Search

Background:Characterization of, and evaluation of strategies to mitigate, the effects of sub-concussive impacts (SCI) on brain structure and function are crucial to understanding potential long-term neurological risks associated with sports participation.Objectives:To evaluate the efficacy of a jugular vein compression collar for preserving functional and structural measures of brain network organization in a cohort of female high school soccer players throughout a season of competitive play.Methods:Athletes were assigned to a collar (N= 72) or non-collar (N= 56) group before engaging in a season of play, during which head impact data were recorded via accelerometer for every practice and competition. Participants completed neuroimaging sessions before and following the season. A graph theoretical framework was applied to the functional and structural connectivity measures computed from resting state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) data.Results:Non-collar-wearing athletes exhibited significantly increased rs-fMRI-derived global clustering coefficients (p= 0.032) and DTI-derived modularity (p= 0.042), compared to collar-wearing athletes. No longitudinal changes in any graph measures were observed for the collar group (p> 0.05).Conclusion:The observed increase in graph measures in the non-collar group is congruent with previous studies of SCI and is similar to graph theoretical studies of traumatic brain injury. The absence of alterations in graph metrics in the collar group indicates a potential ameliorating effect of the collar device against network reorganization, in line with previous literature.

ABSTRACTObjective: The growth in participation in men’s lacrosse has increased the likelihood of sport-specific injuries, yet there continues to be a need for specific epidemiological data concerning lacrosse injuries. The purpose of this literature review is to aggregate available published data on injuries that occur in the sport of men’s lacrosse at the youth, high school, collegiate, and professional levels.Methods: A comprehensive literature search was performed in PubMed, High Wire Press, SPORTDiscus, Google Scholar, and Ovid, using the keywords Lacrosse Injuries, Epidemiology Lacrosse Injuries, Lacrosse Injury, Lacrosse AND Injury and limited to 1990–2016. All bibliographies were cross-referenced to identify any additional publications. Sources were categorized based on data provided and were aggregated into groups based on reported overall injury rates, rates by setting (competition vs. practice), nature of injury, location, type, severity, and player position.Results: The game and practice injury rates in college are greater than the rates in high school, similarly rates greater for high school players than in youth leagues. Rates of injury varied from 0.095–12.98 per 1000 athlete exposures. Game injury rates were higher across all studies. Injuries in men’s lacrosse occur most often from player-to-player contact, which result in immediate injuries, such as concussions, contusions, and lacerations. Overall concussion incidence was reported to range from 0.11–0.84 per 1000 AE. The most common types of injuries were sprain, strain, concussion, and contusions and the most common area of injury was hand (23%), with a significant proportion of these (59.4%) being to the thumb. Limited evidence of different injuries among the player positions suggests there might be a pattern that midfield players had the most injuries, followed by offensive players and then defensive players.Conclusions: The potential for sports-related injury is of relative concern; especially considering rising participation and total number of injuries. Further development and proper enforcement of safety rules on player contact and protective equipment are recommended to decrease the rate of lacrosse-related injury. Additional longitudinal research is needed to better classify and to ultimately predict lacrosse injury factors and mechanisms across all levels of play.

ObjectiveThe aim of the current review was to systematically identify, evaluate and synthesise trials that examine concussion prevention via equipment, educational programmes and training programmes.Data sourcesPubMed and EBSCO host (CINAHL, MEDLINE, SPORTDiscus).Eligibility criteria for selecting studiesThe electronic databases PubMed and EBSCO were searched using the phrases: concussion prevention equipment, concussion prevention trainingand concussion prevention education. Included studies utilised a prospective study design to evaluate the preventative effect of: (1) equipment, (2) training or (3) educational programmes on the incidence of concussions in comparison to a control group.Data extractionDemographic data and intervention methods were recorded. Intervention and control group concussion rates and superficial head injury rates were extracted and combined using random-effects relative risk meta-analysis.Results14 studies evaluated interventions of novel protective equipment. One prospective investigation evaluated an educational programme. The relative risk of concussion for participants enrolled in the interventional arms of trials was not significantly different from that in standard practice arms (RR=0.78, 95% CI 0.55 to 1.11, χ2=1.8, p=0.17; I2=85.3%, 95% CI 71.5% to 90.8%). The relative risk of concussion for participants wearing protective equipment (ie, headgear, full face shields) relative to their counterparts wearing standard or no equipment, calculated from seven available reports, showed no effect of intervention (RR=0.82, 95% CI 0.56 to 1.20, χ2=1.06, p=0.30; I2=86.7%, 95% CI 73.3% to 91.8%). The relative risk of superficial head injury for participants wearing protective equipment relative to their counterparts, calculated from three reports, showed a significant risk reduction (RR=0.41, 95% CI 0.31 to 0.56, χ2=34.13, p<0.0001; I2=53.1%, 95% CI 0% to 85.2%).ConclusionsProspective controlled studies indicate that certain protective equipment may prevent superficial head injury, but these items are suboptimal for concussion prevention in sport.