Academic Accommodations for a Countywide Concussion High School Program

Authors: Ashley D. Lopez, M.S.; Michelle Shnayder; Bryan Pomares, M.H.S.; Jonathan Siegel; Kester Nedd, D.O.; Gillian Hotz, Ph.D.

Corresponding Author:
Gillian Hotz, Ph.D.
1095 NW 14th Ter
Miami, FL 33136
ghotz@med.miami.edu
302-243-4004

Gillian A. Hotz, PhD is a research professor at the University Of Miami Miller School Of Medicine and a nationally recognized behavioral neuroscientist and expert in pediatric and adult neurotrauma, concussion management, and neurorehabilitation. Dr. Hotz is the director of the KiDZ Neuroscience Center, WalkSafe and BikeSafe programs, and has been co-director of the Miller School of Medicine’s Concussion Program since 1995. She continues to assess and treat many athletes from Miami-Dade County public and private high schools, University of Miami, and from other colleges and the community.
Academic Accommodations for a Countywide Concussion High School Program

ABSTRACT

Purpose
To describe a symptom-based distribution of Return to Learn school academic accommodations for adolescent student-athletes recovering from sports-related concussions that can be facilitated as part of their post-injury clinical care. The aim was also to explore demographic and recovery differences between those patients who received and did not receive accommodations.

Method
Adolescent student-athletes from 35 public high schools were eligible for this study. Data collected included their demographics, clinical assessment, and ImPACT (ImPACT Applications, Inc.) testing performance prior to and following a concussion. Student-athletes receiving accommodations were compared with an age-matched comparison group that did not receive accommodations.

Results
Between January 2014 and January 2017, 308 Miami-Dade County public high school student-athletes were seen at the University of Miami’s UConcussion Clinic. Of these, 72 received school accommodations and 236 did not. The first clinical visit for these athletes was a mean of 14 days post injury with mean recovery time and return to play of 25 days. Significant differences were found among female student-athletes as well as patients reporting more initial symptoms despite similar demographics and baseline ImPACT scores.

Conclusions
Concussed adolescent student-athletes, particularly females, reporting greater symptom complaints during their first clinical encounter, may benefit most from a collaborative treatment approach including school accommodations that are individualized and specifically targeted. Future research should continue to investigate accommodation adherence and long-term concussion recovery.

Applications In Sports
Student-athletes receiving academic accommodations may return to play sooner, as academic accommodations allow them to recover from injuries at a quicker pace.
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2017-12-26T08:43:37+00:00December 28th, 2017|Research, Sports Medicine|Comments Off on Academic Accommodations for a Countywide Concussion High School Program

The Evaluation of Exercise-Induced Hematuria in Endurance Athletes

Authors:
Gregory Marshall, RN, BSN, MSN-S
Devinder Jarial, RN, BSN, MSN-S
Dr. Jessica L. Durbin, DNP, FNP-BC

Corresponding Author:
Devinder Jarial, RN, BSN, MSN-S
8942 Bryant Lane Apartment 1A
Indianapolis, IN 46250
dsjarial@gmail.com
317-213-7904

Gregory Marshall and Devinder Jarial are graduate students at Indiana State University completing their Master of Science in Nursing degrees with a family nurse practitioner concentration. Dr. Jessica Durbin is an Assistant Professor in the Department of Advanced Nursing Practice at Indiana State University.

The Evaluation of Exercise-Induced Hematuria in Endurance Athletes

ABSTRACT
Microscopic hematuria can be defined as the presence of greater (>) than 3 red blood cells per milliliter (mL) detected on a high-powered microscopic field, or > 50 red blood cells per mL of urine present on a urine dipstick (14). Exercise-induced hematuria in healthy young adults is not usually associated with significant morbidity or mortality (15). Moderate exercise-induced hematuria is seen habitually, both in athletes and in the general public (14). However, hematuria can be a signal of more serious diseases (15). In endurance athletes, the microscopic hematuria is often self-limiting and resolves within 48-72 hours (1). The abnormal presence of red blood cells in urine may indicate kidney inflammation, infection or trauma in the urinary tract, or neoplastic diseases in the urogenital tract (6). If hematuria doesn’t resolve within 48-72 hours, providers should consider further evaluation. Diagnostics and interventions should be adapted to the individual based on the history of present illness, age, and past medical history. Future research on this topic could be adapted to evaluating and treating microscopic hematuria in multiple sports and activities.
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2017-12-11T11:35:50+00:00December 14th, 2017|Sports Medicine|Comments Off on The Evaluation of Exercise-Induced Hematuria in Endurance Athletes

St. Luke’s Virtual Concussion Clinic: A Unique Structure to Provide Comprehensive Care for Patients

Authors:
Kurt J. Nilsson, MD, MS
St. Luke’s Health System
St. Luke’s Concussion Clinic

Hilary Flint, PhD, MPH
St. Luke’s Health System
St. Luke’s Research

Janet Reis, PhD
Boise State University
College of Health Sciences
Office of Research

