Abstract:
CONTEXT:The sideline assessment of concussion is challenging, given its variable presentations, the limited sensitivity and specificity of sideline assessment tools, and how the presentation of the injury evolves over time. In addition, the diagnostic process, as well as the tools used to assess and manage concussion, continue to progress as research and what we know about concussion advance. This paper focuses on the initial assessment on the sideline by reviewing the concussion-evaluation literature, drawing from clinical experience to emphasize a standardized approach, and underscoring the importance of both familiarity with the athlete and clinical judgment. OBJECTIVE:To review the evidence regarding the clinical assessment of sport-related concussion on the sideline. Additional considerations included making same-day return-to-play decisions, the sensitivity and specificity of sideline testing, and the importance of ongoing assessment and follow-up of injured athletes. DATA SOURCES:I conducted a systematic literature review of the assessment of concussion on the sideline. The PubMed and MEDLINE databases were searched using the key term athletic injuries with concussion and mild traumatic brain injury. The search was refined by adding the key terms sideline assessment and on-field assessment. In addition, select additional position statements and guidelines on concussion were included in the review. RESULTS:The PubMed search using athletic injuries and concussion as key terms produced 1492 results. Refining the search by sideline assessment and on-field assessment produced 29 and 35 results, respectively. When athletic injuries and traumatic brain injury were combined, 1912 results were identified. Refining the search by sideline assessment and on-field assessment led to 28 and 35 results, respectively. Only papers that were English-language titles, original work, and limited to human participants and included sideline assessments of sport-related concussion in athletes older than 13 years were considered for this discussion. A total of 96 papers were reviewed, including systematic reviews, consensus guidelines, and position statements. CONCLUSIONS:The sideline assessment of sport-related concussion is challenging given the elusiveness and variability of presentation, reliance on athlete-reported symptoms, and the varying specificity and sensitivity values of sideline assessment tools. In addition, the recognition of injury and assessment often occur in a time-pressured environment, requiring rapid disposition and decision making. Clinicians should begin the evaluation by assessing for cervical spine injury, intracranial bleeding, and other injuries that can present in a similar fashion or in addition to concussion. The sideline concussion evaluation should consist of a symptom assessment and a neurologic examination that addresses cognition (briefly), cranial nerve function, and balance. Emerging tools that assess visual tracking may provide additional information. The sensitivity and specificity of commonly implemented sideline assessment tools are generally good to very good, especially for symptom scores and cognitive evaluations performed within 48 hours of injury, and they are improved when a baseline evaluation is available for comparison. Serial assessments are often necessary as objective signs and symptoms may be delayed. A standardized assessment is paramount in evaluating the athlete with a suspected concussion, but there is no replacement for being familiar with the athlete and using clinical judgment when the athlete seems "not right" despite a "normal" sideline assessment. Ultimately, the clinician should err on the side of caution when making a return-to-play decision.
journal_name
J Athl Trainjournal_title
Journal of athletic trainingauthors
Putukian Mdoi
10.4085/1062-6050-52.1.08subject
Has Abstractpub_date
2017-03-01 00:00:00pages
236-244issue
3eissn
1062-6050issn
1938-162Xjournal_volume
52pub_type
杂志文章,评审abstract:CONTEXT:Ankle sprains are common problems in acute medical care. The variation in treatment observed for the acutely injured lateral ankle ligament complex in the first week after the injury suggests a lack of evidence-based management strategies for this problem. OBJECTIVE:To analyze the effectiveness of applying res...
