Doctor of Philosophy, The Ohio State University, 2007, Psychology

The dimensions of post-concussive symptoms (PCS) associated with pediatric mild traumatic head injuries (mild TBI) were examined in a prospective, longitudinal study of 186 8- to 15-year-old children with MHI and a comparison group of 99 children with orthopedic injuries (OI). Parents and children completed a 50-item questionnaire within 2 weeks of injury and again at 3 months post injury, rating the frequency of PCS on a 4-point scale. Common factor analysis with target rotation was used to rotate the ratings to four hypothesized dimensions, representing cognitive, somatic, emotional, and behavioral symptoms. The rotated factor matrix for baseline parent ratings was consistent with the target matrix. The rotated matrix for baseline child ratings was consistent with the target matrix for cognitive and somatic symptoms but not for emotional and behavioral symptoms. The rotated matrices for ratings obtained 3 months post injury were largely consistent with the target matrix derived from analyses of baseline ratings, except that parent ratings of behavioral symptoms did not cluster as before. Additional exploratory analyses comparing younger children to older children revealed similar results to the total group for both child-rated and parent-rated symptoms. Injury group exploratory analyses suggested that child- and parent-rated symptom dimensions may be different for the OI group than the mild TBI group. Parent and child ratings of PCS yield consistent factors reflecting cognitive and somatic symptom dimensions, but dimensions of emotional and behavioral symptoms are less robust across time and raters.

Master of Arts in Speech Pathology and Audiology, Cleveland State University, 2022, College of Sciences and Health Professions

The purpose of this study was to identify whether public and private colleges or universities across the United States have procedures to assist student veterans who are facing academic challenges secondary to traumatic brain injury (TBI) or acquired brain injury (ABI). This study aimed to identify whether personnel in college and university veterans services offices, offices of disability services, academic success offices, tutoring centers, or other offices that support student veterans academically are aware of the role of speech-language pathologists in providing treatment to manage the effects of TBI/ABI on academic performance, along with the locations for speech-language pathology services to which their office refers student veterans, and whether their college or university has an on-campus speech-language pathology clinic. Further, this study identified whether such awareness differs based on public or private college or university status, college or university enrollment size, the type of office whose personnel responds to this survey, the employment status of the personnel who respond to this survey, and the region of the United States where the college or university is located. Results indicated that, as a whole, most public and private college or university personnel do not have awareness of the role of speech-language pathologists, do not have procedures for referrals, and are unaware of whether or not there is an existing university speech and hearing clinic. If referrals are made, most are to Veteran Affairs (VA) hospitals or facilities. The implications of these results suggest there is a need to boost awareness among campus personnel of the role of speech-language pathologists in treatment to manage the effects of TBI/ABI on academic performance, and to develop campus-wide procedures to refer veterans to on-campus speech and hearing clinics in order to promote accessibility and decrease the complexity of the referral process.

Specialist in Education (Ed.S.), University of Dayton, 2021, School Psychology

Objective: To examine the efficacy of an online traumatic brain injury (TBI) professional development intervention for preservice educators, In the Classroom After Concussion: Best Practices for Student Success. Design: A random total sample of 55 preservice educators, with 34 in the test group, and 21 in the control group. Test participants completed the pretest, nine online training modules, and the posttest. The control group completed only the pretest and posttest. Results: On the posttest assessment, in comparing the difference in scores from pretest to posttest, test group participants showed significantly greater gains in knowledge (M = 4.65, SD = 6.08) than the control group (M = .19, SD = 5.34). Conclusion: Given the increasing prevalence of TBI in school-aged children, it is paramount to develop and provide cost effect, evidence-based, and easily accessible trainings for TBI professional development. The In the Classroom trainings can be one solution. Implications for effective training will be discussed.

Master of Arts, Miami University, 2021, Speech Pathology and Audiology

The percentage of concussions self-reported by collegiate athletes continues to be less than 50% despite the implementation of the National Collegiate Athletic Association's (NCAA) mandated concussion protocol. Unreported concussions leave affected athletes without beneficial medical, academic, and athletic intervention. This study's primary purpose was to identify factors positively and negatively influencing concussion reporting patterns in NCAA Division one (DI) athletes. A secondary purpose was to obtain the perspective of former collegiate athletes with a history of concussion on factors which may positively or negatively influence the culture of concussion reporting patterns in the future. Seven former NCAA DI athletes completed individual interviews to discuss their concussion experience in college including perceived support from various personnel, concussion education, and suggestions for changing the culture of concussion reporting. Athletic trainers (ATs) and parents were perceived to be supportive of concussion reporting, while participants relayed mixed feelings about coaches. All participants reported that the education received about concussion while in college was unmemorable and a majority expressed a lack of knowledge regarding symptoms of concussion. Suggestions for change included meetings dedicated solely to concussion education presented by a speaker with a personal history of concussion and increased use of visual educational materials.

