Jaclyn Caccese

The Ohio State University | OSU · School of Health and Rehabilitation Sciences

Background and Purpose Sport-specific training may improve postural control, while repetitive head acceleration events (RHAEs) may compromise it. Understanding the neural mechanisms underlying postural control may contextualize changes due to training and RHAE. The goal of this study was to determine whether postural sway during the Balance Error S...

The purpose of this study was to determine if the time interval between two concussive events influences the number of days to asymptomatic status, days to return to play, or performance on common post-concussion assessments following the second concussion. Data from 448 collegiate athletes and service academy cadets with two concussions (time betw...

Background The Sport Concussion Assessment Tool (SCAT) is the most widely used tool following sport-related concussion (SRC) and yields strong sensitivity and specificity. Initial SCAT symptom burden is reportedly the strongest predictor of recovery in collegiate athletes, however; it is unknown if symptom presentation varies within the acute (<48...

We have previously reported wearable loop sensors that can accurately monitor knee flexion with unique merits over the state of the art. However, validation to date has been limited to single-leg configurations, discrete flexion angles, and in vitro (phantom-based) experiments. In this work, we take a major step forward to explore the bilateral mon...

Objective To determine base rates of postconcussional syndrome (PCS) diagnostic categorization in National Collegiate Athletic Association (NCAA) student-athletes with no recent concussion. Design Cross-sectional, observational study. Setting Participants were recruited from 26 civilian schools as part of the NCAA-U.S. Department of Defense Grand...

Objective To describe sex differences in non-sport related concussion (non-SRC). Design Descriptive epidemiology. Setting 30 colleges/universities and military service academies in the Concussion Assessment, Research and Education Consortium. Participants 1,036 cadets and athletes (n=555 females) with non-SRC (outside of competition/practice/tra...

Objective Explore the association between estimated age of first exposure (eAFE) and sex with inflammatory biomarker serum levels at baseline assessment in healthy, non-concussed athletes and military cadets. We hypothesize that inflammatory biomarkers will be positively associated with eAFE for both males and females such that an earlier eAFE woul...

Objective To examine the association between pre-collegiate multisport (MSA) and single-sport student-athletes (SSA) on neurocognitive baseline assessments from the NCAA/DoD CARE data set. We hypothesized that MSA would perform better than SSA on the neurocognitive measures. Design Retrospective, cohort study design Setting Neurocognitive assessm...

Objective To examine changes in sensory reweighting for upright stance across one season in women’s rugby athletes. Design Prospective cohort study. Setting Virtual reality research laboratory. Participants Thirteen women’s rugby athletes (M=20years, SD=1year). Independent Variable Time; baseline (before the first season game), post-season (wit...

Objective To examine sensory reweighting for upright stance sub-acutely following concussion. Design Case-control. Setting Virtual environment in a research laboratory. Participants 13 student-athletes (8 women, 21±3 years) between 2 weeks and 6 months following concussion who reported being asymptomatic at the time of testing and 26 controls (8...

Objective Prior research has suggested deficits in sensorimotor integration during balance; however, multisensory integration (i.e., the ability to combine information from multiple sensory systems) has not been studied in isolation. The Subjective Visual Vertical (SVV) tests a person’s ability to integrate visual and vestibular information in rela...

Objective To determine base rates of postconcussional syndrome (PCS) diagnostic categorization in service academy cadets with no recent concussion Design Cross-sectional, observational study Setting Participants were recruited from 3 U.S. service academies as part of the National Collegiate Athletic Association and U.S. Department of Defense Gran...

Objective To examine the association between estimated age of first exposure to American football (AFE) and concussion history in National Collegiate Athletic Association (NCAA) football players Design Cross-sectional, observational study Setting Participants were recruited from 30 colleges/universities as part of the NCAA-U.S. Department of Defe...

The purpose of this study was to determine sex differences in recovery trajectories of assessments for sport-related concussion using Concussion Assessment, Research and Education (CARE) Consortium data. National Collegiate Athletic Association athletes (N = 906; 61% female) from sex-comparable sports completed a pre-season baseline assessment and...

Law enforcement cadets (LECs) complete weeks of subject control technique training. Similar sport-related combat training has been shown to expose participants to head acceleration events (HAEs) that have potential to result in short- and long-term impairments. The purpose of this study was to describe the number and magnitude of HAEs in LECs throu...

