About

Jeffrey Ryszard Bytomski is a Professor in the Department of Family Medicine and Community Health at Duke University. He is affiliated with the Duke Sports Sciences Institute, located at 3475 Erwin Road, Durham, NC. His contact email is jeffrey.bytomski@duke.edu. The biography provided does not include specific details about his research focus, background, or key contributions.

Research topics

• Medicine
• Physical therapy
• Internal medicine
• Intensive care medicine
• Virology
• Cardiology
• Psychiatry
• Psychology
• Surgery
• Physiology
• History
• Emergency medicine

Selected publications

• Sports Nephrology

  Clinical Journal of the American Society of Nephrology · 2026-03-17

  article
  PublisherDOI

• Early Initiation of Vestibular Therapy Following Sports-Related Concussions: A Retrospective Cohort Study

  Cureus · 2023-05-31 · 6 citations

  articleOpen accessSenior author

  BACKGROUND: Vestibular dysfunction is common following sports-related concussions (SRC). Within the current practice, it is theorized that patients with vestibular dysfunction as sequelae of sports-related concussion have a prolonged recovery time compared to those without vestibular dysfunction. STUDY METHOD: A retrospective, cohort investigation of 282 subjects with sports-related concussions with vestibular dysfunction was conducted at The Sports Medicine Concussion Clinic, Duke University. The primary endpoint was the return-to-play (RTP) date. RESULTS: For every one-day increase in time from injury to initial vestibular therapy, the geometric mean time from injury to RTP increases by 1.02 days (exp{β}=1.02 days; 95% CI: 1.01, 1.02 days; p<0.001). CONCLUSION: Our data suggest an association between the timing of vestibular therapy in SRC and a direct relationship to earlier recovery and return to sport.

  PublisherOA PDFDOI

• Effect of Concussion on Reaction Time and Neurocognitive Factors: Implications for Subsequent Lower Extremity Injury

  International Journal of Sports Physical Therapy · 2022-08-01 · 3 citations

  articleOpen access

  Background: Recent evidence has demonstrated that athletes are at greater risk for a lower extremity injury following a return-to-sport (RTS) after sport-related concussion (SRC). The reason for this is not completely clear, but it has been hypothesized that persistent deficits in neurocognitive factors may be a contributing factor. Hypothesis/Purpose: This study assessed simple reaction time, processing speed, attention, and concentration in a group of athletes, post-concussion upon clearance for RTS for potential deficits that may result in slower reaction time, processing speed, attention, and concentration. The researchers hypothesized that the concussion group would demonstrate worse scores on both assessments compared to a sex-, age-, and sport-matched cohort. Study Design: Case-controlled study. Methods: Twelve participants who had suffered a SRC and eight healthy individuals who were matched to the concussed group by age, sex, and sport were evaluated. Those with a concussion had been cleared for RTS by a licensed healthcare provider. Each participant underwent neurocognitive tests that included a simple reaction time test (SRT) and the King-Devick Test (K-D). Independent t-tests were performed to compare the groups with significance set a priori at p<0.05. Results: There was a significant difference (p =0.024) between groups for SRT with the concussed group demonstrating a better SRT than the control group. There were no significant differences (p =0.939) between the groups for the K-D. Conclusion: With no significant differences between groups in the K-D assessment and, surprisingly, the concussed group having a better SRT compared to the healthy group, our hypothesis was not supported. Clinical Relevance: These specific measures, compounded with extensive post-concussion time lapse until RTS clearance, may have limited capacity in revealing potential persistent deficits in relevant neurocognitive characteristics. Level of Evidence: Level of Evidence 3.

  PublisherOA PDFDOI

• Sports Medicine: Concussion.