Master of Arts, The Ohio State University, 2020, Speech Language Pathology

The subtle cognitive-communication challenges experienced by students with traumatic brain injury (TBI) are often missed, leaving these students with unmet needs in the school environment and increasing the likelihood for negative social, academic, and vocational outcomes. For children and adolescents with TBI, nonstandardized assessment offers several advantages over standardized assessment procedures and may improve speech-language pathologists' ability to identify students who might benefit from intervention services. This paper presents a scoping review of current practice in the realm of nonstandardized assessment of students with identified TBI, as well as an exploration of how these procedures may be implemented in various clinical settings.

Master of Arts, The Ohio State University, 2020, Speech and Hearing Science

The current study aims to evaluate the utility of time to follow commands (TFC), post-traumatic amnesia (PTA), and total duration of impaired consciousness (TFC + PTA) in predicting functional outcome after pediatric traumatic brain injury (TBI), as assessed by the Glasgow Coma Scale—Extended, Pediatric Revision (GOS-E Peds). Given the life-long needs of children with TBI, further research is necessary to identify predictors of functional outcomes. These predictors could guide clinicians when educating a child's caregivers about potential outcomes and prognosis for their child's long-term needs following TBI in order for them to utilize necessary support services following injury. This study obtained information from 60 children with complicated mild to severe TBI (mean age at injury = 13.7 years, range = 5-20 years) in the setting of a pediatric inpatient rehabilitation hospital and associated multidisciplinary brain injury follow-up clinic. Severity measures and outcomes were scored retrospectively on the basis of documentation from each patient's inpatient stay and outpatient follow-up evaluations at two-months and one-year post-injury. Correlations between measures of severity and functional outcome were obtained. TFC and TFC + PTA were found to be moderately correlated with GOS-E Peds scores at both the two-month follow up and the one-year follow-up. The results of this study suggest that TFC and TFC + PTA are important predictors of functional outcomes after TBI.

Doctor of Philosophy, The Ohio State University, 2019, Mechanical Engineering

Millions of head and brain injuries occur each year in the United States with severities ranging from mild to traumatic. Mild traumatic brain injuries, commonly known as concussions are common among sporting activities, specifically American Football. Most research of football concussion injuries focuses on professional and collegiate level athletes. Work is needed to quantify how modern football helmets protect against concussion injuries at the youth level. For this investigation, two studies were carried out. These studies focused on determining how both helmet mass and head-helmet relative motion may affect a youth athlete's concussion risk during impact events. In these studies, impacts were carried out on a child crash test dummy (ATD) wearing youth football helmets of varying mass. The relative motion between the ATD head and football helmets was quantitatively measured throughout each impact using a motion capture system. Results from these studies displayed that both helmet mass and head-helmet relative motion can have a significant effect on injury metrics commonly used to predict concussion. However, helmet mass was found to have less of an effect on injury criteria values than other parameters such as helmet brand and impact direction. Additionally, head-helmet relative motion was found to be positively related to rotationally based injury criteria. The amount of relative motion between the head and helmet was dependent on each helmet's stand-off distance and padding design. While concussions are a mild brain injury with a large prevalence, drone, or UAS head impacts pose a risk for more traumatic head injuries but currently have a low prevalence. However, the rate of drone impacts is likely to increase as the industry is expanding at a rapid rate and benefits associated with drone use are driving new federal regulations which would allow for more widespread UAS flights over people. Before UAS flight over people is made legal, the risk of huma (open full item for complete abstract)

