Sport-Related Concussions: A Review of Epidemiology, Challenges in Diagnosis, and Potential Risk Factors

Sport-related concussion (SRC) is a common mild traumatic brain injury among young, active individuals, affecting approximately 300,000 young American adults annually. In this review of the epidemiology of SRC, we describe the challenges in identifying concussion occurrence and review the studies describing concussion incidence in various sports. In high risk contact sports, American football, soccer (European football), hockey, lacrosse, and basketball athletes experience concussion unintentionally during the course of play. Among these, football concussion incidence is reviewed in greatest detail because it has the highest incidence among the contact sports, and some studies have shown long-term neurophysiologic and neurodegenerative outcomes. Mechanisms of injury differ significantly by sport and can be potential targets for concussion risk mitigation. Despite the apparent high incidence of SRC, risk factors determining initial concussion, recovery periods, recurrence, and long-term outcomes remain poorly understood and warrant further study exploring the influence of age, sex, genetics, and athletic factors.     

Social Role Theory and the Perceived Gender Role Orientation of Athletes

In this research we examined the influence of athletic roles upon the perceived gender role orientations of male and female athletes. Participants were 148 students who read a bogus newspaper article that described either a male or female athlete who had successfully competed in an athletic event. The type of sport (football, basketball, and cheerleading) was manipulated. Female football players and basketball players were perceived as higher in agency than female cheerleaders. Male cheerleaders were perceived as higher in communality than male football players and male basketball players. Participants made external attributions concerning the motivations of athletes who competed in gender traditional sports. They made internal attributions concerning the motivations of athletes who competed in gender nontraditional sports. These findings are examined in relation to social role theory.     

Anger and perceived legitimacy of aggression in male Hong Kong Chinese athletes: Effects of type of sport and level of competition

ProblemThe vast majority of research examining the interplay between aggressive emotions, beliefs, behaviors, cognitions, and situational contingencies in competitive athletes has focused on Western populations and only select sports (e.g., ice hockey). Research involving Eastern, particularly Chinese, athletes is surprisingly sparse given the sheer size of these populations. Thus, this study examines the aggressive emotions, beliefs, behaviors, and cognitions, of competitive Chinese athletes.MethodSeveral measures related to aggression were distributed to a large sample (N = 471) of male athletes, representing four sports (basketball, rugby union, association football/soccer, and squash).ResultsHigher levels of anger and aggression tended to be associated with higher levels of play for rugby and low levels of play for contact (e.g., football, basketball) and individual sports (e.g., squash).ConclusionsThe results suggest that the experience of angry emotions and aggressive behaviors of Chinese athletes are similar to Western populations, but that sport psychology practitioners should be aware of some potentially important differences, such as the general tendency of Chinese athletes to disapprove of aggressive behavior.     

Moral development and form of participation, type of sport, and sport experience

The present study investigated aspects of moral development in sport, according to the form of participation, type of sport, and sport experience. 510 participants, 14 to 49 years of age (M=24.9, SD=8.3) who came from organized competitive sports included athletes (n=327), referees (n=138), and coaches (n=45) in football (n = 161), handball (n = 198), and basketball (n = 150). Years of sport experience ranged from 1 to 6, 7 to 14, and 15 to 30 years of participation in sports. The Defining Issues Test was given; analysis showed no significant differences in development of moral reasoning among participants across different types of sports, forms of participation, and years of experience in sport.     

Static and dynamic visual information about the size and passability of an aperture

The role of static eyeheight-scaled information in perceiving the passability of and guiding locomotion through apertures is well established. However, eyeheight-scaled information is not the only source of visual information about size and passability. In this study we tested the sufficiency of two other sources of information, both of which are available only to moving observers (ie are dynamic) and specify aperture size in intrinsic body-scaled units. The experiment was conducted in an immersive virtual environment that was monocularly viewed through a head-mounted display. Subjects walked through narrow openings between obstacles, rotating their shoulders as necessary, while head and shoulder position were tracked. The task was performed in three virtual environments that differed in terms of the availability of eyeheight-scaled information and the two dynamic sources of information. Analyses focused on the timing and amplitude of shoulder rotation as subjects walked through apertures, as well as walking speed and the number of collisions. Subjects successfully timed and appropriately scaled the amplitude of shoulder rotation to fit through apertures in all three conditions. These findings suggest that visual information other than eyeheight-scaled information can be used to guide locomotion through apertures.     

