Publications by authors named "Lauren A Pierpoint"

42 Publications

No Correlation Between Depth of Acetabuloplasty or Postoperative Lateral Center-Edge Angle on Midterm Outcomes of Hip Arthroscopy With Acetabuloplasty and Labral Repair.

Am J Sports Med 2021 01 25;49(1):49-54. Epub 2020 Nov 25.

Steadman Philippon Research Institute, Vail, Colorado, USA.

Background: The treatment of pincer deformity in hip arthroscopy remains controversial, with some authors advocating that over resection may risk early joint deterioration. The role of acetabular resection depth and postoperative acetabular morphology on postoperative outcomes has yet to be defined.

Purpose/hypothesis: This study measures the influence of acetabular resection depth and postoperative lateral center-edge angle (LCEA) on minimum 5-year patient-reported outcomes (PROs), revision rates, and conversion to total hip arthroplasty using a single surgeon's prospective database. We hypothesized that patients with acetabular resections >10°, as measured by LCEA, or patients with postoperative LCEA outside the normal range of 25° to 35° would have lower PROs, higher revision rates, and higher conversion to total hip arthroplasty at midterm follow-up.

Study Design: Cohort study; Level of evidence, 2.

Methods: A total of 192 patients who underwent primary hip arthroscopy with acetabuloplasty and labral repair by a single surgeon with a minimum 5-year follow-up met the inclusion criteria. Preoperative and postoperative LCEAs were measured on supine anteroposterior radiographs, and patients were divided into cohorts based on LCEA and acetabular resection depth. Cohorts for postoperative LCEA were <20° (dysplasia), 20° to 25° (borderline dysplasia), 25° to 35° (normal), and >35° (borderline overcoverage). Cohorts for acetabular resection depth were <5°, 5° to 10°, and >10° difference from preoperative to postoperative LCEA. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 12-Item Short Form Health Survey, modified Harris Hip Score, Hip Outcome Score, satisfaction scores, revision rates, and conversion to arthroplasty rates.

Results: Patients significantly improved in all outcome score measures at final follow-up. There were no statistically significant differences in PRO scores or conversion to total hip arthroplasty between any cohorts in the postoperative LCEA group. There were more revisions in the 25° to 35° cohort than the other cohorts ( = .02). The 5-10° resection depth cohort demonstrated a higher postoperative WOMAC score ( = .03), but otherwise no statistically significant differences were seen between resection depth cohorts in the remaining postoperative outcomes scores, revision rates, or conversion to total hip arthroplasty rates.

Conclusion: Patients with postoperative LCEA values outside the normal reference range and with large resections perform similar to those with normal postoperative LCEA values and smaller resections at a minimum 5-year follow-up.
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http://dx.doi.org/10.1177/0363546520972998DOI Listing
January 2021

Epidemiology of Sport-Related Concussion.

Clin Sports Med 2021 Jan;40(1):1-18

Datalys Center for Sports Injury Research and Prevention, 401 West Michigan Street, Suite 500, Indianapolis, IN 46202, USA.

Sport-related concussions are common in the United States. Concussion rates have increased over time, likely due to improved recognition and awareness. Concussion rates vary across level (high school vs college), sex, and sport. Concussion rates are the highest among men, particularly in football, wrestling, ice hockey, and lacrosse where collisions and contact are inherent to the sports, although girls'/women's soccer rates are high. In gender-comparable sports, women have higher concussion rates. Continued data collection will increase understanding of sport-related concussion and provide areas for targeted prevention in the future.
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http://dx.doi.org/10.1016/j.csm.2020.08.013DOI Listing
January 2021

Sex-Based Differences in Anterior Cruciate Ligament Injuries Among United States High School Soccer Players: An Epidemiological Study.

Orthop J Sports Med 2020 May 28;8(5):2325967120919178. Epub 2020 May 28.

Department of Orthopedics and Sports Medicine, Seattle Children's, Seattle, Washington, USA.

Background: Anterior cruciate ligament (ACL) tears are common among high school athletes, with sex-based differences accounting for higher injury rates in girls. Previous epidemiological studies on ACL injuries focusing on adolescent athletes have looked at injuries across multiple sports, but few have analyzed ACL tears in solely high school soccer athletes.

Purpose: To examine sex-based differences in the epidemiology of ACL injuries among high school soccer players in the United States (US).

Study Design: Descriptive epidemiological study.

Methods: ACL injury data for US high school soccer players were obtained from the internet-based National High School Sports-Related Injury Surveillance Study's High School RIO (Reporting Information Online) system. Athletic trainers from a random sample of 100 high schools from 8 strata based on US Census geographic region reported data for athlete-exposures (AEs) (practice or competition) and ACL injuries from 2007 through 2017. Injury rates were calculated as the number of ACL injuries per 100,000 AEs. Subgroup differences were evaluated with rate ratios (RRs) or injury proportion ratios (IPRs) and 95% CIs. Statistical differences in demographics between groups were examined using independent tests. Comparisons of categorical data (ie, level of play) were performed using the Wald chi-square test.

Results: The reported number of ACL injuries corresponded to weighted national estimates of 41,025 (95% CI, 33,321-48,730) ACL injuries in boys' soccer and 110,028 (95% CI, 95,349-124,709) in girls' soccer during the study period. The rate of injuries was higher in girls' soccer (13.23/100,000 AEs) than boys' soccer (4.35/100,000 AEs) (RR, 3.04 [95% CI, 2.35-3.98]). The rate of ACL injuries was higher in competition compared with practice for girls (RR, 14.77 [95% CI, 9.85-22.15]) and boys (RR, 8.69 [95% CI, 5.01-15.08]). Overall, a smaller proportion of ACL injuries were caused by player-player contact for girls (30.1%) compared with boys (48.6%) (IPR, 0.62 [95% CI, 0.41-0.93]).

Conclusion: ACL injury rates and patterns in high school soccer players differed between sex, type of exposure (practice vs competition), and mechanism of injury.
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http://dx.doi.org/10.1177/2325967120919178DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262988PMC
May 2020

Are high school girls' lacrosse players at increased risk of concussion because they are not allowed to wear the same helmet boys' lacrosse players are required to wear?

Inj Epidemiol 2020 May 18;7(1):18. Epub 2020 May 18.

Department of Communication, University of Colorado Denver, Denver, CO, USA.

Background: Boys' lacrosse (LAX), a full contact sport allowing body and stick checking, mandates hard shell helmets with full face masks. Girls' LAX, which prohibits body checking and whose sphere rule is supposed to prevent stick checking to the head, allows optional flexible headgear with/without integrated eye protection. Whether the required boys' LAX helmets should also be mandated in girls' LAX has been debated.

Methods: In this retrospective cohort study we used LAX concussion data from a national high school sports-related injury surveillance study to determine if girls' LAX players were at increased risk of concussion from stick or ball contact due to differences in helmet regulations by calculating the attributable risk and attributable risk percent (AR%) for concussion resulting from ball or stick impacts.