Master of Arts, The Ohio State University, 2018, Speech Language Pathology

Adolescents with traumatic brain injury (TBI) may exhibit subtle cognitive-communication deficits that are not consistently identified by the formal assessments commonly used to qualify children for special education services. Expository discourse production is rarely used as an assessment tool with students who have TBI, despite its relevance to the curriculum. Research is needed to explore the cognitive-linguistic processes and linguistic features that are required for students to successfully produce exposition. The current study conducted microlinguistic and fluency analyses of verbal summaries produced by five adolescents with traumatic brain injury and five matched peers with typical development (TD). Each participant verbally summarized one narrative and two expository (compare-contrast, cause-effect) discourse lectures that were then transcribed and analyzed for microlinguistic measures, mazing behaviors, and pausing patterns. The group with TBI was significantly less productive than the group with TD during cause-effect and compare-contrast productions. No other microlinguistic differences were identified between groups. The group with TBI produced significantly fewer filled pauses per utterance during cause-effect production. The group with TBI also produced significantly more within-clause pauses per utterance during compare-contrast production. No significant differences were found between groups on any variable analyzed during narrative productions. On average, the group with TD produced more mazes, and the group with TBI produced more pauses of longer lengths. These findings support other studies that suggest that different types of exposition have different production requirements, and that they are distinct from narrative productions. The different patterns of mazing and pausing found between groups help to characterize discourse production by adolescents with TBI and are discussed in terms of decreased language processing abilities. Differences in (open full item for complete abstract)

Bachelor of Arts, Wittenberg University, 2015, Psychology

Pediatric traumatic brain injury (TBI) is the leading cause of death and disability in children and affects approximately 322,000 children under the age of nine every year. Thus, concussion rates and outcomes in adolescents and young adults have received much attention in recent years. Separately from concussions, repeated subconcussive head injury is thought to increase risk for cognitive and behavioral decline. In particular, the relationship between subconcussive head injury and mental health requires study. For example, the effects of subconcussive head injury on ability to manage anxiety remain unknown. Previous work has shown that TBI can lead to deficits in ability to manage anxiety. The present study examined the relationship between subconcussive head injury and ability to manage anxiety. Subconcussive head injury frequency and severity was measured using a subconcussive head injury scale adapted from Marchi et al. (2013). Results revealed no significant correlation between scores on the anxiety inventory and scores on the subconcussive head injury scale. Findings from this study imply that an increased number of head hits does not lead to an increase of anxiety symptoms.

Specialist in Education (Ed.S.), University of Dayton, 2016, School Psychology

There are many students who have sustained a Traumatic Brain Injury (TBI) who are pursuing post-secondary education each year and many of these students will need accommodations to successfully graduate from college. Accommodations for students with TBI in primary and secondary education are well documented; however, accommodations that are provided for students in post-secondary education have not been studied to date. Further, there have not been studies examining what services may be helpful for students with TBI in post-secondary education. The present study examined the college disability services provided for students with TBI in post-secondary education and what accommodations may be beneficial, using a qualitative design. Respondents from twelve colleges were interviewed to gain insight about accommodations in their setting. The results provide a better understanding of what accommodations are provided and those that may be beneficial for students with TBI in college settings. Suggestions are made for staff at universities to help better serve students with TBI, improving their successful completion of post-secondary degrees.

Doctor of Philosophy, The Ohio State University, 2014, Mechanical Engineering

Head injuries to older motor vehicle crash occupants are of increasing importance because of the growing number of older occupants on the road and their elevated vulnerability to injury compared to younger occupants. Crash data analysis to understand head injuries of particular importance among aging crash victims identified subdural hematomas from bridging vein bleeding as particularly frequent and life-threatening for older occupants. Ultimately, in order to quantify the age-dependent relationship between whole head motion and risk of subdural hematoma from bridging vein bleeding, experimental test methods are needed to measure the potential for bridging vein stretch as a function of head kinematics. To that end, methods were developed to use high-frequency, high-speed, Brightness-mode (B-mode) ultrasound to image motion of the meninges and peripheral brain in head rotation tests using post mortem human subjects. Results of preliminary low-rate rotation tests using the developed methods suggest that motion relative to the skull resulted from deformation of the cortex, rather than from sliding of the meningeal layers. High-rate testing confirmed the potential effectiveness of the developed methods, which represent a first essential step in the definition of age-dependent estimates of the risk of subdural hematoma from bridging vein bleeding in motor vehicle crashes.