Is the Critical Point for Aperture Crossing Adapted to the Person-Plus-Object System?

When passing through apertures, individuals scale their actions to their shoulder width and rotate their shoulders or avoid apertures that are deemed too small for straight passage. Carrying objects wider than the body produces a person-plus-object system that individuals must account for in order to pass through apertures safely. The present study aimed to determine whether individuals scale their critical point to the widest horizontal dimension (shoulder or object width). Two responses emerged: Fast adapters adapted to the person-plus-object system by maintaining a consistent critical point regardless of whether the object was carried while slow adapters initially increased their critical point (overestimated) before adapting back to their original critical point. The results suggest that individuals can account for increases in body width by scaling actions to the size of the object width but people adapt at different rates.     

Visual behavior and perception of trajectories of moving objects with visual occlusion

Experienced athletes in sports with moving objects have shown greater skill when using visual information to anticipate the direction of a moving object than nonexperienced athletes of those sports. Studies have shown that expert athletes are more effective than novices in occlusion situations in the first stages of the sports sequence. In this study, 12 athletes with different competitive experience in sports with moving objects viewed a sequence of tennis ball launches with and without visual occlusion, launched by a ball-shooting machine toward different areas with respect to the participant's position. The relation among visual behavior, occlusion time, and the precision of the task is reviewed. The spot where the balls bounced was analysed by a digital camera and visual behavior by an Eye Tracking System. Analysis showed that the nonexperienced athletes made significantly more errors and were more variable in visual occlusion conditions. Participants had a stable visual search strategy.     

Executive functions in elite athletes – Comparing open-skill and closed-skill sports and considering the role of athletes' past involvement in both sport categories

Previous research documented differences in executive functions between elite athletes in different sports. It was argued that athletes in sport disciplines with higher cognitive demands (i.e., open-skill) show better executive functions than athletes in less cognitively challenging sport disciplines (i.e., closed-skill). In the current study, we aimed at detecting differences in executive functions between elite athletes in open-skill versus closed-skill sports and questioned the role of their total involvement in these sports until the age of 18 on executive functions.Seventy-five elite athletes (45 males and 30 females; M_age = 23.03 ± 4.41 years) from various sports were classified as open- or closed-skill athletes based on the sport they currently competed in. The athletes conducted a series of neuro-psychological tests measuring working memory, inhibition, and cognitive flexibility (Design Fluency test, Trail Making test, Flanker task, and a 2-back task). Retrospective interviews assessed athletes' sport involvement in open-skill and closed-skill sports until the age of 18.MANCOVAs revealed that athletes in open-skill sports performed better on measures of working memory and cognitive flexibility. Generalized Linear Models displayed that elite athletes in closed-skill sports, with greater involvement in open-skill sports until the age of 18, performed better during working memory and cognitive flexibility tasks.The results indicate that extensive time spent in open- and closed-skill sports can affect executive functions in elite athletes. A high involvement in open-skill sports proved to be beneficial for executive functions, in particular for elite athletes in closed-skill sports. These findings suggest that experiences in cognitively demanding sports may cause benefits for the development of executive functions.     

Economic Exploitation in Intercollegiate Athletics

This paper investigates philosophically the question of whether or not college and university athletes in the USA are doing something morally wrong should they terminate their college or university experience prior to graduation and enter the professional athletic ranks. Various moral arguments are brought to bear in order to attempt to shed light on this issue. One reason why such athletes ‘turn professional’ before they graduate is the perceived economic exploitation they experience as essentially underpaid workers earning much revenue for their respective institutions. But who is exploiting whom here? Is it just student athletes who are exploited by the system? I expand the reasoning about the exploitation of intercollegiate athletics to include not just student athletes, but their supporting colleges and universities. In the end, it is proposed that the National Collegiate Athletic Association and similar academically related athletic agencies should permit and encourage each of their constituent institutions as a matter of policy to protect themselves (and their supporting taxpayers, in the cases of public institutions) contractually from economic exploitation by professional sports franchises. Thus the question of student athletes leaving college for professional sports contracts has hidden beneath it questions of private professional sports franchises’ exploitation of the institutions with which such student athletes are affiliated.     

