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CTE may affect memory, mood and behavior

iStock_000023508896SmallIf you pay attention to headlines about sports injuries, you’ve probably heard a lot recently about chronic traumatic encephalopathy (CTE), a brain disease associated with repeat brain trauma including concussions in athletes. On August 21, new research was released from the largest CTE study of its kind that shows the disease may impact people in two major ways: initially affecting behavior or mood or initially affecting memory and thinking abilities. CTE has been found in amateur and professional athletes, members of the military and others who experienced repeated head injuries, including concussions and subconcussive trauma.

“This is the largest study to date of the clinical presentation and course of CTE in autopsy-confirmed cases of the disease,” said study author Robert A. Stern, PhD, a professor of neurology and neurosurgery at Boston University School of Medicine. “However, the overall number of cases in the study is still small and there may be more variations in CTE than described here.”

For the study, scientists examined the brains and reviewed medical records of 36 male athletes, ages 17 to 98, diagnosed with CTE after death, and who had no other brain disease, such as Alzheimer’s. The majority of the athletes had played amateur or professional football, with the rest participating in hockey, wrestling or boxing. Family members were also interviewed about the athletes’ life and medical history, specifically dementia, changes in thinking, memory, behavior, mood, motor skills or ability to carry out daily living tasks. Some of the findings included:

  • A total of 22 of the athletes had behavior and mood problems as their first symptoms of CTE, while 11 had memory and thinking problems as their first symptoms. Three of the athletes did not show any symptoms of CTE at the time of death.
  • Those with behavior and mood problems experienced symptoms at a younger age, with the first symptom appearing at an average age of 35, compared to an average age of 59 for those with memory and thinking problems. Almost all people in the mood/behavior group, or 91 percent, experienced symptoms of memory and thinking decline at some point, but fewer in the cognition group experienced mood and behavior symptoms throughout their disease, with 55 percent experiencing behavior symptoms and 64 percent experiencing mood symptoms at some point.
  • The group that experienced mood symptoms was more explosive, out of control, physically and verbally violent and depressed than the group that experienced memory and thinking deficits, with family members reporting that 73 percent of those in the first group were “explosive,” compared to 27 percent in the second group. A total of 64 percent of the first group were described as being “out of control,” compared to 27 percent of the second group, and 68 percent were physically violent, compared to 18 percent. A total of 74 percent were verbally violent, compared to 18 percent. And 86 percent had depression, compared to 18 percent of those with memory symptoms.

The study was supported by the National Institutes of Health, the Department of Veterans Affairs, the National Operating Committee on Standards for Athletic Equipment, the Sports Legacy Institute, the National Football League (NFL) and the Andlinger Foundation. The neuropathological examinations were conducted by Ann McKee, MD, professor of neurology and pathology at BUSM. McKee and Stern were co-founders of the Boston University Center for the Study of Traumatic Encephalopathy, along with neurosurgeon Robert Cantu, MD, and Christopher Nowinski, Executive Director of Sports Legacy Institute.

You can review the study in the August 21, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology. To learn more about concussions, visit www.aan.com/concussion.

Source: This post is based on information provided by American Academy of Neurology.

 


Safe Kids Worldwide reports over one million children visit ER’s annually for sports-related injuries

press_release_thumbnail for safe kidsOn August 5, Safe Kids Worldwide released a new research report indicating that every 25 seconds, or 1.35 million times each year, a young athlete suffers a sports injury severe enough to go to the emergency room. The report,  called “Game Changers,” takes an in-depth look at data from the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) to explore what type of injuries are sidelining young athletes.

According to the report that studied the 14 most popular sports, concussions account for 163,000 of those ER visits, or 12 percent. That’s a concussion-related ER visit every three minutes. Surprisingly, it is not just high school athletes suffering concussions; athletes ages 12 to 15 make up almost half (47%) of the sports-related concussions seen in the ER, a statistic made even more disturbing by the knowledge that younger children with concussions take a longer time to recover than older children.

“We uncovered some surprising and disturbing data about how often our kids are being injured playing sports,” said Kate Carr, president and CEO of Safe Kids Worldwide. “But we also found some inspiring stories from people and programs that are making a marked difference.