  PubMed · 2022-07-01 · 4 citations

  article1st authorCorresponding

  Sports-related concussion is a common injury in organized and recreational sports. Collision and contact sports are higher risk activities. Female athletes may be at more risk of concussion compared with male athletes; however, more research is needed. Evaluation of concussion involves assessments of multiple domains or clinical profiles, including vestibular, ocular, headache, cognitive, mood, fatigue, and other systems. Initial management consists of a short rest period followed by increasing activity that does not exacerbate symptoms. Cognitive modifications for school or work also are initiated early in the management plan. Use of other management modalities is based on findings from the physical examination. Imaging may be needed in cases of worsening or progressive symptoms. When athletes have returned to baseline symptom burden and have returned to school or work, they may transition to a return to play/sport progression. Most sports-related concussions resolve within 2 weeks for adults and 4 weeks for adolescents. Risk factors for prolonged recovery include initial high symptom burden, multiple concussions, young age, mental health issues, and migraine history.

  Publisher

• Cardiac Troponin Testing as a Component of Return to Play Cardiac Screening in Young Competitive Athletes Following SARS‐CoV‐2 Infection

  Journal of the American Heart Association · 2022 · 6 citations

  • Medicine
  • Cardiology
  • Internal medicine

  Background Initial protocols for return to play cardiac testing in young competitive athletes following SARS-CoV-2 infection recommended cardiac troponin (cTn) to screen for cardiac involvement. This study aimed to define the diagnostic yield of cTn in athletes undergoing cardiovascular testing following SARS-CoV-2 infection. Methods and Results This prospective, observational cohort study from ORCCA (Outcomes Registry for Cardiac Conditions in Athletes) included collegiate athletes who underwent cTn testing as a component of return to play protocols following SARS-CoV-2 infection. The cTn values were stratified as undetectable, detectable but within normal limits, and abnormal (>99% percentile). The presence of probable or definite SARS-CoV-2 myocardial involvement was compared between those with normal versus abnormal cTn levels. A total of 3184/3685 (86%) athletes in the ORCCA database met the inclusion criteria for this study (age 20±1 years, 32% female athletes, 28% Black race). The median time from SARS-CoV-2 diagnosis to cTn testing was 13 days (interquartile range, 11, 18 days). The cTn levels were undetectable in 2942 athletes (92%), detectable but within normal limits in 210 athletes (7%), and abnormal in 32 athletes (1%). Of the 32 athletes with abnormal cTn testing, 19/32 (59%) underwent cardiac magnetic resonance imaging, 30/32 (94%) underwent transthoracic echocardiography, and 1/32 (3%) did not have cardiac imaging. One athlete with abnormal troponin met the criteria for definite or probable SARS-CoV-2 myocardial involvement. In the total cohort, 21/3184 (0.7%) had SARS-CoV-2 myocardial involvement, among whom 20/21 (95%) had normal troponin testing. Conclusions Abnormal cTn during routine return to play cardiac screening among competitive athletes following SARS-CoV-2 infection appears to have limited diagnostic utility.

  PublisherOA PDFDOI

• Cardiovascular Outcomes in Collegiate Athletes After SARS-CoV-2 Infection: 1-Year Follow-Up From the Outcomes Registry for Cardiac Conditions in Athletes

  Circulation · 2022-05-12 · 24 citations

  letter
  PublisherDOI

• Evidence based management of sports related concussion

  Journal of Osteopathic Medicine · 2021-04-09

  articleOpen access

  Abstract Sports related concussion (SRC) is a common condition evaluated by healthcare professionals. In an article entitled “Return to Play After Concussion: Clinical Guidelines for Young Athletes” published in the December 2019 issue of the Journal of the American Osteopathic Association , guidelines for the management of SRC were presented to assist healthcare professionals in the management of patients with SRC. However, much of the information presented in that article is contradicted by current expert recommendations and evidence based practice guidelines. The management of SRC has evolved to a nuanced, domain driven diagnosis requiring a multidisciplinary treatment team and a customized management plan for each patient to ensure competent treatment of patients with SRC. As such, this Commentary summarizes current recommendations for diagnosis and management of SRC.

