Running head: LITERATURE REVIEW 1

Literature Review

Jakeira Ford

University of Texas At El Paso

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Abstract
In this literature review I will be giving information on the topic of Concussions in Sports.

There are three research questions that will be answered within brief paragraphs to support and

give evidence on concussions. The first question is How are concussion being treated? Do you

think their being treated well or not? The second question is What are the causes of concussions?

And the third question is How important are concussions within sports? All of these research

questions were properly answered using both primary and secondary sources, including a survey.

There were specific topics that were discussed including the methods used to determine whether

or not someone has a concussion, if a specific type of person is likely to get a concussion, and

what problems may arise after receiving a concussion. This essay also emphasizes the

importance of treating concussions and how concussions can impact ones future and their life.
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It is important for athletes to study concussion because it is more likely that they would

get a concussion in comparison of the general public. It is also important for them to know what

a concussion is because a concussion is a serious injury that any athlete could be affected by.

Primary research was conducted to gather information about the topic from the general public,

and secondary sources will be used to create a discussion about concussions in relation to sports

and the different opinions and understanding of concussion and the people that get them. Here

are a few questions that will be provided to discuss concussions in relation to sports.

How are concussion being treated? Do you think their being treated well or not?

What are the causes of concussions?

How important are concussions within sports?

Primary research was collected for this assignment and must be explained to put it into context

for the rest of the essay.

For this assignment the primary research was conducted over a survey. Since literature

review is over concussions in sports, it was decided that a few athletes were to fill out the survey

and provide information on what they are aware of about concussions themselves. The data was

collected through survey questions on October 27, 2017. Ten questions were asked to the

respondents. There were 5 respondents to the survey. The research questions were discussed in

the survey and can be used to discuss the following research questions. The respondents tended

to have similar responses to the questions that were asked, and this may be because they are all

in a similar environment that spends a lot of time emphasizing how crucial knowledge about

head injuries is. This may have been different if the respondents were not involved in spots and
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dint have to know about concussions because it was unlikely that they would get one in the near

future.

The first research questions were, how are concussions being treated? Do you think their

being treated well or not? Concussions are considered one of the most pressing issues in sports

medicine and are challenging to diagnose (Adirim, 2007). Concussions are difficult to spot in

individuals because of the nature of concussions. Sometimes the injury makes it hard for people

to recognize or to admit that they are having problems (Concussion & Brain Injury, 2004).

Because it is difficult for people to understand they have a brain injury, it is not easy to begin

treatments for those individuals. All of the sources had something that answered these questions

that seemed to be very important. My first source stated that, Recent publications focus on

guidelines for immediate post-concussion sideline assessments, implementation of testing

programs, the sensitivity and specificity of standardized measures, and statistical methods for

documenting post-concussion changes (McKeever & Schatz, 2017). This is the protocol that

Catherine K. McKeever and Philip Schatz stated was used for the treatment of concussion in

athletes.

Depending on your symptoms, you age, and the severity of the injury the doctors might

decide that you go through a few tests either the Neurological test, CT scan, or a MRI scan

(What Should You Do If, 2012). A Neurological test is a basic neurological exam in the ER

assesses motor and sensory skills, the functioning of one or more cranial nerves, hearing and

speech, vision, coordination and balance, mental status and changes in mood or behavior, among

others (What Should You Do If, 2012). The purpose of this test is to make sure the individual

that is getting this test is neurologically ok and not impaired. A CT scan is a special

computerized x-ray that provides images of the brain and is sometimes used to look for
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suspected bleeding or swelling (What Should You Do If, 2012). A CT scan is used to search for

bleeding and swelling within the brain that cant be detected without the machinery. A MRI

scan is a Magnetic Resonance Imaging test that provides detailed pictures of the brain using

magnetic energy instead of radiation (What Should You Do If, 2012). This have a similar

purpose as the CT scan with finding swelling in the brain.

Another test is a computerized neuropsychologic assessment. Computerized

neuropsychologic assessment programs have made the evaluation of athletes easier and more

sensitive and are in fact considered the criterion standard for diagnosing and monitoring sports

concussions (Adirim, 2007). Computerized assessment programs basically put you through

different segments that shows change within your responses to mental and physical tasks that

could be altered by a bring that has been damaged. All of these test could help to be notified on

a concussion. These test make it easier for trainers and doctors to recognize concussions, which

in turn, gives them the opportunity to assess it early enough.

