Browsing by Author "Dompier, Thomas P."

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    Comprehensive Coach Education Reduces Head Impact Exposure in American Youth Football
    (2015-10) Kerr, Zachary Y.; Yeargin, Susan W.; Valovich McLeod, Tamara C.; Mensch, James; Hayden, Ross; Dompier, Thomas P.
    BACKGROUND: Despite little evidence that defines a threshold of head impact exposure or that participation in youth sports leads to long-term cognitive impairments, it is prudent to identify methods of reducing the frequency of head impacts. PURPOSE: To compare the mean number of head impacts between youth football players in practice and games between leagues that implemented the Heads Up Football (HUF) educational program and those that did not (NHUF). STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: During the 2014 season, head impact exposure was measured using xPatch accelerometers from 70 youth football players aged 8 to 15 years from 5 leagues. Data were collected during both games and practices. The NHUF group comprised 32 players from 8 teams within 3 leagues. The HUF group comprised 38 players from 7 teams within 2 leagues. Independent-sample t tests evaluated differences in head impact exposure across groups (ie, HUF and NHUF). RESULTS: Players (mean ± SD: age, 11.7 ± 1.4 years; height, 152.2 ± 10.5 cm; weight, 51.6 ± 9.6 kg) experienced a total of 7478 impacts over 10g, of which 4250 (56.8%) and 3228 (43.2%) occurred in practices and games, respectively. The majority of impacts occurred within the NHUF group (62.0%), followed by the HUF group (38.0%). With a 10g impact threshold, the mean number of impacts during practice per individual event was lower in the HUF group (mean ± SD, 5.6 ± 2.9) than in the NHUF group (mean ± SD, 8.9 ± 3.1; difference, 3.4; 95% CI, 2.9-3.9). This difference was attenuated when the threshold was changed to 20g but remained significant (difference, 1.0; 95% CI, 0.7-1.3). At both the 10g and 20g impact thresholds, no differences were found in games. CONCLUSION: Players who participated in HUF leagues accumulated fewer head impacts per practice at both the 10g and 20g thresholds. Youth football leagues should consider the HUF educational program, while exploring additional interventions, to help reduce the number of head impacts in players.
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    Concussion-Related Protocols and Preparticipation Assessments Used for Incoming Student-Athletes in National Collegiate Athletic Association Member Institutions
    (Journal of Athletic Training/NATA, 2015-11) Kerr, Zachary Y.; Snook, Erin M.; Lynall, Robert C.; Dompier, Thomas P.; Sales, Latrice; Parsons, John T.; Hainline, Brian; School of Health and Rehabilitation Sciences
    CONTEXT: National Collegiate Athletic Association (NCAA) legislation requires that member institutions have policies to guide the recognition and management of sport-related concussions. Identifying the nature of these policies and the mechanisms of their implementation can help identify areas of needed improvement. OBJECTIVE: To estimate the characteristics and prevalence of concussion-related protocols and preparticipation assessments used for incoming NCAA student-athletes. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: Head athletic trainers from all 1113 NCAA member institutions were contacted; 327 (29.4%) completed the survey. INTERVENTION(S): Participants received an e-mail link to the Web-based survey. Weekly reminders were sent during the 4-week window. MAIN OUTCOME MEASURE(S): Respondents described concussion-related protocols and preparticipation assessments (eg, concussion history, neurocognitive testing, balance testing, symptom checklists). Descriptive statistics were compared by division and football program status. RESULTS: Most universities provided concussion education to student-athletes (95.4%), had return-to-play policies (96.6%), and obtained the number of previous concussions sustained by incoming student-athletes (97.9%). Fewer had return-to-learn policies (63.3%). Other concussion-history-related information (e.g., symptoms, hospitalization) was more often collected by Division I universities. Common preparticipation neurocognitive and balance tests were the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; 77.1%) and Balance Error Scoring System (46.5%). In total, 43.7% complied with recommendations for preparticipation assessments that included concussion history, neurocognitive testing, balance testing, and symptom checklists. This was due to moderate use of balance testing (56.6%); larger proportions used concussion history (99.7%), neurocognitive testing (83.2%), and symptom checklists (91.7%). More Division I universities (55.2%) complied with baseline assessment recommendations than Division II (38.2%, χ2 = 5.49, P = .02) and Division III (36.1%, χ2 = 9.11, P = .002) universities. CONCLUSIONS: National Collegiate Athletic Association member institutions implement numerous strategies to monitor student-athletes. Division II and III universities may need additional assistance to collect in-depth concussion histories and conduct balance testing. Universities should continue developing or adapting (or both) return-to-learn policies.