journal_title:Journal of athletic training
pub_type: 杂志文章,meta分析,评审
doi:10.4085/1062-6050-47.4.14
更新日期:2012-07-01 00:00:00
abstract:CONTEXT:Scapular rehabilitation exercises should focus on selective activation of weaker muscles and minimal activation of hyperactive muscles. For rehabilitation of overhead athletes, single-plane open chain exercises below 90° of shoulder elevation are often recommended. Moreover, incorporating the kinetic chain in s...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-136-19
更新日期:2020-04-01 00:00:00
abstract:CONTEXT:Researchers have examined the physical activity (PA) habits of certified athletic trainers; however, none have looked specifically at athletic training students. OBJECTIVE:To assess PA participation and constraints to participation among athletic training students. DESIGN:Cross-sectional study. SETTING:Entry...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-49.3.56
更新日期:2015-02-01 00:00:00
abstract:CONTEXT:Athletic directors are charged with making impactful decisions for secondary school athletic programs that mitigate risk for stakeholders involved. This includes decision-making regarding the provision of medical care for student-athletes. To date, limited research has explored athletic directors' perceptions o...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/54-20
更新日期:2020-11-05 00:00:00
abstract::States regulate professions to protect the public from harm by unqualified practitioners. Without regulation of athletic trainers (ATs), there is no legal way to assure quality health care to athletes because there is no legal definition as to what an AT can and cannot do. Problems exist, however; 1) ATs nationwide ma...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:CONTEXT:Thermal responses of average-sized male subjects (mass of approximately 70 kg) may not accurately reflect the rate of heat storage in larger athletes with greater muscle mass. OBJECTIVE:To determine if core temperature (T(c)) is different in National Football League linemen and backs and if T(c) is related to ...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:CONTEXT:Cooling jackets are a common method for removing stored heat accumulated during exercise. To date, the efficiency and practicality of different types of cooling jackets have received minimal investigation. OBJECTIVE:To examine whether a cooling jacket containing a phase-change material (PC17) results in more r...
journal_title:Journal of athletic training
pub_type: 杂志文章,随机对照试验
doi:10.4085/1062-6050-45.2.164
更新日期:2010-03-01 00:00:00
abstract:CONTEXT:Female athletic trainers (ATs) are currently underrepresented in the collegiate setting. Parenting and family obligations may play a role in this underrepresentation. OBJECTIVE:To examine female ATs' perspectives on parenting and working in the secondary school and collegiate employment settings. DESIGN:Cross...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-45.5.459
更新日期:2010-09-01 00:00:00
abstract:CONTEXT:The ingestion of carbohydrate (CHO) before and during exercise and at halftime is commonly recommended to soccer players for maintaining blood glucose concentrations throughout match play. However, an exercise-induced rebound glycemic response has been observed in the early stages of the second half of simulate...
journal_title:Journal of athletic training
pub_type: 杂志文章,随机对照试验
doi:10.4085/1062-6050-49.3.12
更新日期:2014-07-01 00:00:00
abstract:CONTEXT:Many athletes continue to participate in practices and games while experiencing concussion-related symptoms, potentially predisposing them to subsequent and more complicated brain injuries. Limited evidence exists about factors that may influence concussion-reporting behaviors. OBJECTIVE:To examine the influen...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-48.3.20
更新日期:2013-09-01 00:00:00
abstract:CONTEXT:Deficits in dynamic postural control predict lower limb injury. Differing fatiguing protocols negatively affect dynamic postural control. The effect of high-intensity, intermittent exercise on dynamic postural control has not been investigated. OBJECTIVE:To investigate the effect of a high-intensity, intermitt...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-49.6.08
更新日期:2015-04-01 00:00:00
abstract:CONTEXT:With regard to intermittent training exercise, the effects of the mode of recovery on subsequent performance are equivocal. OBJECTIVE:To compare the effects of 3 types of recovery intervention on peak torque (PT) and electromyographic (EMG) activity of the knee extensor muscles after fatiguing isokinetic inter...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-46.4.386
更新日期:2011-07-01 00:00:00
abstract::Various continental sporting events have exposed team sports referees to different environmental conditions. Several studies have focused on strategies to prevent athlete performance impairment induced by heat or warm (or both) conditions, but few authors have investigated the effect of heat on referees' performance. ...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-51.3.04
更新日期:2016-03-01 00:00:00
abstract:CONTEXT:Athletic trainers (ATs) know to diagnose exertional heat stroke (EHS) via rectal thermometry (T(re)) and to treat EHS via cold-water immersion (CWI) but do not implement these recommendations in clinical practice. OBJECTIVE:To gain an understanding of educational techniques used to deliver content regarding EH...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-46.5.523
更新日期:2011-09-01 00:00:00
