Kin 1080
Sport Related Concussion
● Recognize concussions to identify when athletes can return to play, return to
educational/occupational settings - increased risk to damage of brain
● Sport Related Concussion: damage that occurs to neural and glial networks when a
force translated to the body (Mild traumatic brain injury - MTBI)
○ Top three sports to have most concussions: Men’s Football, Women’s soccer,
Women’s Basketball
■ Physiological differences may be the reason why women’s sports are
number 2 and 3 or they may be more open to tell trainers they have a
concussion
■ Men’s cross country is the lowest
■ 110 Players on Football team vs tinier squads for volleyball and soccer
● More athletes = more opportunities to get a concussion
■ Numbers are misleading when relating to absolute number of concussion
incidents due to the difference in size of squads
○ Using absolute and relative measures of frequency determines how to compare
and contrast concussion frequency between sports
○ Player match hours: considers number of hours of practice and play and
numbers of players on field during the time to determine the concussion
frequency
■ Rugby and Australian rules football is much higher than American rules
football
● Horse racing and equestrian has very high incidence
● Mechanisms of sport related to concussion
○ Linear translation - flexing your head (snapping it forward)
○ Rotational (angular) acceleration - head turns to the side very quickly
■ Primary mitigator of concussion
○ Impact deceleration - impact to one side of brain (backward) sudden deceleration
to strike against occipital bone
■ Impact deceleration secondary to head striking an opposing players body
● Coup and contra-coup injury
○ Coup: initial contact to smacking head against a block (ex. Running backs knee)
affecting frontal lobe
■ Frontal lobe helps with executive (problem solving skill) and high level
cognitive function
○ Contra-coup: after head strikes knee brain hits opposite side of the head striking
occipital bone affecting temporal lobe
■ Temporal lobe affects memory and language function
● Neurometabolic Cascade (see image on right): potassium leaks out of cell causing cell to
react to asking for more sodium out of cell and potassium into cell
○ More glucose needed to provide energy for this process
○ Cerebral blood flow is suppressed causing the ions to the brain to decrease
, ■ 7-10 days to fix this issue
○ Cell increases need for ions causing a lactate
accumulation = depresses overall activity for brain
● Sport Concussion Assessment Tool (SCAT-5)
○ Test symptoms of athlete and the severity of each to
determine clinical diagnosis
○ Cognitive Motor Tasks: (state months in reverse order,
memory recall, balance task, reverse number recall)
■ Low Resolution tasks that can provide indefinite
results
● Chronic Traumatic Encephalopathy (CTE)
○ Brain becomes smaller (atrophy), ventricles sizes are much larger (holds more
spinal fluid)
■ Can lead to Parkinsonism, aggressiveness, suicidal behaviour, dementia,
motor neuron disease, poor impulse control, depression, decline in
memory and cognition, motor neuron disease (ALS)
■ Only be diagnosed after Death
○ Causes:
■ Repetitive brain trauma with or without receiving a concussion
● Athletes (football) may experience 2000 subconcussive impacts
which can contribute to CTE
■ Strong link between concussion and CT
○ Characteristics:
■ Disorder of brain
■ Holes in brain that lead to damage around small vessels of deep folds in
brain
● Reaction of proteins released from brain
■ Neuropathological investigations show that this is very distinct due to the
damage is surrounded around small blood vessels compared to other
diseases that are similar
● Neuropsychological Assessment (executive abilities)
○ Trail making task - evaluate to switch and move you attention
○ Ray-Osterreirh Complex Figure Test - ability to accurately depict this
○ Concussed athletes may not show any deficits so it may show that these
activities are not sensitive enough to diagnose concussion
● Further Research:
○ Magnetic resonance imagery - not very effective
○ Blood test - testing protein and enzymes in blood
○ ERP (event related brain potential): measure of brain cognitive response to
specific stimulus
■ N2Pc: event related brain potential related to visuospatial attention
(attention to regulate your visual space around you)
■ P300 = measure of stimuli classification processing speed (measure
