Evaluating the test–retest reliability of symptom indices associated with the ImPACT post-concussion symptom scale (PCSS)

Merritt, Victoria C.; Bradson, Megan L; Meyer, Jessica; Arnett, Peter A.

doi:10.1080/13803395.2017.1353590

Cited by 37 publications

(30 citation statements)

References 56 publications

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“…We also observed improvement in the visual memory domain of the ImPACT test and a 9-point mean improvement in self-report of concussion-related symptoms, an improvement with suggested clinical relevance ( 45 ). These improvements should be interpreted with caution given that this was a single-arm study and outcomes measures were secondary aims.…”

Section: Discussionmentioning

confidence: 68%

The Ketogenic Diet in the Treatment of Post-concussion Syndrome—A Feasibility Study

2020

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Concussion is the most common form of mild traumatic brain injury (mTBI). Although most patients' symptoms resolve within a month, patients with post-concussion syndrome (PCS) may continue to experience symptoms for years and have limited treatment options. This pilot study assessed the feasibility and symptom-related effects of a ketogenic diet (KD) in patients with PCS symptoms. The Ketogenic Diet in Post-Concussion Syndrome (KD-PCS) was a single-arm trial of a 2-month KD high in non-starchy vegetables and supplemented with medium-chain triglyceride (MCT) oil. Macronutrient targets were ≥70% fat, ≤10% carbohydrate, and the remainder as protein as energy. We assessed feasibility by daily self-reported measure of urine acetoacetate and collection of 3-day food records and serum beta-hydroxybutyrate at multiple timepoints. We assessed symptoms by administering the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and Modified Balance Error Scoring System (M-BESS) at baseline and month 2 and the Post-Concussion Symptom Scale (PCSS) at baseline, month 1, and month 2. Fourteen participants enrolled in the KD-PCS. Twelve participants completed the study and 11 implemented the KD (73% fat, 9% carbohydrate, and 18% protein) and achieved ketosis. One participant complained of MCT-related diarrhea that resolved and another reported nausea and fatigue that resulted in withdrawal from the study. Among compliant participants, the visual memory domain of the ImPACT improved by 12 points (p = 0.02) and PCSS scores improved by 9 points, although not statistically significant. This pilot trial suggests that the KD is a feasible experimental treatment for PCS and justifies further study of its efficacy.

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Section: Discussionmentioning

confidence: 68%

The Ketogenic Diet in the Treatment of Post-concussion Syndrome—A Feasibility Study

2020

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“…21 Patient-reported outcomes included five scales that collectively provide insight on the potential symptoms that stem from deficits in the cervical spine, vestibular and visual systems. [22][23][24][25][26] The Post-Concussion Symptom Scale (PC-SS) assesses general post-concussion symptoms with specific symptom indices for associated sequelae including headache, with variable reliability for the different indices. 22 The Dizziness Handicap Inventory (DHI) assesses the impact of dizziness on functional, emotional, and physical quality of life with excellent reliability and internal consistency.…”

Section: Assessmentsmentioning

confidence: 99%

“…[22][23][24][25][26] The Post-Concussion Symptom Scale (PC-SS) assesses general post-concussion symptoms with specific symptom indices for associated sequelae including headache, with variable reliability for the different indices. 22 The Dizziness Handicap Inventory (DHI) assesses the impact of dizziness on functional, emotional, and physical quality of life with excellent reliability and internal consistency. 23 Visual impairment was assessed with the Convergence Insufficiency Symptom Survey (CISS), which has excellent reliability, 24 and the Acquired Traumatic Brain Injury Vision Symptom Questionnaire, since adapted and renamed the Brain Injury Vision Symptom Survey (BIVSS).…”

Section: Assessmentsmentioning

confidence: 99%

Sequencing and Integration of Cervical Manual Therapy and Vestibulo-oculomotor Therapy for Concussion Symptoms: Retrospective Analysis