Results: From 2008-09 through 2018-19, boys' LAX players sustained 614 concussions during 1,318,278 athletic exposures (AEs) (4.66 per 10,000 AEs) and girls' LAX players sustained 384 concussions during 983,291 AEs (3.91 per 10,000 AEs). For boys, athlete-athlete contact was the most common mechanism of concussion accounting for 66.4% of all concussions, while stick or ball contact accounted for 23.5%. For girls, stick or ball contact accounted for 72.7% of all concussions, while athlete-athlete contact accounted for 19.8%. Concussion rates from stick or ball contact were significantly higher in girls vs. boys (RR = 2.60, 95% CI 2.12-3.18). The attributable risk associated with playing girls' vs. boys' LAX for concussion resulting from stick or ball contact was 1.75 concussions per 10,000 AEs (95% CI 1.37-2.12) and the AR% was 61.5% (95% CI 52.9-68.5). An estimated 44.7% of all girls' LAX concussions could have been prevented if girls' LAX players wore the helmet mandated in boys' LAX.

Conclusions: Girls' LAX players who are allowed, but not required, to wear a flexible headgear are at increased risk of concussions from stick or ball impacts compared to boys' LAX players, who are required to wear a hard shell helmet with full face mask. Additional research is needed to determine if there are any defendable arguments to continue justifying restricting girls' LAX players access to this effective piece of protective equipment.
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http://dx.doi.org/10.1186/s40621-020-00242-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232834PMC
May 2020

A comparison of recreational skiing- and snowboarding-related injuries at a Colorado ski resort, 2012/13-2016/17.

Res Sports Med 2020 Jul-Sep;28(3):413-425. Epub 2020 Apr 23.

Department of Family Medicine, University of Colorado School of Medicine , Denver, CO, USA.

The purpose of this study was to compare injury patterns between recreational skiers and snowboarders. Injured skiers (n = 3,961) and snowboarders (n = 2,428) presented to a mountainside medical clinic, 2012/13-2016/17. Variables investigated for analysis included demographics/characteristics, injury event information, and injury information. Skiers were older than snowboarders (34.3 ± 19.3 vs. 23.2 ± 10.5 years, p < 0.001); a greater proportion of skiers were female (46.3% vs. 27.8%, p < 0.001). Most skiers (84.4%) and snowboarders (84.5%) were helmeted at the time of injury (p = 0.93). Snowboarders were most frequently beginners (38.9%), skiers were intermediates (37.8%). Falls to snow (skiers = 72.3%, snowboarders = 84.8%) and collisions with natural objects (skiers = 9.7%, snowboarders = 7.4%) were common injury mechanisms. Common skiing injuries were knee sprains (20.5%) and head trauma (8.9%); common snowboarding injuries were wrist fractures (25.7%), shoulder separations (9.1%), and head trauma (9.0%). Given that injury patterns significantly differ between sports, it is important for clinicians, ski patrollers, and resorts to develop and deliver sport-specific injury prevention interventions to most effectively decrease injury burden.
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http://dx.doi.org/10.1080/15438627.2020.1754821DOI Listing
December 2020

Concussion Symptom Characteristics and Resolution in 20 United States High School Sports, 2013/14-2017/18 Academic Years.

Neurosurgery 2020 09;87(3):573-583

Vanderbilt Sports Concussion Center, Vanderbilt University School of Medicine, Nashville, Tennessee.

Background: High school (HS) sport-related concussions (SRCs) remain a public health concern in the United States.

Objective: To describe patterns in symptom prevalence, symptom resolution time (SRT), and return-to-play time (RTP) for SRCs sustained in 20 HS sports during the 2013/14-2017/18 academic years.

Methods: A convenience sample of athletic trainers reported concussion information to the HS RIOTM surveillance system. Symptom prevalence, average number of symptoms, and SRT and RTP distributions were examined and compared by event type (practice, competition), injury mechanism (person contact, nonperson contact), sex, and contact level (collision, high contact, and low contact) with chi-square tests and Wilcoxon rank-sum tests.

Results: Among all SRCs (n = 9542), headache (94.5%), dizziness (73.8%), and difficulty concentrating (56.0%) were commonly reported symptoms. On average, 4.7 ± 2.4 symptoms were reported per SRC. Overall, 51.3% had symptoms resolve in <7 d, yet only 7.9% had RTP < 7 d. Differential prevalence of amnesia was seen between practice and competition-related SRCs (8.8% vs 13.0%; P < .001); nonperson-contact and person-contact SRCs (9.3% vs 12.7%; P < .001); and female and male SRCs in low-contact sports (5.8% vs 17.5%; P < .001). Differential prevalence of loss of consciousness was seen between practice and game-related SRCs (1.3% vs 3.2%; P < .001); and female and male SRCs in high contact sports (1.2% vs 4.0%; P < .001). Differential longer SRT (>21 d) was seen between new and recurrent SRCs (9.4% vs 15.9%; P < .001).

Conclusion: Headache was the most commonly reported symptom. Notable group differences in the prevalence of amnesia, loss of consciousness, and SRT may be associated with more severe SRCs, warranting further attention.
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http://dx.doi.org/10.1093/neuros/nyaa091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133332PMC
September 2020

Epidemiology of lacrosse injuries treated at the United States emergency departments between 1997 and 2015.

Res Sports Med 2020 Jul-Sep;28(3):426-436. Epub 2020 Jan 27.

Department of Orthopedics, Johns Hopkins University , Baltimore, MD, USA.

Lacrosse has gained substantial popularity across age groups in the past few decades, but epidemiologic sex differences of lacrosse injuries in emergency settings have not been well described. We characterized and described lacrosse-related injuries presenting to United States Emergency Departments (US EDs) using data from the National Electronic Injury Surveillance System (NEISS). From 1997 to 2015, 7,587 lacrosse-related injuries were treated at US EDs (national estimate of 256,358 injuries). Males accounted for 75.5% of injuries. Average age was 16.0 ± 5.0 (range 5-71) years. Sprains/strains (25.4%), contusions/abrasions (23.9%), and fractures (18.7%) were the most common diagnoses. Females sustained a higher proportion of sprains/strains (36.0%) than males (21.9%) (< 0.01), while males sustained a higher proportion of fractures (injury proportion ratios [IPR]; 21.3% vs. 10.8%, < 0.01). Similar proportions of concussions were observed (IPR; 6.1% in males, 6.2% among females). Differences in injury patterns may be secondary to differences in rules and equipment between the two sports.
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http://dx.doi.org/10.1080/15438627.2020.1721499DOI Listing
December 2020

Concussion Incidence and Trends in 20 High School Sports.

Pediatrics 2019 11 15;144(5). Epub 2019 Oct 15.

Department of Neurological Surgery, and Sports Concussion Center, School of Medicine, Vanderbilt University, Nashville, Tennessee.