  PublisherDOI

• Uncommon Cause of Unilateral Leg Pain in a Collegiate Athlete

  Journal of Medical - Clinical Research & Reviews · 2020-12-28

  articleOpen access
  PublisherDOI

• Clinical examination factors that predict delayed recovery in individuals with concussion

  Archives of Physiotherapy · 2020 · 8 citations

  • Medicine
  • Physical therapy
  • Internal medicine

  BACKGROUND: Risk factors for prolonged recovery after concussion have been well researched, but specific objective clinical examination findings have not. This study examined whether clinical examination results could predict delayed recovery (DR) in individuals with concussion diagnosis. A secondary aim explored the influence of early examination on individual prognosis. METHODS: The study was a retrospective, observational cohort design that included 163 individuals seen at a concussion clinic who were followed longitudinally until cleared for sports activity. Cognitive, visual, balance, vestibular, and cervical clinical testing and symptom assessment were performed at initial evaluation. DR was calculated by taking the median value associated with time to clearance for activity. Bivariate logistic regression analysis was calculated to determine odds ratios (and 95% confidence intervals) for the odds of DR with presence or absence of each clinical finding. Multivariate analyses were used to define the best predictors of DR. RESULTS: 80 of 163 individuals were considered delayed in their clearance to activity. Cognitive impairments (OR = 2.72; 95%CI = 1.40, 5.28), visual exam findings (OR = 2.98; 95%CI = 1.31, 6.80), and vestibular exam findings (OR = 4.28; 95%CI = 2.18, 8.43) all increased the odds of a DR. Multivariate modeling retained cognitive symptoms and clinical examination-vestibular testing as predictors of delayed recovery. Time to examination after injury was a mediator for DR. CONCLUSIONS: The clinical examination provides value in identifying individuals who are likely to exhibit a delayed clearance. In particular, vestibular impairments identified clinically at initial evaluation and cognitive symptoms were associated with increased odds of a DR to return to activity. Our data support that early implementation of a standardized clinical examination can help to identify individuals who may be more at risk of prolonged recovery from concussion.

  PublisherOA PDFDOI

• Atlantic Coast Conference Mandatory College Football Medical Observer. A Necessary Addition to the Preexisting Medical Team?

  PubMed · 2020-01-01

  articleOpen access

  Background: Some NCAA conferences now require a press box-based Medical Observer for all football games to identify injuries missed by on-field providers. The objective of this study was to determine whether a Medical Observer identified injuries missed by the on-field medical personnel. Methods: This was a comparative observational study of injury identification methods which was done at nine NCAA football games. The athletes on a single institution's varsity football team participated. Eight games and one bowl game were studied. Observers were sports medicine Fellows (Orthopaedic, Primary Care). Injury logs were kept by the Medical Observer to document game day injuries. The athletic training staff collected injury reports in the days following games. These were compared with game day injury logs to identify any injuries that were not reported to the medical staff during competition. Results: A total of 41 game injuries were identified (4.56 injuries/ game). 29 injuries (29/41; 71%) were identified by both the sideline medical providers and the Observer, 12 (12/41; 29%) were identified by only the sideline medical providers and no injuries were identified by only the Observer. A total of 95 game-related injuries were evaluated in the training room on the day after each game. 27 injuries (27/95; 28%) had been identified during the game (9 [33%] by the sideline medical team and 18 [67%] by both the sideline medical team and the Observer). Fourteen game injuries were not severe enough to require care the following day. There were 68 (68/95; 72%) delayed self-reported injuries treated by the training room staff the next day. Conclusions: .

  PublisherOA PDF

Frequent coauthors

• Corina Martinez

  Duke University

  29 shared

• Courtney Pyles

  Mayo Clinic in Florida

  26 shared

• Emily K. Reinke

  Duke University

  26 shared

• Cynthia L. Green

  Duke University

  25 shared

• Thomas Risoli

  Catalyst Health Economics Consultants Ltd

  25 shared

• Gary E. Means

  United States Army

  25 shared

• Rock Vomer

  Jacksonville College

  25 shared

• Benjamin Ferry

  Duke University

  25 shared