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- OʼConnell, Brendan, et al.
(author)
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Use of Blood Biomarkers in the Assessment of Sports-Related Concussion-A Systematic Review in the Context of Their Biological Significance
- 2018
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In: Clinical Journal of Sports Medicine. - : Lippincott Williams & Wilkins. - 1050-642X .- 1536-3724. ; 28:6, s. 561-571
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Research review (peer-reviewed)abstract
- OBJECTIVES: To critically review current knowledge on the positive and negative predictive value of blood biomarkers for concussion; to illustrate the clinical and biological contexts that help evaluate the use of these markers in sport-related traumatic brain injuries (TBIs).METHODS: This systematic review was performed in accordance with PRISMA guidelines. We reviewed the measurement, clinical utility, endpoint, and biological significance of blood biomarkers in concussion.RESULTS: A total of 4352 publications were identified. Twenty-six articles relating to blood biomarkers were included in the review. Four common blood biomarkers, namely S100B, tau, neuron-specific enolase (NSE), and glial fibrillary acidic protein (GFAP), were examined. Overall, the studies showed S100B measurement and use, either acutely or at several time points, can distinguish injured from noninjured patients with an uncertain degree of utility in predicting mortality. At present, S100B has largely become an acceptable biomarker of TBI; however, studies have begun to highlight the need to incorporate clinical symptoms instead of S100B concentration in isolation on the basis of inconsistent results and lack of specificity across published studies. Further research is needed to evaluate and validate the use of tau, NSE, and GFAP as a diagnostic aid in the management of concussion and TBI.CONCLUSIONS: At present, blood biomarkers have only a limited role in the evaluation and management of concussion. Although several biomarkers of brain injury have been identified, continued research is required. S100B holds promise as the most clinically useful diagnostic biomarker. Blood biomarkers, in combination with other clinical data, such as head computed tomography, would maximize the diagnostic accuracy. The methodological limitations evident in blood biomarker research results in the need for the clinical utility of blood biomarker use in concussion to be further explored.
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| 2. |
- Pauelsen, Mascha, et al.
(author)
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Concussion in ice hockey : A Cohort Study Across 29 Seasons
- 2017
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In: Clinical Journal of Sports Medicine. - : Wolters Kluwer. - 1050-642X .- 1536-3724. ; 27:3, s. 283-287
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Journal article (peer-reviewed)abstract
- Objective: The aim of this study was to analyse the concussion incidence rate ratios (IRR) across 29 seasons in a Swedish Hockey League team.Design: Cohort study over 29 seasons within one Swedish elite series ice hockey team. Participants: All players who were part of one Swedish elite ice hockey team during the research period gave consent for participation in the study.Independent Variables: Exposure to top level Swedish ice hockey. Main Outcome Measures: Incidence rate ratio for concussion as well as rehabilitation periods due to concussion were calculated and analysed.Results: During the research period, 267 players in total were part of the team. A total of 1638 traumatic injuries were registered of which 162 were concussions. Incidence rates ranged from 0/1,000 games during the first season to 118/1,000 games for the final recorded season. The incidence rate ratio was 1.06 (CI = 1.03-1.10) for the entire research period. A shift towards longer rehabilitation periods was discovered.Conclusions: This study showed a significant increase of concussion incidence rate and a trend towards longer rehabilitation periods due to concussion. Possible risk factors were discussed. Risk behaviour and rehabilitation protocols should be prioritized areas in the research of concussion in ice hockey.
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| 3. |
- Van Slingerland, Krista J, et al.
(author)
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Canadian Centre for Mental Health and Sport (CCMHS) Position Statement : Principles of Mental Health in Competitive and High-Performance Sport.
- 2019
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In: Clinical Journal of Sports Medicine. - : Wolters Kluwer. - 1050-642X .- 1536-3724. ; 29:3, s. 173-180
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Journal article (peer-reviewed)abstract
- The brave decision made by many Canadian athletes to share their experience with mental illness has fed a growing dialogue surrounding mental health in competitive and high-performance sport. To affect real change for individuals, sport culture must change to meet demands for psychologically safe, supportive, and accepting sport environments. This position statement addresses mental health in competitive and high-performance sport in Canada, presenting solutions to current challenges and laying a foundation for a unified address of mental health by the Canadian sport community. The paper emerged from the first phase of a multidisciplinary Participatory Action Research (PAR) project, in which a sport-focused mental health care model housed within the Canadian Centre for Mental Health and Sport (CCMHS) is currently being designed, implemented, and evaluated by a team of 20 stakeholders, in collaboration with several community partners and advisors.
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