Efficacy of Guardian Cap Soft-Shell Padding on Head Impact Kinematics in American Football: Pilot Findings.

Sport-related concussion prevention strategies in collision sports are a primary interest for sporting organizations and policy makers. After-market soft-shell padding purports to augment the protective capabilities of standard football helmets and to reduce head impact severity. We compared head impact kinematics [peak linear acceleration (PLA) and peak rotational acceleration (PRA)] in athletes wearing Guardian Cap soft-shell padding to teammates without soft-shell padding. Ten Division I college football players were enrolled [soft-shell padding (SHELL) included four defensive linemen and one tight end; non-soft-shell (CONTROL) included two offensive linemen, two defensive linemen, and one tight end]. Participants wore helmets equipped with the Head Impact Telemetry System to quantify PLA (g) and PRA (rad/s2) during 14 practices. Two-way ANOVAs were conducted to compare log-transformed PLA and PRA between groups across helmet location and gameplay characteristics. In total, 968 video-confirmed head impacts between SHELL (n = 421) and CONTROL (n = 547) were analyzed. We observed a Group x Stance interaction for PRA (F1,963 = 7.21; p = 0.007) indicating greater PRA by SHELL during 2-point stance and lower PRA during 3- or 4-point stances compared to CONTROL. There were no between-group main effects. Protective soft-shell padding did not reduce head impact kinematic outcomes among college football athletes.

Quality of Life Differences in Children and Adolescents With 0, 1 to 2, or 3+ Persistent Postconcussion Symptoms.

CONTEXT: Persistent postconcussion symptoms (PPCSs) are associated with lower health-related quality of life (HRQoL) in children and adolescents. Despite commonly cited criteria for PPCSs involving 3 or more complaints, many individuals experience just 1 or 2 symptoms that may still negatively affect HRQoL. OBJECTIVE: To determine differences in HRQoL between children and adolescents with 0, 1 to 2, or 3+ parent-reported persistent symptoms at 1 month postconcussion. DESIGN: Prospective cohort study. SETTING: Community practice clinics. PATIENTS OR OTHER PARTICIPANTS: Individuals aged 8 to 18 years presented for the initial visit within 3 days of a sport- or recreation-related concussion. One month later, parents or guardians reported persistent symptoms using the Rivermead Post Concussion Symptoms Questionnaire (RPQ). Individuals with complete symptom data were analyzed (n = 236/245, n = 97 females, age = 14.3 ± 2.1 years). Participants were grouped by the number of discrete RPQ symptoms reported as worse than preinjury (0, 1-2, or 3+). MAIN OUTCOME MEASURE(S): Total summary and subscale scores on the Pediatric Quality of Life Inventory (PedsQL) 23-item HRQoL inventory and 18-item Multidimensional Fatigue Scale (MDFS). RESULTS: Kruskal-Wallis rank sum tests highlighted differences in PedsQL HRQoL and MDFS total scores across symptom groups (PedsQL HRQoL: χ22 = 85.53, P < .001; MDFS: χ22 = 93.15, P < .001). Dunn post hoc analyses indicated all 3 groups were statistically significantly different from each other (P < .001). The median (interquartile range) values for the Peds QL Inventory HRQoL totals were 93.5 (84.2-98.8) for those with 0 symptoms; 84.8 (73.9-92.4) for those with 1 to 2 symptoms; and 70.7 (58.7-78.0) for those with 3+ symptoms. The median (interquartile range) values for the MDFS totals were 92.4 (76.4-98.6) for those with 0 symptoms; 78.5 (65.6-88.9) for those with 1 to 2 symptoms; and 54.2 (46.2-65.3) for those with 3+ symptoms. Similar group differences were observed for each PedsQL HRQoL and MDFS subscale score. CONCLUSIONS: Children and adolescents whose parents reported 1 to 2 PPCSs had lower HRQoL and more fatigue than those with 0 symptoms. Across all 3 groups, those with 3+ persistent symptoms had the lowest HRQoL and most fatigue. These findings indicate the continued need for intervention in this age group to prevent and address PPCSs.

Individual Symptom Report Prevalence in Children and Adolescents With One, Two, and Three or More Persistent Symptoms After Concussion: A Brief Report.

