Browsing by Author "Emery, Carolyn A"

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    Absence of differences between male and female adolescents with prior sport concussion
    (Wolters Kluwer, 2014-01) Brooks, Brian L; Mrazik, Martin; Barlow, Karen M; McKay, Carly D; Meeuwisse, Willem H; Emery, Carolyn A
    Sex differences following concussion are poorly understood. The purpose of this study was to examine whether male and female adolescent athletes with prior concussions differ regarding neurocognitive function and symptom reporting.
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    Consequences of Adolescent Sport-Related Concussion and Musculoskeletal Injury: Examining Long-term Impacts on Body Composition and Physical Activity Levels
    (2024-06-11) Leggett, Benjamin T; Emery, Carolyn A; Schneider, Kathryn J; Smirl, Jonathan D; Eliason, Paul
    Sport-related concussions (SRC) may be encumbering injuries and are experienced in high rates amongst Canadian adolescents participating in sport. Little is known of the long-term effects of SRC in how they may affect both physical activity behaviors and body composition as adults later in life. This thesis examined appropriate algorithms to employ when utilizing Actigraphs as objective measures of free-living physical activity behaviors, and then the body composition levels and physical activity levels of adults (ages 18-33) with a 5–15-year history of either SRC or musculoskeletal (MSK) injury relative to uninjured controls (UC). Data were collected for 268 individuals participating through the SHRed Consequences of Concussion cohort study. Analyses displayed that SRC and MSK injury cohorts relative to UC had comparable body compositions, identified through lean mass and fat mass indices, as well as comparable physical activity behaviors, denoted by daily amounts of sedentary time and light, moderate, moderate-to-vigorous, and vigorous physical activity. This demonstrated that those with adolescent SRC or MSK injury history continue to participate in physically active lifestyles as young adults as evidenced by either maintaining and/or acquiring body compositions and participating in physical activities similar to those without injury history. Future research should take a more granular look at long-term sport-related injury through examining persistent concussion symptoms for those with SRC history as well as type/location of MSK injury in an effort to consider the heterogeneity of these injuries.
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    Injury and concussion in youth female rugby: Evaluating and informing injury and concussion prevention strategies
    (2024-06-17) Shill, Isla Jordan; Emery, Carolyn A; Hagel, Brent E; Palmer, Debbie; Pike, Ian; Stokes, Keith A
    Injury and concussion rates in Canadian female high school rugby are the highest reported in youth rugby. The tackle accounts for the largest proportion of injuries. All injury prevention strategy evaluations are in male populations with none in youth females. This is insufficient to improve female player welfare. Therefore, the objectives of this dissertation were to (1) summarise the rugby injury epidemiology literature within youth female rugby, (2) discuss strengths and limitations of the literature using video analysis for rugby injury epidemiology, (3) evaluate the association between tackle-related characteristics and concussion in female rugby (high school, varsity), and (4) evaluate the effectiveness of a rugby-specific neuromuscular training (NMT) warm-up on injury and concussion in high school female rugby. The association between tackle-related characteristics and suspected concussion was examined using a case-control video analysis study. Within female varsity rugby, ball-carrier concussion was associated with head contact intensity of 2/4 and 3-4/4, illegal and tap tackle, and down head position. Tackler concussion was associated with 3 tacklers in the event, tap tackle, head contact intensity of 3-4/4, and away head position. Within a female high school population, ball-carrier concussion was associated with illegal and trip/collision tackle, increased tackle height compared with knee to upper leg, deceleration and no change of speed, and any head contact. Tackler concussion was associated with 2-3 tacklers in the event, tap or trip/collision tackle, sternum to armpit tackle height, down head position, and any head contact. The effectiveness of a rugby-specific NMT warm-up in high school female rugby players was evaluated using a multi-year quasi-experimental study. There was no difference in injury and concussion rates between control and intervention cohorts, as well as no differences based on adherence to the NMT warm-up. All match and training injury burden were estimated to be lower in those that used a NMT warm-up compared with those that did not. These studies provide a summary of injury prevention evaluations in female rugby. To inform appropriate recommendations for female player safety, a multifaceted approach to injury prevention should be considered. A combination of a NMT warm-up and a tackle injury prevention intervention, such as a tackle training program or tackle law change (e.g., lower legal tackle height), should be considered.
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    Is a history of concussions associated with measures of cervical spine, vestibulo-ocular reflex, oculomotor, and dynamic balance in adolescent (ages 10-19) sport participants?