Concussion has been described in the United States (US) collegiate student–athlete population, but female-specific findings are often underrepresented and underreported. Our study aimed to describe female collegiate student–athletes’ initial injury characteristics and return to activity outcomes following concussion. Female collegiate student–athle...

Mild traumatic brain injury (mTBI) has been described in the United States (US) military service academy cadet population, but female-specific characteristics and recovery outcomes are poorly characterized despite sex being a confounder. Our objective was to describe female cadets’ initial characteristics, assessment performance, and return-to-acti...

Context: Concussion research has primarily focused on sport-related mechanisms and excluded non-sport related mechanisms. In adult populations, non-sport related concussions (non-SRC) demonstrate worse clinical outcomes relative to sport-related concussions (SRC); however, there is limited research examining non-SRC in college-aged patients. Obje...

Since the implementation of the US Soccer heading guidelines released in 2015, little to no research on ball-head impact exposure in the United States youth soccer population has been conducted. The purpose was to compare ball-head impact exposure across sex and age in youth soccer players over a weekend tournament. Ten male and female games for ea...

Purpose To determine if performance on the Sway Medical Mobile Application Balance Test differs by age and gender. Methods Pre-season baseline data from 33,784 individuals (51.3% girls/women) between ages 12 and 22 (mean=16.8 years, SD=2.5), tested in the summer of 2022, without a self-reported concussion in the past 6 months, and without self-rep...

This prospective cohort study aimed to determine whether pre-injury characteristics and performance on baseline concussion assessments predicted future concussions among collegiate student-athletes. Participant cases (concussed = 2,529; control = 30,905) completed pre-injury: demographic forms (sport, concussion history, sex), Immediate Post-Concus...

Background There is a broad and diverse range of symptoms after a concussion, from irritability to nausea. This heterogeneity of symptoms is a challenge for clinicians managing the different presentations among injuries. Prior research has investigated the structure of postconcussive symptoms to determine if they can be grouped into clusters of rel...

Context: Data on the early- to mid-life effects of repetitive neurotrauma on patient reported outcomes have been delimited to homogeneous samples of male athletes with failure to utilize comparison groups or account for modifying factors such as physical activity. Objective: To determine the effect of contact/collision sport participation on pat...

Background To determine the effect of contact/collision sport participation on measures of single-task (ST) and dual-task (DT) gait among early- to middle-aged adults. Methods The study recruited 113 adults (34.9 ± 11.8 years, 53.0% female) representing 4 groups. Groups included: (a) former non-contact/collision athletes and non-athletes who are n...

Objective: (1) To determine test-retest reliability of individual Sport Concussion Assessment Tool-Third Edition (SCAT-3) symptom scores and symptom severity scores, (2) to examine the specificity/sensitivity of individual SCAT-3 symptom severity scores acutely (24-48 hours) postconcussion, and (3) to develop a model of symptoms best able to diffe...

Purpose: The purpose of this study was to determine changes in neurocognitive, psychosocial, and balance functioning in collegiate male and female soccer players across three consecutive years of baseline testing compared to a control group of non-contact athletes. Methods: Generalized estimating equations were used to compare changes in annual,...

Objective: Impaired balance and postural stability can occur with advanced age, following traumatic brain injury, in association with neurological disorders and diseases, and as the result of acute or chronic orthopedic problems. The remote assessment of balance and postural stability could be of value in clinical practice and research. We examined...

The use of head kinematic measurement devices has recently proliferated owing to technology advances that make such measurement more feasible. In parallel, demand to understand the biomechanics of head impacts and injury in sports and the military has increased as the burden of such loading on the brain has received focused attention. As a result,...

Objective Concussions are common among youth athletes and could disrupt critical neurodevelopment. This study examined the association between age of first concussion (AFC) and neurocognitive performance, psychological distress, postural stability, and symptoms commonly associated with concussion in healthy collegiate men and women student athletes...

Background: Investigations of estimated age of first exposure to repetitive head impacts from collision and contact sports have shown no associations with neurocognitive or neurobehavioral function at the collegiate level, but the effect of career duration may be a more comprehensive factor. Understanding whether longer career duration influences...

Soccer athletes experience repetitive head impacts (RHI) through purposeful heading and unintentional head impacts, which may be associated with acute and chronic brain injury. Previous soccer studies have sought to quantify and characterize RHI, but to-date no consistent, standardized methods exist. The Heads-Up Checklist (HUC), originally used fo...

