Browsing by Author "Emery, Carolyn Ann"

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    Injury Prevention in Youth Tackle Football
    (2023-09-22) Cairns, Joshua Thomas; Emery, Carolyn Ann; Schneider, Kathryn J; Jordan, Matthew J; Pasanen, Kati; Smith, Julianne D
    This thesis contains two projects that aim to investigate injury and injury prevention strategies in Canadian adolescent tackle football. The first project aimed to examine the current utilization of Neuromuscular Training components (NMT) in tackle football warm-ups and the second project examined adolescent (ages 14-17) tackle football epidemiology. Objectives: 1. To describe the current time spent by adolescent tackle football teams in five key neuromuscular training (NMT) components (aerobic, agility, balance and coordination, strength, and head on neck control) and determine if time in warm-up components differed throughout the season. 2. To describe injury rates, burden, types, mechanisms, and risk factors in adolescent (ages 14-17) community tackle football players in one season. Methods: Teams consented to video-recording of practice and game warm-ups. Video was analyzed using Dartfish tagging software (Dartfish, USA). Validated injury surveillance methods were used during a prospective cohort in a single nine-week competition season for participants aged 14-17. Injury rates (IR), concussion rates (CR), and incidence rate ratios (IRR) were reported based on univariable Poisson regression analyses (offset by player-hours and controlling for cluster by team). Results: Teams spent a median of 456.2 seconds in warm-up prior to sessions and a median time of 275 seconds in active warm-up components. Teams spent more time in some NMT components (aerobic and strength) compared to others (balance, agility and coordination, and head on neck control), however other than aerobic (58%) the use of other NMT components was low (time in NMT components 1-9%). Teams were relatively consistent with component utilization throughout the season. The overall IR was 4.61 injuries/1000 player-hours (95%CI; 3.84 – 5.53) and the CR was 1.20 concussions/1000 player-hours (95%CI; 0.90-1.61). Concussion rates were higher in games (IR=3.86 concussions/1000 player game-hours 95%CI; 2.74 – 5.43) than practices (IR=0.44 concussions/1000 practice player hours, 95%CI;0.25 – 0.75) (IRR=8.82,95%CI; 4.52- 18.27). Previous history of injury in the past 12 months (IRR=1.66,95%CI; 1.07-2.57) and being obese (BMI > 30.00) (IRR=2.55, 95%CI; 1.35-4.84) were associated with higher rates of practice-related injury. Lifetime history of concussion (IRR=1.58, 95%CI; 1.00 – 2.50) and being in the 75th percentile for height (IRR=1.58, 95%CI; 1.19 – 2.18) were associated with higher game-related injury rates, with the former being insignificant and the latter significant. Conclusions: Injury and concussion rates are high in adolescent tackle football. There are opportunities for research examining injury and concussion prevention strategies in tackle football in Canada. Football teams do not engage in NMT warm-up components and there is significant opportunity for implementation of such a prevention strategy in this sport.
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    Sleep Disturbances and Impairments in High School Sport Participants at Baseline and Following a Sport-Related Concussion
    (2023-08-15) McCallum, Jocelyn Haley; Black, Amanda Marie; Emery, Carolyn Ann; Tomfohr-Madsen, Lianne; Samuels, Charles
    Introduction: Approximately one in five youth sustain at least one sport-related concussion by the time they complete high school. There are limited studies examining the association between the Patient-Reported Outcomes Measurement Information System (PROMIS) pediatric sleep questionnaires and common demographic and medical variables, including the Sport Concussion Assessment Tool 5 (SCAT5). How sleep changes throughout recovery has not yet been examined using the PROMIS sleep questionnaires. Objectives: 1) Describe PROMIS sleep questionnaire t-scores at baseline in a sample of adolescent sport participants, and to examine the association and interactions of age, sex, number of previous concussions, depression, anxiety, attention-deficit hyperactivity disorder (ADHD), and the SCAT5 symptom severity score on PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment scores. 2) Describe sleep disturbances and impairments using the PROMIS sleep questionnaires and the SCAT5 sleep-related symptom evaluation in the baseline, acute, and return-to-play (RTP) timepoints following concussion among male and female adolescent sport participants. Methods: Cross-sectional and prospective cohort designs. Participants completed the PROMIS questionnaires and SCAT5 at baseline. Adolescents who sustained a concussion completed the SCAT5 and PROMIS questionnaires acutely and completed the PROMIS questionnaires bi-weekly until RTP. Descriptive statistics illustrated sleep disturbances and impairments at baseline, acutely, and at RTP. For baseline t-scores, mean effects of covariates and their interactions were examined using random intercept regression models and likelihood ratio tests. Results: At baseline, 26% to 29% of males and 43% to 50% of females had mild to severe sleep disturbances or impairments. Furthermore, higher PROMIS scores were associated with being female, being an older adolescent, and the SCAT5 symptom severity score. Significantly higher sleep disturbance scores were observed in those with anxiety, and lower sleep-related impairment scores were observed in those with ADHD at baseline. In the acute phase of concussion, 38% to 44% of males and 37% to 48% of females had sleep disturbance and impairment scores within the mild to severe ranges. Conclusion: There are many factors influencing sleep in healthy adolescent sport participants. A high proportion of males and females had sleep disturbance and impairment scores over the ‘normal’ range at baseline and acutely following a concussion.