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    Epidemiology of National Collegiate Athletic Association Men's and Women's Cross-Country Injuries, 2009-2010 Through 2013-2014
    (National Athletic Trainers' Association, 2016-01) Kerr, Zachary Y.; Kroshus, Emily; Grant, Jon; Parsons, John T.; Folger, Dustin; Hayden, Ross; Dompier, Thomas P.; Department of Kinesiology, School of Physical Education and Tourism Management
    CONTEXT: Recent injury-surveillance data for collegiate-level cross-country athletes are limited. OBJECTIVE: To describe the epidemiology of National Collegiate Athletic Association (NCAA) men's and women's cross-country injuries during the 2009-2010 through 2013-2014 academic years. DESIGN: Descriptive epidemiology study. SETTING: Aggregate injury and exposure data collected from 25 men's and 22 women's cross-country programs, providing 47 and 43 seasons of data, respectively. PATIENTS OR OTHER PARTICIPANTS: Collegiate student-athletes participating in men's and women's cross-country during the 2009-2010 through 2013-2014 academic years. MAIN OUTCOME MEASURE(S): Injury rates; injury rate ratios (RRs); injury proportions by body site, diagnosis, and apparatus; and injury proportion ratios were reported with 95% confidence intervals (CIs). RESULTS: The Injury Surveillance Program captured 216 injuries from men's cross-country and 260 injuries from women's cross-country, leading to injury rates of 4.66/1000 athlete-exposures (AEs) for men (95% CI = 4.04, 5.28) and 5.85/1000 AEs for women (95% CI = 5.14, 6.56). The injury rate in women's cross-country was 1.25 times that of men's cross-country (95% CI = 1.05, 1.50). Most injuries affected the lower extremity (men = 90.3%, women = 81.9%). The hip/groin-injury rate in women (0.65/1000 AEs) was higher than that in men (0.15/1000 AEs; RR = 4.32; 95% CI = 1.89, 9.85). The ankle-injury rate in men (0.60/1000 AEs) was higher than that in women (0.29/1000 AEs; RR = 2.07; 95% CI = 1.07, 3.99). Common diagnoses were strains (men = 19.9%, women = 20.4%) and inflammation (men = 18.1%, women = 23.8%). The majority of injuries were classified as overuse (men = 57.6%, women = 53.3%). CONCLUSIONS: Consistent with prior research, injury distributions varied between male and female athletes, and the injury rate among females was higher. Understanding the epidemiology of these cross-country injuries may be important for developing appropriate preventive interventions.
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    Epidemiology of National Collegiate Athletic Association men's and women's swimming and diving injuries from 2009/2010 to 2013/2014
    (BMJ Publishing Group, 2015-04) Kerr, Zachary Y.; Baugh, Christine M.; Hibberd, Elizabeth E.; Snook, Erin M.; Hayden, Ross; Dompier, Thomas P.; School of Health and Rehabilitation Sciences
    BACKGROUND: Recent injury data for collegiate-level swimming and diving are limited. This study describes the epidemiology of men's and women's swimming and diving injuries reported by the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) during the 2009/2010 to 2013/2014 academic years. METHODS: Injuries and athlete-exposure (AE) data reported within 9 men's and 13 women's swimming and diving programmes were analysed. Injury rates, injury rate ratios (IRR), and injury proportions by body site, diagnosis and mechanism were reported with 95% CIs. RESULTS: The ISP captured 149 and 208 injuries for men's and women's swimming and diving, respectively, leading to injury rates of 1.54/1000 and 1.71/1000 AEs. Among females, divers had a higher injury rate (2.49/1000 AEs) than swimmers (1.63/1000 AEs; IRR=1.53; 95% CI 1.07 to 2.19). Injury rates for male divers (1.94/1000 AEs) and swimmers (1.48/1000 AEs) did not differ (IRR=1.33; 95% CI 0.85 to 2.31). Most injuries occurred to the shoulder, resulted in strains and were classified as overuse or non-contact. Female swimmers had a higher overuse injury rate (1.04/1000 AEs) than male swimmers (0.66/1000 AEs; IRR=1.58; 95% CI 1.14 to 2.19). Overuse injury rates for female divers (0.54/1000 AEs) and male divers (0.46/1000 AEs) did not differ (IRR=1.16; 95% CI 0.40 to 3.34). Injury rates in 2012/2013-2013/2014 were lower than those in 2009/2010-2011/2012 for women's swimming (IRR=0.70; 95% CI 0.52 to 0.95) and diving (IRR=0.56; 95% CI 0.30 to 1.08), respectively. No time trends existed for men's swimmers or divers. CONCLUSIONS: Shoulder, strain and overuse injuries were common in collegiate men's and women's swimming and diving. Female swimmers were more likely to suffer an overuse injury than male swimmers. In addition, divers may have higher injury rates than swimmers, although small reported numbers warrant additional research.
