Research Summary of “Concussion History and Knowledge Base in Competitive Equestrian Athletes. By Heather N. Kuhl, et al, Sports Health”

After the movie Concussion there are a lot of people focused more on concussion. This article identified that most of the educational campaigns have been focused on athletes in football, soccer, rugby, and motorcycle and auto racing.4,6,11,19 Because of this the authors wrote the article to say “Hey, equestrians need to wear helmets, too.” Which is true. I wanted to know more about the education that they would recommend and the recommendations they would give to equestrians who have had concussions, but that information was not available.

This summary identified that there is equally as many self-reported concussions in equestrian athletes. Using measures of central tendency the authors identified a rate of concussion between 3% and 91%.4

This was determined by self-reports of symptoms after falling off of a horse. Of the 94 riders surveyed 45% reported having concussions. This was determined by ranking 23 symptoms associated with concussion. The most important of which were ranked in the following order:

1. loss of consciousness (n = 37)

2. amnesia (n = 30)

3. blurred vision (n = 29)

4. poor balance(n = 28)

5. memory problems (n = 28)

6. vomiting (n = 28)

Of the 45% who reported having a concussion only 22% received any education from a doctor, psychologist or parent about concussion prevention, diagnosis and treatment. The authors did not clearly define what this education would look like. The common intervention for riders was to take time off. Approximately 51% took less than 5 days off, 30% took between 14 and 21 days off and 8% took more than 30 days off following a brain injury.

After the concussion 30% of the riders changed their riding style or approach to concussion management.

Even though this was a small sample size it is evident that concussion awareness and education is not prevalent in the equestrian community. Educational programs aimed at providing riders with the information necessary to make informed medical decisions to reduce the risk of concussion and minimize its complications needs to be instituted. The main recommendation is the use of protective head gear.

The authors did not discussion what the specifics of this concussion education would look like. I would have liked to read more about the suggested interventions.

References (Pulled directly from the article, is that considered plagiarism?)

1. Ball CG, Ball JE, Kirkpatrick AW, Mulloy RH. Equestrian injuries: incidence, injury patterns, and risk factors for 10 years of major traumatic injuries. Am J Surg. 2007;193:636–640.

2. Bixby-Hammet DM. Horse related hospital emergency room admissions, 2008. Equestrian Med Safety Assoc. 2008;22(3):1–15.

3. Bixby-Hammet DM, Brooks WH. Common injuries in horseback riding: a review. Sports Med. 1990;9:36–47.

4. Broshek DK. Concussion diagnosis and management. Am Med Equestrian Assoc. 2001;12(4):1–4.

5. Chitnavis JP, Gibbons CL, Hirigoyen M, Lloyd Parry J, Simpson AH. Accidents with horses: what has changed in 20 years? Injury. 1996;27:103–105.

6. Condie C, Rivara FP, Bergman AB. Strategies of a successful campaign to promote the use of equestrian helmets. Pub Health Reports. 1993;106:121–126.

7. Frankel HL, Haskel R, Digiacomo C, Rotondo M. Recidivism in equestrian trauma. Am Surg. 1998;64:151–155.

8. Hobbs GD, Yealy DM, Rivas J. Equestrian injuries: a five-year review. J Emerg Med. 1994;12:143–145.

9. Jagodzinski T, DeMuri GP. Horse-related injuries in children: a review. Wisconsin Med J. 2005;104(2):50–55.

10. Kriss TC, Kriss VM. Equine-related neurosurgical trauma: a prospective series of 30 patients. J Trauma. 1997;43:97–99.

11. Lindsay KW, McLatchie G, Jennett B. Serious brain injury in sport. Br Med J. 1980;281:789–791.

12. Lloyd RG. Riding and other equestrian injuries: considerable injury. Br J Sports Med. 1987;21:22–24.

13. Masters RG. Equestrian injuries: a review. Clin J Sports Med. 1991;1:123–126.

14. McCrory PM, Turner M. Equestrian injuries. Br J Sports Med. 2005;48:8–17.

15. Moss PS, Wan A, Whitlock MR. A changing pattern of injuries to horse riders. Emerg Med J. 2002;19:412–414.

16. Nelson DE, Bixby-Hammett D. Equestrian injuries in children and young adults. Am J Dis Child. 1992;146:611–614.

17. Nelson DE, Rivara FP, Condie C. Helmets and horseback riders. Am J Prev Med. 1994;10:15–19.

18. Nelson DE, Rivara FP, Condie C, Smith SM. Injuries in equestrian sports. Phys Sportsmed. 1994;22:53–60.

19. Watt GM, Finch CF. Preventing equestrian injuries: locking the stable door. Sports Med. 1996;24:187–197.

20. Whitlock MR, Whitlock J, Johnston B. Equestrian injuries: a comparison of professional and amateur injuries in Berkshire. Br J Sports Med. 1987;21:25–26.

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