Background: Ongoing monitoring of concussion rates and distributions is important in assessing temporal patterns. Examinations of high school sport-related concussions need to be updated. This study describes the epidemiology of concussions in 20 high school sports during the 2013-2014 to 2017-2018 school years.

Methods: In this descriptive epidemiology study, a convenience sample of high school athletic trainers provided injury and athlete exposure (AE) data to the National High School Sports-Related Injury Surveillance Study (High School Reporting Information Online). Concussion rates per 10 000 AEs with 95% confidence intervals (CIs) and distributions were calculated. Injury rate ratios and injury proportion ratios examined sex differences in sex-comparable sports (soccer, basketball, baseball and softball, cross country, track, and swimming). We also assessed temporal trends across the study period.

Results: Overall, 9542 concussions were reported for an overall rate of 4.17 per 10 000 AEs (95% CI: 4.09 to 4.26). Football had the highest concussion rate (10.40 per 10 000 AEs). Across the study period, football competition-related concussion rates increased (33.19 to 39.07 per 10 000 AEs); practice-related concussion rates decreased (5.47 to 4.44 per 10 000 AEs). In all sports, recurrent concussion rates decreased (0.47 to 0.28 per 10 000 AEs). Among sex-comparable sports, concussion rates were higher in girls than in boys (3.35 vs 1.51 per 10 000 AEs; injury rate ratio = 2.22; 95% CI: 2.07 to 2.39). Also, among sex-comparable sports, girls had larger proportions of concussions that were recurrent than boys did (9.3% vs 6.4%; injury proportion ratio = 1.44; 95% CI: 1.11 to 1.88).

Conclusions: Rates of football practice-related concussions and recurrent concussions across all sports decreased. Changes in concussion rates may be associated with changes in concussion incidence, diagnosis, and management. Future research should continue to monitor trends and examine the effect of prevention strategies.
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http://dx.doi.org/10.1542/peds.2019-2180DOI Listing
November 2019

Effect of environmental conditions on injury rates at a Colorado ski resort.

Inj Prev 2020 08 19;26(4):324-329. Epub 2019 Jul 19.

Epidemiology, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA.

Objective: To determine the effect of daily environmental conditions on skiing and snowboarding-related injury rates.

Methods: Injury information was collected from a mountainside clinic at a large Colorado ski resort for the 2012/2013 through 2016/2017 seasons. Daily environmental conditions including snowfall, snow base depth, temperature, open terrain and participant visits were obtained from historical resort records. Snowpack and visibility information were obtained for the 2013/2014 through 2014/2015 seasons and included in a subanalysis. Negative binomial regression was used to estimate injury rate ratios (IRRs) and 95% CIs.

Results: The overall injury rate among skiers and snowboarders was 1.37 per 1000 participant visits during 2012/2013 through 2016/2017. After adjustment for other environmental covariates, injury rates were 22% higher (IRR=1.22, 95% CI 1.14 to 1.29) on days with <2.5 compared with ≥2.5 cm of snowfall, and 14% higher on days with average temperature in the highest quartile (≥-3.1°C) compared with the lowest (<-10.6°C; IRR=1.14, 95% CI 1.03 to 1.26). Rates decreased by 8% for every 25 cm increase in snow base depth (IRR=0.92, 95% CI 0.88 to 0.95). In a subanalysis of the 2013/2014 and 2014/2015 seasons including the same covariates plus snowpack and visibility, only snowpack remained significantly associated with injury rates. Rates were 71% higher on hardpack compared with powder days (IRR=1.71, 95% CI 1.18 to 2.49) and 36% higher on packed powder compared with powder days (IRR 1.36, 95% CI 1.12 to 1.64).

Conclusions: Environmental conditions, particularly snowfall and snowpack, have a significant impact on injury rates. Injury prevention efforts should consider environmental factors to decrease injury rates in skiers and snowboarders.
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http://dx.doi.org/10.1136/injuryprev-2019-043275DOI Listing
August 2020

The Association between Mandated Preseason Heat Acclimatization Guidelines and Exertional Heat Illness during Preseason High School American Football Practices.

Environ Health Perspect 2019 04;127(4):47003

6 Department of Epidemiology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA.

Background: The risk of heat-related illness and death may continue to increase in many locations as a consequence of climate change, but information on the effectiveness of policies to protect populations from the adverse effects of excessive heat is limited. In 2009, the National Athletic Trainers' Association Inter-Association Task Force (NATA-IATF) released guidelines to reduce exertional heat illness (EHI) among U.S. high school athletes participating in preseason sports activities, including preseason practice sessions for American football. A subset of state high school athletic associations have implemented state-mandated guidelines consistent with the 2009 NATA-IATF recommendations, but their effectiveness for reducing preseason EHI is unknown.

Objectives: This study examines the association between the enactment of state high school athletic association-mandated NATA-IATF guidelines and the rate of EHI among high school students during preseason American football practice sessions.

Methods: We performed a quasi-experimental interrupted time-series study of EHI during high school American football practices in the 2005/2006-2016/2017 school years. We estimated state-level EHI rates using High School Reporting Information Online injury and athlete-exposure data, and used generalized estimating equations Poisson regression models to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) comparing state-years with and without mandated NATA-IATF guidelines. State-level covariates included state-year-specific average August temperatures, yearly deviations from each state's August average temperature across the study period, and school year.

Results: Data were available for 455 state-years from 48 states, including 32 state-years (7.0%) from 8 states when mandated guidelines consistent with the NATA-IATF recommendations were implemented. During an estimated 2,697,089 athlete-exposures, 190 EHIs were reported. Estimated preseason EHI rates were lower during state-years with versus without mandated guidelines (adjusted [Formula: see text], 95% CI: 0.23, 0.87).

Conclusions: Our findings suggest that high school athletes would benefit from enactment of the 2009 NATA-IATF guidelines. Similar analyses of the effectiveness of other public health policies to reduce adverse health effects from ambient heat are warranted. https://doi.org/10.1289/EHP4163.
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http://dx.doi.org/10.1289/EHP4163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6777902PMC
April 2019

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Baseball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Baseball (2004-2005 Through 2013-2014).

J Athl Train 2019 Feb;54(2):198-211

Department of Exercise and Sport Science, Colorado School of Public Health, University of Colorado Anschutz, Aurora.

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's baseball injury data.

Objective: To describe the epidemiology of injuries sustained in high school boys' baseball in the 2005-2006 through 2013-2014 academic years and collegiate men's baseball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: Descriptive epidemiology study.

Setting: Online injury surveillance from baseball teams in high school boys (annual average = 100) and collegiate men (annual average = 34).

Patients Or Other Participants: Boys' or men's baseball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college, respectively.

Main Outcome Measure(s): Athletic trainers collected time-loss injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) compared injury rates by school size or division, time in season, event type, and competition level.