executive function)
, ● Football Players testing of three groups (plus control groups)
○ Group 1: no detected concussion
○ Group 2: one confirmed diagnosis of concussion
○ Group 3: 2 or more concussions (9 months after last concussion)
■ For each ERP task, no difference between each group
■ No difference in amplitude for N2pc scores (similar visuospatial
awareness)
■ P300 scores: larger amplitude with no concussion group = executive
deficits after a concussion
Movement Neuroscience
● Movement in the context of daily living and everything we do: brain/spinal cord to
skeletal muscle
● Motor Learning: internal processes Associated with practice or experience leading to
relatively permanent gain in performance capabilities
○ Learning only occurs if improvement can be transferred over for a long period of
time
○ Short period growth = performance effect, not a learning effect
● Motor Control: understanding of neural, physical, and behavioural aspects of
movement
○ Brain processes selects and responds to environmental stimuli or intrinsic stimuli
to move
● Motor Learning/control came from the convergence of psychology, neuroscience,
engineering, education
○ Cognitive psychology: brain processes selects and responds to stimuli
■ Richard Shiffrin and Atkinson: Atkinson model of memory processing: 3
Distinct memory systems
● Learning/Feature selection
● Language processing
● Vision
○ Education - Franklin M. Henry
■ Study of gross motor skills (entire body), training people for performance
■ Taught how to learn motor skills
○ Neuroscience - reciprocal innervation (Sharingtons Law)
■ Activation and relaxation of agonist and antagonist muscles respectively
○ Engineering - Arthur Melton/Paul Fitts
■ Melton - simple tasks to determine who would be the best pilot (good at
simple task = good at complex tasks)
● Do not do a good job of prediction (no correlation between simple
and complex task)
■ Fitts - redesigned Airplane to fit pilot needs for optimally interact with
plane (cognitive ergonomics)
● Spatial Compatibility: stimulus and response are in same visual
field/location (incompatibly is opposite = longer reaction time)
Central Nervous System/Peripheral Nervous System
Sport Related Concussion
● Recognize concussions to identify when athletes can return to play, return to
educational/occupational settings - increased risk to damage of brain
● Sport Related Concussion: damage that occurs to neural and glial networks when a
force translated to the body (Mild traumatic brain injury - MTBI)
○ Top three sports to have most concussions: Men’s Football, Women’s soccer,
Women’s Basketball
■ Physiological differences may be the reason why women’s sports are
number 2 and 3 or they may be more open to tell trainers they have a
concussion
■ Men’s cross country is the lowest
■ 110 Players on Football team vs tinier squads for volleyball and soccer
● More athletes = more opportunities to get a concussion
■ Numbers are misleading when relating to absolute number of concussion
incidents due to the difference in size of squads
○ Using absolute and relative measures of frequency determines how to compare
and contrast concussion frequency between sports
○ Player match hours: considers number of hours of practice and play and
numbers of players on field during the time to determine the concussion
frequency
■ Rugby and Australian rules football is much higher than American rules
football
● Horse racing and equestrian has very high incidence
● Mechanisms of sport related to concussion
○ Linear translation - flexing your head (snapping it forward)
○ Rotational (angular) acceleration - head turns to the side very quickly
■ Primary mitigator of concussion
○ Impact deceleration - impact to one side of brain (backward) sudden deceleration
to strike against occipital bone
■ Impact deceleration secondary to head striking an opposing players body
● Coup and contra-coup injury
○ Coup: initial contact to smacking head against a block (ex. Running backs knee)
affecting frontal lobe
■ Frontal lobe helps with executive (problem solving skill) and high level
cognitive function
○ Contra-coup: after head strikes knee brain hits opposite side of the head striking
occipital bone affecting temporal lobe
■ Temporal lobe affects memory and language function
● Neurometabolic Cascade (see image on right): potassium leaks out of cell causing cell to
