Does Vestibular-Ocular-Motor (VOM) Impairment Affect Time to Return to Play, Symptom Severity, Neurocognition and Academic Ability in Student-Athletes following acute Concussion?

Abstract

Introduction: Research indicates Sports-Related Concussion (SRC) impairs Vestibular-Ocular-Motor (VOM) function. The aim was to explore if VOM impairment correlates with longer Return To Play (RTP), symptom burden, neurocognitive performance and academic capability. Participants; 40 (61.4% male) Loughborough University, UK, rugby union student-athletes sustained 42 SRC's. Methods: Student-athletes completed an assessment battery during pre-season (baseline), 2, 4, 8 and 14 days post SRC and prior to RTP and were managed according to the rugby Football Union' community pathway. Outcome measures; Vestibular Ocular-Motor Screening (VOMS), Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), Post-Concussion Symptom Scale (PCSS), Perceived Academic Impairment Tool (PAIT) questionnaire and percentage of academic activities specifically missed due to SRC.Results: VOMS scores were significantly (p<0.005) greater than baseline at all time points except RTP. Prescence of VOM dysfunction at 14 days post SRC significantly correlated with a longer RTP, greater symptom burden and increased odds ratio at 2, 4 and 8 days and academic time loss at 2, 4 and 8 days post-SRC.Conclusion: VOM impairment is associated with an increased symptom burden and impaired academic capability, and a longer time to RTP when present at 14 days post-SRC.

Investigating the Student in Returning to Learn After Concussion: A Systematic Review and Meta‐Analysis

“…Time post injury was related to school absences and perceived academic difficulties, and students in the acute stage were more likely to report academic dysfunction 57 . Greater number of symptoms, higher symptom severity, longer duration (over a month), and vestibular ocular‐motor dysfunction were related to more days of school missed 3,42,44,45,50,51 and increased difficulty in learning 12,42,44,50,72,74 . Vestibular ocular‐motor dysfunction, difficulty remembering and concentrating, executive dysfunction, and problems falling asleep were directly associated with school performance and academic concerns 12,17,42,52,83 .…”

“…57 Greater number of symptoms, higher symptom severity, longer duration (over a month), and vestibular ocular-motor dysfunction were related to more days of school missed 3,42,44,45,50,51 and increased difficulty in learning. 12,42,44,50,72,74 Vestibular ocular-motor dysfunction, difficulty remembering and concentrating, executive dysfunction, and problems falling asleep were directly associated with school performance and academic concerns. 12,17,42,52,83 Psychological symptoms were potential mediators between concussion and school problems.…”

“…School attendance, evaluated as missed days of school after concussion, was reported in 20 studies. Of these, 2 focused on college students, 42,43 6 were adolescents, 16,19,[44][45][46][47] and 12 were mixedage groups. 3,[48][49][50][50][51][52][53][54][55][56][57] Absences from school ranged widely, from a mean of 3 to 69.2 days.…”

“…Concussion was found to interfere with students' academic experiences in all 17 studies. Four studies examined college students, 18,42,67,68 7 investigated adolescents, 12,44,[69][70][71][72][73] and 6 included mixed-age groups. 17,50,52,57,74,75 Between 15% 56 and 88% 75 of students reported concussion interfering with academics.…”

“…12,42,44,50,72,74 Vestibular ocular-motor dysfunction, difficulty remembering and concentrating, executive dysfunction, and problems falling asleep were directly associated with school performance and academic concerns. 12,17,42,52,83 Psychological symptoms were potential mediators between concussion and school problems. 18,74 Consequently, students with persistent symptoms and prolonged recovery were also more likely to receive accommodations.…”