Investigating Concussion Knowledge in US Born Versus Internationally Born Collegiate Student-Athletes in the United States.

OBJECTIVE: To compare concussion knowledge between US born and internationally born collegiate student-athletes. Furthermore, to investigate whether length of time in the United States impacted concussion knowledge. DESIGN: Survey. SETTING: Preparticipation physicals at a midwestern NAIA college. PARTICIPANTS: Three hundred one collegiate student-athletes. INTERVENTIONS: Demographic questionnaire and the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS). MAIN OUTCOME MEASURES: t test was used to determine whether a difference in Concussion Knowledge Index (CKI) scores exists between US born and internationally born student-athletes. A one-way analysis of variance was used to determine significance for length of time in the United States. RESULTS: A statistically significant difference was found for CKI scores between US born (19.22 ± 2.38) and internationally born student-athletes (18.01 ± 2.57) (t = 3.895, P = 0.000). Analysis of variance demonstrated statistically significant difference for CKI scores (F2,300 = 13.883, P = 0.001). Post hoc analysis found significant differences in CKI scores between US born (19.22 ± 2.38) and internationally born student-athletes in the United States less than 2 years (17.31 ± 2.52) (P = 0.000), and between internationally born student-athletes in the United States 2 or more years (19.15 ± 2.25) and internationally born student-athletes in the United States less than 2 years (17.31 ± 2.52) (P = 0.002). CONCLUSION: Among this sample, being born in the United States and length of time in the United States contribute to student-athletes' concussion knowledge. CLINICAL RELEVANCE: Standardized guidelines are needed to assist health care professionals in properly educating student-athletes about concussions as the recognition and management of concussions can be affected by a student-athlete's knowledge.

Effect of different levels of localized muscle fatigue on knee position sense.

There is little information available regarding how proprioceptive abilities decline as the amount of exertion increases during exercise. The purpose of this study was to determine the role of different levels of fatigue on knee joint position sense. A repeated measures design was used to examine changes in active joint reposition sense (AJRS) prior to and following three levels of fatigue. Eighteen participants performed knee extension and flexion isokinetic exercise until torque output was 90%, 70%, or 50% of the peak hamstring torque for three consecutive repetitions. Active joint reposition sense at 15, 30, or 45 degrees was tested following the isokinetic exercise session. Following testing of the first independent measure, participants were given a 20 minute rest period. Testing procedures were repeated for two more exercise sessions following the other levels of fatigue. Testing of each AJRS test angle was conducted on three separate days with 48 hours between test days. Significant main effect for fatigue was indicated (p = 0.001). Pairwise comparisons indicated a significant difference between the pre-test and following 90% of peak hamstring torque (p = 0.02) and between the pre-test and following 50% of peak hamstring torque (p = 0.02). Fatigue has long been theorized to be a contributing factor in decreased proprioceptive acuity, and therefore a contributing factor to joint injury. The findings of the present study indicate that fatigue may have an effect on proprioception following mild and maximum fatigue. Key pointsA repeated measures design was used to examine the effect of different levels of fatigue on active joint reposition sense (AJRS) of the knee at joint angles of 15°, 30° and 45° of flexion.A statistically significant main effect for fatigue was found, specifically between no fatigue and mild fatigue and no fatigue and maximum fatigue.A statistically significant interaction effect between AJRS and fatigue was not found.Secondary analysis of the results indicated a potential plateau effect of AJRS as fatigue continues to increase.Further investigation of the effect of increasing levels of fatigue on proprioception is warranted.