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      Comparison of Volleyball-Related Injuries at US Emergency Departments Between High School and Collegiate Athletes: A 10-Year NEISS Database Study

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          Abstract

          Background:

          There is a paucity of current data regarding the sport-specific injury patterns and epidemiological trends associated with volleyball.

          Purpose:

          To provide an updated, comparative assessment of the epidemiology of volleyball-related injuries among female high school– and college-aged athletes and to characterize the burden of these injuries on emergency departments (EDs) across the United States.

          Study Design:

          Descriptive epidemiological study.

          Methods:

          Data were obtained from the National Electronic Injury Surveillance System for volleyball-related injuries between 2012 and 2021 in high school–aged (14-18 years) and college-aged (19-23 years) patients. Incidence, injury characteristics, incident locales, and dispositions were analyzed with weighted population statistics based on National Federation of State High School Associations and National Collegiate Athletic Association data as well as incidence rates and incidence rate ratios (IRRs) and 95% CIs.

          Results:

          In total, an estimated 214,302 female athletes aged 14 to 23 years were evaluated in EDs across the United States with volleyball-related injuries between 2012 and 2021. Female college-aged athletes were nearly 3 times more likely to be evaluated with these injuries than their high school–aged counterparts, with incidence rates of 12.8 per 100 at-risk individuals among college-aged athletes and 4.3 per 100 at-risk individuals in high school–aged athletes (IRR, 0.338; 95% CI, 0.333-0.342). The ankle, head, and knee were most frequently injured, often involving strains/sprains, contusions, fractures, and concussions. The IRRs of nearly all injuries were higher among collegiate athletes, especially among knee (IRR, 4.56; 95% CI, 4.40-4.72) and shoulder (IRR, 5.07; 95% CI, 4.81-5.35) injuries.

          Conclusion:

          Among volleyball-related injuries evaluated in EDs between 2012 and 2021, the incidence rates of injuries in college-aged athletes far surpassed those of their high school–aged peers irrespective of injury type or bodily location. While sprains and strains were the most frequent injuries, head injuries accounted for the second most common diagnosis in both groups, suggesting that clinicians should maintain a high index of suspicion for concussion when evaluating players.

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          Most cited references18

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          American Medical Society for Sports Medicine position statement on concussion in sport

          Sport-related concussion (SRC) is a common injury in recreational and organised sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment and management of SRC. In addition to a growing need for knowledgeable healthcare professionals to provide evidence-based care for athletes with SRC, media attention and legislation have created awareness and, in some cases, fear about many issues and unknowns surrounding SRC. The American Medical Society for Sports Medicine (AMSSM) formed a writing group to review the existing literature on SRC, update its previous position statement, and to address current evidence and knowledge gaps regarding SRC. The absence of definitive outcomes-based data is challenging and requires relying on the best available evidence integrated with clinical experience and patient values. This statement reviews the definition, pathophysiology and epidemiology of SRC, the diagnosis and management of both acute and persistent concussion symptoms, the short-term and long-term risks of SRC and repetitive head impact exposure, SRC prevention strategies, and potential future directions for SRC research. The AMSSM is committed to best clinical practices, evidence-based research and educational initiatives that positively impact the health and safety of athletes.
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            Epidemiology of concussions among United States high school athletes in 20 sports.