Background: Early sport specialization has been associated with an increased risk of musculoskeletal injuries and unfavorable psychological outcomes; however, it is unknown whether sport specialization is associated with worse cognitive, postural, and psychological functions in first-year collegiate student-athletes. Methods: First-year collegia...

Objective To examine how concussion may impair sensory processing for control of upright stance.Methods Participants were recruited from a single university into 3 groups: 13 participants (8 women, 21 ± 3 years) between 2 weeks and 6 months post-injury who initiated a return-to-play progression (under physician management) by the time of testing (r...

A controversial theory proposes that playing tackle football before the age of 12 causes later in life brain health problems. This theory arose from a small study of 42 retired National Football League (NFL) players, which reported that those who started playing tackle football at a younger age performed worse on selected neuropsychological tests a...

The purpose of this study was to examine the association between sports participation history, including estimated age of first exposure (eAFE) to high-risk sports, and concussion history in first year (i.e., freshmen) collegiate athletes. Athletes increased their odds of sustaining a pre-college concussion by 5% [odds ratio(OR) = 1.05 (95%CI:1.05–...

Context Preseason testing can be time intensive and cost prohibitive. Therefore, using normative data for postconcussion interpretation in lieu of preseason testing is desirable. Objective To establish the recovery trajectory for clinical reaction time (RTclin) and assess the usefulness of changes from baseline (comparison of postconcussion scores...

Background: The purpose of this study was to determine if earlier age of first exposure to football is associated with worse brain health in middle-aged and older adult men who played high school football. Methods: Men from the United States, aged 35 and older, who reported playing high school football, completed a customized, online health survey...

Background Symptom resolution is a key marker in determining fitness for return to activity following concussion, but in some cases, distinguishing persistent symptoms due to concussion versus symptoms related to other factors can be challenging.Objective To determine base rates of postconcussional syndrome (PCS) diagnostic categorization in health...

Purpose: To determine the relationship between age of first exposure (AFE) to repetitive head impacts (RHI) through contact/collision sports and patient-reported outcomes in community rugby players. Methods: We recruited community rugby players over the age of 18 with at least 1-year of contact rugby participation to complete an online survey. P...

The aim of this cross-sectional study was to explore the effects of different ball types and characteristics on head acceleration during purposeful heading in youth football players. Experienced male and female players (n=61) aged between 12-17 years completed heading trials with 4 different balls (Ball 1 mass 192 grams(g), pressure 5.0 pounds per...

Background Since concussion is the most common injury in ice hockey, the objective of the current study was to elucidate risk factors, specific mechanisms, and clinical presentations of concussion in men's and women's ice hockey. Methods Ice hockey players from 5 institutions participating in the Concussion Assessment, Research and Education (CARE...

Context: Pre-season testing is often used to establish baseline scores for post-concussion interpretation. However, pre-season testing can be time-intensive and cost-prohibitive, in which case normative data may be used for post-injury interpretation. Objective: To compare change from baseline and normative-based cutoff scores in interpreting clini...

Objective This study examined the association between age of first concussion (AFC) and neurocognitive performance, psychological distress, postural stability, and concussion symptoms in healthy collegiate student athletes. Background Concussions are common among youth athletes, yet the long-term clinical consequences are largely unknown. We hypot...

Objective The purpose of this study was to examine sensory reweighting for upright stance in three groups (i.e., sub-acute concussion, concussion history, control). Background Balance impairments are common following concussion; however, the physiologic mechanisms underlying these impairments are not well understood. Design/methods There were 13...

Background Considering the potential cumulative effects of repetitive head impact (HI) exposure, we need sensitive biomarkers to track short- and long-term effects. Circulating small extracellular vesicles (sEVs) (<200 nm) traffic biological molecules throughout the body and may have diagnostic value as biomarkers for disease. The purpose of this s...

The purpose of this study was to determine if earlier age of first exposure to football is associated with worse brain health in middle-aged men who played high school football. We assessed 123 men ages 35-55, who played high school football, using (i) a survey of demographic information as well as medical, sport participation, and concussion histo...

Objective: To examine the association between estimated age of first exposure (eAFE) to American football and clinical measures throughout recovery following concussion. Methods: Participants were recruited across 30 colleges and universities as part of the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium. There were 294...

Objective This study examined if earlier age of first exposure (AFE) to football is associated with worse brain health in middle-aged men who played high school football. Method Using an online crowdsourcing platform, we recruited 123 men ages 35–55 who played high school football. Participants completed self-report measures that assessed (i) demo...