Results: The High School Reporting Information Online system documented 1537 time-loss injuries during 1 573 257 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2574 time-loss injuries during 804 737 AEs. The injury rate was higher in college than in high school (3.20 versus 0.98/1000 AEs; IRR = 3.27; 95% CI = 3.07, 3.49). The competition injury rate was higher than the practice injury rate in high school (IRR = 2.27; 95% CI = 2.05, 2.51) and college (IRR = 2.32; 95% CI = 2.15, 2.51). Baseball players at the high school and collegiate levels sustained a variety of injuries across the body, with the most common injuries reported to the upper extremity. Many injuries also occurred while fielding or pitching.

Conclusions: Injury rates were greater in collegiate versus high school baseball and in competition versus practice. These findings highlight the need for injury-prevention interventions focused on reducing the incidence of upper extremity injuries and protecting batters from pitches and fielders from batted balls.
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http://dx.doi.org/10.4085/1062-6050-239-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464305PMC
February 2019

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Softball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Women's Softball (2004-2005 Through 2013-2014).

J Athl Train 2019 Feb;54(2):212-225

Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of girls' and women's softball injury data.

Objective: To describe the epidemiology of injuries sustained in high school girls' softball in the 2005-2006 through 2013-2014 academic years and collegiate women's softball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: Descriptive epidemiology study.

Setting: Online injury surveillance from softball teams in high school girls (annual average = 100) and collegiate women (annual average = 41).

Patients Or Other Participants: Girls' or women's softball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school and the 2004-2005 through 2013-2014 academic years in college.

Main Outcome Measure(s): Athletic trainers collected time-loss injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) compared injury rates by competition level, school size or division, event type, and time in season.

Results: The High School Reporting Information Online system documented 1357 time-loss injuries during 1 173 722 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 1848 time-loss injuries during 579 553 AEs. The injury rate was higher in college than in high school (3.19 versus 1.16/1000 AEs; IRR = 2.76; 95% CI = 2.57, 2.96). The competition injury rate was higher than the practice injury rate in high school (IRR = 2.02; 95% CI = 1.82, 2.25) and in college (IRR = 1.39; 95% CI = 1.27, 1.52). Softball players at both levels sustained a variety of injuries, with the most common being ankle sprains and concussions. Many injuries also occurred while fielding or running bases.

Conclusions: Injury rates were greater in collegiate versus high school softball and in competitions versus practices. These findings highlight the need for injury-prevention interventions, including strength-training and prevention programs to reduce ankle sprains and provide protection for batters from pitches and fielders from batted balls.
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http://dx.doi.org/10.4085/1062-6050-206-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464304PMC
February 2019

Postconcussion Academic Support in Children Who Attend a Primary Care Provider Follow-up Visit after Presenting to the Emergency Department.

J Pediatr 2019 06 8;209:168-175. Epub 2019 Mar 8.

Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO.

Objective: To examine whether a primary care provider (PCP) follow-up visit after emergency department evaluation of concussion improved the children's likelihood of receiving academic support.

Study Design: This was a prospective cohort study. Concussed children, aged 8-18 years, presenting to a regional pediatric trauma center emergency department (n = 160) were contacted 7 and 30 days after injury to gather data on PCP follow-up, symptoms, quality of life, and receipt of academic support instituted after and because of the concussion. Bivariate comparisons of demographics, concussion characteristics, quality of life, and symptoms were made between children who did and did not receive support using independent samples t tests, Wilcoxon rank sum tests, or χ tests. ORs and 95% CIs were calculated using multivariable logistic regression with backwards elimination to test the association between attending an outpatient follow-up visit and the receipt of academic support for variables where P < .2 in bivariate comparisons.

Results: Overall, 51.3% (n = 82) received academic support; of these, 84.2% attended a follow-up visit compared with 71.8% of 78 children who attended a follow-up visit but did not receive support (P = .06). Children who received support were more likely to have commercial insurance; experience a sports-related injury mechanism; have parents whose primary language was English; suffer from learning disabilities and migraines; and be non-Hispanic (P < .05). There was no association between attending a follow-up visit and receipt of academic support (adjusted OR 1.83; 95% CI 0.75-4.45).

Conclusions: Although the majority of children received academic support postconcussion, accommodations were associated with several demographic, medical history, and injury characteristics, but not attending a PCP follow-up visit.
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http://dx.doi.org/10.1016/j.jpeds.2019.01.041DOI Listing
June 2019

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Lacrosse (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Men's Lacrosse (2004-2005 Through 2013-2014).

J Athl Train 2019 Jan;54(1):30-41

Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's lacrosse injury data.

Objective: To describe the epidemiology of injuries sustained in high school boys' lacrosse in the 2008-2009 through 2013-2014 academic years and collegiate men's lacrosse in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: Descriptive epidemiology study.

Setting: Online injury surveillance from lacrosse teams of high school boys (annual average = 55) and collegiate men (annual average = 14).

Patients Or Other Participants: Boys' and men's lacrosse players who participated in practices and competitions during the 2008-2009 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college.

Main Outcome Measure(s): Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.

Results: High School Reporting Information Online documented 1407 time-loss injuries during 662 960 AEs. The National Collegiate Athletic Association Injury Surveillance Program documented 1882 time-loss injuries during 390 029 AEs. The total injury rate from 2008-2009 through 2013-2014 was higher in college than in high school (3.77 versus 2.12/1000 AEs; IRR = 1.78; 95% CI = 1.63, 1.94). Most injuries occurred during competitions in high school (61.4%) and practices in college (61.4%). Injury rates were higher in competitions compared with practices in high school (IRR = 3.59; 95% CI = 3.23, 4.00) and college (IRR = 3.38; 95% CI = 3.08, 3.71). Lower limb injuries, muscle strains, and ligament sprains were common at both levels. Concussion was the most frequent competition diagnosis for all high school player positions.

Conclusions: Rates of time-loss injury were higher in college versus high school and in competitions versus practices. Attention to preventing common lower leg injuries and concussions, especially at the high school level, is essential to decrease their incidence and severity.
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http://dx.doi.org/10.4085/1062-6050-200-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410990PMC
January 2019

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Lacrosse (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Women's Lacrosse (2004-2005 Through 2013-2014).

J Athl Train 2019 Jan;54(1):42-54

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online (HS RIO) system and the National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) has aided the acquisition of girls' and women's lacrosse injury data.

Objective: To describe the epidemiology of injuries sustained in high school girls' lacrosse in the 2008-2009 through 2013-2014 academic years and collegiate women's lacrosse in the 2004-2005 through 2013-2014-academic years using Web-based sports injury surveillance.

Design: Descriptive epidemiology study.

Setting: Online injury surveillance from high school girls' (annual average = 55) and collegiate women's (annual average = 19) lacrosse teams.

Patients Or Other Participants: Female lacrosse players who participated in practices or competitions during the 2008-2009 through 2013-2014 academic years for high school or the 2004-2005 through 2013-2014 academic years for college.

Main Outcome Measure(s): Athletic trainers collected time-loss injury (≥24 hours) and exposure data. We calculated injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis.

