Head injury mechanisms in FIS World Cup alpine and freestyle skiers and snowboarders
- Authors: Steenstrup, Sophie , Bakken, Arnhild , Bere, Tone , Patton, Declan , Bahr, Roald
- Date: 2018
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 52, no. 1 (2018), p. 61-69
- Full Text: false
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- Description: Introduction Head injuries represent a concern in skiing and snowboarding, with traumatic brain injuries being the most common cause of death. Aim To describe the mechanisms of head and face injuries among World Cup alpine and freestyle skiers and snowboarders. Methods We performed a qualitative analysis of videos obtained of head and face injuries reported through the International Ski Federation Injury Surveillance System during 10 World Cup seasons (2006-2016). We analysed 57 head impact injury videos (alpine n=29, snowboard n=13, freestyle n=15), first independently and subsequently in a consensus meeting. Results During the crash sequence, most athletes (84%) impacted the snow with the skis or board first, followed by the upper or lower extremities, buttocks/pelvis, back and, finally, the head. Alpine skiers had sideways (45%) and backwards pitching falls (35%), with impacts to the rear (38%) and side (35%) of the helmet. Freestyle skiers and snowboarders had backwards pitching falls (snowboard 77%, freestyle 53%), mainly with impacts to the rear of the helmet (snowboard 69%, freestyle 40%). There were three helmet ejections among alpine skiers (10% of cases), and 41% of alpine skiing injuries occurred due to inappropriate gate contact prior to falling. Athletes had one (47%) or two (28%) head impacts, and the first impact was the most severe (71%). Head impacts were mainly on snow (83%) on a downward slope (63%). Conclusion This study has identified several characteristics of the mechanisms of head injuries, which may be addressed to reduce risk.
Sports injuries in Victoria, 2012-13 to 2014-15 : Evidence from emergency department records
- Authors: Fernando, Tharanga , Berecki-Gisolf, Janneke , Finch, Caroline
- Date: 2018
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 208, no. 6 (2018), p. 255-260
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- Description: Objectives: To report the incidence of presentations to emergency departments (EDs) in Victoria for sport-and active recreation-related injuries; to establish which sports have the highest rates of injury per participant; to assess the effects of age and sport type on the rate of serious sport injury (resulting in admission to hospital). Design, setting and participants: Retrospective analysis of 171 541 ED presentations to 38 Victorian hospitals, 2012-13 to 2014-15. Sports-and active recreation-related injuries in people aged 5 years or more were identified from coded data and by text searches. Main outcome measures: Population rates of injuries by sport and ranking of sports by per participant injury rates (for people aged 15 years or more); proportions of presenting patients subsequently admitted to hospital (serious sport injuries) (for people aged 5 years or more). Results: During 2012-13 to 2014-15, there were 171 541 presentations to EDs with sports-related injuries. Sports most commonly associated with presentation by people aged 15 years or more were Australian football, motor sports, and cycling/ BMX; the highest per participant injury rates (people aged 15 or more) were for motor sports, rugby, and skateboarding/inline hockey/roller sports. 11% of ED patients aged 5 years or more were subsequently admitted to hospital; the odds of admission were highest for those with injuries from motor sports, horse riding, or cycling/BMX. Conclusions: Assessing sports injury rates corrected for participation rates and evaluating the relative severity of injuries is important for monitoring safety. Our findings can assist decisions about which sports should be the focus of injury prevention efforts.
Traumatic cricket-related fatalities in Australia : A historical review of media reports
- Authors: Brukner, Peter , Gara, Thomas , Fortington, Lauren
- Date: 2018
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 208, no. 6 (2018), p. 261-264
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- Description: The known The tragic death of Phillip Hughes in 2014 challenged the perception that cricket is a safe sport. The new 174 trauma-related deaths in cricket over 152 years were identified: 83 in organised settings, 91 in informal play. The number of fatalities appears to have dropped dramatically in the past 30 years, probably reflecting the adoption of helmets by batsmen and close-in fielders. All recent deaths were caused by chest and neck injuries. The implications Fatal injuries resulting fromdirect trauma in cricket are rare in Australia. Continued investigation of chest and neck protection is important for preventing further fatalities.