The study details both the types of injuries and the rates of injuries for the most popular sports. Not surprising, in 2011, the sport with the most injuries is football, which also has the highest concussion rate. Wrestling and cheerleading have the second and third highest concussion rate. The sport with the highest percent of concussion injuries is ice hockey.

The report also includes profiles of actions some communities, sports leagues, and individual athletes who are taking a proactive stance in order to turn these statistics around. You can Download the Report or helpful Sports Safety Tips from Safe Kids Worldwide here.

Safe Kids Worldwide is a global network of organizations dedicated to providing parents and caregivers with practical and proven resources to protect kids from unintentional injuries, the number one cause of death to children in the United States. Throughout the world, almost one million children die of an injury each year, and every one of these tragedies is preventable. Safe Kids works with an extensive network of more than 600 coalitions in the U.S. and in 23 countries to reduce traffic injuries, drownings, falls, burns, poisonings and more. Since 1988, Safe Kids has helped reduce the U.S. childhood death rate from unintentional injury by 55 percent. Visit www.safekids.org to learn more.


More concussions suffered by NCAA players than we thought?

brock blog april 2013We just read a thought-provoking article by Mike Freeman of CBS Sports.com that focused on an interesting number – 29,225. You see according to the NCAA’s own injury-tracking data, that represents the total number of concussions from all NCAA sports during 2004- 2009 – and over half of them occurred in football, which is more than all other fall sports combined. He wonders if a legion of players entered the NFL already having head trauma from their collegiate days….

Here’s an excerpt from his story:

Of the many accusations springing from what is emerging as a historic legal case against the NCAA, the biggest claims negligence in how the governing body of college athletics monitored and handled concussions for its athletes.

The issues are complicated, but what I mainly wanted to do was examine a number: 29,225.

That, according to the NCAA’s own injury-tracking data, was the total number of concussions from all NCAA sports from 2004-2009.


American Academy of Neurology Updates Sports Concussions Guidelines

AAN logoDid you know that concussions impact more than one million American athletes each year? That’s why the American Academy of Neurology (AAN) released an evidence-based guideline for evaluating and managing athletes with concussions a few months ago.  The updated guidelines, developed through an objective evidence-based review of the literature by a multidisciplinary committee of experts, have been endorsed by a broad range of athletic, medical and patient groups.

“Among the most important recommendations the Academy is making is that any athlete suspected of experiencing a concussion immediately be removed from play,” said co-lead guideline author Christopher C. Giza, MD, with the David Geffen School of Medicine and Mattel Children’s Hospital at UCLA and a member of the AAN. “We’ve moved away from the concussion grading systems we first established in 1997 and are now recommending that concussion and return to play be assessed in each athlete individually. There is no set timeline for safe return to play.”

The updated guideline recommends athletes with suspected concussion be immediately taken out of the game and not returned until assessed by a licensed health care professional trained in concussion, return to play slowly and only after all acute symptoms are gone. Athletes of high school age and younger with a concussion should be managed more conservatively in regard to return to play, as evidence shows that they take longer to recover than college athletes.

Highlights of the updated guideline include:

  • Among the sports in the studies evaluated, risk of concussion is greatest in football and rugby, followed by hockey and soccer. The risk of concussion for young women and girls is greatest in soccer and basketball.
  • An athlete who has a history of one or more concussions is at greater risk for being diagnosed with another concussion.
  • The first 10 days after a concussion appears to be the period of greatest risk for being diagnosed with another concussion.
  • There is no clear evidence that one type of football helmet can better protect against concussion over another kind of helmet. Helmets should fit properly and be well maintained.
  • Licensed health professionals trained in treating concussion should look for ongoing symptoms (especially headache and fogginess), history of concussions and younger age in the athlete. Each of these factors has been linked to a longer recovery after a concussion.
  • Risk factors linked to chronic neurobehavioral impairment in professional athletes include prior concussion, longer exposure to the sport and having the ApoE4 gene.

To learn more, visit http://www.aan.com/concussion.

 


Atlanta High School Students Win the Brock Safety MVP Contest!