MA, University of Cincinnati, 2001, Allied Health Sciences : Communication Sciences and Disorders

Traumatic brain injury (TBI) affects millions of individuals each year, and is the leading cause of death and disability for individuals under age 40. For many individuals who incur mild, moderate, or severe TBI, college attendance is an age-appropriate and feasible activity despite the presence of cognitive, communicative, behavioral, and physical impairments associated with the injury, many of which may be subtle. However, it is asserted that many individuals with TBI who attempt to meet the challenges of college entry or re-entry require a strong network of support in order to successfully manage the transition from post-injury convalescence or rehabilitation to the rigors of the academic environment. An important link in such a support network can be the provision of cognitive-linguistic therapy designed to remediate higher-level cognitive skills necessary for academic success. The present study sought to determine if academically oriented cognitive-linguistic therapy services are desired by high school and college-age students with mild, moderate, and severe TBI. Demographic data and information about provision of inpatient and outpatient speech-language services were collected from patient charts at two local facilities. Telephone interviews were then conducted to acquire additional information. Overall, results of the study indicate that there is a desire for cognitive-linguistic therapy designed to address higher-order cognitive and communication skills among local high school and college-age students who have incurred TBI. Results also show that improved identification of individuals with mild TBI and broader knowledge of potentially significant impairments associated with mild TBI are needed in order for individuals with mild TBI to receive the patient education and services they need for facilitation of successful recovery.

Master of Arts, The Ohio State University, 2009, Psychology

Several studies in the pediatric literature have demonstrated that increases in post-concussive symptoms (PCS) are correlated with worse outcomes or greater neurological damage following mild traumatic brain injury (mTBI). This study assessed whether it is possible to predict injury severity from PCS presentation in children. The sample included 285 children ages 8 to 15, 186 with mTBI and a comparison group of 99 with orthopedic injuries (OI). Both parent and child rated frequency and severity of PCS at baseline (within 2 weeks post-injury) and follow-up visits at 3 and 12 months post-injury. The mTBI group was divided into high and low injury severity using either the incidence of LOC or the presence of intracranial abnormalities on MRI. A series of discriminant function analyses revealed that ratings of PCS collected at baseline differentiated children with mTBI from OI while those at later time points could not. Somatic PCS accounted for most of the discriminatory power. Only parent ratings as baseline were able to discriminate between all three groups. Overall, predicted group classification was poor with a large proportion of false negatives. While it is clear that children with mTBI endorse more PCS than children with OI, accurate prediction of injury severity from symptom presentation is not yet possible.

PHD, Kent State University, 2008, College of Nursing

Traumatic brain injury (TBI) affects over 1.4 million Americans every year. Interdisciplinary care focuses on treating the primary brain injury and limiting further brain damage from secondary brain injury. Intensive care unit (ICU) nurses have an integral role in preventing secondary brain injury; however, little is known about how ICU nurses make judgments when managing secondary brain injury. The purpose of this study was to examine how physiological, situational, and nurse variables influenced ICU nurse judgments about patient risk of secondary brain injury and determining appropriate levels of intervention. This study was guided by social judgment theory and incorporated a multiple segment factorial survey design. Vignettes reflecting the complexity of real life patient scenarios were randomly generated using different values of each independent variable. Anonymous vignette surveys were administered to ICU registered nurses from two Level I trauma centers. Multiple regression was used to examine which variables influenced judgments about secondary brain injury. Sixty seven nurses completed study surveys. Judgments about risk for secondary brain injury were influenced by oxygen saturation (O2sat), intracranial pressure (ICP), cerebral perfusion pressure (CPP), mechanism of injury, primary diagnosis, and nursing shift. Judgments about level of intervention were influenced by O2sat, CPP, and nursing shift. The initial judgments made by nurses were the most significant variable predicting follow up judgments. Findings from this study provide information about factors influencing nurse judgments when managing secondary brain injury. This information will serve as the basis for future educational initiatives for nurses, which may improve management of secondary brain injury and improve patient outcomes.