Avoidance behaviours while circumventing to the left or right of someone with different shoulder widths and facing directions: How do side,width, or orientation matter?

BackgroundCollision avoidance during locomotion is influenced by a variety of situational factors. When circumventing around an inanimate object, the amount of clearance is dependent on the side of avoidance. When avoiding other pedestrians, individuals most often choose to walk behind a moving pedestrian, and avoid people differently depending on their body size. However, side of avoidance has not been evaluated with human obstacles, nor facing direction of a stationary pedestrian, nor the size of a single pedestrian. Therefore, the aim of this study is to evaluate these knowledge gaps concurrently.Research questionHow do people avoid a collision to the left-side or right-side of a single stationary pedestrian (interferer) of varying shoulder width and orientation?MethodsParticipants (n = 11) walked along a 10 m pathway towards a goal, while a stationary interferer stood 6.5 m from the start. The interferer faced one of three directions relative to the participant (orientation); forward, leftward, or rightward, with either their normal shoulder width or enlarged width created by wearing football shoulder pads. Participants were explicitly instructed as to which side of the interferer to avoid (forced-left vs forced-right). Each participant completed 32 randomized avoidance trials. Centre of Mass separation at the time of crossing was used to examine individual's avoidance behaviours.ResultsResults revealed no effect of interferer width, but a significant side of avoidance effect, where the centre of mass separation between the participant and interferer at the time of crossing was smallest when participants avoided to their left.SignificanceFindings suggest that changing the facing direction or artificially increasing the shoulder width of a stationary interferer will not affect one's avoidance behaviours. However, an asymmetry in side of avoidance is maintained similar to that observed in obstacle avoidance behaviours.     

Regulatory fit as a determinant of sport performance: How to succeed in a soccer penalty-shooting

ObjectivesAccording to regulatory focus theory, goal pursuit can be achieved by either keeping a promotion or a prevention focus [Higgins, E. T. (1997). Beyond pleasure and pain. American Psychologist, 52, 1280–1300; Higgins, E. T. (2000). Making a good decision: value from fit. American Psychologist, 55, 1217–1230]. Moreover, it has been assumed that people experience fit when they pursue a goal in a manner that sustains their chronic orientation and that fit has a positive impact on performance. In two studies, we investigated the significance of regulatory focus and fit in the realm of sports performance, such as the success rate in a soccer penalty-shooting task.Methods and ResultsIn a pilot study, we assessed the chronic regulatory orientation of 211 athletes from different sports. Among others, we found more promotion focus with attackers than with defenders. In the main study, we assessed the chronic regulatory orientation of 20 soccer players who took part in a penalty-shooting task. For half of them, the task was described in terms of promotion, for the others in terms of prevention. We found a positive impact of regulatory fit on scoring performance.ConclusionsOur findings demonstrate a great potential of regulatory focus theory for the understanding and enhancement of sport performance. The assessment of athletes' chronic regulatory orientation could be of importance for the selection of athletes, the adjustment of tactics and strategies, and coaches' framing of instructions.     

Terror management and the vicissitudes of sports fan affiliation: the effects of mortality salience on optimism and fan identification

The present research examined the hypothesis derived from terror management theory that identifications with sports teams shield against the potential consequences of awareness of death. Experiment 1 demonstrated that Dutch participants who were reminded of their death expressed greater optimism about the results of the national soccer team compared to a control condition. Experiment 2 conceptually replicated this finding with American participants and college sports teams. In addition, Experiment 2 tested the hypothesis that success of a team is a prerequisite for sports fan affiliation to function as a buffer against death concerns. Before the college football season began, participants who were reminded about death expressed greater relative preference for a more salient, but less successful college football team over a national college champion basketball team compared to control participants. However, after the football team lost its first game of the season, participants who were reminded about death indicated greater relative preference for the successful basketball team. Results are discussed with regard to the psychological function of social identifications. Copyright © 2000 John Wiley & Sons, Ltd.     