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    Epidemiology of National Collegiate Athletic Association Women's Gymnastics Injuries, 2009-2010 Through 2013-2014
    (National Athletic Trainers' Association, 2015-08) Kerr, Zachary Y.; Hayden, Ross; Barr, Megan; Klossner, David A.; Dompier, Thomas P.; School Of Social Sciences
    Context Recent injury-surveillance data for collegiate-level women's gymnastics are limited. In addition, researchers have not captured non–time-loss injuries (ie, injuries resulting in restriction of participation <1 day). Objective To describe the epidemiology of National Collegiate Athletic Association (NCAA) women's gymnastics injuries during the 2009–2010 through 2013–2014 academic years. Design Descriptive epidemiology study. Setting Aggregate injury and exposure data collected from 11 women's gymnastics programs providing 28 seasons of data. Patients or Other Participants Collegiate student-athletes participating in women's gymnastics during the 2009–2010 through 2013–2014 academic years. Intervention(s) Women's gymnastics data from the NCAA Injury Surveillance Program (ISP) during the 2009–2010 through 2013–2014 academic years were analyzed. Main Outcome Measure(s) Injury rates; injury rate ratios; injury proportions by body site, diagnosis, and apparatus; and injury proportion ratios were reported with 95% confidence intervals (CIs). Results The ISP captured 418 women's gymnastics injuries, a rate of 9.22/1000 athlete-exposures (AEs; 95% CI = 8.33, 10.10). The competition injury rate (14.49/1000 AEs) was 1.67 times the practice injury rate (8.69/1000 AEs; 95% CI = 1.27, 2.19). When considering time-loss injuries only, the injury rate during this study period (3.62/1000 AEs) was lower than rates reported in earlier NCAA ISP surveillance data. Commonly injured body sites were the ankle (17.9%, n = 75), lower leg/Achilles tendon (13.6%, n = 57), trunk (13.4%, n = 56), and foot (12.4%, n = 52). Common diagnoses were ligament sprain (20.3%, n = 85) and muscle/tendon strain (18.7%, n = 78). Overall, 12.4% (n = 52) of injuries resulted in time loss of more than 3 weeks. Of the 291 injuries reported while a student-athlete used an apparatus (69.6%), most occurred during the floor exercise (41.9%, n = 122) and on the uneven bars (28.2%, n = 82). Conclusions We observed a lower time-loss injury rate for women's gymnastics than shown in earlier NCAA ISP surveillance data. Safety initiatives in women's gymnastics, such as “sting mats,” padded equipment, and a redesigned vault table, may have contributed to minimizing the frequency and severity of injury.
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    The epidemiology of NCAA men’s lacrosse injuries, 2009/10-2014/15 academic years
    (Springer, 2017-12) Kerr, Zachary Y.; Quigley, Adam; Yeargin, Susan W.; Lincoln, Andrew E.; Mensch, James; Caswell, Shane V.; Dompier, Thomas P.; School Of Social Sciences
    BACKGROUND: Participation in lacrosse has grown at the collegiate levels. However, little research has examined the epidemiology of collegiate men's lacrosse injuries. This study describes the epidemiology of injuries in National Collegiate Athletic Association (NCAA) men's lacrosse during the 2009/10-2014/15 academic years. METHODS: Twenty-five men's lacrosse programs provided 63 team-seasons of data for the NCAA Injury Surveillance Program (NCAA-ISP) during the 2009/10-2014/15 academic years. Injuries occurred from participation in an NCAA-sanctioned practice or competition, and required attention from an AT or physician. Injuries were further classified as time loss (TL) injuries if the injury restricted participation for at least 24 h. Injuries were reported through electronic medical record application used by the team medical staff throughout the academic year. Injury rates per 1000 athlete-exposures (AE), injury rate ratios (RR), 95% confidence intervals (CI), and injury proportions were reported. RESULTS: Overall, 1055 men's lacrosse injuries were reported, leading to an injury rate of 5.29/1000AE; 95%CI: 4.98-5.61. The TL injury rate was 2.74/1000AE (95%CI: 2.51-2.96). The overall injury rate was higher in competition than practice (12.35 vs. 3.90/1000AE; RR = 3.16; 95%CI: 2.79-3.58). Most injuries were to the lower extremity (58.3%), particularly the ankle (14.1%) in competition and the upper leg (14.3%) in practice. Sprains and strains were the most common diagnoses in both competition (26.9 and 23.7%, respectively) and practice (20.2% and 27.4%, respectively). Most injuries in competitions and practices were due to player contact (32.8 and 17.5%, respectively) and non-contact (29.6 and 40.0%, respectively). CONCLUSIONS: Our estimated injury rates are lower than those from previous college men's lacrosse research. This may be due to increased injury awareness, advances in injury prevention exercise programs, or rule changes. Still, injury prevention can aim to continue reducing the incidence and severity of injury, particularly those sustained in competitions and to the lower extremity.
