Effects of exercise on symptoms, vestibular/ocular motor screening and postural stability in a college-aged sample

Moran, Ryan; Murray, Nicholas G.; Esco, Michael R.; Dobbs, Ward C; McAllister-Deitrick, Jamie

doi:10.2217/cnc-2020-0003

Cited by 21 publications

(12 citation statements)

References 32 publications

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“…However, no differences were noted on cognitive tasks, such as orientation, memory, or concentration, nor Standardized Assessment of Concussion (SAC) scores. Similar results were noted by Moran et al [4], who noted worse total symptoms, symptom severity, and somatic, cognitive, emotional, and fatigue/sleep symptom factors scores following a maximal bout of exercise. Additionally, postural control sway scores also worsened when compared to pre-and post-exercise.…”

Section: Introductionsupporting

confidence: 88%

Impact of Acute Exercise on Baseline Concussion Measures

2022

Sports Injr Med

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Concussions present with a myriad of symptoms and deficits related to balance, cognition, and vestibular/ocular motor assessments. To increase accuracy in concussion diagnosis and management, baseline assessments are recommended to provide individualized, pre-injury assessment measures. While symptom reduction and recovery may be aided by physical activity postconcussion, further information is needed to understand the potential influence of post-exercise symptoms in healthy athletes. Therefore, the purpose of this study was to compare the effects of acute exercise on baseline measures of concussion including the SCAT5, KD, ImPACT, BESS, and VOMS. We completed a cross-sectional, laboratory study with 1 independent variable group (exercise, control). Subjects were matched on sex, age, and sport-related concussion (SRC) history and then randomly allocated into the exercise or control group prior to data collection. The dependent variables were comprised of outcome scores from the ImPACT, SCAT5, BESS, VOMS, and K-D test. A total of 93 recreationally active college students (age range = 18-24 years; physical exertion n = 47, control n = 46) were recruited to participate in this study. The exercise group engaged in a one-time, 15-minute exercise protocol before completing the SRC assessments, while the control group completed the SRC assessment protocol in a rested state. Significant differences were noticed between groups on SCAT total number of symptoms and symptom severity, as well as ImPACT symptom severity score, with the control group scoring higher in all categories. For future practice, sports medicine professionals should consider the effect exercise may have on baseline measurements of concussions, specifically symptoms. It may be beneficial to conduct baseline measurements after practice or conditioning, for a better indication of the athlete's true baseline. Additionally, it is important that clinicians and sports medicine professionals continue to use a multimodal approach when treating concussions, as symptoms alone may not be a good indication.

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Section: Introductionsupporting

confidence: 88%

Impact of Acute Exercise on Baseline Concussion Measures

2022

Sports Injr Med

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“…The methods of evaluating VOMS symptoms have been published extensively 10,26,28,29,32 ; in this study, the total symptom provocation was calculated by summing the total number of increased symptoms from baseline (pre-test) for each VOMS item. 32 In addition, each VOMS subtest total reported symptoms were evaluated individually.…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The VOMS tests were administered by 5 trained administrators who were evaluated by the principal investigator as being the most consistent and reliable, as determined by subjective analysis. The subtests were administered as follows according to literature standards 10,26,28,29,32 : Smooth Pursuits. For smooth pursuits, the subject would sit in a designated chair and the administrator would hold the target in front of the subject's face at a distance of 3 feet.…”

Section: Procedures Voms Administered Manually With Handheld Targetsmentioning

confidence: 99%

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Virtual Reality Application for Vestibular/Ocular Motor Screening: Current Clinical Protocol Versus a Novel Prototype