OBJECTIVE: To examine differences in individual symptom report prevalence between children and adolescents experiencing 1 to 2 versus ≥3 persistent postconcussion symptoms. DESIGN: A prospective cohort study. SETTING: Three community practice concussion clinics within a family practice network. PATIENTS: Children and adolescents aged 8 to 18 years presenting to clinics within 72 hours of a sport-related or recreation-related concussion. Those with complete symptom data from a 1-month follow-up time point (n = 236) were included in analyses. INDEPENDENT VARIABLES: One hundred thirty-six patients (n = 136) reported 0 symptoms as worse than preinjury at the 1-month time point. Participants reporting 1+ symptoms as worse than preinjury at 1 month were assigned to groups based on the number of symptoms endorsed: those with 1 to 2 (n = 38) compared with those experiencing ≥3 (n = 62). MAIN OUTCOME MEASURES: Fisher exact tests were used to compare symptom report prevalence for each item of the Rivermead Postconcussion Symptoms Questionnaire. This research question was formulated and examined after completion of data collection. RESULTS: Across both groups, headache and fatigue were the most commonly reported persistent postconcussion symptoms. Several emotional symptoms (eg, irritability, depression) were primarily or only present in those reporting ≥3 persistent symptoms. CONCLUSIONS: Findings provide detail regarding the clinical manifestation of experiencing fewer versus more persistent postconcussion symptoms, underscoring the importance of developing individualized, multifaceted rehabilitation programs.

Physical activity and sleep moderate the relationship between stress and screen time in college-aged adults.

For undergraduate students, excessive screen time is associated with poorer mental health and greater perceived stress. Objective: The purpose of the present investigation was to determine the potential moderating influence of physical activity and sleep on the relationship between screen time and stress. Participants & Methods: A cross-sectional sample of 513 undergraduate students between Fall 2017 & Spring 2020 were given a questionnaire to assess perceived stress level, physical activity engagement, screen time, and sleep. Results: Stepwise hierarchical regression analyses identified that screen time, sleep, and the three-way interaction between screen time, sleep, and physical activity were associated with stress. Post-hoc decomposition revealed that higher levels of physical activity and sleep both mitigated the relationship between screen time and stress. Conclusions: Findings suggest that modifiable health behaviors such as physical activity and sleep may be important factors for managing the negative effects of screen time on stress in college-aged adults.

HighlightsExcessive screen time is associated with higher levels of stress.Cross-sectional sample of 513 college-aged young adults.Adiposity and aerobic fitness were unrelated to stress.In high active individuals, screen time is unrelated to stress.In low active individuals, greater sleep attenuates the screen time-stress relationship.

Aerobic fitness relates to superior exact and approximate arithmetic processing in college-aged adults.

BACKGROUND: Aerobic fitness relates to superior math achievement, but the underlying reasons remain unclear. This study tested how more efficient processing (efficiency hypothesis) or enhanced allocation of cognitive resources (resources hypothesis) underly fitness-related differences in arithmetic cognition in a sample of 138 college-aged adults. METHOD: Participants completed an arithmetic task while pupillary measures were recorded prior to an aerobic fitness test. RESULTS: Higher aerobic fitness was associated with shorter reaction time for all problems and greater pupillary reactivity for problems requiring approximate and exact arithmetic. CONCLUSIONS: Superior aerobic fitness relates to greater cognitive resources available to execute exact and approximate arithmetic faster. Fitness-related differences in math achievement may be driven by the cognitive resources underlying arithmetic strategy. These differences may extend beyond educational achievement and affect the motivation to engage in health behaviors based on quantitative information. Thus, improving cardiovascular fitness has the potential to also ameliorate health numeracy.

Phasic activity of the locus-coeruleus is not a mediator of the relationship between fitness and inhibition in college-aged adults.

Aerobic fitness is consistently and robustly associated with superior performance on assessments of cognitive control. One potential mechanism underlying this phenomenon is activation of the locus-coeruleus. Specifically, individuals with greater aerobic fitness may be better able to sustain engagement in a cognitively demanding task via a superior ability to meet the metabolic demands of this neural system. Accordingly, the present investigation examined 1) the relationship between aerobic fitness and phasic activation of the locus-coeruleus (indexed using pupillometry) and 2) the potential mediating influence of locus-coeruleus activity on the relationship between aerobic fitness and cognitive task performance. Participants performed an inhibition task while their pupillary responses were measured using an infrared eye tracker. A VO2max test was then performed to determine individuals' aerobic fitness levels. Consistent with previous research, higher levels of aerobic fitness were related to shorter reaction time. However, phasic activity of the locus-coeruleus did not mediate this relationship - nor did it relate to aerobic fitness level. These results suggest that aerobic fitness does not relate to differences in locus-coeruleus activity in the context of cognitive control in college-aged adults.

