Consensus statement on Concussion in Sport—The 4th International Conference on Concussion in Sport held in Zurich, November 2012

McCrory, Paul; Meeuwisse, Willem; Aubry, Mark; Cantu, Bob; Dvořák, Jiří; Echemendía, Ruben J.; Engebretsen, Lars; Johnston, Karen; Kutcher, Jeff; Raftery, Martin; Sills, Allen K.; Benson, Brian W.; Davis, Gavin A; Ellenbogen, Richard G.; Guskiewicz, Kevin M.; Herring, Stanley A.; Iverson, Grant L.; Jordan, Barry; Kissick, James; McCrea, Michael; McIntosh, Andrew S.; Maddocks, David; Makdissi, Michael; Purcell, Laura; Putukian, Margot; Schneider, Kathryn; Tator, Charles H.; Turner, Michael S.

doi:10.1016/j.jsams.2013.02.009

Cited by 142 publications

(161 citation statements)

References 133 publications

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“…Dysfunction may occur in one or more domains, resulting in physical symptoms, behavioral changes, emotional disturbances, and sleep impairment. While up to 90% of concussions resolve in 7–10 days, recovery time may be longer 2. The time to recover may reflect the extent of microscopic neuronal shearing3 and the impairment of cellular and metabolic function 4, 5.…”

Section: Introductionmentioning

confidence: 99%

Rapid number naming in chronic concussion: eye movements in the King–Devick test

Rizzo

Hudson

Dai³

et al. 2016

Ann Clin Transl Neurol

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ObjectiveThe King–Devick (KD) test, which is based on rapid number naming speed, is a performance measure that adds vision and eye movement assessments to sideline concussion testing. We performed a laboratory‐based study to characterize ocular motor behavior during the KD test in a patient cohort with chronic concussion to identify features associated with prolonged KD reading times.MethodsTwenty‐five patients with a concussion history (mean age: 31) were compared to control participants with no concussion history (n = 42, mean age: 32). Participants performed a computerized KD test under infrared‐based video‐oculography.ResultsAverage intersaccadic intervals for task‐specific saccades were significantly longer among concussed patients compared to controls (324.4 ± 85.6 msec vs. 286.1 ± 49.7 msec, P = 0.027). Digitized KD reading times were prolonged in concussed participants versus controls (53.43 ± 14.04 sec vs. 43.80 ± 8.55 sec, P = 0.004) and were highly correlated with intersaccadic intervals. Concussion was also associated with a greater number of saccades during number reading and larger average deviations of saccade endpoint distances from the centers of the to‐be‐read numbers (1.22 ± 0.29° vs. 0.98 ± 0.27°, P = 0.002). There were no differences in saccade peak velocity, duration, or amplitude.InterpretationProlonged intersaccadic intervals, greater numbers of saccades, and larger deviations of saccade endpoints underlie prolonged KD reading times in chronic concussion. The KD test relies upon a diffuse neurocognitive network that mediates the fine control of efferent visual function. One sequela of chronic concussion may be disruption of this system, which may produce deficits in spatial target selection and planning of eye movements.

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Section: Introductionmentioning

confidence: 99%

Rapid number naming in chronic concussion: eye movements in the King–Devick test

Rizzo

Hudson

Dai³

et al. 2016

Ann Clin Transl Neurol

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“…A concussion is defined as a complex pathophysiological process that results from a direct blow to the head or other body part with biomechanical forces transmitted to the brain [1] . Functional impairments in neurological function usually resolve over short periods of time without radiological evidence of structural injury [1,2] , although advanced neuroimaging modalities may provide insight into the microstructural and functional neurobiological changes including diffuse axonal injury, metabolic impairment, alteration in neural activation and cerebral blood flow alterations that may contribute to the patient's symptomatology [3] .…”

Section: Introductionmentioning

confidence: 99%

“…Functional impairments in neurological function usually resolve over short periods of time without radiological evidence of structural injury [1,2] , although advanced neuroimaging modalities may provide insight into the microstructural and functional neurobiological changes including diffuse axonal injury, metabolic impairment, alteration in neural activation and cerebral blood flow alterations that may contribute to the patient's symptomatology [3] . In paediatric sport-related concussions there is usually no loss of consciousness, and most symptoms resolve sequentially over a period of 1-2 weeks, although some persist for longer.…”

Section: Introductionmentioning

confidence: 99%

Symptom Experience and Quality of Life in Children after Sport-Related Head Injuries: A Cross-Sectional Study

Vassilyadi

Macartney²,

Barrowman³

et al. 2015

Pediatr Neurosurg

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Background: Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. Methods: A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Results: Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p < 0.05) than for males across all of the HRQL domains. Trouble falling asleep and memory problems explained 62% of the variance in the PedsQL total scores. Conclusions: Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities.

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“…5 Yet measures that focus on the most prevalent symptoms experienced by individuals after a concussion injury could help in diagnosis. The most common symptoms are headaches, dizziness, and balance problems.…”

mentioning

confidence: 99%

“…The most common symptoms are headaches, dizziness, and balance problems. 5,6 Of the 3 top symptoms, dizziness and balance dysfunction are related. Thus, examining balance dysfunction after a concussion could provide a quantitative, objective measure of the injury.…”

mentioning

confidence: 99%

Reliability and Validity Evidence of Multiple Balance Assessments in Athletes With a Concussion

Murray

Salvatore

Powell

et al. 2014

Journal of Athletic Training

124

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Context: An estimated 300 000 sport-related concussion injuries occur in the United States annually. Approximately 30% of individuals with concussions experience balance disturbances. Common methods of balance assessment include the Clinical Test of Sensory Organization and Balance (CTSIB), the Sensory Organization Test (SOT), the Balance Error Scoring System (BESS), and the Romberg test; however, the National Collegiate Athletic Association recommended the Wii Fit as an alternative measure of balance in athletes with a concussion. A central concern regarding the implementation of the Wii Fit is whether it is reliable and valid for measuring balance disturbance in athletes with concussion. Objective: To examine the reliability and validity evidence for the CTSIB, SOT, BESS, Romberg test, and Wii Fit for detecting balance disturbance in athletes with a concussion. Data Sources: Literature considered for review included publications with reliability and validity data for the assessments of balance (CTSIB, SOT, BESS, Romberg test, and Wii Fit) from PubMed, PsycINFO, and CINAHL. Data Extraction: We identified 63 relevant articles for consideration in the review. Of the 63 articles, 28 were considered appropriate for inclusion and 35 were excluded. Data Synthesis: No current reliability or validity information supports the use of the CTSIB, SOT, Romberg test, or Wii Fit for balance assessment in athletes with a concussion. The BESS demonstrated moderate to high reliability (interclass correlation coefficient = 0.87) and low to moderate validity (sensitivity = 34%, specificity = 87%). However, the Romberg test and Wii Fit have been shown to be reliable tools in the assessment of balance in Parkinson patients. Conclusions: The BESS can evaluate balance problems after a concussion. However, it lacks the ability to detect balance problems after the third day of recovery. Further investigation is needed to establish the use of the CTSIB, SOT, Romberg test, and Wii Fit for assessing balance in athletes with concussions.

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Consensus statement on Concussion in Sport—The 4th International Conference on Concussion in Sport held in Zurich, November 2012

Cited by 142 publications

References 133 publications

Rapid number naming in chronic concussion: eye movements in the King–Devick test

Rapid number naming in chronic concussion: eye movements in the King–Devick test

Symptom Experience and Quality of Life in Children after Sport-Related Head Injuries: A Cross-Sectional Study

Reliability and Validity Evidence of Multiple Balance Assessments in Athletes With a Concussion

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