react to asking for more sodium out of cell and potassium into cell
○ More glucose needed to provide energy for this process
○ Cerebral blood flow is suppressed causing the ions to the brain to decrease
, ■ 7-10 days to fix this issue
○ Cell increases need for ions causing a lactate
accumulation = depresses overall activity for brain
● Sport Concussion Assessment Tool (SCAT-5)
○ Test symptoms of athlete and the severity of each to
determine clinical diagnosis
○ Cognitive Motor Tasks: (state months in reverse order,
memory recall, balance task, reverse number recall)
■ Low Resolution tasks that can provide indefinite
results
● Chronic Traumatic Encephalopathy (CTE)
○ Brain becomes smaller (atrophy), ventricles sizes are much larger (holds more
spinal fluid)
■ Can lead to Parkinsonism, aggressiveness, suicidal behaviour, dementia,
motor neuron disease, poor impulse control, depression, decline in
memory and cognition, motor neuron disease (ALS)
■ Only be diagnosed after Death
○ Causes:
■ Repetitive brain trauma with or without receiving a concussion
● Athletes (football) may experience 2000 subconcussive impacts
which can contribute to CTE
■ Strong link between concussion and CT
○ Characteristics:
■ Disorder of brain
■ Holes in brain that lead to damage around small vessels of deep folds in
brain
● Reaction of proteins released from brain
■ Neuropathological investigations show that this is very distinct due to the
damage is surrounded around small blood vessels compared to other
diseases that are similar
● Neuropsychological Assessment (executive abilities)
○ Trail making task - evaluate to switch and move you attention
○ Ray-Osterreirh Complex Figure Test - ability to accurately depict this
○ Concussed athletes may not show any deficits so it may show that these
activities are not sensitive enough to diagnose concussion
● Further Research:
○ Magnetic resonance imagery - not very effective
○ Blood test - testing protein and enzymes in blood
○ ERP (event related brain potential): measure of brain cognitive response to
specific stimulus
■ N2Pc: event related brain potential related to visuospatial attention
(attention to regulate your visual space around you)
■ P300 = measure of stimuli classification processing speed (measure
executive function)
, ● Football Players testing of three groups (plus control groups)
○ Group 1: no detected concussion
○ Group 2: one confirmed diagnosis of concussion
○ Group 3: 2 or more concussions (9 months after last concussion)
■ For each ERP task, no difference between each group
■ No difference in amplitude for N2pc scores (similar visuospatial
awareness)
■ P300 scores: larger amplitude with no concussion group = executive
deficits after a concussion
Movement Neuroscience
● Movement in the context of daily living and everything we do: brain/spinal cord to
skeletal muscle
● Motor Learning: internal processes Associated with practice or experience leading to
relatively permanent gain in performance capabilities
○ Learning only occurs if improvement can be transferred over for a long period of
time
○ Short period growth = performance effect, not a learning effect
● Motor Control: understanding of neural, physical, and behavioural aspects of
movement
○ Brain processes selects and responds to environmental stimuli or intrinsic stimuli
to move
● Motor Learning/control came from the convergence of psychology, neuroscience,
engineering, education
○ Cognitive psychology: brain processes selects and responds to stimuli
■ Richard Shiffrin and Atkinson: Atkinson model of memory processing: 3
Distinct memory systems
● Learning/Feature selection
● Language processing
● Vision
○ Education - Franklin M. Henry
■ Study of gross motor skills (entire body), training people for performance
■ Taught how to learn motor skills
○ Neuroscience - reciprocal innervation (Sharingtons Law)
■ Activation and relaxation of agonist and antagonist muscles respectively
○ Engineering - Arthur Melton/Paul Fitts
■ Melton - simple tasks to determine who would be the best pilot (good at
simple task = good at complex tasks)
● Do not do a good job of prediction (no correlation between simple
and complex task)
■ Fitts - redesigned Airplane to fit pilot needs for optimally interact with
plane (cognitive ergonomics)
● Spatial Compatibility: stimulus and response are in same visual
field/location (incompatibly is opposite = longer reaction time)
Central Nervous System/Peripheral Nervous System