    (2023-09-18) Sick, Stacy Rochelle; Emery, Carolyn A; Schneider, Kathryn J; Frémont, Pierre; Lun, Victor; Eliason, Paul H
    Objectives: To examine the association between previous history of concussion and measures of the cervical spine, vestibulo-ocular reflex, oculomotor, and dynamic balance in adolescent (aged 10-19 years) sport participants. Participants: 1653 adolescents [988 (59.77%) male; 653 (39.50%) females; 12 (0.73%) undisclosed] participating in SHRed Concussions (Surveillance in High school and community to REDuce the risk of Concussion and their consequences). Assessment of Risk Factors: Generalized estimating equations were used to examine the association of clinical outcomes with previous number of concussions (0, 1, 2+). Model covariates included age (years), sex (male/female), baseline symptom severity score (xx/132), and sport type (collision/non-collision). Outcome Measures: Cervical [Range of motion (ROM), flexor endurance (CFE), flexion-rotation test (CFRT), head perturbation (HPT)], vestibulo-ocular reflex [head thrust (HTT), dynamic visual acuity (DVA)], oculomotor (symptom provocation / performance on smooth pursuit, horizontal and vertical saccades, and convergence) and dynamic balance [combined functional gait assessment (C-FGA)]. Results: An association was found between concussions history and clinical outcomes of vertical saccades symptom [OR1 relative to 0: 2.02, (1.09-3.76)] convergence performance [OR1 relative to 0: 2.02 (1.09-3.76)] and errors on CFA [OR2+ relative to 0 -0.14, (-0.58-0.30)]. In addition, the association between concussion history was modified by sex for the CFRT [OR males 1 relative to 0: 0.52 (0.27-0.99)], horizontal saccades symptom [OR females 2+ relative to 0: 4.08 (1.56-10.65)], vertical saccade performance [OR females 2+ relative to 0: 2.25 (1.30-3.92)], and HTT [OR females 1 relative to 0: 2.25 (1.30-3.92)]; OR females 2+ relative to 0: 2.25 (1.30-3.92); OR females 2+ relative to 0: 2.25 (1.30-3.92)]. Conclusion: Differences based on concussion history existed in all clinical domains, with females with a history of concussion(s) typically having poorer outcomes. Future research is needed to better understand the relationship between concussion history and clinical outcomes.
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    Subjective, but not objective, lingering effects of multiple past concussions in adolescents
    (Mary Ann Liebert, Inc., 2013-09-01) Brooks, Brian L; McKay, Carly D; Mrazik, Martin; Barlow, Karen M; Meeuwisse, Willem H; Emery, Carolyn A
    The existing literature on lingering effects from concussions in children and adolescents is limited and mixed, and there are no clear answers for patients, clinicians, researchers, or policy makers. The purpose of this study was to examine whether there are lingering effects of past concussions in adolescent athletes. Participants in this study included 643 competitive Bantam and Midget hockey players (most elite 20% by division of play) between 13 and 17 years of age (mean age=15.5, SD=1.2). Concussion history at baseline assessment was retrospectively documented using a pre-season questionnaire (PSQ), which was completed at home by parents and players in advance of baseline testing. Players with English as a second language, self-reported attention or learning disorders, a concussion within 6 months of baseline, or suspected invalid test profiles were excluded from these analyses. Demographically adjusted standard scores for the five composites/domains and raw symptom ratings from the brief Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) computerized battery were analyzed. Adolescent athletes with one or two or more prior concussions did not have significantly worse neurocognitive functioning on ImPACT than did those with no previous concussions. There were significantly more symptoms reported in those with two or more prior concussions than in those with no or one prior concussion. Adolescents with multiple previous concussions had higher levels of baseline symptoms, but there were not group differences in neurocognitive functioning using this brief computerized battery.
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    The built environment and active transportation safety in children and youth: a study protocol
    (2019-06-11) Hagel, Brent E; Macpherson, Alison; Howard, Andrew; Fuselli, Pamela; Cloutier, Marie-Soleil; Winters, Meghan; Richmond, Sarah A; Rothman, Linda; Belton, Kathy; Buliung, Ron; Emery, Carolyn A; Faulkner, Guy; Kennedy, Jacqueline; Ma, Tracey; Macarthur, Colin; McCormack, Gavin R.; Morrow, Greg; Nettel-Aguirre, Alberto; Owens, Liz; Pike, Ian; Russell, Kelly; Torres, Juan; Voaklander, Donald; Embree, Tania; Hubka, Tate
    Abstract Background Active transportation, such as walking and biking, is a healthy way for children to explore their environment and develop independence. However, children can be injured while walking and biking. Many cities make changes to the built environment (e.g., traffic calming features, separated bike lanes) to keep people safe. There is some research on how effective these changes are in preventing adult pedestrians and bicyclists from getting hurt, but very little research has been done to show how safe various environments are for children and youth. Our research program will study how features of the built environment affect whether children travel (e.g., to school) using active modes, and whether certain features increase or decrease their likelihood of injury. Methods First, we will use a cross-sectional study design to estimate associations between objectively measured built environment and objectively measured active transportation to school among child elementary students. We will examine the associations between objectively measured built environment and child and youth pedestrian-motor vehicle collisions (MVCs) and bicyclist-MVCs. We will also use these data to determine the space-time distribution of pedestrian-MVCs and bicyclist-MVCs. Second, we will use a case-crossover design to compare the built environment characteristics of the site where child and youth bicyclists sustain emergency department reported injuries and two randomly selected sites (control sites) along the bicyclist’s route before the injury occurred. Third, to identify implementation strategies for built environment change at the municipal level to encourage active transportation we will conduct: 1) an environmental scan, 2) key informant interviews, 3) focus groups, and 4) a national survey to identify facilitators and barriers for implementing built environment change in municipalities. Finally, we will develop a built environment implementation toolkit to promote active transportation and prevent child pedestrian and bicyclist injuries. Discussion This program of research will identify the built environment associated with active transportation safety and form an evidence base from which municipalities can draw information to support change. Our team’s national scope will be invaluable in providing information regarding the variability in built environment characteristics and is vital to producing evidence-based recommendations that will increase safe active transportation.