PhD, University of Cincinnati, 2024, Nursing: Nursing - Doctoral Program

Background. Traumatic Brain Injury (TBI) is a chronic disease process affecting various aspects of an individual's life for years after the injury. Survivors of moderate to severe traumatic brain injury (msTBI) are vulnerable to physical problems, emotional dysregulation, psychological disorders, cognitive impairments, neurobehavioral disability, and neurodegenerative sequala. Family caregivers play a pivotal role is sustaining and supporting the survivor's recovery. Although studies have addressed the needs and concerns of msTBI caregivers, there is a lack of studies exploring caregiver needs and concerns specifically related to neurobehavioral changes in the msTBI survivor. No existing measure captures caregiving activities based on these unique needs and concerns. The purpose of this dissertation was to develop and validate the Traumatic Brain Injury Caregiving Scale (TBI-CAS) designed to quantify the ease or difficulty of caregiving activities grounded in the needs and concerns of msTBI caregivers. Methods. This dissertation had three main aims: For Aim 1, an integrative review of the reported needs and concerns of msTBI caregivers was completed. For Aim 2, a descriptive qualitative study was conducted with 20 family caregivers of persons with msTBI who had neurobehavioral changes. Semi-structured interviews with open-ended questions and prompts were conducted. Data were analyzed using content analysis with hybrid deductive-inductive coding, categorizing into an existing five-domain caregiver needs framework. In Aim 3, an exploratory sequential mixed-mixed methods design was used to extract themes from the integrative review and qualitative study to develop items for the TBI-CAS scale. Content validity of the TBI-CAS was tested in a panel of 8 experts (5 researchers and 3 clinicians) to ensure appropriateness, relevance, and clarity. A survey of the TBI-CAS items was followed by semi-structured cognitive interviewing techniques (i.e.,think aloud and ve (open full item for complete abstract)

Bachelor of Arts, Wittenberg University, 2024, Psychology

Concussions are a type of mild traumatic brain injury that can result in physical, functional, and behavioral consequences. Behavioral manifestations that arise include impulsivity. Impulsivity can be defined as acting without prior thinking or planning. Previous studies have found that impulsivity has been affected by sustaining a concussion. In the present study we related prior concussion history to impulsivity. Participants completed a background survey related to their concussion history, a modified version of the Barratt Impulsiveness Scale as a self-report measure, and an online Go/No-Go task as a behavioral measure. The Go/No-Go task used two levels of perceptual degradation (blur) to slow perception so that responding may be slowed and inhibitory processes may be improved resulting in fewer commission errors. We found a positive correlation between the subcomponents of the Barratt Impulsiveness Scale we presented (motor and self-control). Negative correlations were also found relating to age and self-reported impulsivity; and self-reported impulsivity and accuracy in blurred No-Go conditions (commission errors). Concussion participants reported significantly more impulsivity. Concussion status did not significantly affect No-Go accuracy. While participants with concussions self-reported to be more impulsive, there was no significant effect found between the participant's concussion history and their accuracy on the Go/No-Go task.

Master of Science, The Ohio State University, 2024, Anatomy

A traumatic brain injury (TBI) is caused by a forceful blow to the head or body and can lead to temporary or permanent brain damage, or even death. There are many complications that may arise from sustaining a TBI. Depending on the severity of the injury, TBI patients may experience a level of immune suppression, and this may result in an increased risk for developing nosocomial infections. Because the brain plays a role in the regulation of the autonomic nervous system (ANS), a TBI may also cause ANS dysfunction downstream and an upregulation of the sympathetic nervous system. The body's inability to maintain physiological balance after injury may create worse outcomes for patients long term. Currently, there are a limited number of studies that show reliable methods for predicting future outcomes for patients with TBIs. In recent years, heart rate variability (HRV) has been shown to be a non-invasive indicator of predicting patient outcomes after sustaining such injuries in the adult population. Heart rate variability is the variability in the time elapsed between each heartbeat and measures the body's ability to return to a baseline heart rate after experiencing a stressful event. This study sought to analyze the relationship between heart rate variability and the level of immunosuppression in pediatric TBI patients to see if there is a negative correlation between the two measures. Immune suppression was determined by a lipopolysaccharide (LPS) stimulated TNF – α production value of <520 pg/mL. HRV data was analyzed using a frequency and time domain analysis and the two measures were correlated. This study found a significant positive correlation between time domain measures and the LPS induced TNF – α response. Power in the low frequency band of heart rate (0.04-0.15 Hz) is used as a marker of sympathetic and parasympathetic activity. Power in the high frequency band of heart rate (0.15-0.40 Hz) is used as a marker of parasympathetic activity. Significant c (open full item for complete abstract)