Is safety as important as winning to your school sports team? That’s the question students nationwide answered in Brock’s Safety MVP Contest, which was created to recognize U.S. schools that place a high value on student-athlete safety in light of the growing youth sports concussion crisis. A lot of great video submissions were received and top honors went to Atlanta high school juniors Brendan Rosenberg and Jacob Schlanger.

“Our coaches’ start every season talking about safety and making it a priority,” explained Rosenberg. “The school’s philosophy is not ‘to win at all costs’ because each coach wants his or her players to be healthy, safe and have longevity so they can continue to build a winning team season after season.”

Rosenberg, a student at Holy Innocents’ Episcopal School and Schlanger, who attends North Springs High School, took a humorous “Sports Center” approach to the topic as you can see in the video below. Holy Innocents’ Episcopal School will receive the competition’s grand prize of $5,000 worth of sports equipment for their team.

“We were deeply moved by the terrific entries received,” said Dan Sawyer, CEO of Brock International.  “Our team hopes this contest brings more attention to the proactive efforts taken by coaches, schools, parents and America’s youth to reduce the quantity and severity of injuries on the playing field.”

Want to see more of the contest videos received? Visit us on YouTube at:  http://www.youtube.com/user/SaferYouthSports

 


Spotlight on the Youth Concussion Act

iStock_000016583408SmallWe are big believers in truth in advertising. That’s why our team wanted to recognize the Youth Sports Concussion Act, which helps ensure that safety standards for sports equipment used by young athletes are up to date and informed by the latest science. Introduced on May 22, 2013 by U.S. Senators Tom Udall (D-N.M.) and John D. “Jay” Rockefeller IV (D-W.Va.), Chairman of the Senate Committee on Commerce, Science, and Transportation, the legislation seeks to protect youth athletes from the dangers of sports-related traumatic brain injuries by improving equipment safety standards and curbing false advertising claims.

“We want our children to be active and participate in sports, but we must take every precaution to protect them from traumatic head injuries,” said Senator Udall in the press announcement.”There will always be some risk, but athletes, coaches and parents need to be aware of the dangers and signs of concussion. And in order for them to best protect the young athletes, we must make sure they are using safe equipment and curb misleading advertising that gives them a false sense of security.”

During the 2011-2012 school year, more than 300,000 high school athletes in the most common sports were diagnosed with concussions, though many head injuries continue to go unreported and ignored. Researchers have found that children and adolescents are particularly susceptible to concussions and that – once concussed – the likelihood of suffering another increases each time. Sports are the second leading cause of traumatic brain injury for people who are 15 to 24 years old, behind only motor vehicle crashes. Every year American athletes suffer up to an estimated 3.8 million sports-related concussions.

Goals of the Youth Sports Concussion Act:

  • Instruct the Consumer Product Safety Commission (CPSC) to review the findings of a forthcoming National Academy of Sciences (NAS) report on sports-related concussions in youth;
  • Authorize the CPSC to make recommendations to manufacturers and, if necessary, promulgate new consumer rules for protective equipment based on the findings of the NAS report; and
  • Allow the Federal Trade Commission (FTC) to impose civil penalties for using false claims to sell protective gear for sports. State attorneys general could also enforce such violations.

 
What do you think of the Youth Sports Concussion Act?

 

Source:

Senator Tom Udall’s website, Udall, Rockefeller Introduce Bill to Help Protect Young Athletes from Sports-Related Traumatic Brain Injuries, May 22, 2013


The Rise of Youth Sports Concussion Clinics

iStock_000009674442SmallWhen the increasing number of sports concussions in the game of football began dominating the headlines, coaches, school administrators and parents started clamoring for more ways to keep student-athletes safer on the field. Education and legislation focusing on concussion prevention and awareness became more common. Mouth guards, helmets, computerized testing and smart phone applications have taken injury prevention technology to new heights. Attention started shifting to the playing field itself as our sponsor, Brock International, launched the first synthetic turf safety and drainage layer engineered specifically for the ideal footing requirements and safety of high school and middle school athletes.

But one of the most rapidly growing responses to concussion concerns is the proliferation of specialized facilities created to deal with brain injuries and their aftermath.  As this recent New York Times story reports, dozens of youth concussion clinics in the form of outpatient centers connected to large hospitals have opened in nearly 35 states. Like in Boston, where the sports concussion clinic at Massachusetts General Hospital sees spikes in visits and phone calls every time a major story breaks about youth concussions or the long-term effects of brain injuries in professional athletes.

