Does time since concussion alter the factor structure of a multidomain assessment in adolescents?

Kissinger-Knox, Alicia; Eagle, Shawn R.; Jennings, Sabrina; Collins, Michael W.; Kontos, Anthony P.

doi:10.1080/09297049.2021.1936475

Cited by 9 publications

(9 citation statements)

References 34 publications

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“…When incorporating the VOMS with the full SCAT3, sensitivity was reported to increase 9% and the AUC was improved 4.4% to 0.85 up to 48 hours post-concussion in a high-quality study including collegiate athletes 142. An acceptable quality cross-sectional study evaluated symptoms, ImPACT and VOMS on testing in adolescent athletes and found the three-component model accounted for 69.2% of the variance observed 147. Overall, the literature is consistent and a combination of tests and outcomes received a SORT A recommendation.…”

Section: Resultsmentioning

confidence: 99%

Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: a systematic review

Echemendia,

Burma,

Bruce

et al. 2023

Br J Sports Med

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ObjectivesTo systematically review the scientific literature regarding the acute assessment of sport-related concussion (SRC) and provide recommendations for improving the Sport Concussion Assessment Tool (SCAT6).Data sourcesSystematic searches of seven databases from 2001 to 2022 using key words and controlled vocabulary relevant to concussion, sports, SCAT, and acute evaluation.Eligibility criteria(1) Original research articles, cohort studies, case–control studies, and case series with a sample of >10; (2) ≥80% SRC; and (3) studies using a screening tool/technology to assess SRC acutely (<7 days), and/or studies containing psychometric/normative data for common tools used to assess SRC.Data extractionSeparate reviews were conducted involving six subdomains: Cognition, Balance/Postural Stability, Oculomotor/Cervical/Vestibular, Emerging Technologies, and Neurological Examination/Autonomic Dysfunction. Paediatric/Child studies were included in each subdomain. Risk of Bias and study quality were rated by coauthors using a modified SIGN (Scottish Intercollegiate Guidelines Network) tool.ResultsOut of 12 192 articles screened, 612 were included (189 normative data and 423 SRC assessment studies). Of these, 183 focused on cognition, 126 balance/postural stability, 76 oculomotor/cervical/vestibular, 142 emerging technologies, 13 neurological examination/autonomic dysfunction, and 23 paediatric/child SCAT. The SCAT discriminates between concussed and non-concussed athletes within 72 hours of injury with diminishing utility up to 7 days post injury. Ceiling effects were apparent on the 5-word list learning and concentration subtests. More challenging tests, including the 10-word list, were recommended. Test–retest data revealed limitations in temporal stability. Studies primarily originated in North America with scant data on children.ConclusionSupport exists for using the SCAT within the acute phase of injury. Maximal utility occurs within the first 72 hours and then diminishes up to 7 days after injury. The SCAT has limited utility as a return to play tool beyond 7 days. Empirical data are limited in pre-adolescents, women, sport type, geographical and culturally diverse populations and para athletes.PROSPERO registration numberCRD42020154787.

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Section: Resultsmentioning

confidence: 99%

Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: a systematic review

Echemendia,

Burma,

Bruce

et al. 2023

Br J Sports Med

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“…Prior work has emphasized the importance of timely care after a concussion in providing an accurate diagnosis, initiating treatment early in recovery, and contributing to improved patient outcomes. 2,3,7,8,12,[15][16][17]24 Our study identified a number of areas that may affect time from the injury to a specialty evaluation and subsequently patient outcomes. Specifically, the division of time to the specialty evaluation into 2 sequential time frames, that is, time from the injury to scheduling and time from scheduling to the specialty evaluation, allows for a preliminary understanding of how patient and injury factors specifically influence the process of accessing care after an injury.…”

Section: Discussionmentioning

confidence: 99%

Predicting Time to Evaluation After Pediatric Concussion: Factors Affecting Specialty Concussion Care