What is the definition of sports-related concussion : A systematic review
- Authors: McCrory, Paul , Feddermann-Demont, Nina , Dvorak, Jiri , Cassidy, David , McIntosh, Andrew , Vos, Pieter , Echemendia, Ruben , Meeuwisse, Willem , Tarnutzer, Alexander
- Date: 2017
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 51, no. 11 (2017), p. 877-887
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- Description: Objectives: Various definitions for concussion have been proposed, each having its strengths and weaknesses. We reviewed and compared current definitions and identified criteria necessary for an operational definition of sports-related concussion (SRC) in preparation of the 5th Concussion Consensus Conference (Berlin, Germany). We also assessed the role of biomechanical studies in informing an operational definition of SRC. Design: This is a systematic literature review. Data sources: Data sources include MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Clinical Trials and SPORT Discus (accessed 14 September 2016). Eligibility criteria for selecting studies: Eligibility criteria were studies reporting (clinical) criteria for diagnosing SRC and studies containing SRC impact data. Results: Out of 1601 articles screened, 36 studies were included (2.2%), 14 reported on criteria for SRC definitions and 22 on biomechanical aspects of concussions. Six different operational definitions focusing on clinical findings and their dynamics were identified. Biomechanical studies were obtained almost exclusively on American football players. Angular and linear head accelerations linked to clinically confirmed concussions demonstrated considerable individual variation. Summary/conclusions: SRC is a traumatic brain injury that is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces with several common features that help define its nature. Limitations identified include that the current criteria for diagnosing SRC are clinically oriented and that there is no gold/standard to assess their diagnostic properties. A future, more valid definition of SRC would better identify concussed players by demonstrating high predictive positive/negative values. Currently, the use of helmet-based systems to study the biomechanics of SRC is limited to few collision sports. New approaches need to be developed to provide objective markers for SRC. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.
A preliminary video analysis of concussion in the National Rugby League
- Authors: Gardner, Andrew , Iverson, Grant , Quinn, Tanya , Makdissi, Michael , Levi, Christopher , Shultz, Sandy , Wright, David , Stanwell, Peter
- Date: 2015
- Type: Text , Journal article
- Relation: Brain Injury Vol. 29, no. 10 (2015), p. 1182-1185
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- Description: Primary objective: To conduct the first video analysis of concussion in the Australian National Rugby League (NRL) and describe player and injury characteristics, situational factors and time to return to play.Research design: Descriptive, observational case series.Methods and procedures: Video analysis of 20 medically diagnosed concussions for three consenting clubs during the 2013 NRL season.Main outcome and results: Most concussions (83%) occurred during a high tackle, and all injured ball carriers were hit high. Loss of consciousness was observed in 30% of cases. Common observable signs of injury included clutching of the head, balance problems or wobbly legs and a blank or vacant state. There were no post-concussive seizures. All players with loss of consciousness were removed from play. However, only half of the total sample was removed from play and one athlete who was removed returned to play in the same match. Of the players who were removed from play, the large majority returned the following week. Illegal play accounted for 25% of all concussions.Conclusions: Video analysis may be a useful method to study the incidence, mechanism and management of concussion in sports such as Rugby League. Future studies may include larger numbers to validate this preliminary data and may also investigate other levels of play and age ranges. © 2015 Taylor and Francis Group, LLC.
What are the most effective risk-reduction strategies in sport concussion?
- Authors: Benson, Brian , McIntosh, Andrew , Maddocks, David , Herring, Stanley , Raftery, Martin , Dvorak, Jiri
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 47, no. 5 (2013), p. 321-326
- Full Text: false
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- Description: Aim To critically review the evidence to determine the efficacy and effectiveness of protective equipment, rule changes, neck strength and legislation in reducing sport concussion risk. Methods Electronic databases, grey literature and bibliographies were used to search the evidence using Medical Subject Headings and text words. Inclusion/ exclusion criteria were used to select articles for the clinical equipment studies. The quality of evidence was assessed using epidemiological criteria regarding internal/external validity (eg, strength of design, sample size/power, bias and confounding). Results No new valid, conclusive evidence was provided to suggest the use of headgear in rugby, or mouth guards in American football, significantly reduced players' risk of concussion. No evidence was provided to suggest an association between neck strength increases and concussion risk reduction. There was evidence in ice hockey to suggest fair-play rules and eliminating body checking among 11-years-olds to 12-years-olds were effective injury prevention strategies. Evidence is lacking on the effects of legislation on concussion prevention. Equipment self-selection bias was a common limitation, as was the lack of measurement and control for potential confounding variables. Lastly, helmets need to be able to protect from impacts resulting in a head change in velocities of up to 10 and 7 m/s in professional American and Australian football, respectively, as well as reduce head resultant linear and angular acceleration to below 50 g and 1500 rad/s2, respectively, to optimise their effectiveness. Conclusions A multifactorial approach is needed for concussion prevention. Future well-designed and sportspecific prospective analytical studies of sufficient power are warranted.