Results: High school RIO documented 700 time-loss injuries during 481 687 AEs; the NCAA-ISP documented 1027 time-loss injuries during 287 856 AEs. The total injury rate during 2008-2009 through 2013-2014 was higher in college than in high school (2.55 versus 1.45/1000 AEs; IRR = 1.75; 95% CI = 1.54, 1.99). Most injuries occurred during competitions in high school (51.1%) and practices in college (63.8%). Rates were higher during competitions compared with practices in high school (IRR = 2.32; 95% CI = 2.00, 2.69) and college (IRR = 2.38; 95% CI = 2.09, 2.70). Concussion was the most common diagnosis among all high school and most collegiate player positions, and the main mechanism of contact was with a playing apparatus (eg, stick, ball). Ligament sprains were also common (HS RIO practices = 22.2%, competitions = 30.3%; NCAA-ISP practices = 25.5%, competitions = 30.9%).

Conclusions: Rates of injury were higher in college versus high school female lacrosse players and in competitions versus practices. Injury-prevention strategies are essential to decrease the incidence and severity of concussions and ligament sprains.
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http://dx.doi.org/10.4085/1062-6050-201-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410991PMC
January 2019

The Epidemiology and Management of Exertional Heat Illnesses in High School Sports During the 2012/2013–2016/2017 Academic Years.

J Sport Rehabil 2020 03 6;29(3):332-338. Epub 2019 Jun 6.

Recent data on exertional heat illness (EHI) in high school sports are limited yet warranted to identify specific settings with the highest risk of EHI. To describe the epidemiology of EHI in high school sports during the 2012/2013-2016/2017 academic years. Descriptive epidemiology study. Aggregate injury and exposure data collected from athletic trainers working in high school sports in the United States. High school athletes during the 2012/2013-2016/2017 academic years. High School Reporting Information Online surveillance system data from the 2012/2013-2016/2017 academic years were analyzed. EHI counts, rates per 10,000 athlete exposures (AEs), and distributions were examined by sport, event type, and US census region. EHI management strategies provided by athletic trainers were analyzed. Injury rate ratios with 95% confidence intervals (CIs) compared EHI rates. Overall, 300 EHIs were reported for an overall rate of 0.13/10,000 AE (95% CI, 0.11 to 0.14). Of these, 44.3% occurred in American football preseason practices; 20.7% occurred in American football preseason practices with a registered air temperature ≥90°F and ≥1 hour into practice. The EHI rate was higher in American football than all other sports (0.52 vs 0.04/10,000 AE; injury rate ratio = 11.87; 95% CI, 9.22 to 15.27). However, girls' cross-country had the highest competition EHI rate (1.18/10,000 AE). The EHI rate was higher in the South US census region than all other US census regions (0.23 vs 0.08/10,000 AE; injury rate ratio = 2.96; 95% CI, 2.35 to 3.74). Common EHI management strategies included having medical staff on-site at the onset of EHI (92.7%), removing athlete from play (85.0%), and giving athlete fluids via the mouth (77.7%). American football continues to have the highest overall EHI rate although the high competition EHI rate in girls' cross-country merits additional examination. Regional differences in EHI incidence, coupled with sport-specific variations in management, may highlight the need for region- and sport-specific EHI prevention guidelines.
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http://dx.doi.org/10.1123/jsr.2018-0364DOI Listing
March 2020

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Wrestling (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Wrestling (2004-2005 Through 2013-2014).

J Athl Train 2018 Dec;53(12):1143-1155

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of wrestling injury data.

Objective: To describe the epidemiology of injuries sustained in high school boys' wrestling in the 2005-2006 through 2013-2014 academic years and collegiate men's wrestling in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: Descriptive epidemiology study.

Setting: Online injury surveillance from wrestling teams of high school boys (annual average = 100) and collegiate men (annual average = 11).

Patients Or Other Participants: Male wrestlers who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college.

Main Outcome Measure(s): Athletic trainers collected time-loss (≥24 hours) injuries and exposure data during this time period. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios with 95% confidence intervals, and injury proportions by body site and diagnosis were calculated.

Results: The High School Reporting Information Online documented 3376 time-loss injuries during 1 416 314 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2387 time-loss injuries during 257 297 AEs. The total injury rate was higher in college than in high school (9.28 versus 2.38/1000 AEs; injury rate ratio = 3.89; 95% confidence interval = 3.69, 4.10). In high school, the most commonly injured body parts for both practices and competitions were the head/face (practices = 19.9%, competitions = 21.4%) and shoulder/clavicle (practices = 14.1%, competitions = 21.0%). In college, the most frequently injured body parts for both practices and competitions were the knee (practices = 16.7%, competitions = 30.4%) and head/face (practices = 12.1%, competitions = 14.6%).

Conclusions: Injury rates were higher in collegiate than in high school players, and the types of injuries sustained most often differed. Based on these results, continued study of primary and secondary prevention of injury in wrestlers across levels of competition is warranted.
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http://dx.doi.org/10.4085/1062-6050-154-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365066PMC
December 2018

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Ice Hockey (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Men's and Women's Ice Hockey (2004-2005 Through 2013-2014).

J Athl Train 2018 Dec;53(12):1129-1142

Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.

Context: Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided efforts to collect data on ice hockey injuries.

Objective: To describe the epidemiology of injuries sustained in high school boy's ice hockey in the 2008-2009 through 2013-2014 academic years and collegiate men's and women's ice hockey in the 2004-2005 through 2013-2014 academic years using Web-based surveillance.

Design: Descriptive epidemiology study.

Setting: Online injury surveillance of ice hockey teams of high school boys (annual average = 34), collegiate men (annual average = 20), and collegiate women (annual average = 11).

Patients Or Other Participants: Boys', men's, and women's ice hockey players who participated in practices and competitions during the 2008-2009 through 2013-2014 high school academic years or the 2004-2005 through 2013-2014 collegiate academic years.

Main Outcome Measure(s): Athletic trainers collected time-loss (≥24 hours) injury and exposure data. We calculated injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis.

Results: The High School Reporting Information Online system documented 831 boys' ice hockey time-loss injuries during 356 997 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2611 men's ice hockey time-loss injuries during 552 642 AEs and 752 women's ice hockey injuries during 232 051 AEs. Injury rates were higher in collegiate men than in high school boys during 2008-2009 through 2013-2014 (4.38 versus 2.33/1000 AEs; IRR = 1.88; 95% CI = 1.73, 2.05) and collegiate women during 2004-2005 through 2013-2014 (IRR = 1.46; 95% CI = 1.34, 1.58). Most injuries occurred during competitions (boys = 80.0%, men = 66.9%, women = 55.3%); injury rates were higher in competitions than in practices for boys (IRR = 8.14; 95% CI = 6.87, 9.65), men (IRR = 6.58; 95% CI = 6.06, 7.13), and women (IRR = 3.63; 95% CI = 3.14, 4.19). At all levels, most injuries occurred to the head/face and shoulder/clavicle and resulted in concussions, contusions, or ligament sprains.