Wingerson,

Magliato,

Smulligan

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: The timing of clinical evaluation after pediatric concussion represents an important and potentially modifiable clinical milestone for diagnosis, selection of appropriate treatment pathways, and recovery prognosis. Patient demographics, socioeconomic status, or medical history may affect the time to the initial evaluation and subsequently influence recovery outcomes. Purpose/Hypothesis: The purpose of this investigation was to evaluate the association of patient characteristics with the time to specialty evaluation after a concussion. It was hypothesized that patients with a history of concussion, a preexisting relationship with our specialty concussion program, or a higher ZIP code–based income estimate would present for care more quickly after a concussion than patients without these characteristics. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Included were patients with a concussion between 6 and 18 years old who were seen for care at a single sports medicine center between January 1 and December 31, 2019. Patient demographic, socioeconomic, injury, and clinical characteristics were collected through a retrospective review of the medical records. The primary outcome was the number of days between the date of the concussion and the patient’s initial specialty evaluation. Results: Overall, 220 patients (mean age, 14.4 ± 2.5 years; 46% female) were seen for care at a mean of 9.7 ± 5.6 days (range, 1-21 days) after concussion. A shorter time to specialty evaluation was associated with a history of concussion (β = –1.72 [95% CI, –3.24 to –0.20]; P = .03) and a prior clinical relationship with the treating clinical department (β = –1.85 [95% CI, –3.52 to –0.19]; P = .03). Referral by a primary care provider was associated with a longer time to evaluation (β = 3.86 [95% CI, 2.39-5.33]; P < .0001). Conclusion: A history of concussion and having a preexisting clinical relationship with the deparment were associated with a shorter time to evaluation after concussion. Referral from a primary care physician was associated with a longer time to evaluation. Issues may exist in the propensity to access care after an injury, resulting in delays for initiating early treatment.

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Section: Introductionmentioning

confidence: 99%

“…8 Most findings support this basic 4-factor structure, with additional factors identified by some or observed differences in item content by others within the 4-factor solution depending on sample, whether the data were collected before or after concussion, and the degree of granularity selected by the researchers. 7,[10][11][12][13] The purpose of this study was 2-fold. First, we endeavored to determine base rates for self-reported cognitive, affective/ emotional, sleep, and somatic/physical symptoms using the SCAT5 PCSS in a multilingual sample of professional hockey players.…”

Section: Introductionmentioning

confidence: 99%

Characterizing Symptoms Before and Following Concussion in Professional Hockey

Bruce

Meeuwisse²,

Hutchison

et al. 2022

Clinical Journal of Sport Medicine

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Objective:Examine SCAT5 baseline and acute symptom subscales in professional hockey players.Design:Longitudinal case–control.Setting:Preseason medical evaluations and suspected concussion evaluations.Participants:NHL/AHL players were given the NHL-modified SCAT5 before the 2018-2019 season (n = 1924). During the season, English-speaking players evaluated within 1 day of injury and diagnosed with concussion (n = 140) were compared with players evaluated for possible concussion, but not given a concussion diagnosis (n = 174).Independent Variables:Concussion diagnosis and demographic characteristics.Main Outcome Measures:Postconcussion Symptoms Scale (PCSS) items were subdivided into affective/emotional, cognitive, somatic/physical, sleep, and headache subscales.Results:Cognitive (13%), somatic/physical (10%), sleep (26%), affective (18%), and headache (6%) symptoms were reported by players at baseline. Concussed players reported more acute symptoms than active controls on each of the subscales (all P's < 0.001). Players who underwent a suspected concussion evaluation were more likely to be diagnosed with concussion if they reported affective/emotional symptoms at baseline (P < 0.001). Postinjury cognitive (P < 0.001), somatic/physical (P < 0.001), and headache (P < 0.001) symptoms best differentiated concussed players and active controls.Conclusions:Player reports of increased cognitive difficulties, somatic/physical difficulties, and headache were most associated with concussion diagnosis at the acute evaluation. An abbreviated “acute” PCSS that includes only headache, cognitive, and/or physical symptoms may be useful for diagnostic purposes when evaluation time is limited. Approximately 2% of players reported significantly elevated affective/emotional symptoms at baseline and report of affective/emotional symptoms at baseline was associated with an increased likelihood of concussion diagnosis among players referred for a suspected concussion evaluation.

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Does time since concussion alter the factor structure of a multidomain assessment in adolescents?

Cited by 9 publications

References 34 publications

Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: a systematic review

Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: a systematic review

Predicting Time to Evaluation After Pediatric Concussion: Factors Affecting Specialty Concussion Care

Characterizing Symptoms Before and Following Concussion in Professional Hockey

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