Background Collegiate football players who started playing tackle football before age 12 years did not show worse neuropsychological test performance than those who started playing tackle football after age 12 years. It is unknown if beginning other contact sports, such as lacrosse, at a younger age is associated with worse neurocognitive performan...

The purpose of this study was to compare sensory reweighting for upright stance between soccer players who report higher soccer heading exposure to those who report lower soccer heading exposure. Thirty participants completed a self-reported questionnaire to estimate the number of soccer headers experienced over the prior year and were divided into...

US Soccer eliminated soccer heading for youth players ages 10 years and younger and limited soccer heading for children ages 11–13 years. Limited empirical evidence associates soccer heading during early adolescence with medium-to-long-term behavioral deficits. The purpose of this study was to compare sensory reweighting for upright stance between...

The use of virtual reality (VR) technology continues to grow in the areas of clinical assessment and rehabilitation. Both researchers and health-care providers are exploring ways to incorporate VR in clinical practice as an emerging technology. VR postural control and neuropsychological testing represent a promising next step in sport-related concu...

Context In the absence of baseline testing, normative data may be used to interpret postconcussion scores on the clinical reaction-time test (RT clin ). However, to provide normative data, we must understand the performance factors associated with baseline testing. Objective To explore performance factors associated with baseline RT clin from amon...

Younger age of first exposure (AFE) to American football has been associated with later‐life cognitive deficits in former National Football League players experiencing cognitive and behavioral deficits, but not in other cohorts of high school, college, amateur, or professional contact/collision sports athletes. Although several studies evaluated cl...

Objective To examine the association between estimated age of first exposure (eAFE) to American football and clinical measures throughout recovery following concussion. Background In collegiate football players, we reported no association between eAFE and baseline neurocognitive function. It is possible that neurocognitive deficits from earlier eA...

Objective To compare sensory reweighting for upright stance between collegiate collision and non-contact sport athletes. Background The potentially adverse effects of repetitive head impact (RHI) exposure through routine collision sport participation have become a major public health concerns. Design/Methods Thirty male collegiate athletes were g...

Objective To compare sensory reweighting for upright stance between soccer players who began soccer heading before age 10 years (AFE ≤ 10) and those who began soccer heading after age 10 years (AFE > 10). Background In 2015, US Soccer announced an initiative to eliminate soccer heading for youth players ages 10 years and younger and to limit socce...

Objective To compare sensory reweighting between soccer players who report higher exposure to soccer heading and those who report lower exposure to soccer heading. Background Exposure to repetitive head impacts (RHI), such as through routine soccer heading, may have potentially detrimental effects. Design/Methods Thirty participants completed a s...

Objective: To evaluate the influences of sociodemographic factors, estimated head impact exposure, and academic aptitude on ImPACT scores in college athletes. Methods: Data were reported on 18,886 participants (58% male) from the NCAA/DoD CARE Consortium. Race, SES, concussion history, estimated repetitive head impact exposure (eRHIE), and academic...

This study examined the association between estimated age of first exposure (eAFE) to contact sport participation and neurocognitive performance and symptom ratings in U.S. service academy National Collegiate Athletic Association (NCAA) athletes. Male cadets (N = 891), who participate in lacrosse (n = 211), wrestling (n = 170), ice hockey (n = 81),...

Purpose To examine the association between estimated age of first exposure (eAFE) to contact sports and neurocognitive performance and symptom ratings in collegiate U.S. Military Service Academy athletes. We hypothesized that contact-sports participation before the age of 12 would not be associated with worse neuropsychological test performance or...

The purpose was to determine differences in pre-season baseline performance between student-athletes who suffered a future sport-related concussion (fSRC) and those who did not. Collegiate student-athletes (82 fSRC, 82 matched control, age = 18.4 ± 0.8years, height = 172.7 ± 10.3 cm, mass = 80.1 ± 20.9 kg) completed baseline Immediate Post-Concussi...

Purpose: The purpose of this study was to determine the relationship between repetitive head impacts (RHI) and clinical concussion assessments across a season among collegiate football (FB) and women's soccer (WSOC) players. Methods: Fifteen male FB and 23 WSOC players participated in this study. Participants were included if they were medically...

Background Repetitive subconcussive head impacts (RHI) may be associated with current and future detrimental neurological effects. However, the effects of RHI on sensory processing for balance control is unknown and may have significant clinical implications if athletes are still participating in sport despite impairments. Research Question Are th...

