Context: Evidence suggests that athletes engaging in high-intensity activities after concussion have more difficulties with cognitive recovery. Objective: To examine the role postinjury activity level plays in postconcussive symptoms and performance on neurocognitive tests in a population of student-athletes. Design: Retrospective cohort study with repeated measures of neurocognitive performance and symptom reporting. Setting: University-based sports concussion clinic. Patients or Other Participants: Ninety-five student-athletes (80 males, 15 females: age = 15.88 ± 1.35 years) were retrospectively assigned to 1 of 5 groups based on a postinjury activity intensity scale. Main Outcome Measure(s): We employed a regression analysis for repeated measures to evaluate the relationship of activity intensity to symptoms and neurocognitive outcome up to 33 days after concussion. Postconcussion symptom scores and neurocognitive (verbal memory, visual memory, visual motor speed, and reaction time) scores served as the primary outcome measures. Results: Level of exertion was significantly related to all outcome variables (P < .02 for all comparisons). With multivariate analysis, activity intensity remained significant with respect to visual memory (P = .003) and reaction time (P < .001). Conclusions: Activity level after concussion affected symptoms and neurocognitive recovery. Athletes engaging in high levels of activity after concussion demonstrated worse neurocognitive performance. For these tasks, those engaging in moderate levels of activity demonstrated the best performance.

OBJECTIVE. To determine the relationship between recorded head accelerations and impact locations and acute clinical outcome of symptomatology, neuropsy

OBJECTIVE. There exists a need to better understand the biomechanical forces associated with head impacts in American football. The purpose of this stud

To summarize the factors associated with athletes' disclosure-and non-disclosure-of sports-related concussion and concussion symptoms within the context of the socio-ecological framework and to identify research gaps in the current literature. Searches using electronic databases identified studies written in English, published through October 2013 and addressing some aspect of disclosure of concussion and concussion symptoms. The literature search aimed to be comprehensive and inclusive of all previous contributions. Of the 30 identified studies, most originated from the US (n = 19) and sampled athletes (n = 21) and coaches (n = 10) from high school (n = 11) and college levels (n = 9). The identified reasons for non-disclosure were organized into four levels using the socio-ecological framework: intra-personal (e.g. lack of knowledge; internal pressure; sex; concussion history; n = 20 studies); inter-personal (e.g. others' knowledge/attitudes; external pressure; external support; n = 15 studies); environment (e.g. access to concussion prevention materials; sports culture; n = 4 studies); and policy (e.g. concussion-related legislation; n = 3 studies). No study examined all four levels. Research gaps exist concerning factors influencing athletes' disclosure of sports-related concussions and concussion symptoms. Notably, researchers have focused on intra-personal and inter-personal levels, placing less emphasis on the environment and policy levels.

Previous concussion biomechanics research has relied heavily on the animal model or laboratory reconstruction of concussive injuries captured on video footage. Real-time data collection involves a novel approach to better understanding the medical issues related to sport concussion. Recent studies suggest that a concussive injury threshold is elusive and may, in fact, be irrelevant when predicting the clinical outcome.

Objectives: To examine the correction of posture, increase in strength and decrease in shoulder pain and dysfunction in varsity swimmers. Design and Setting: Randomised clinical trial. Participants: Twenty-eight National Collegiate Athletic Association division I varsity swimmers. Measurements: Two testing sessions were conducted before and after an 8-week time period. Posture, strength and shoulder pain and function were assessed. Forward head angle was measured using a digital inclinometer, forward head translation was measured using a ruler and total scapular distance was measured with unmarked string. Average and peak values (N) of strength were measured with the hand-held dynamometer. The intervention subjects then participated in an 8-week exercise training programme to correct posture. The procedures were then repeated in the post-test. Results: Significant group by time interactions (p<0.05) were found in forward head angle and forward shoulder translation indicating a decrease in forward head angle and forward shoulder translation. Significant main effects for time (p<0.05) were found in strength measures for all muscle groups indicating increased strength for shoulder girdle muscles tested. Conclusions: The exercise intervention was successful at decreasing forward head and rounded shoulder postures in elite swimmers. This study supports the theoretical basis for clinical rehabilitation of posture and the shoulder.