Conclusions: Injury rates varied across sports but were consistently higher in competitions than in practices. In competitions, concussions were common injuries, highlighting the need for continued development of injury-prevention strategies.
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http://dx.doi.org/10.4085/1062-6050-176-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365065PMC
December 2018

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Basketball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Women's Basketball (2004-2005 Through 2013-2014).

J Athl Train 2018 Nov;53(11):1037-1048

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of girls' and women's basketball injury data.

Objective: To describe the epidemiology of injuries sustained in high school girls' basketball in the 2005-2006 through 2013-2014 academic years and collegiate women's basketball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: Descriptive epidemiology study.

Setting: Online injury surveillance from basketball teams in high school girls (annual average = 100) and collegiate women (annual average = 57).

Patients Or Other Participants: Girls' and women's basketball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college.

Main Outcome Measure(s): Certified athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) were used to compare injury rates by school size or division, time in season, event type, and competition level.

Results: The High School Reporting Information Online system documented 2930 time-loss injuries during 1 609 733 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 3887 time-loss injuries during 783 600 AEs. The injury rate was higher in college than in high school (4.96 versus 1.82/1000 AEs; IRR = 2.73; 95% CI = 2.60, 2.86). The injury rate was higher in competitions than in practices for both high school (IRR = 3.03; 95% CI = 2.82, 3.26) and collegiate (IRR = 1.99; 95% CI = 1.86, 2.12) players. The most common injuries at both levels were ligament sprains, concussions, and muscle/tendon strains; the majority of injuries affected the ankle, knee, and head/face. These injuries were often caused by contact with another player or a noncontact mechanism.

Conclusions: Injury rates were higher in collegiate than in high school athletes and in competitions than in practices. Similarities in distributions of injuries by body parts, specific diagnoses, and mechanisms of injury suggest that both levels may benefit from similar injury-prevention strategies.
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http://dx.doi.org/10.4085/1062-6050-150-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333223PMC
November 2018

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Basketball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Basketball (2004-2005 Through 2013-2014).

J Athl Train 2018 Nov;53(11):1025-1036

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's basketball injury data.

Objective: To describe the epidemiology of injuries sustained in high school boys' basketball in the 2005-2006 through 2013-2014 academic years and collegiate men's basketball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: Descriptive epidemiology study.

Setting: Online injury surveillance from basketball teams of high school boys (annual average = 100) and collegiate men (annual average = 55).

Patients Or Other Participants: Boys' and men's basketball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college.

Main Outcome Measures: Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) compared injury rates by school size or division, time in season, event type, and competition level.

Results: The High School Reporting Information Online system documented 3056 time-loss injuries during 1 977 480 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 4607 time-loss injuries during 868 631 AEs. The injury rate was higher for college than for high school (5.30 versus 1.55/1000 AE; IRR = 3.43; 95% CI = 3.28, 3.59). The injury rate was higher for competitions than for practices in both high school (IRR = 2.38; 95% CI = 2.22, 2.56) and college (IRR = 2.02; 95% CI = 1.90, 2.14). The most common injuries at both levels were ligament sprains, muscle/tendon strains, and concussions; most injuries affected the ankle, knee, and head/face. Injuries were most often caused by contact with another player or noncontact mechanisms.

Conclusions: Injury rates were greater among collegiate players compared with high school players and were greater during competitions than practices at both levels. Distributions of injuries by body part, diagnoses, and mechanisms of injury were similar, suggesting that athletes at both levels may benefit from similar injury-prevention strategies.
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http://dx.doi.org/10.4085/1062-6050-148-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333228PMC
November 2018

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Basketball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Basketball (2004-2005 Through 2013-2014).

J Athl Train 2018 Nov;53(11):1025-1036

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's basketball injury data.

Objective: To describe the epidemiology of injuries sustained in high school boys' basketball in the 2005-2006 through 2013-2014 academic years and collegiate men's basketball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: Descriptive epidemiology study.

Setting: Online injury surveillance from basketball teams of high school boys (annual average = 100) and collegiate men (annual average = 55).

Patients Or Other Participants: Boys' and men's basketball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college.

Main Outcome Measures: Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) compared injury rates by school size or division, time in season, event type, and competition level.

Results: The High School Reporting Information Online system documented 3056 time-loss injuries during 1 977 480 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 4607 time-loss injuries during 868 631 AEs. The injury rate was higher for college than for high school (5.30 versus 1.55/1000 AE; IRR = 3.43; 95% CI = 3.28, 3.59). The injury rate was higher for competitions than for practices in both high school (IRR = 2.38; 95% CI = 2.22, 2.56) and college (IRR = 2.02; 95% CI = 1.90, 2.14). The most common injuries at both levels were ligament sprains, muscle/tendon strains, and concussions; most injuries affected the ankle, knee, and head/face. Injuries were most often caused by contact with another player or noncontact mechanisms.

Conclusions: Injury rates were greater among collegiate players compared with high school players and were greater during competitions than practices at both levels. Distributions of injuries by body part, diagnoses, and mechanisms of injury were similar, suggesting that athletes at both levels may benefit from similar injury-prevention strategies.
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http://dx.doi.org/10.4085/1062-6050-148-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333228PMC
November 2018

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Volleyball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Women's Volleyball (2004-2005 Through 2013-2014).

J Athl Train 2018 Oct;53(10):926-937

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: : The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided in the acquisition of girls' and women's volleyball injury data.

Objective: : To describe the epidemiology of injuries sustained in high school girls' volleyball in the 2005-2006 through 2013-2014 academic years and collegiate women's volleyball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: : Descriptive epidemiology study.

Setting: : Online injury surveillance from high school girls' (annual average = 100) and collegiate women's (annual average = 50) volleyball teams.

Patients Or Other Participants: : Girls' and women's volleyball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school and the 2004-2005 through 2013-2014 academic years in college.

Main Outcome Measure(s): : Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.

Results: : The High School Reporting Information Online system documented 1634 time-loss injuries during 1 471 872 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2149 time-loss injuries during 563 845 AEs. The injury rate was higher in college than in high school (3.81/1000 versus 1.11/1000 AEs; IRR = 3.43; 95% CI = 3.22, 3.66), and higher in high schools with ≤1000 students than in those with >1000 students (IRR = 1.35; 95% CI = 1.23, 1.49). Injury rates did not vary by collegiate division. The injury rate was higher during competitions than practices for high school (IRR = 1.23; 95% CI = 1.12, 1.36) but not for college (IRR = 1.01; 95% CI = 0.92, 1.10). Ankle sprains were common in both the high school and collegiate setting. However, liberos had a high incidence of concussion.

Conclusions: : Injury rates were higher among collegiate than high school players. However, injury rates differed by event type in high school, unlike college. Concussion injury patterns among liberos varied from those for other positions. These findings highlight the need for injury-prevention interventions specific to setting and position.
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http://dx.doi.org/10.4085/1062-6050-162-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263083PMC
October 2018

Epidemiology of Concussions in High School Boys' Ice Hockey, 2008/09 to 2016/17 School Years.