In sports, athletic trainer deal with a lot of individuals who suffer or suffered from

concussions. It is important for sports medicine professionals to continue to stay up to date on

the advances in understanding concussions and how to care individually for each player who

sustains a concussion (Powell, 2001). People who work with athletes have to be aware of how

concussions have been treated recently because the people they work with are more likely to get

concussions than the general public. If trainers are not aware that the athletes in their care are

suffering from a concussion, it could lead those individuals into danger situations as it is

important that the medicine professionals working with them understand their unique

circumstances.
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The second source stated that, To date, our ability to treat and reduce the effects of

concussion injuries remains ineffective. There is no effective way of treating a concussion with

modern medicine at the moment. With the exception of rest to allow for complete or near

complete recovery, there is little else we can offer. Which means that there is no other cure than

rest for concussions. Therefore, the best treatment continues to be prevention or concussion and

its sequelae. You can only get rest, which Is not very effective for athletes. While an athlete is

recovering from a concussion, they are missing valuable practice time and potentially missing

games to recover.

Since there are no other cures for concussions, it is even more important for athletes to be

aware of concussions and their causes. These sources state that there are not too many things that

can be done to treat a concussion, but that they are very dangerous if left unattended. The

primary source says that they feel that concussions are being well treated in many of ways. They

also state that concussions could cause severe damages, therefore nowadays trainers tend to have

strict rules on athletes if they are dealing with a concussion. In many cases impairments can last

a life time (Concussion & Brain Injury, 2004). Because of this treatment is extremely important

and needs to be taken seriously.

A concussion is a traumatic brain injury caused by a bump, blow, or jolt to the head or a

hit to the body that causes the head and brain to move rapidly back and forth. An individual

could notice if they have a concussion if their headaches are getting worse, weakness, numbness,

or decreased coordination. Symptoms of a concussion range from mild to severe and can last for

hours, days, weeks, or even months. There are persistent symptoms that can last a life time and

lead to other brain damage related injuries, including brain impairments such as CTE. The

discussion from what treatments are used from concussion stems from what causes concussions.
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The second research question was, what are the causes of concussions? The first source

states a few things. It begins by stating, Concussions may be caused by a direct blow to the

head, face, neck, or elsewhere on the body with an impulsive force transmitted to the head

(Saffary, Chin, & Cantu, 2011). This source says that concussions are caused by a blow to the

head. Concussion typically results in the rapid onset of short lived impairment of neurological

function that resolves spontaneously. Concussions can be caused in different ways.

It is said that concussions mainly result in neuropathological changes but the acute

clinical symptoms largely reflect a functional disturbance rather than structural injury. This

injury causes changes in the brain rather than an actual injury to the brain. Concussion results in

a graded set of clinical syndromes that may or may not involve loss of consciousness. Resolution

of the clinical and cognitive symptoms typically follows a sequential course. My primary source

says that they had a concussion once. They said that when they were dealing with a concussion

they noticed that physical damage within the head, neck or brain could cause a concussion.

When receiving a concussion, a blood clot that crowds the brain against the scull might form

which can lead to life threatening consequences (Signs and Symptoms, 2017).

Young athletes struggle with sports related injury more than adults do. Younger athletes

appear to be at increased risk for concussion. Giza and Hovda discussed the potential

vulnerability of youth athletes who sustain concussion during critical stages in brain

development, especially during a time of increased plasticity. Young athletes are more likely to

get a concussion due to the development of their bodies. Since a child athlete is still growing,

they are going to be more likely to suffer serious injuries, especially when it comes to brain

trauma.
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Concussions are caused by scientific and natural means. From a biomechanical

standpoint, acceleration-deceleration forces and linear as well as especially rotational forces have

been implicated in causing concussive injuries (Saffary, Chin, & Cantu, 2011). This statement

specifies the scientific explanation of concussions. during the Third International Conference on

Concussion in Sport, held in Zurich 2008, concussion was defined as a complex

pathophysiological process affecting the brain induced by traumatic biomechanical forces. This

is the actual reaction that causes a concussion in relation to physics. Because of the affect and

causes of concussions it is important for individuals, especially athletes to be aware of

concussions. People who have had repeated brain injuries, such as boxers or football players,

may have serious problem later in life. These problems include difficulty with concentration

and memory and sometimes with physical coordination (Concussion & Brain Injury, 2004).

The last research question is what important knowledge is there about concussions within

sports? The syndrome occurs when an athlete who sustains a head injury, often a concussion or

worse injury, such as a cerebral contusion sustains a second head injury before symptoms

associated with the first have cleared (Saffary, Chin, & Cantu, 2011). This specific head injury

is not something that is commonly known within the athletic community, therefore making it an

important knowledge for athlete to know. In this study, female athletes were consistently found

to be at higher risk for sustaining concussions than male athletes participating in the high school

sport (McKeever & Schatz, 2017). Female athletes tend to be more at risk of dangerous side

effects of concussions.