Wong

Ziaks

Vargas

et al. 2021

International Journal of Sports Physical Therapy

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Background BackgroundAfter concussion many people have cervicogenic headache, visual dysfunction, and vestibular deficits that can be attributed to brain injury, cervical injury, or both. While clinical practice guidelines outline treatments to address the symptoms that arise from the multiple involved systems, no preferred treatment sequence for post-concussion syndrome has emerged. Purpose PurposeThis study sought to describe the clinical and patient-reported outcomes for people with post-concussion symptoms after a protocol sequenced to address cervical dysfunction and benign paroxysmal positional vertigo within the first three weeks of injury, followed by integrated vision and vestibular therapy. Study Design Study DesignRetrospective longitudinal cohort analysis Methods MethodsRecords from a concussion clinic for 38 patients (25 male 13 female, aged 26.9±19.7 years) with post-concussion symptoms due to sports, falls, assaults, and motor vehicle accident injuries were analyzed. Musculoskeletal, vision, and vestibular system functions were assessed after pragmatic treatment including early cervical manual therapy and canalith repositioning treatment-when indicated-integrated with advanced vision and vestibular rehabilitation. Patient-reported outcomes included the Post-Concussion Symptom Scale (PCSS) for general symptoms; and for specific symptoms, the Dizziness Handicap Index (DHI), Convergence Insufficiency Symptom Scale (CISS), Activities-specific Balance Confidence scale (ABC), and the Brain Injury Vision Symptom Survey (BIVSS). Paired t-tests with Bonferroni correction to minimize familywise error (p<0.05) were used to analyze the clinical and patient-reported outcomes. Results ResultsAfter 10.4±4.8 sessions over 57.6±34.0 days, general symptoms improved on the PCSS (p=0.001, 95%CI=12.4-30.6); and specific symptoms on the DHI (p<0.001, 95%CI=14.5-33.2), CISS (p<0.002, 95%CI=7.1-18.3), ABC (p<0.024, 95%CI=-.3 --.1), and BIVSS (p<0.001, 95%CI=13.4-28.0). Clinical measures improved including cervical range-of-motion (55.6% fully restored), benign paroxysmal positional vertigo symptoms (28/28, fully resolved), Brock string visual convergence (p<0.001, 95%CI=3.3-6.3), and score on the Balance Error Scoring System (p<0.001, 95%CI=5.5-11.6).

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“…The subjective measure is valuable in the clinical assessment for balance issues; however, studies Concussion and Balance in Sports DOI: http://dx.doi.org/10.5772/intechopen.97024 frequently do not report comorbid circumstances or complains, such as cervical abnormalities that could affect in these symptoms associated with a lengthy recovery. More recently, the symptoms have been organized into clusters based on the etiology or concussion domain [32,33].…”

Section: Post-concussion Symptom Scale (Pcss)mentioning

confidence: 99%

Concussion and Balance in Sports

Felipe¹

2021

Contemporary Advances in Sports Science

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Balance, spatial orientation and stable vision are imperative factors for sports or any other physical activity. It is achieved and maintained by a complex integration set of sensorimotor control systems that include sensory input from vision, proprioception or somatosensory and the vestibular system. A Sport-Related Concussion (SRC) is an individualized injury that presents a range of clinical signs and symptoms (cognitive, physical, emotional, somatic, and sleep-related). For this reason, SPR is a meaningful public health issue that involves a multidisciplinary team to properly manage it. In the sports medicine filed, Sports-Related Concussion assessment and management has become an argumentative issue. Presently, the consensus includes a combination of subjective examination, combined by multifactorial evaluation batteries that allowed to verify several components of brain function. Athletes frequently complain of dizziness and imbalance subsequent a concussion, and these symptoms can expect increased period to recover and return to play. Balance assessment is an important component of the concussion evaluation, as it can contribute with an awareness about the function of the sensorimotor systems.

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Evaluating the test–retest reliability of symptom indices associated with the ImPACT post-concussion symptom scale (PCSS)

Abstract: These results suggest that evaluating additional symptom indices beyond the total symptom score from the PCSS is beneficial. Findings from this study can be applied to athlete samples to assess reliable change in symptoms following concussion.

Cited by 37 publications

References 56 publications

The Ketogenic Diet in the Treatment of Post-concussion Syndrome—A Feasibility Study

The Ketogenic Diet in the Treatment of Post-concussion Syndrome—A Feasibility Study

Sequencing and Integration of Cervical Manual Therapy and Vestibulo-oculomotor Therapy for Concussion Symptoms: Retrospective Analysis

Concussion and Balance in Sports

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