“We are really in the trenches of a new medical experience,” said Richard Ginsburg, the director of psychological services at Massachusetts General Hospital’s youth sports concussion clinic, in the article. “First of all, there’s some hysteria, so a big part of our job is to educate people that 90 percent of concussions are resolved in a month, if not sooner. As for the other 10 percent of patients, they need somewhere to go. So we see them. We see it all.”

From our perspective, we feel that the more people know about the dangers of concussions, the better equipped they will be to prevent them. Specialized treatment centers are meeting a growing need. When an injury is quickly resolved, parents and students alike will have more peace of mind about taking the right steps after the concussion is incurred. And for those with more serious needs, getting the best treatment possible immediately can impact the rest of their lives.

What do you think about the rise of specialized youth sports concussion clinics?


Participating in Multiple Sports Can Help Reduce Youth Injury Levels

iStock_000001221748SmallApril is National Youth Sports Safety Month, but the issue prompts growing concern in parents, coaches and teachers the other 11 months of the year too. According to Healthline, over 20 million kids in the U.S. participate in sports annually and almost one million suffer serious sports related injuries. However, recent research notes that diversifying participation in a multitude of sports and not playing year-round can help reduce injury levels and improve athletic performance.

The study, published in Sports Health: A Multidisciplinary Approach, analyzed articles from 1990 to 2011 for information helping them determine if sports specialization actually helps or hurts kids. Researchers also utilized recent work conducted by the article’s lead author, Dr. Neeri Jayanthi, the medical director of primary care sports medicine at Loyola University Chicago. Dr. Jayanthi’s research evaluated injury rates in 519 tennis players ages 10-18 who spent, on average, 11-15 hours/per week training.

Their results highlighted that kids who specialized in tennis were 1.5 times more likely to get an injury, regardless of their total training time. Performance was also investigated by the researchers and the studies illustrated that in sports like cycling, swimming, and skating, those who started significant training around age 15 were more likely to become elite-level athletes (defined by podium placings in European competitions and top-10 results in World and Olympic events) than their peers who started training earlier.

“Kids often receive pressure from their parents or coaches to be the best in one given sport, when in reality participating in free play and a multitude of sports from an early age is the best strategy to create an outstanding athlete,” said William Levine, MD, Chair of the STOP Sports Injuries Advisory Committee.

STOP (Sports Trauma and Overuse Prevention) Sports Injuries is a comprehensive public outreach program that focuses on the importance of sports safety-specifically relating to overuse and trauma injuries. The initiative not only raises awareness and provides education on injury reduction, but also highlights how playing safe and smart can enhance and extend a child’s athletic career, improve teamwork, reduce obesity rates and create a lifelong love of exercise and healthy activity. Initiated by the American Orthopaedic Society for Sports Medicine (AOSSM) in early 2007, the campaign’s organizational partners include the American Academy of Pediatrics, the National Athletic Trainers’ Association, the American Medical Society for Sports Medicine and SAFE Kids USA.

We recommend checking out the organization’s helpful injury prevention tip sheets specific to numerous sports, ranging from football and field hockey to cheerleading, swimming and lacrosse. Visit www.STOPSportsInjuries.org to learn more about preventing youth sports injuries.

 


Major League Lacrosse Protects Athletes with New Concussion Program

iStock_000010001932SmallUsually it is the safety risks from playing football that make the headlines. But other sports that involve contact between players and field surfaces need to protect participants from concussions too. That’s why Major League Lacrosse (MLL), the premier professional outdoor lacrosse league, has partnered with the Sports Legacy Institute (SLI) to create an innovative, comprehensive concussion program for the 2013 season.  Considering that Major League Lacrosse sets an example for youth sports organizations, the partnership is expected to help protect athletes of all ages.

“Concussions are a critical issue in sports today,” said MLL Commissioner David Gross. “We asked SLI, the experts in the field, to develop the most aggressive program in professional sports so that we can protect our players’ long-term health, ensure longevity of their careers and set a strong example for youth and college sports programs to make concussion care and training a priority.”