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    High School Football Injury Rates and Services by Athletic Trainer Employment Status
    (National Athletic Trainers' Association, 2016-01) Kerr, Zachary Y.; Lynall, Robert C.; Mauntel, Timothy C.; Dompier, Thomas P.; Department of Kinesiology, School of Physical Education and Tourism Management
    Context Reported injury rates and services in sports injury surveillance may be influenced by the employment setting of the certified athletic trainers (ATs) reporting these data. Objective To determine whether injury rates and the average number of AT services per injury in high school football varied by AT employment status. Design Cross-sectional study. Setting We used data from the National Athletic Treatment, Injury and Outcomes Network and surveyed ATs about their employment setting. Patients or Other Participants Forty-four responding ATs (37.9% of all National Athletic Treatment, Injury and Outcomes Network participants) worked at high schools with football programs and were included in this study. Fourteen ATs were full-time employees of the high school, and 30 ATs were employed as outreach ATs (ie, full-time and part-time ATs from nearby clinics, hospitals, and graduate school programs). Main Outcome Measure(s) We calculated injury rates per 1000 athlete-exposures and average number of AT services per injury. Results Reported injury rates and services per injury were greater among full-time school employees compared with outreach ATs. However, injury rates did not differ when restricted to time-loss injuries only. Conclusions Our findings suggest that ATs who are full-time school employees may be able to identify and care for more patients with injuries.
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    Injury Rates in Age-Only Versus Age-and-Weight Playing Standard Conditions in American Youth Football
    (SAGE Publications, 2015-09) Kerr, Zachary Y.; Marshall, Stephen W.; Simon, Janet E.; Hayden, Ross; Snook, Erin M.; Dodge, Thomas; Gallo, Joseph A.; Valovich McLeod, Tamara C.; Mensch, James; Murphy, Joseph M.; Nittoli, Vincent C.; Dompier, Thomas P.; Ragan, Brian; Yeargin, Susan W.; Parsons, John T.; School of Health and Rehabilitation Sciences
    BACKGROUND: American youth football leagues are typically structured using either age-only (AO) or age-and-weight (AW) playing standard conditions. These playing standard conditions group players by age in the former condition and by a combination of age and weight in the latter condition. However, no study has systematically compared injury risk between these 2 playing standards. PURPOSE: To compare injury rates between youth tackle football players in the AO and AW playing standard conditions. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Athletic trainers evaluated and recorded injuries at each practice and game during the 2012 and 2013 football seasons. Players (age, 5-14 years) were drawn from 13 recreational leagues across 6 states. The sample included 4092 athlete-seasons (AW, 2065; AO, 2027) from 210 teams (AW, 106; O, 104). Injury rate ratios (RRs) with 95% CIs were used to compare the playing standard conditions. Multivariate Poisson regression was used to estimate RRs adjusted for residual effects of age and clustering by team and league. There were 4 endpoints of interest: (1) any injury, (2) non-time loss (NTL) injuries only, (3) time loss (TL) injuries only, and (4) concussions only. RESULTS: Over 2 seasons, the cohort accumulated 1475 injuries and 142,536 athlete-exposures (AEs). The most common injuries were contusions (34.4%), ligament sprains (16.3%), concussions (9.6%), and muscle strains (7.8%). The overall injury rate for both playing standard conditions combined was 10.3 per 1000 AEs (95% CI, 9.8-10.9). The TL injury, NTL injury, and concussion rates in both playing standard conditions combined were 3.1, 7.2, and 1.0 per 1000 AEs, respectively. In multivariate Poisson regression models controlling for age, team, and league, no differences were found between playing standard conditions in the overall injury rate (RRoverall, 1.1; 95% CI, 0.4-2.6). Rates for the other 3 endpoints were also similar (RRNTL, 1.1 [95% CI, 0.4-3.0]; RRTL, 0.9 [95% CI, 0.4-1.9]; RRconcussion, 0.6 [95% CI, 0.3-1.4]). CONCLUSION: For the injury endpoints examined in this study, the injury rates were similar in the AO and AW playing standards. Future research should examine other policies, rules, and behavioral factors that may affect injury risk within youth football.
