A note on normative data for a test sensitive to concussion in Australian rules footballers

Abstract

he medical diagnosis of concussion and assessment of recovery in athletes has traditionally been subjectively T based on clinical symptoms such as headache, nausea, and dizziness. Recently, there has been increasing interest in the use of neuropsychological tests as objective measures of recovery from concussion. In particular, performance on tests of speed of information processing, such as the Digit-Symbol subtest (DS) from the Wechsier Adult Intelligence Scale -Revised (WAIS-R), has been found to be reduced in the first weeks after concussion. In the present study, baseline DS data were obtained from Australian Rules footballers. DS was administered to a sample of 200 professional Australian Rules football players according to standard WAIS-R procedures. Players were then grouped according to concussive history. No player had been concussed within six months of the study. No significant differences were found between the groups. Therefore, while previous research suggests that performance on DS may be affected in the first few weeks following concussive injury, the present results demonstrated that DS performance does not differentiate concussed and nonconcussed players by the sixth month posttrauma. These data constitute normative values against which the DS can be interpreted in concussed footballers in the early stages of recovery.

Neuropsychological Testing as It Relates to Recovery From Sports‐related Concussion

“…The domains of cognitive function that demonstrate deficits by NP testing after concussive injury include memory and learning [8,[39][40][41]; reduced attention and the ability to process information [42][43][44]; slowed reaction times and increased variability in response [45][46][47][48]; and reduced planning, diminished problem solving, and decreased ability to switch a mental set [49][50][51][52]. In many situations, NP testing has demonstrated deficits in neurocognitive function that persist despite the resolution of symptoms related to SRC [3,5,11,53,54].…”

Value of neuropsychological testing after head injuries in football

“…[14][15][16][17] They determined that the digit symbol substitution task (from the Wechsler Adult Intelligence Scale-Revised), paced auditory serial addition task, and choice reaction time were the most sensitive tools in the assessment of concussed players. The added advantage was that these tests were quick and easy to administer and were readily accepted in terms of face validity by subjects.…”

Ethically we can no longer sit on the fence - a neuropsychological perspective on the cerebrally hazardous contact sports

“…21,28 On examination, however, all those studies with negative findings reveal methodological problems in that usually there is limited control for age, education, IQ or gender, or all four of these potentially confounding variables. Furthermore, no concussion-based studies with negative findings identified by the authors had any non-contact sport-control group.…”

“…20,28 Findings such as these, which go against hypothetical expectations on theoretical and empirical grounds, need to be scrutinised rigorously for risk of type II error (false-negative effects), before making premature suggestions in respect of falsification of the expected effects.…”