The policies, developed by SLI Medical Director and concussion expert Robert Cantu, MD, and SLI Executive Director Chris Nowinski, combine best practices from peer sports leagues while adding new elements focusing on education, reporting, assessment and management. SLI is a Boston-based non-profit organization founded to advance the study, treatment and prevention of brain trauma in athletes and other at-risk groups.

Innovations in the MLL concussion program include:

  • Education: To accelerate culture change, MLL players will participate in two educational sessions, one before and one during the season, as well as be required to complete an online training program and view the documentary Head Games. Coaches, general managers, referees and medical personnel will all be required to meet a minimum educational standard.
  • Remove-from-play: MLL will become the first professional sports organization to mandate the King-Devick test — an objective rapid sideline screening test of concussions that a growing body of studies show is an effective test for concussion — as an additional sideline assessment tool.
  • Concussion Check: A new concept developed by SLI, MLL will pilot a program designed to improve concussion reporting by training MLL personnel to recognize concussion signs and symptoms and emphasize that they have a responsibility to alert the team medical staff or referee. If a teammate, coach, general manager, athletic trainer, physician/doctor, equipment manager, opposing team physician or referee triggers a concussion check, the player must be removed and evaluated by the medical team using the new MLL Sideline Assessment Tool.
  • Concussion Caretaker: A new concept developed by SLI, when a player is diagnosed with a concussion, MLL medical staffs will educate at least one family member and/or caretaker, designated by the player before the season, on concussion management and how to support an athlete recovering from a concussion.
  • Research: MLL will encourage teams to participate in innovative research, including participating in the SLI Hit Count™ Initiative, and encouraging players to participate in research programs, including the brain donation program at the Boston University Center for Study of Traumatic Encephalopathy.

 

“We’re excited about the opportunity to raise the bar and pilot new concepts and look forward an exciting MLL season,” noted Dr. Cantu, who serves as an advisor to the National Football League, National Football League Players Association, Ivy League and co-author of every International Consensus Statement on Concussion in Sport.

To learn more about the program, visit www.majorleaguelacrosse.com or www.sportslegacy.org.

 


New legislation helps coaches put safety first

brock blog april 2013Giving it your all on the football field has been a mantra for high school and college football players for generations. From “Remember the Titans” and “Friday Night Lights” to “The Blind Side,” pop culture has certainly embraced the concept, showing tired, battered student-athletes pushing past the odds to prevail in the end. But that’s not always the best course of action, especially when prospective concussions are involved.

In the past few years, research has proven that returning to the game after suffering a blow to the head can lead to permanent, significant damage. Still it can be challenging for players and coaches pressured to win games to know when it’s time for a student athlete to sit it out. That’s why the South Carolina House of Representatives just passed a bill requiring schools to have a concussion policy for all sports:  As this segment from WJBF-TV in Aiken County, South Carolina attests, new statewide legislation could put a dent in concussions.

“If you don’t tell them you have to do it, they’re going to take the easy path,” says Tim McLane, the Head Athletic Trainer at Georgia Regents Sports Medicine Center, in this news story. “They have enough pressure on them from administrators and the community, ‘you need to win and you need to do it right.’”

The new S.C. Bill requires coaches to go over the statewide concussion policy with players and parents, and if a player shows signs or seems out of it, they’re out of the game.  It is part of a national shift to better protect student-athletes. According to USA Football, 43 states and Washington, D.C., had passed laws by the end of 2012 protecting student-athletes from returning to play too soon after suffering the effects of a concussion. With South Carolina on board, we’re hoping all 50 states have these policies in places soon.

Do you know of a high school that considers safety as important as winning for its sports teams? Encourage them to enter the Brock Safety MVP Contest for the chance to win $5,000 worth of sports equipment for their school. The entry deadline has been extended to May 15, 2013!

 


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Safety Contest
Holy Innocents’ Episcopalian School in Atlanta, Georgia Won $5,000 Worth of Sports Equipment in the Brock Safety MVP National Contest!
When the game clock hits zero and the final buzzer sounds, all that’s left are the stats. But win or lose, each team names one most valuable player for the game. What if safety was named the MVP in every game? What if safety was as important to each player as winning?

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