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    Methods and Descriptive Epidemiology of Services Provided by Athletic Trainers in High Schools: The National Athletic Treatment, Injury and Outcomes Network Study
    (National Athletic Trainers' Association, 2015-12) Kerr, Zachary Y.; Dompier, Thomas P.; Dalton, Sara L.; Miller, Sayers John; Hayden, Ross; Marshall, Stephen W.; Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health
    CONTEXT: Research is limited on the extent and nature of the care provided by athletic trainers (ATs) to student-athletes in the high school setting. OBJECTIVE: To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) project and provide the descriptive epidemiology of AT services for injury care in 27 high school sports. DESIGN: Descriptive epidemiology study. SETTING: Athletic training room (ATR) visits and AT services data collected in 147 high schools from 26 states. PATIENTS OR OTHER PARTICIPANTS: High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011-2012 through 2013-2014 academic years. MAIN OUTCOME MEASURE(S): The number of ATR visits and individual AT services, as well as the mean number of ATR visits (per injury) and AT services (per injury and ATR visit) were calculated by sport and for time-loss (TL) and non-time-loss (NTL) injuries. RESULTS: Over the 3-year period, 210 773 ATR visits and 557 381 AT services were reported for 50 604 injuries. Most ATR visits (70%) were for NTL injuries. Common AT services were therapeutic activities or exercise (45.4%), modalities (18.6%), and AT evaluation and reevaluation (15.9%), with an average of 4.17 ± 6.52 ATR visits and 11.01 ± 22.86 AT services per injury. Compared with NTL injuries, patients with TL injuries accrued more ATR visits (7.76 versus 3.47; P < .001) and AT services (18.60 versus 9.56; P < .001) per injury. An average of 2.24 ± 1.33 AT services were reported per ATR visit. Compared with TL injuries, NTL injuries had a larger average number of AT services per ATR visit (2.28 versus 2.05; P < .001). CONCLUSIONS: These findings highlight the broad spectrum of care provided by ATs to high school student-athletes and demonstrate that patients with NTL injuries require substantial amounts of AT services.
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    The National Athletic Treatment, Injury and Outcomes Network (NATION): Methods of the Surveillance Program, 2011-2012 Through 2013-2014
    (National Athletic Trainers' Association, 2015-08) Dompier, Thomas P.; Marshall, Stephen W.; Kerr, Zachary Y.; Hayden, Ross; Department of Epidemiology, Richard M. Fairbanks School of Public Health
    CONTEXT: Previous epidemiologic researchers have examined time-loss (TL) injuries in high school student-athletes, but little is known about the frequency of non-time-loss (NTL) injuries in these athletes. OBJECTIVE: To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) Surveillance Program and provide descriptive epidemiology of TL and NTL injuries across athletes in 27 high school sports. DESIGN: Descriptive epidemiology study. SETTING: Aggregate injury and exposure data collected from 147 high schools in 26 states. PATIENTS OR OTHER PARTICIPANTS: High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011-2012 through 2013-2014 academic years. MAIN OUTCOME MEASURE(S): Athletic trainers documented injuries and exposures using commercially available injury-tracking software packages. Standard injury-tracking software was modified by the software vendors to conform to the surveillance needs of this project. The modified software exported a set of common data elements, stripped of personally identifiable information, to a centralized automated verification and validation system before they were included in the centralized research database. Dependent measures were injury and exposure frequencies and injury rates with 95% confidence intervals stratified by sport, sex, and injury type (TL or NTL). RESULTS: Over the 3-year period, a total of 2337 team seasons across 27 sports resulted in 47 014 injuries and 5 146 355 athlete-exposures. The NTL injuries accounted for 38 765 (82.45%) and TL injuries for 8249 (17.55%) of the total. CONCLUSIONS: The NTL injuries accounted for a substantial amount of the total number of injuries sustained by high school student-athletes. This project demonstrates the feasibility of creating large-scale injury surveillance systems using commercially available injury-tracking software.