            In the United States (US), an estimated 300,000 sports-related concussions occur annually. Among individuals 15 to 24 years of age, sports are second only to motor vehicle crashes as the leading cause of concussions. To investigate the epidemiology of concussions in high school athletes by comparing rates and patterns of concussion among 20 sports. Descriptive epidemiology study. Using an Internet-based data collection tool, RIO, certified athletic trainers from a large, nationally disperse sample of US high schools reported athlete exposure and injury data for 20 sports during the 2008-2010 academic years. During the study period, 1936 concussions were reported during 7,780,064 athlete-exposures (AEs) for an overall injury rate of 2.5 per 10,000 AEs. The injury rate was higher in competition (6.4) than practice (1.1) (rate ratio [RR], 5.7; 95% confidence interval [CI], 5.2-6.3). The majority of concussions resulted from participation in football (47.1%, n = 912), followed by girls' soccer (8.2%, n = 159), boys' wrestling (5.8%, n = 112), and girls' basketball (5.5%, n = 107). Football had the highest concussion rate (6.4), followed by boys' ice hockey (5.4) and boys' lacrosse (4.0). Concussions represented a greater proportion of total injuries among boys' ice hockey (22.2%) than all other sports studied (13.0%) (injury proportion ratio [IPR], 1.7; 95% CI, 1.4-2.1; P < .01). In gender-comparable sports, girls had a higher concussion rate (1.7) than boys (1.0) (RR, 1.7; 95% CI, 1.4-2.0). The most common mechanisms of injury were player-player contact (70.3%) and player-playing surface contact (17.2%). In more than 40% of athletes in sports other than girls' swimming and girls' track, concussion symptoms resolved in 3 days or less. Athletes most commonly returned to play in 1 to 3 weeks (55.3%), with 22.8% returning in less than 1 week and 2.0% returning in less than 1 day. Although interest in sports-related concussions is usually focused on full-contact sports like football and ice hockey, concussions occur across a wide variety of high school sports. Concussion rates vary by sport, gender, and type of exposure. An understanding of concussion rates, patterns of injury, and risk factors can drive targeted preventive measures and help reduce the risk for concussion among high school athletes in all sports.
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              College Sports-Related Injuries - United States, 2009-10 Through 2013-14 Academic Years.

              Sports-related injuries can have a substantial impact on the long-term health of student-athletes. The National Collegiate Athletic Association (NCAA) monitors injuries among college student-athletes at member schools. In academic year 2013-14, a total of 1,113 member schools fielded 19,334 teams with 478,869 participating student-athletes in NCAA championship sports (i.e., sports with NCAA championship competition) (1). External researchers and CDC used information reported to the NCAA Injury Surveillance Program (NCAA-ISP) by a sample of championship sports programs to summarize the estimated national cumulative and annual average numbers of injuries during the 5 academic years from 2009-10 through 2013-14. Analyses were restricted to injuries reported among student-athletes in 25 NCAA championship sports. During this period, 1,053,370 injuries were estimated to have occurred during an estimated 176.7 million athlete-exposures to potential injury (i.e., one athlete's participation in one competition or one practice). Injury incidence varied widely by sport. Among all sports, men's football accounted for the largest average annual estimated number of injuries (47,199) and the highest competition injury rate (39.9 per 1,000 athlete-exposures). Men's wrestling experienced the highest overall injury rate (13.1 per 1,000) and practice injury rate (10.2 per 1,000). Among women's sports, gymnastics had the highest overall injury rate (10.4 per 1,000) and practice injury rate (10.0 per 1,000), although soccer had the highest competition injury rate (17.2 per 1,000). More injuries were estimated to have occurred from practice than from competition for all sports, with the exception of men's ice hockey and baseball. However, injuries incurred during competition were somewhat more severe (e.g., requiring ≥7 days to return to full participation) than those acquired during practice. Multiple strategies are employed by NCAA and others to reduce the number of injuries in organized sports. These strategies include committees that recommend rule and policy changes based on surveillance data and education and awareness campaigns that target both athletes and coaches. Continued analysis of surveillance data will help to understand whether these strategies result in changes in the incidence and severity of college sports injuries.
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                Author and article information

                Journal
                Orthop J Sports Med
                Orthop J Sports Med
                OJS
                spojs
                Orthopaedic Journal of Sports Medicine
                SAGE Publications (Sage CA: Los Angeles, CA )
                2325-9671
                30 June 2023
                June 2023
                : 11
                : 6
                : 23259671231180534
                Affiliations
                [* ]Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, El Paso, Texas, USA.
                []School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
                [§ ]Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, Texas, USA.
                []Department of Orthopaedic Surgery, Carthage Area Hospital, Carthage, New York, USA.
                []Claxton-Hepburn Medical Center, Ogdensburg, New York, USA.
                [6-23259671231180534] Investigation performed at Carthage Area Hospital, Carthage, New York, USA
                Author notes
                [*] []Clare K. Green, BS, School of Medicine and Health Sciences, The George Washington University, 2300 I Street NW, Washington, DC 20052, USA (email: ckgreen@ 123456gwu.edu ).
                Article
                10.1177_23259671231180534
                10.1177/23259671231180534
                10333631
                1c9b9c12-b03e-44e5-8edf-21649c1fe785
                © The Author(s) 2023

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License ( https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 5 February 2023
                : 9 March 2023
                Categories
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                neiss,volleyball,epidemiology,ncaa,high school
                neiss, volleyball, epidemiology, ncaa, high school

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