Self-experience as a mechanism for learning about others: a training study in social cognition

Using a gaze-following task, the authors assessed whether self-experience with the view-obstructing properties of blindfolds influenced infants' understanding of this effect in others. In Experiment 1, 12-month-olds provided with blindfold self-experience behaved as though they understood that a person wearing a blindfold cannot see. When a blindfolded adult turned to face an object, these infants gaze followed significantly less than control infants who had either (a) seen and felt the blindfold but whose view had not been obstructed by it or (b) experienced a windowed blindfold through which they could see. In Experiment 2, 18-month-olds experienced either (a) a trick blindfold that looked opaque but could be seen through, (b) an opaque blindfold, or (c) baseline familiarization. Infants receiving trick-blindfold experience now followed a blindfolded adult's gaze significantly more than controls. The authors propose 3 mechanisms underlying infants' capacity to use self-experience as a framework for understanding the visual perception of others.     

Retrospective and concurrent perspectives of the transition into senior professional female football within the United Kingdom

In the United Kingdom (UK), professional female football has grown exponentially in recent years, including with the advent of the Women's Super League. Given this growth, the present study aimed to (a) to explore the junior-to-senior transition in the UK female football players (i.e., perceived demands, barriers, resources, and coping strategies); (b) to analyze how changes in the UK female football context (i.e., increased professionalization) influenced players' perception of the transition. Six professional female soccer players from two groups took part in the study; senior athlete (N = 3) and transitional athletes (N = 3). To acquire a holistic understanding, semi-structured interviews were conducted with all athletes. Results highlighted transitional athletes appeared to have a different JST experience compared to the senior group, with the difference in experience attributed to the increased professionalization of female football. In particular, demands associated with being a dual career athlete and greater difficulty balancing the competing demands. As a result, transitional athletes also engaged in more coping strategies. This study provides valuable findings in relation to the JST in professional female football and the context of the increasing professionalization of female football in the UK.     

The rise and fall of executive functions in high-level football players

IntroductionExecutive functions are higher-level cognitive functions. Despite being relevant to many aspects of everyday life, it is contentious whether executive functions are important for high performing athletes. Executive functions increase throughout the career of an athlete, yet it remains unknown what are the main contributors. Therefore, this study examined the effect of age and experience on executive functions in a cohort of high performing football players.MethodsData were collected over three seasons, resulting in a mixed longitudinal sample of 1018 observations in 343 male players (1–5 observations/player, age: 10.34–34.72 years; playing experience: 5–22 years) from the U12-Senior age groups of a professional German football club. Players participated in four cognitive tasks aimed at measuring higher-level cognitive functioning: a precued choice reaction-time task, a stop-signal reaction-time task, a sustained attention task, and a multiple-object tracking task, from which a total of eight dependent variables related to response time and/or accuracy were derived.ResultsLinear and non-linear mixed effects regressions were used to investigate the relationship between age, experience and executive functions. A second order polynomial revealed that, generally, a negatively accelerated curve best described the relationship between age, experience and executive functions. An increasingly smaller difference in executive functioning was generally observed between subsequent age groups, with a performance plateau evident around adulthood (~21 years old). Age and experience only explained a very low to moderate proportion of the variance in executive functions (marginal explained variance ranged between 2 and 57%). A significant age by field position interaction effect was only observed for the sustained attention task’s accuracy and response time components (p < 0.001).ConclusionsBoth age and experience showed a negatively accelerated relationship with executive functions in youth football players, and this relationship was generally field position-independent. These negatively accelerated curves seem to reflect those observed in general populations, where a plateau phase in the development of higher-level cognitive functioning is also observed around 21 years, reflecting the maturation of the central nervous system in normally developing individuals. Therefore, this study challenges the assumption surrounding the use and validity of executive functions as a measure of football performance potential in high performing athletes.     

Influence of sport participation upon sex role orientation of caucasian males and their attitudes toward women

Differences in psychological androgyny and attitudes toward women were examined in male Caucasian intercollegiate contact and noncontact sport athletes and male Caucasian college nonathletes. Contact athletes in the sports of football and wrestling, noncontact athletes in the sports of baseball and track and field, and nonathletes completed the Attitudes Toward Women Scale (ATWS) and the Bem Sex Role Inventory (BSRI) to assess egalitarian attitudes toward women and sex role orientation. Results of analyses of variance (ANOVAs) on the ATWS indicate that athletes as a group possessed more conservative, traditional attitudes toward women than did nonathletes, but that no differences existed between contact sport athletes and noncontact sport athletes. Results of ANOVAs and chi-square analyses on the BSRI indicated no differences between groups regarding sex role orientation based upon self-perceptions of masculinity and femininity.     