Clin J Sport Med 2021 Jan;31(1):e21-e28

Department of Exercise and Sport Performance, University of New England, Biddeford, Maine.

Objective: This study examined the epidemiology of concussions in high school boys' ice hockey during the 2008/09 to 2016/17 school years.

Design: Prospective cohort study. Athletic trainers from an average 33 high schools annually reported boys' ice hockey concussion and athlete-exposure (AE) data for the High School Reporting Information Online system.

Setting: Convenience sample of high school boys' ice hockey programs during the 2008/09 to 2016/17 school years.

Patients Or Other Participants: High school boys' ice hockey players (aged ∼14-18 years).

Independent Variables: Concussion data on event type, injury mechanism, symptom resolution time, and time loss were obtained.

Main Outcome Measures: Concussion rates with 95% confidence intervals (CIs) and distributions were calculated.

Results: Overall, 348 concussions were reported in boys' ice hockey during the 2008/09 to 2016/17 academic years, leading to a concussion rate of 0.68/1000 AEs (95% CI, 0.61-0.75). Most occurred in competitions (85.6%), particularly after the first period (72.1% of all competition concussions). Among practice concussions, most occurred after the first hour of practice (60.0%). Most concussions were due to player contact (47.7%) and boards/glass contact (31.9%). Although 69.0% of concussed athletes had symptoms resolve in less than 7 days, only 14.1% returned to activity within a week.

Conclusions: Most concussions occurred within the second and third periods. Preventive strategies that counter an increased risk of concussion due to a greater intensity of gameplay coupled with increased fatigue may be warranted. Moreover, athletes may further benefit from prevention efforts that focus on anticipating impacts during gameplay.
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http://dx.doi.org/10.1097/JSM.0000000000000697DOI Listing
January 2021

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Soccer (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Soccer (2004-2005 Through 2013-2014).

J Athl Train 2018 Sep;53(9):893-905

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: : The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's soccer injury data.

Objective: : To describe the epidemiology of injuries sustained in high school boys' soccer in the 2005-2006 through 2013-2014 academic years and collegiate men's soccer in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: : Descriptive epidemiology study.

Setting: : Online injury surveillance from soccer teams of high school boys (annual average = 100) and collegiate men (annual average = 41).

Patients Or Other Participants: : Boys' or men's soccer players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school and the 2004-2005 through 2013-2014 academic years in college, respectively.

Main Outcome Measure(s): : Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.

Results: : High School Reporting Information Online documented 2912 time-loss injuries during 1 592 238 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 4765 time-loss injuries during 686 918 AEs. The injury rate was higher in college than in high school (6.94 versus 1.83/1000 AEs; IRR = 3.79; 95% CI = 3.62, 3.97). Injury rates increased with smaller school size for high schools and were higher in Division I than in Divisions II and III. The injury rate was higher during competitions than during practices in both high school (IRR = 3.55; 95% CI = 3.30, 3.83) and college (IRR = 3.45; 95% CI = 3.26, 3.65). Most injuries were to the lower extremity. However, concussion was a common injury, particularly in collegiate goalkeepers and at all positions for high school players. Concussions accounted for more than one-fifth of injuries in high school games.

Conclusions: : Injury-prevention interventions should be tailored to reflect variations in the incidence and type of injury by level of competition, event type, and position.
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http://dx.doi.org/10.4085/1062-6050-166-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208297PMC
September 2018

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Soccer (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Women's Soccer (2004-2005 Through 2013-2014).

J Athl Train 2018 Sep;53(9):880-892

Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.

Context: : The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of girls' and women's soccer injury data.

Objective: : To describe the epidemiology of injuries sustained in high school girls' soccer in the 2005-2006 through 2013-2014 academic years and collegiate women's soccer in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: : Descriptive epidemiology study.

Setting: : Online injury surveillance from soccer teams in high school girls (annual average = 100) and collegiate women (annual average = 52).

Patients Or Other Participants: : Female high school and collegiate soccer players who participated in practices or competitions during the 2004-2005 through 2013-2014 academic years.

Main Outcome Measure(s): : Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), injury proportions by body site, and diagnoses were calculated.

Results: : The High School Reporting Information Online system documented 3242 time-loss injuries during 1 393 753 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 5092 time-loss injuries during 772 048 AEs. Injury rates were higher in college than in high school (6.60 versus 2.33/1000 AEs; IRR = 2.84; 95% CI = 2.71, 2.96), and during competitions than during practices in high school (IRR = 4.88; 95% CI = 4.54, 5.26) and college (IRR = 2.93; 95% CI = 2.77, 3.10). Most injuries at both levels affected the lower extremity and were ligament sprains or muscle/tendon strains. Concussions accounted for 24.5% of competition injuries in high school but 14.6% of competition injuries in college. More than one-third of competition injuries to high school goalkeepers were concussions.

Conclusions: : Injury rates were higher in college versus high school and during competitions versus practices. These differences may be attributable to differences in reporting, activity intensity, and game-play skill level. The high incidence of lower extremity injuries and concussions in girls' and women's soccer, particularly concussions in high school goalkeepers, merits further exploration and identification of prevention strategies.
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http://dx.doi.org/10.4085/1062-6050-156-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208306PMC
September 2018

Epidemiology of knee internal derangement injuries in United States high school girls' lacrosse, 2008/09-2016/17 academic years.

Res Sports Med 2019 Oct-Dec;27(4):497-508. Epub 2018 Oct 14.

Department of Exercise and Sport Science, University of North Carolina , Chapel Hill , NC , USA.

Research on knee internal derangement (KID) injuries in high school girls' lacrosse is limited, yet needed to identify sport-specific risk factors. This study describes the epidemiology of KID injuries in United States high school girls' lacrosse during the 2008/09-2016/17 academic years. Athletic trainers (ATs) reported injury and athlete-exposure (AE) data to the High School Reporting Information Online (RIO) surveillance system. KID injuries involved the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), lateral collateral ligament (LCL), and menisci. Injury rates per 10,000AE and injury rate ratios (IRR) with 95% confidence intervals (CI) were reported. Linear regression assessed injury rate time trends. ATs reported 148 KID injuries (rate = 1.92/10,000AE). The injury rate was higher in competition than practice (IRR = 8.40; 95%CI: 5.66-12.49). ACLs comprised a large proportion of KID injuries (46.6%). The ACL injury rate increased over time (P = 0.002), highlighting the need to develop/refine lacrosse-specific KID injury prevention programs.
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http://dx.doi.org/10.1080/15438627.2018.1533471DOI Listing
February 2020

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in United States High School Football (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Football (2004-2005 Through 2013-2014).

J Athl Train 2018 Aug 23;53(8):738-751. Epub 2018 Aug 23.

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: : The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of football injury data.

Objective: : To describe the epidemiology of injuries sustained in high school football in the 2005-2006 through 2013-2014 academic years and collegiate football in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: : Descriptive epidemiology study.