abstract:CONTEXT:A narrow base of gait (BOG), the mediolateral distance between the foot and the body's line of gravity at midstance, during running is a suggested cause of injuries such as iliotibial band syndrome and tibial stress injury. However, an understanding of modifiable and nonmodifiable factors that influence BOG is ...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-565-19
更新日期:2020-12-01 00:00:00
abstract:CONTEXT: Seventy-seven percent of musculoskeletal injuries sustained by United States Army Special Forces Operators are preventable. Identification of predictive characteristics will promote the development of screening methods to augment injury-prevention programs. OBJECTIVE: To determine physical and performance c...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-52.12.22
更新日期:2017-12-01 00:00:00
abstract:CONTEXT: It is important to understand the process whereby athletic trainers learn about their future roles, particularly when the roles can be complex and demanding. Little is known about the experiences of athletic training doctoral students, including facilitators and barriers to socialization as aspiring faculty m...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-52.7.01
更新日期:2017-10-01 00:00:00
abstract:CONTEXT:Exercise in the heat produces cellular conditions that may leave skeletal muscle susceptible to exercise-induced microdamage. Delayed-onset muscle soreness (DOMS) is a clinical model of contraction-induced skeletal muscle injury. OBJECTIVE:To determine whether thermoregulation during exercise heat stress adver...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE: To present recommendations for the diagnosis, management, outcomes, and return to play of athletes with superior labral anterior-posterior (SLAP) injuries. BACKGROUND: In overhead athletes, SLAP tears are common as either acute or chronic injuries. The clinical guidelines presented here were developed bas...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-59-16
更新日期:2018-03-01 00:00:00
abstract:CONTEXT:Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided efforts to collect data on ice hockey injuries. OBJECTIVE:To describe the epidemiology of injuries sustained in hi...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-176-17
更新日期:2018-12-01 00:00:00
abstract::OBJECTIVE: To explain the ethnographic, phenomenologic, and grounded theory approaches to qualitative research and to describe how these approaches can be applied to contemporary topics related to athletic training education. BACKGROUND: Athletic training education has recently experienced an increase in the use of qu...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:
更新日期:2002-12-01 00:00:00
abstract::OBJECTIVE: Our objectives were to describe the preoperative mood levels and psychological readiness levels of patients undergoing primary reconstruction of the anterior cruciate ligament (ACL) and to examine differences between adolescent and adult sports medicine patients relative to psychological readiness for ACL s...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:
更新日期:2003-06-01 00:00:00
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journal_title:Journal of athletic training
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract:CONTEXT:The ratio of clinicians to patients has been associated with health outcomes in many medical contexts but has not been explored in collegiate sports medicine. The relationship between administrative and financial oversight models and staffing is also unknown. OBJECTIVE:To (1) evaluate staffing patterns in Nati...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:10.4085/1062-6050-0463-19
更新日期:2020-06-23 00:00:00
abstract:OBJECTIVE:Researchers have produced a hypothesis of transient heat intolerance (HI) after exertional heat stroke (EHS). Based on this hypothesis, heat-tolerance testing (HTT) has been postponed until weeks 6 to 8 after EHS and other types of exertional heat illness (EHI). We compared the HTT results of participants aft...
journal_title:Journal of athletic training
pub_type: 杂志文章
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更新日期:2020-03-01 00:00:00
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journal_title:Journal of athletic training
pub_type: 杂志文章
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更新日期:2009-09-01 00:00:00
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journal_title:Journal of athletic training
pub_type: 杂志文章
doi:
更新日期:2005-10-01 00:00:00
abstract::In this study, I investigated and analyzed the various joint motions in the shoulders of college baseball players. Twenty-six players (age=20.38+/-1.36 yr) from two colleges were examined for upper extremity range of motion (ROM), including shoulder flexion, extension, internal rotation at 90 degrees abduction, and ex...
journal_title:Journal of athletic training
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::OBJECTIVE: To document neurocognitive and neurobehavioral consequences of 1 versus 2 concussions. DESIGN AND SETTING: Nonequivalent, pretest-posttest cohort design with multiple dependent measures. Participants were selected from a large sample of athletes who participated in a comprehensive, multiuniversity study of ...
journal_title:Journal of athletic training
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doi:
更新日期:2001-09-01 00:00:00
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journal_title:Journal of athletic training
pub_type: 杂志文章
doi:
更新日期:2006-07-01 00:00:00