It is important for female athletes to be especially aware of concussion because they are

at a higher risk for them. These gender disparities represent approximate female-to-male

concussion ratios of 5:4 for soccer, 4:3 for basketball, and 2:1 for softball and baseball
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(McKeever & Schatz 2017). In sports, women are more likely to get a concussion, therefor

there should be more training for them to balance the discrepancy. Since Congress had passed

Title IX in 1972, the number of female varsity athletes in college has quadrupled (Zillmer,

2010). Because of the amount of women that have joined sports since Title IX was passed, there

are a lot of concussions that are happening within women sports because women experience

concussions at a higher rate. The primary source states that they believe concussions are very

important. Concussions arent just important to know about within sports, but concussions could

also play a huge part of some ones health problems and its very important for them to be treat

as well as possible. It is especially relevant to female athletes to be aware of the high rate that

they can receive concussions due to their more fragile anatomy which is why they receive more

concussions in the first place.

Concussions within sports could be very dangerous for young athletes. It is by far one of

the most serious problems for athletes, especially athletes that are in middle school and high

school as their still developing. Its very important that individuals with concussions are being

treated well. A concussion could harm an individual, since multiple concussions could damage

an individuals brain. However, with that being said, it is in athlete trainers and doctors hands to

help prevent concussion and help treat them so it wouldnt be so hard for a person to live their

life. Neurosurgeons and other brain-injury experts emphasize that although some concussions

are less serious than others, there is no such thing as a minor concussion (Concussion, 2017).

This is especially relevant to children because of the development of their skull. Children

that receive concussions are maybe at risk of many complications in the future. There are more

than 300,000 sports-related concussions in the U.S. (Concussion, 2017). Because of this high

rate of concussions specifically in sports it is important to pay special attention to child athletes,
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as they seem to be a group that must be protected from brain injuries as it may stunt their growth

and lead to developmental issues as they get older.

It is important to note that concussions can be under diagnosed, especially when

discussing athletes. 70% and 63% of football and soccer players, respectively, reported

symptoms concistent with concussion, although only 23% and 20% realized they had, in fact

sustained a concussion (Moser et al, 2007). Not knowing that they have a concussion is

extremely dangerous for athletes because if they continue to play with a concussion and they get

another concussion they could suffer with severe brain damage. 1500 high school football

players were surveyed and noted that more that 40% believed that they were concussed but

deliberately did not reveal this information for fear of losing playing time (Moser et al, 2007).

These were at a high risk of making their brain injuries worse by not acknowledging their

injuries. If they had sustained a concussion and received another concussion the result could be

deadly. If they continue to sustain these injuries early in their athletic careers, it could be

problematic for their future, because they may not be able to continue to play and may have a

difficult time working jobs that are not related to athletics due to the trauma their brains have

faced earlier in their lives.

The previous information supported the importance of athletes knowledge about

concussions. According to the primary research and the collected information for the literature

review, there is a lot of information that professionals and intellectuals specifically on what

concussions are, how concussions are treated, and what information the general public needs to

know about concussions. The readings that were used as well as the survey that as conducted all

support the relevance of brain trauma and concussions themselves.

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References

Aubry M., Cantu R., Dvorak J., Graf-Baumann T., Johnston K., Kelly J., Lovell

M., McCrory P., Meeuwisse W., Schamasch P. (2002) Summary and agreement statement of

the first International Conference on Concussion in Sport, Vienna 2001. British Journal of

Sports Medicine 36: 67

Concussion & Brain Injury - A Guide for Family and Friends (n.d.). Retrieved November 16,

2017, fromhttp://www.headinjury.com/braininjurytxmild.html

Concussions in Sports and Recreation. (2007, April 05). Retrieved November 16, 2017, from

http://www.sciencedirect.com/science/article/pii/S1522840107000031

Concussion. (n.d.). Retrieved November 16, 2017, from http://www.aans.org/Patients/Neurosurgical-

Conditions-and-Treatments/Concussion

McKeever K, Schatz P. Current Issues in the Identification, Assessment, and Management of

Concussions in Sports-related Injuries. (n.d.). Retrieved October 11, 2017, from

http://www.tandfonline.com/doi/abs/10.1207/S15324826AN1001_2

Neuropsychological evaluation in the diagnosis and management of sports-related concussion.

(2007, November 07). Retrieved November 16, 2017, from

http://www.sciencedirect.com/science/article/pii/S0887617707002028

Powell, J. W. (2001). Cerebral Concussion: Causes, Effects, and Risks in Sports. Retrieved November 16,

2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC155423/

Saffary, R., Chin, L. S., & Cantu, R. C. (2011). Concussions in Sports.

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Traumatic Brain Injury & Concussion. (2017, March 22). Retrieved November 16, 2017, from

https://www.cdc.gov/traumaticbraininjury/symptoms.html

What Should You Do If You Think You Have Had a Concussion? (2017, October 27). Retrieved

November 16, 2017, from https://www.brainline.org/article/what-should-you-do-if-you-

think-you-have-had-concussion

Zillmer, E. Applied Neuropsychology. (2010). Retrieved October 11, 2017, from

http://www.tandfonline.com/doi/pdf/10.1207/S15324826AN1001_1