Background: Repetitive head impacts in young athletes are potentially detrimental to later life (e.g., age 50 + years) neurological function; however, it is unknown what the short-term effects (e.g., age 20 years) are in collegiate student-athletes. Objective: The purpose of this study was to determine the effect of the estimated age of first ex...

Objective Immediate removal from activity after sport-related concussion is associated with less time missed from sport, a shorter symptomatic period, and better outcomes on acute clinical measures than delayed removal from activity. However, the effects of undiagnosed concussion on clinical outcomes have not been studied. In the case of an undiagn...

Exposure to repetitive subconcussive head impacts (RSHI), specifically soccer heading, is associated with white matter microstructural changes and cognitive performance impairments. However, the effect of soccer heading exposure on vestibular processing and balance control during walking has not been studied. Galvanic vestibular stimulation (GVS) i...

Objective: To determine the acute effects of repetitive soccer heading on postural control. Design: Prospective study; participants were divided into 2 groups: a soccer heading group and a control group. Setting: Biomechanics laboratory. Participants: One hundred sixty participants, including youth (age = 13.0 ± 0.8 years), high school (age...

Context: Heading, an integral component of soccer, exposes athletes to a large number of head impacts over a career. The literature has begun to indicate that cumulative exposure may lead to long-term functional and psychological deficits. Quantifying an athlete's exposure over a season is a first step in understanding cumulative exposure. Object...

Differences in head–neck segment mass, purposeful heading technique, and cervical strength and stiffness may contribute to differences in head accelerations across sex and age. The purpose of this study was to compare head acceleration across sex and age (youth [12–14 years old], high school and collegiate) during purposeful soccer heading. One-hun...

There is increasing societal concern about the long-term effects of repeated impacts from soccer heading, but there is little information about ways to reduce head impact severity. The purpose of this study was to identify factors that contribute to head acceleration during soccer heading. One-hundred soccer players completed 12 controlled soccer h...

Objective Do differences in neurological assessments exists in a cohort of intercollegiate soccer players with varied concussion histories after an acute bout of soccer heading? Design Pre-posttest. Setting Soccer turf field and clinic. Participants 67 female collegiate soccer athletes (age=19.1 ± 0.9 yr.; mass=60.5 ± 5.0 kg; height=165.3 ± 5.9...

Objective To compare linear and rotational acceleration across age and gender in controlled purposeful soccer heading. Design Prospective study. Setting Biomechanics laboratory. Participants One-hundred soccer players (42 male, 58 female, 17.1±3.5 years, 168.5±20.3 cm, 61.5±13.7 kg) classified as collegiate, high school (HS), or youth (12–14 yea...

Objective To identify factors that contribute to head acceleration during purposeful soccer heading. Design Prospective. Setting Biomechanics laboratory. Participants One-hundred soccer players (42 male, 58 female, 17.1±3.5 years (range: 12-24years), 168.5±20.3 cm, 61.5±13.7 kg). Exclusionary criteria: history of neurologic disorder, cervical sp...

I investigated (1) head acceleration during purposeful football heading across age and sex and (2) determinants of head impact severity. Nearly 4% of the world’s population plays football, including over 26 million women. Although there are unrefuted positive health effects of playing football,1 chronic traumatic encephalopathy (CTE) has been iden...

Background: The role of cervical muscle (neck) strength in traumatic brain and spine injury and chronic neck pain disorders is an area of active research. Characterization of the normal ranges of neck strength in healthy young adults is essential to designing future investigations of how strength may act as a modifier for risk and progression in h...

Physicians and healthcare professionals are often asked for recommendations on how to keep athletes safe during contact sports such as soccer. With an increase in concussion awareness and concern about repetitive subconcussion, many parents and athletes are interested in mitigating head acceleration in soccer, so we conducted a literature review on...

The long-term effects of repetitive head impacts due to heading are an area of increasing concern, and exposure must be accurately measured; however, the validity of self-report of cumulative soccer heading is not known. In order to validate HeadCount, a 2-week recall questionnaire, the number of player-reported headers was compared to the number o...

The purpose of this study was to measure peak linear and rotational head acceleration in women's collegiate soccer and explore the variations in acceleration across different strategic scenarios. Game videos from 14 games were used to identify the strategic scenario in which the athlete headed the ball. Strategic scenarios included: bounce, seconda...