Pavilionis

Adhanom

Moran

et al. 2023

Sports Health: A Multidisciplinary Approach

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Background: Virtual reality (VR) has been explored to improve baseline and postinjury assessments in sport-related concussion (SRC). Some experience symptoms related to VR, unrelated to concussion. This may deter use of vestibular/ocular motor screening (VOMS) using VR. Baseline VR VOMS symptomatology differentiates baseline from overall symptomatology. Hypothesis: There will be no difference between current clinical manual VOMS (MAN), a clinical prototype (PRO), and VR for symptom provocation change score (SPCS) and near point of convergence (NPC) average score in a healthy population and sex differences among the 3 modes of administration. Study Design: Cohort study. Level of Evidence: Level 3. Methods: A total of 688 National Collegiate Athletic Association Division I student-athletes completed VOMS using 3 methods (MAN, N = 111; female athletes, N = 47; male athletes, N = 64; average age, 21 years; PRO, N = 365; female athletes, N = 154; male athletes, N = 211; average age, 21 years; VR, N = 212; female athletes, N = 78; male athletes, N = 134; average age = 20 years) over a 3-year period (2019-2021) during annual baseline testing. Exclusion criteria were as follows: self-reported motion sickness in the past 6 months, existing or previous neurological insult, attention deficit hyperactivity disorder, learning disabilities, or noncorrected vision impairment. Administration of MAN followed the current clinical protocols, PRO used a novel prototype, and VR used an HTC Vive Pro Eye head mounted display. Symptom provocation was compared using Mann-Whitney U tests across each VOMS subtest with total SPCS and NPC average by each method. Results: MAN had significantly ( P < 0.01) more baseline SPCS (MAN = 0.466 ± 1.165, PRO = 0.163 ± 0.644, VR = 0.161 ± 0.933) and significantly ( P < 0.01) and more SPCS (MAN = 0.396 ± 1.081, PRO = 0.128 ± 0.427, VR = 0.48 ± 0.845) when compared with PRO and VR. NPC average measurements for VR (average, 2.99 ± 0.684 cm) were significantly greater than MAN (average, 2.91 ± 3.35 cm; P < 0.01; Cohen’s d = 0.03) and PRO (average, 2.21 ± 1.81 cm; P < 0.01; Cohen’s d = 0.57). For sex differences, female athletes reported greater SPCS with PRO (female athletes, 0.29 ± 0.87; male athletes, 0.06 ± 0.29; P < 0.01) but not in VR or MAN. Conclusion: Using a VR system to administer the VOMS may not elicit additional symptoms, resulting in fewer false positives and is somewhat stable between sexes. Clinical Relevance: VOMS may allow for standardization among administrators and reduce possible false positives.

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“…Participants may have independently engaged in physical activity before testing, which can negatively affect performance on the SCAT5. [46][47][48] To mitigate this, participants were requested to not engage in physical activity immediately before testing sessions. Testing sessions were scheduled at the beginning of regular sport participation sessions or on nonparticipation days for respective sports to mitigate the potential effect of physical activity.…”

Section: Limitationsmentioning

confidence: 99%

Youth Preseason Performance on the Sport Concussion Assessment Tool 5 Across Multiple Sports

Leggett,

Eliason,

Sick

et al. 2023

Clinical Journal of Sport Medicine

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Objective: To examine preseason Sport Concussion Assessment Tool 5 (SCAT5) performance of adolescent sport participants by environment (in-person/virtual), sex, age, concussion history, collision/noncollision sport participation, and self-reported medical diagnoses. Design: Cross-sectional. Setting: Canadian community and high-school sport settings. Participants: Three thousand eight hundred five adolescent (2493 male, 1275 female, and 37 did not disclose; 11- to 19-year-old) sport participants. Assessment of Risk Factors: Sport Concussion Assessment Tool 5 administration method (in-person/virtual), sex (male/female/unreported), age (years), concussion history (0/1/2/3+), collision/noncollision sport participant, and self-reported medical diagnoses [attention deficit disorder or attention-deficit/hyperactivity disorder, headache/migraine, learning disability, and psychiatric disorder (ie, anxiety/depression/other)]. Outcome Measures: Preseason SCAT5 outcomes including total number of symptoms (TNS; /22), symptom severity score (SSS; /132), Standardized Assessment of Concussion (SAC; /50), and modified Balance Error Scoring System (mBESS; /30). Results: Multiple multilevel linear or Poisson regression complete case analyses adjusting for clustering and robust standard errors, with β-coefficients (95% CI) back-transformed to indicate an increase/decrease in SCAT5 subdomains when relevant for clinical interpretation. Virtual (V) performance was associated with fewer symptoms reported [TNSDifference V-IP = −1.53 (95% CI, −2.22 to −0.85)], lower SSS [−2.49 (95% CI, −4.41 to −0.58)], and fewer mBESS errors (IP) [−0.52 (95% CI, −0.77 to −0.27)] compared with in-person. For every one-year increase in age, more symptoms [TNS = 0.22 (95% CI, 0.01-0.44)], higher SSS [0.52 (95% CI, 0.01-1.06)], higher SAC [0.27 (95% CI, 0.15-0.38), and poorer balance [mBESS = −0.19 (−0.28 to −0.09)] were observed. Differences between males and females were also seen across all SCAT5 outcomes. Individuals reporting any medical diagnosis or 3+ concussion history also reported more symptoms (TNS) and higher SSS than those who did not. Conclusions: Administration environment, sex, age, concussion history, and medical diagnoses were associated with SCAT5 subdomains and are important considerations when interpreting the SCAT5 results.

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Effects of exercise on symptoms, vestibular/ocular motor screening and postural stability in a college-aged sample

Cited by 21 publications

References 32 publications

Impact of Acute Exercise on Baseline Concussion Measures

Impact of Acute Exercise on Baseline Concussion Measures

Virtual Reality Application for Vestibular/Ocular Motor Screening: Current Clinical Protocol Versus a Novel Prototype

Youth Preseason Performance on the Sport Concussion Assessment Tool 5 Across Multiple Sports

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