Setting: : Online injury surveillance from football teams of high school boys (annual average = 100) and collegiate men (annual average = 43).

Patients Or Other Participants: : Football players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college.

Main Outcome Measure(s): : Athletic trainers collected time-loss injury (≥24 hours) and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.

Results: : The High School Reporting Information Online system documented 18 189 time-loss injuries during 4 539 636 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 22 766 time-loss injuries during 3 121  476 AEs. The injury rate was higher among collegiate than high school (7.29 versus 4.01/1000 AEs; IRR = 1.82; 95% CI = 1.79, 1.86) athletes. Most injuries occurred during competitions in high school (53.2%) and practices in college (60.9%). The competition injury rate was higher than the practice injury rate among both high school (IRR = 5.62; 95% CI = 5.46, 5.78) and collegiate (IRR = 6.59; 95% CI = 6.41, 6.76) players. Most injuries at both levels affected the lower extremity and the shoulder/clavicle and were diagnosed as ligament sprains and muscle/tendon strains. However, concussion was a common injury during competitions among most positions.

Conclusions: : Injury rates were higher in college than in high school and higher for competitions than for practices. Concussion was a frequent injury sustained during competitions, which confirms the need to develop interventions to mitigate its incidence and severity.
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http://dx.doi.org/10.4085/1062-6050-144-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188086PMC
August 2018

Injuries in girls' soccer and basketball: a comparison of high schools with and without athletic trainers.

Inj Epidemiol 2018 Jul 16;5(1):29. Epub 2018 Jul 16.

Department of Epidemiology, Program for Injury Prevention, Education and Research, University of Colorado Anschutz, Aurora, CO, USA.

Background: Sports injuries impose physical and economic burdens on high school athletes, yet only 37% of high schools have access to a fulltime certified athletic trainer (AT). Although intuitively there are multiple benefits of AT coverage, research demonstrating the measurable effect of AT coverage on rates and patterns of injury is limited. Our objective was to investigate the epidemiology of girls' basketball and soccer injuries in high schools with and without an AT.

Methods: We compared data captured by two similar sports injury surveillance systems during the 2006/07-2008/09 academic years. High School Reporting Information Online (RIO) included a national sample of schools with ATs, and the Sports Injury Surveillance System (SISS) included a sample of Chicago public high schools without ATs.

Results: Overall injury rates were higher in schools without ATs than schools with ATs in girls' soccer (RR: 1.73, 95% CI: 1.51-2.00) and basketball (RR: 1.22, 95% CI: 1.03-1.45). Recurrent injury rates were even higher in schools without ATs compared to schools with ATs in soccer (RR: 6.00 95% CI: 4.54-7.91) and basketball (RR: 2.99, 95% CI: 2.12-4.14). Conversely, concussion rates were higher in schools with ATs than schools without ATs in soccer (RR: 8.05, 95% CI: 2.00-32.51) and basketball (RR: 4.50, 95% CI: 1.43-14.16). Other injury patterns were similar between the two samples.

Conclusions: This study demonstrated the effectiveness of AT coverage of high school girls' soccer and basketball, both in reducing overall and recurrent injury rates and in identifying athletes with concussions. Future studies should evaluate the effect of ATs on other high school sports and on youth sports to determine if these findings are generalizable across sports and age groups.
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http://dx.doi.org/10.1186/s40621-018-0159-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046284PMC
July 2018

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Field Hockey (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Women's Field Hockey (2004-2005 Through 2013-2014).

J Athl Train 2018 Oct 11;53(10):938-949. Epub 2018 Jul 11.

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: : The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of data for girls' and women's field hockey injuries.

Objective: : To describe the epidemiology of injuries sustained in high school girls' field hockey in the 2008-2009 through 2013-2014 academic years and collegiate women's field hockey in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: : Descriptive epidemiology study.

Setting: : Online injury surveillance from field hockey teams in high school girls (annual average = 61) and collegiate women (annual average = 14).

Patients Or Other Participants: : Girls' and women's field hockey players who participated in practices and competitions during the 2008-2009 through 2013-2014 high school academic years and the 2004-2005 through 2013-2014 collegiate academic years.

Main Outcome Measure(s): : Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.

Results: : The High School Reporting Information Online system documented 983 time-loss injuries during 569 551 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 996 time-loss injuries during 185 984 AEs. The injury rate from 2008-2009 through 2013-2014 was higher in college than in high school (3.25 versus 1.73/1000 AEs; IRR = 1.89; 95% CI = 1.63, 2.18). Most injuries occurred during practices in high school (52.0%) and college (60.7%). Injury rates were higher during competitions than practices in high school (IRR = 2.00; 95% CI = 1.76, 2.26) and college (IRR = 1.96; 95% CI = 1.73, 2.23). At both levels, injuries most commonly occurred to the lower extremity and head/face and resulted in muscle/tendon strains and contusions. However, injury patterns varied between practices and competitions.

Conclusions: : Injury rates and patterns varied across age groups and between practices and competitions, highlighting the need for development of targeted injury-prevention strategies at both levels of play.
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http://dx.doi.org/10.4085/1062-6050-173-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263078PMC
October 2018

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Field Hockey (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Women's Field Hockey (2004-2005 Through 2013-2014).

J Athl Train 2018 Oct 11;53(10):938-949. Epub 2018 Jul 11.

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: : The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of data for girls' and women's field hockey injuries.

Objective: : To describe the epidemiology of injuries sustained in high school girls' field hockey in the 2008-2009 through 2013-2014 academic years and collegiate women's field hockey in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: : Descriptive epidemiology study.

Setting: : Online injury surveillance from field hockey teams in high school girls (annual average = 61) and collegiate women (annual average = 14).

Patients Or Other Participants: : Girls' and women's field hockey players who participated in practices and competitions during the 2008-2009 through 2013-2014 high school academic years and the 2004-2005 through 2013-2014 collegiate academic years.

Main Outcome Measure(s): : Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.

Results: : The High School Reporting Information Online system documented 983 time-loss injuries during 569 551 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 996 time-loss injuries during 185 984 AEs. The injury rate from 2008-2009 through 2013-2014 was higher in college than in high school (3.25 versus 1.73/1000 AEs; IRR = 1.89; 95% CI = 1.63, 2.18). Most injuries occurred during practices in high school (52.0%) and college (60.7%). Injury rates were higher during competitions than practices in high school (IRR = 2.00; 95% CI = 1.76, 2.26) and college (IRR = 1.96; 95% CI = 1.73, 2.23). At both levels, injuries most commonly occurred to the lower extremity and head/face and resulted in muscle/tendon strains and contusions. However, injury patterns varied between practices and competitions.

Conclusions: : Injury rates and patterns varied across age groups and between practices and competitions, highlighting the need for development of targeted injury-prevention strategies at both levels of play.
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http://dx.doi.org/10.4085/1062-6050-173-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263078PMC
October 2018
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