Facing temptation: The neural correlates of gambling availability during sports picture exposure

Nowadays, sports betting has become increasingly available and easy to engage in. Here we examined the neural responses to stimuli that represent sporting events available for betting as compared to sporting events without a gambling opportunity. We used a cue exposure task in which football (soccer) fans (N = 42) viewed cues depicting scheduled football games that would occur shortly after the scanning session. In the “betting” condition, participants were instructed to choose, at the end of each block, the game (and the team) they wanted to bet on. In the “watching” condition, participants chose the game they would prefer to watch. After the scanning session, participants completed posttask rating questionnaires assessing, for each cue, their level of confidence about the team they believed would win and how much they would enjoy watching the game. We found that stimuli representing sport events available for betting elicited higher fronto-striatal activation, as well as higher insular cortex activity and functional connectivity, than sport events without a gambling opportunity. Moreover, games rated with more confidence towards the winning team resulted in greater brain activations within regions involved in affective decision-making (ventromedial prefrontal cortex), cognitive inhibitory control (medial and superior frontal gyri) and reward processing (ventral and dorsal striatum). Altogether, these novel findings offer a sensible simulation of how the high availability of sports betting in today’s environment impacts on the reward and cognitive control systems. Future studies are needed to extend the present findings to a sample of football fans that includes a samilar proportion of female and male participants.     

“My natural environment has provided me with about fifty different ways of expressing frustration”: Mining the visceral angst of Australian Rules football followers

Modern spectator sports provoke intense bodily passions in fans as well as athletes yet the embodied emotions of sports fans are understudied. This paper explores the frustrations of Australian Rules football supporters. Drawing on psychoanalysis and religious studies it traces the expressions and possible causes of their frustration by mining material from a set of interviews with fans along with the comments of Australian Rules football followers in books, articles and internet forums. An underlying question is how the frustrations of these football supporters might reveal something of the intersections of emotion, bodies and sport that spectator sports provoke.     

Compression and texture in socks enhance football kicking performance

The purpose of this study was to observe effects of wearing textured insoles and clinical compression socks on organisation of lower limb interceptive actions in developing athletes of different skill levels in association football. Six advanced learners and six completely novice football players (15.4 ± 0.9 years) performed 20 instep kicks with maximum velocity, in four randomly organised insoles and socks conditions, (a) Smooth Socks with Smooth Insoles (SSSI); (b) Smooth Socks with Textured Insoles (SSTI); (c) Compression Socks with Smooth Insoles (CSSI) and (d), Compression Socks with Textured Insoles (CSTI). Reflective markers were placed on key anatomical locations and the ball to facilitate three-dimensional (3D) movement recording and analysis. Data on 3D kinematic variables and initial ball velocity were analysed using one-way mixed model ANOVAs. Results revealed that wearing textured and compression materials enhanced performance in key variables, such as the maximum velocity of the instep kick and increased initial ball velocity, among advanced learners compared to the use of non-textured and compression materials. Adding texture to football boot insoles appeared to interact with compression materials to improve kicking performance, captured by these important measures. This improvement in kicking performance is likely to have occurred through enhanced somatosensory system feedback utilised for foot placement and movement organisation of the lower limbs. Data suggested that advanced learners were better at harnessing the augmented feedback information from compression and texture to regulate emerging movement patterns compared to novices.     

Relative age effect in Japanese male athletes

The present study investigated the relative age effect, a biased distribution of elite athletes' birthdates, in Japanese male athletes. Japan applies a unique annual-age grouping for sport and education, which is from April 1 to March 31 of the following year. A total of 4,318 male athletes was evaluated from 12 sports: baseball, soccer, basketball, volleyball, handball, golf, horse racing, rugby, American football, sumo, Ekiden (track and field in long distance), and badminton. They played in the top level of Japanese leagues for each sport in 2010. The distribution of the birth dates was examined in each sport and showed significant relative age effect in baseball, soccer, volleyball, Ekiden, basketball, sumo, and horse racing, but not in all sports. The findings suggest that although the school year in Japan starts on April 1, significant relative age effects are observed in some sporting events.