Krisi Pardue, CCC-SLP, CBIS
St. Luke’s Health System
St. Luke’s Concussion Clinic

Corresponding Author:
Kurt J. Nilsson, MD, MS
St. Luke’s Health System
St. Luke’s Concussion Clinic
600 N. Robbins Rd, Boise, ID 83702
208-383-2665
knilsson@slhs.org

St. Luke’s Virtual Concussion Clinic: A Unique Structure to Provide Comprehensive Care for Patients

ABSTRACT
Purpose: Failure to provide timely assessment and management of patients with concussions creates prolonged challenges for patients and primary care providers by disrupting work and school, interpersonal and family relationships, and placing patients at risk of injury. Thus, it is essential to provide timely and appropriate care to minimize post-concussion symptoms. The development of a virtual concussion clinic with a central referral and care coordination system is described. Additionally, key identifiers of virtual clinic patients are presented.

Methods: Intake and referral processes were implemented within 18 specialty clinics and 3 emergency departments. All patients (n= 623) completed a modified version of the Centers for Disease Control (CDC) Acute Concussion Evaluation (ACE) Form prior to their referred appointment with a clinician. Data was collected over a year and a half period.

General linear models compared the ACE domains and overall ACE scores with fixed variables of gender and cause of concussion.

Results: For our sample, most referrals came from emergency departments and primary care physicians. The sample was majority male (57%), with mean age 21.8 years. Females playing soccer, basketball, and cheerleading were most likely to have a concussion, whereas football represented 65% of concussions in male patients.

Significant effects for gender (p <0.02) were observed for all ACE domains except for Cognitive, and cause of concussion (p < .001) was significant for all ACE domains. The interaction between gender and cause of concussion (p=0.02) on the Physical ACE domain was significant. Conclusions: A virtual concussion clinic can successfully match the patient and his/her individual health care needs to an appropriate provider. Results demonstrate gender and cause of concussion impact evaluation, and warrants further research to discern optimal care for patients with concussion.
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2017-09-13T11:51:32+00:00October 26th, 2017|Sports Medicine|Comments Off on St. Luke’s Virtual Concussion Clinic: A Unique Structure to Provide Comprehensive Care for Patients

The Value of Athletic Training Employment in Secondary School Athletics

Authors: Rachele E. Vogelpohl, PhD, ATC

Corresponding Author:
Rachele E. Vogelpohl
109 HC Nunn Drive
Highland Heights, KY 41099
vogelpohlra@nku.edu
859-572-5623

Rachele Vogelpohl is an assistant professor and Athletic Training Program director at Northern Kentucky University, and is a certified athletic trainer. She graduated from Northern Kentucky University with a bachelor’s degree and from the University of Hawaii, Manoa with both a master’s and doctoral degree.

The Value of Athletic Training Employment in Secondary School Athletics

ABSTRACT
Millions of secondary school students participate in interscholastic athletics each year, and unfortunately, injuries occur. Athletic trainers are health care providers specifically trained in injury prevention, diagnosis, and rehabilitation. Employment of an athletic trainer in the secondary school setting ensures that the student athletes are participating in a safe environment, that they are being cared for free of charge, and that emergency situations are handled in the proper way.
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2017-07-11T08:57:36+00:00August 31st, 2017|Commentary, Sports Medicine|Comments Off on The Value of Athletic Training Employment in Secondary School Athletics

Cardiopulmonary Resuscitation and Automated External Defibrillator Certification of Club Coaches in Alaska, Idaho, Oregon, Montana, and Washington

Authors: Jessica M. Kerns, MSAT, LAT, ATC; Dani M. Moffit, PhD, LAT, ATC

Corresponding Author:
Jessica M. Kerns
Sport Science and Physical Education Department
219 S. 8th Avenue, Stop 8105
Pocatello, ID 83209-8105
208-996-6737
harrjes3@isu.edu

Cardiopulmonary Resuscitation and Automated External Defibrillator Certification of Club Coaches in Alaska, Idaho, Oregon, Montana, and Washington

ABSTRACT
Cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) qualifications for coaches within club sport systems appear largely unregulated. This is a concern because CPR/AED qualifications should be a safety consideration. This study attempted to identify the prevalence of CPR and AED certification for club sport coaches in five states, as well as assess the availability of AEDs at practices and games. Not all coaches surveyed identified having CPR (n=84, 72.6%) and/or AED (n=83, 75%) training. A majority of coaches reported having an AED at practice (n=43, 54.4%). For games, there were fewer coaches identifying the availability of an AED (n=36, 43.4%). While the majority of coaches report having CPR/AED certification several coaches did not select having both CPR and AED certification although AED is a part of all CPR training courses. There was no consistency as to the availability of an AED at practices or games. Through investigating this topic, it was learned that there is no overarching governing body in club sports and therefore, few agreed upon regulations.

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2016-11-29T11:53:41+00:00January 26th, 2017|Sports Medicine|Comments Off on Cardiopulmonary Resuscitation and Automated External Defibrillator Certification of Club Coaches in Alaska, Idaho, Oregon, Montana, and Washington