi-structured interview with the lead author. Questions broadly focused on post-concussion stress, with specific probes for caregiving responsibilities, concussion knowledge, and athletic participation.

Attention-Deficit/Hyperactivity Disorder and Outcome from Concussion: Examining Duration of Active Rehabilitation and Clinical Recovery.

Aims: The objective of this study was to compare recovery time and duration of active rehabilitation following concussion between adolescents with and without attention-deficit/hyperactivity disorder (ADHD).

Methods: A retrospective cohort study was conducted among adolescents presenting to a specialty concussion clinic. One-quarter of the eligible episodes of care were selected.

Lifetime History of Concussion Among Youth With ADHD Presenting to a Specialty Concussion Clinic.

Child and adolescent student athletes with attention-deficit/hyperactivity disorder (ADHD) report a greater lifetime history of concussion than those without ADHD. This case-control study compared youth with and without ADHD presenting for care at a specialty concussion clinic on their lifetime history of concussion. We hypothesized that a greater proportion of youth with ADHD would report a history of prior concussion.

Higher parental stress is significantly related to longer clinical recovery times in concussed children: A mixed-methods study.

Objectives: Parental stress and anxiety negatively influences a child's recovery following traumatic brain injury, but these relationships are largely unexplored in a concussion-specific sample. We hypothesized that children with parents experiencing high stress or with pre-existing anxiety would take significantly longer to recover from concussion.

Design: Mixed-methods.

Physical Activity Interventions for Individuals With a Mild Traumatic Brain Injury:: A Scoping Review.

Objective: To document the characteristics, measured outcomes, and effectiveness of physical activity (PA) interventions designed to improve health-related outcomes in individuals with a mild traumatic brain injury (mTBI) to assist in rehabilitation quality improvement efforts of a TBI rehabilitation program.

Methods: A scoping review following a 6-step iterative framework search across 5 databases (MEDLINE, CINAHL, PsycINFO, SPORTDiscuss, and EMBASE) and the gray literature (Google) was performed. Selected PA interventions were designed for individuals of all ages and any mechanism of injury (eg, sports-related and falls).

Vestibular-ocular reflex dysfunction following mild traumatic brain injury: A narrative review.

Mild traumatic brain injury (mTBI) is a prevalent injury which occurs across many populations, including children and adolescents, athletes, military personnel, and the elderly. mTBI can result in various subjective symptoms and clinical deficits, such as abnormalities to the vestibulo-ocular reflex (VOR). Over 50% of individuals with mTBI are reported to have VOR abnormalities, which strongly contribute to feelings of dizziness and unsteadiness.

Perceptual Cognitive Training Does Not Improve Clinical Outcomes at 4 and 12 Weeks Following Concussion in Children and Adolescents: A Randomized Controlled Trial.

Objective: To determine whether a perceptual-cognitive training program using 3D-multiple object tracking (3D-MOT) can improve symptoms following acute pediatric concussion.

Setting: Research laboratory within a pediatric trauma center.

Participants: Children and adolescents (n = 62, age= 13.

Sex and Sport Differences in College Lacrosse and Soccer Head Impact Biomechanics.

Purpose: Sport-related head impact biomechanics research has been male-centric and focused primarily on American football and ice hockey, which do not address popular sports in which both sexes participate. The purpose of this study was to quantify college female and male lacrosse and soccer head impact biomechanics.

Methods: Head impact biomechanics were collected from college lacrosse and soccer players across two Division 1 college athletic programs (96 female athletes, 141 male athletes; age, 19.

The Use of Electroencephalography as an Informative Tool in Assisting Early Clinical Management after Sport-Related Concussion: a Systematic Review.

Sport-related concussion (SRC) is managed primarily through serial clinical evaluations throughout recovery. However, studies suggest that clinical measures may not be suitable to detect subtle alterations in functioning and are limited by numerous internal and external factors. Electroencephalography (EEG) has been used for over eight decades to discern altered function following illnesses and injuries, including traumatic brain injury.

Parent-Child Agreement on Postconcussion Symptoms in the Acute Postinjury Period.

Objectives: To evaluate parent-child agreement on postconcussion symptom severity within 48 hours of injury and examine the comparative predictive power of a clinical prediction rule when using parent or child symptom reporting.

Methods: Both patients and parents quantified preinjury and current symptoms using the Postconcussion Symptom Inventory (PCSI) in the pediatric emergency department. Two-way mixed, absolute measure intraclass correlation coefficients were calculated to evaluate the agreement between patient and parent reports.

Comparison of Concussion Sideline Screening Measures Across Varying Exertion Levels Within Simulated Games.

Context: Currently, there is no gold standard to evaluate the effect of varying game-like exertion states on Sport Concussion Assessment Tool 3rd Edition (SCAT-3) outcomes. Baseline assessments may occur before, during, or after physical activity, while postinjury evaluations predominantly occur following physical activity. Thus, clinicians may be comparing postinjury evaluations completed following exertion to baseline evaluations completed following varying levels of rest or exertion, which may not be a valid method for clinical decision making.

Near Point of Convergence Deficits and Treatment Following Concussion: A Systematic Review.

Context: Convergence dysfunction following concussion is common. Near point of convergence (NPC) is a quick and easy assessment that may detect oculomotor dysfunction such as convergence insufficiency (CI), but NPC measurements are rarely reported. Convergence dysfunction is treatable in otherwise healthy patients; the effectiveness of oculomotor therapy following concussion is unclear.

Head Impact Biomechanics Differ Between Girls and Boys Youth Ice Hockey Players.

The influence of sex on head impact biomechanics is unknown for youth ice hockey. We sought to determine sex differences in head impact severity and frequency in youth ice hockey players. Male (n = 110) and female (n = 25) players (13-16 years old) were recruited from a local hockey organization.