Date of Award

12-2018

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Dr. Linda Shuster

Second Advisor

Dr. Nickola Wolf Nelson

Third Advisor

Dr. Roberta DePompei

Keywords

concussion, traumatic brain injury, assessment, cognition, education, student athletes

Abstract

The research presented in this study examines concussion among athletes from the perspectives of prevention, assessment, and recovery. The first study examines concussion education for high school athletes by surveying 157 collegiate athletes, who primarily attended high school in Illinois and Indiana, about the previous concussion education, including whether they received mandated education, the methods and providers of education, and their ability to name a variety of concussion symptoms. This study finds that despite legislative mandates in these states, 20% of student-athletes continue to report not receiving concussion education in high school, with females more likely to report not receiving education than males. A casual conversation is the most commonly reported method of education, and an athletic trainer the most common provider. Athletes who report receiving education show no improvement in ability to name a diversity of concussion signs and symptoms, compared to those who report receiving no education. These results indicate that continued efforts need to be made to ensure that all athletes report receiving education, and that there are still deficiencies in athletes' knowledge of the signs and symptoms of concussion, particularly cognitive and behavioral ones.

Early identification of concussion-induced cognitive deficits is imperative for student athletes, and functional cognitive deficits following concussion can be difficult to assess. The second study examines whether story retell is a useful tool for identifying concussion-induced cognitive communication changes in collegiate athletes following concussion. This cross-sectional study finds that athletes with recent (<30 >month) concussions perform worse on the immediate story retell than on the Montreal Cognitive Assessment (MoCA). Little or no correlation was seen between the MoCA and either the immediate or delayed story retell tests, or between self-reported academic difficulties of athletes with concussion with the immediate or delay story retell tasks. Immediate story retell appears to be a more sensitive measure of cognitive and language differences that presented in participants who sustained a recent concussion.

The final study consists of descriptive case studies examining the experiences of two collegiate athletes who had sustained concussions and experienced post-concussion syndrome (PCS), detailing their recovery process and reintegration into their educational and athletic activities. Both students experienced disruptions to their academic studies and participation in sporting activities because of their concussions, as well as social difficulties and feelings of isolation. For both students, despite the attempted utilization of best-practice protocols, there was a breakdown in the return-to-learn and return-to-play processes.

Concussion in athletes is a complex problem. These studies highlight concerns regarding concussion education, assessment, and recovery in collegiate athletes that are best served by an interdisciplinary team including a variety of health-care and educational professionals.

Access Setting

Dissertation-Open Access

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