Aerobic Fitness Unrelated to Acquisition of Spatial Relational Memory in College-Aged Adults.

While compelling evidence indicates that poorer aerobic fitness relates to impairments in retrieving information from hippocampal-dependent memory, there is a paucity of research on how aerobic fitness relates to the acquisition of such relational information. Accordingly, the present investigation examined the association between aerobic fitness and the rate of encoding spatial relational memory-assessed using a maximal oxygen consumption test and a spatial configuration task-in a sample of 152 college-aged adults. The findings from this investigation revealed no association between aerobic fitness and the acquisition of spatial relational memory. These findings have implications for how aerobic fitness is characterized with regard to memory, such that aerobic fitness does not appear to relate to the rate of learning spatial-relational information; however, given previously reported evidence, aerobic fitness may be associated with a greater ability to recall relational information from memory.

Carbohydrate mouth rinse has no effects on behavioral or neuroelectric indices of cognition.

Rinsing the mouth with a carbohydrate solution has been suggested as a means to enhance aspects of both physical and cognitive performance. However, evidence in support of these assertions is relatively weak. The purpose of this study was to investigate the effects of a carbohydrate mouth rinse solution on motor speed, inhibition, and sustained attention as indexed by both behavioral and neuroelectric measures. Using a double-blind, placebo-controlled, within-subjects crossover design, 50 college-aged young adults performed a battery of cognitive tasks both before and after rinsing their mouth for 10 s with 20 mL of either a carbohydrate mouth rinse solution or a sensory-matched placebo control solution. A simple tapping task was used as a measure of motor speed, a modified Eriksen flanker task was used to index inhibition, and a rapid visual information processing task was used as a measure of sustained attention. Participants demonstrated longer reaction times in the Flanker task after rinsing their mouths with the carbohydrate mouth rinse, relative to pretest. No differences in reaction time were observed for the placebo control condition. P3 latency in the Flanker task as an index of attentional processing speed was shorter at posttest than at pretest in the placebo control - but not the carbohydrate mouth rinse - condition. These results suggest that despite claims of cognitive enhancement, carbohydrate mouth rinses do not appear to alter motor speed, inhibition, or sustained attention as compared to a placebo control in non-physically-fatigued college-aged adults.

Aerobic fitness relates to differential attentional but not language-related cognitive processes.

Compelling evidence supports an association between the attribute of aerobic fitness and achievement scores on standardized tests of reading. However, such standardized assessments provide only a broad valuation of a complex network of language related sub-processes that contribute to reading and are heavily confounded by other attention-related processes. The present investigation sought to clarify the nature of the association between aerobic fitness and language processing in a sample of college-aged adults. Participants were bifurcated based on aerobic fitness level and on a separate day were asked to complete a lexical decision task while neuroelectric activity was recorded. Analysis of word-level language-related ERP components revealed no fitness differences. However, lower aerobically-fit individuals elicited smaller amplitude for attention-related ERP components relative to the higher aerobically-fit group. These data provide initial evidence to suggest that fitness-related differences in reading achievement may result from attentional processes rather than acting upon specific language-related processes.

Pupillometric indices of locus-coeruleus activation are not modulated following single bouts of exercise.

Single bouts of exercise have been observed to enhance numerous domains of cognition including inhibitory aspects of cognitive control and neuroelectric indices of attention. Given that the locus-coeruleus norepinephrine system regulates alertness and attention, this system may underlie these exercise-induced enhancements. The present study used pupillometry to examine the extent to which a single bout of exercise induces changes in aspects of locus-coeruleus activation, as well as the extent to which changes in locus-coeruleus activation were associated with changes in inhibition and neuroelectric indices of attention. Using a within-participants crossover design, behavioral, neuroelectric, and pupillometric measures were assessed in response to an inhibitory control task before and after 20-min of either aerobic exercise or an active-control condition during two separate, counterbalanced sessions. The aerobic exercise condition consisted of walking/jogging on a motor driven treadmill at an intensity of approximately 70% of age-predicted maximum heart rate. The active control condition consisted of walking on the treadmill at 0.5 mph and 0% grade. Replicating prior findings, enhancements in both reaction time and neuroelectric indices of attention were observed in response to the exercise condition. However, neither the exercise nor the active control conditions were observed to induce changes in activation of the locus-coeruleus as indexed by pupil size, and changes in activation of the locus-coeruleus were not associated with exercise-induced changes in inhibition and neuroelectric indices of attention. Accordingly, these findings provide evidence to suggest that activation of the locus-coeruleus is not a mechanism underlying exercise-induced enhancements in cognition.