Master of Arts, Miami University, 2024, Speech-Language Pathology

College student athletes (CSA) can experience a variety of cognitive symptoms during the early recovery phase of a mild traumatic brain injury (mTBI) which can affect written text processing and academic performance. Research examining eye movement patterns during the early recovery phase is lacking despite some individuals with chronic mTBI endorsing difficulties reading (Ratiu et al., 2022). Utilizing eye tracking technology to compare CSA with mTBI in the early recovery phase to college students (CS) when reading can reveal eye movement patterns that are unknown during observation. The goal of this study was to examine average forward fixations, regression patterns, processing time and the average fixation duration CSA and CS experience when reading paragraphs. Nine CSAs were matched to nine CS participants in gender, education, and age. Eye movements and processing time were measured using a Tobii Dynavox © Pro Spectrum eye tracker. No significant differences were found between groups for the average number of forward fixations, regressions, and processing time. However, CSA demonstrated significantly longer fixation durations than CS participants. Further research is needed with a larger, more diverse sample to examine possible differences in eye movement patterns and processing time experienced by CSA and CS participants.

MS, University of Cincinnati, 2024, Engineering and Applied Science: Mechanical Engineering

This study proposes a novel approach to intracranial pressure (ICP) analysis. ICP is the pressure exerted by fluids and tissue inside of the brain and reveals crucial insights regarding a patient's physiological state after undergoing traumatic brain injury (TBI). ICP waveform morphological analysis can provide clinicians with information regarding a patient's health and facilitate proactive intervention and inhibit the development of secondary pathologies such as cerebral edema (swelling), ischemia (lack of blood to the brain), vascular injuries, neurological dysfunction, and cognitive/behavioral changes. By integrating arterial blood pressure (ABP) and electrocardiogram (ECG) data from patients who have undergone TBI this method aims to enhance the analysis of not just ICP waveform morphology but cross-signal morphological features. The proposed methodology was evaluated on ten patients and their respective ICP, ABP, and ECG data; it involved three key steps: 1) multimodal signal pre-processing alongside manual labeling of ICP waveform morphologies to train a base support vector machine (SVM) morphological classifier. 2) The use of semi-supervised learning leveraging a subject matter expert (SME) to further train the SVM ICP waveform morphological classifier and augment its training data set on all ten patients to assign incoming pre-processed ICP waveforms with a morphology label. A SME used the posterior probability of the SVM machine learning model to aid the algorithm in adapting to new and unseen ICP waveform morphologies that were not present in the initial manually labeled SVM training data set. 3) The utilization of dynamic time warping barycenter averaging (DBA) to produce representative averages (centroids) of ICP waveforms present in the SVM training data set and derivative dynamic time warping (DDTW)-driven subpeak identification to map subpeaks from DBA generated centroid templates with SME assigned ground truth subpeak(s) to incoming SVM clas (open full item for complete abstract)

PhD, University of Cincinnati, 2024, Medicine: Neuroscience/Medical Science Scholars Interdisciplinary

Sports-related brain injuries, including both sports-related concussions (SRCs) and repetitive head impacts (RHI), are forms of brain injury that result from a direct hit to the head or biomechanical forces that are transmitted from the body to the head. It is estimated that 1.6 to 3.8 million SRCs occur annually with approximately 1.9 million occurring annually in adolescent athletes. With previous research focused on the management of neurocognitive and neurobehavioral symptoms following SRC, neuromuscular control deficits are also present in athletes following concussion. Neuromuscular control alterations have been noted up to two years following initial injury, potentially placing athletes at an increased risk for lower extremity injury following clearance of return to play. Additionally, athletes with a prior history of SRC have demonstrated a ~2.5 times greater risk for subsequent lower extremity injury compared to uninjured controls. Behavioral data has provided initial insight into the relationship between SRC and lower extremity injury, however, changes in the central nervous system (CNS) underlying this relationship have not been fully realized. Characterizing neural alterations associated with motor control may provide further insight as to why athletes with a history of SRC display neuromuscular deficits. Additionally, there is an unclear understanding of how RHI exposure may precipitate to the development of motor control deficits. Unlike athletes with an SRC, the absence of overt clinical symptoms, behavioral changes, or neurocognitive manifestations may lead to this population being overlooked. To characterize how sports-related brain injuries may lead to motor control deficits, a literature review is warranted to present the current evidence as it relates to sport-related head injuries, and subsequent lower extremity injury. The literature synthesis (Chapter 1) will provide a comprehensive overview of SRC, RHIs, and previous work that has identified (open full item for complete abstract)