Predicting Sport-related mTBI Symptom Resolution Trajectory Using Initial Clinical Assessment Findings: A Retrospective Cohort Study

McGeown, Joshua P.; Kara, Stephen; Fulcher, Mark; Crosswell, Hannah; Borotkanics, Robert; Hume, Patria; Quarrie, Kenneth L; Theadom, Alice

doi:10.1007/s40279-019-01240-4

Cited by 16 publications

(21 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the mechanism underlying this relationship is unknown, it is possible that the individuals who present with more severe dynamic balance deficits may in turn require a longer period to progress through the RTP process. Previous research investigating predictors for symptom resolution in sports related concussion (N = 568 participants) reported that female sex, a higher positive symptom total and cervicogenic and/or vestibulo-ocular predominant symptom cluster increased the odds of an individual having prolonged symptom resolution (> 14 days) 30 . Interestingly, McGeown et al highlighted that athletes who presented with a vestibulo-ocular predominant symptom cluster may have an increased likelihood of having a prolonged recovery 30 .…”

Section: Discussionmentioning

confidence: 88%

“…Previous research investigating predictors for symptom resolution in sports related concussion (N = 568 participants) reported that female sex, a higher positive symptom total and cervicogenic and/or vestibulo-ocular predominant symptom cluster increased the odds of an individual having prolonged symptom resolution (> 14 days) 30 . Interestingly, McGeown et al highlighted that athletes who presented with a vestibulo-ocular predominant symptom cluster may have an increased likelihood of having a prolonged recovery 30 . This may in part help explain these observations, highlighting that poorer balance performance was associated with an increased time to RTP.…”

Section: Discussionmentioning

confidence: 88%

See 1 more Smart Citation

Concussion Recovery Evaluation Using the Inertial Sensor Instrumented Y Balance Test

Heiderscheit

Coughlan

McLoughlin

et al. 2020

Journal of Neurotrauma

View full text Add to dashboard Cite

The current sports concussion assessment paradigm lacks reliability, has learning effects and is not sufficiently challenging for athletes. As a result, subtle deficits in sensorimotor function may be unidentified, increasing the risk of future injury. This study examined if the inertial-sensor instrumented Y Balance test could capture concussion induced alterations in dynamic movement control. A cohort of 226 elite Rugby Union, American Football and Ice Hockey athletes were evaluated using the inertialsensor instrumented Y balance test. Dynamic balance performance was quantified using normalised reach distance, jerk magnitude root-mean-squared (Jerk Mag RMS) and gyroscope magnitude sample entropy (Gyro Mag SEn). Concussed athletes who consented to follow-up were evaluated 24 to 48hours post-injury, and at the point of return to full contact training (RTP). Seventeen athletes sustained a concussion and consented to both the 24 to 48-hour and RTP follow-up testing. Twenty uninjured control athletes were re-tested 6-months following initial screening. Concussed athletes had reductions in normalised reach distance (Cohens D = 0.66-1.16) and Jerk Mag (Cohens D = 0.57-1.14) 24 to 48hours post-injury, which returned to pre-injury levels by the point of RTP. There was no significant difference in performance between the baseline and 6-month follow-up in the 20 un-injured athletes (Cohens D=0.06-0.51). There was a statistically significant linear association between Jerk Mag RMS 24 to 48-hours post-injury and the natural log of RTP duration (R 2 = 0.27 to 0.33). These results indicate that concussed athletes possessed alterations in dynamic movement control 24 to 48-hours postconcussion, which typically returns to pre-injury levels by the point of RTP. Furthermore, evaluation of dynamic movement control 24 to 48 hours post injury may aid in the evaluation of recovery prognosis.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 88%

Concussion Recovery Evaluation Using the Inertial Sensor Instrumented Y Balance Test

Heiderscheit

Coughlan

McLoughlin

et al. 2020

Journal of Neurotrauma

View full text Add to dashboard Cite

show abstract

“…There is also evidence that dominant symptom clusters, such as high physiological symptom reporting, may be additional predictors of prolonged recovery [21]. Particular symptom clusters may also indicate where specific professional input is needed early in treatment (e.g.…”

Section: Fundingmentioning

confidence: 99%

“…Particular symptom clusters may also indicate where specific professional input is needed early in treatment (e.g. a referral for neurophysiotherapy) [21][22][23]. Use of different tools and concussion policies across different situational contexts and sports is confusing and inefficient for clinicians and patients alike increasing variation in health care delivery.…”

Section: Fundingmentioning

confidence: 99%

“…The excellent scale reliability of the total scale and the three factors of the BIST supports its potential use in adults exploring the predictive value of symptom clusters on recovery. There is increasing evidence that symptom clusters may be useful in identifying people who may need early additional support and specifically the type of support they need [21][22][23]. Evidence for use of the BIST total score will assist in determining a cut off score that may help distinguish people needing early specialist intervention and those who can be given early advice and monitored in primary care to assist with resource allocation, particularly given a high proportion of people do recover naturally [4,5].…”

Section: Plos Onementioning

confidence: 99%

See 1 more Smart Citation

The Brain Injury Screening Tool (BIST): Tool development, factor structure and validity

et al. 2021

Self Cite

View full text Add to dashboard Cite

Currently health care pathways (the combination and order of services that a patient receives to manage their injury) following a mild traumatic brain injury vary considerably. Some clinicians lack confidence in injury recognition, management and knowing when to refer. A clinical expert group developed the Brain Injury Screening Tool (BIST) to provide guidance on health care pathways based on clinical indicators of poor recovery. The tool aims to facilitate access to specialist services (if required) to improve longer term prognosis. The tool was developed using a three-step process including: 1) domain mapping; 2) item development and 3) item testing and review. An online retrospective survey of 114 adults (>16 years) who had experienced a mild brain injury in the past 10 years was used to determine the initial psychometric properties of the 15-item symptom scale of the BIST. Participants were randomised to complete the BIST and one of two existing symptom scales; the Rivermead Post-concussion Symptom Questionnaire (RPQ) or the Sports Concussion Assessment Test (SCAT-5) symptom scale to determine concurrent validity. Participant responses to the BIST symptom scale items were used to determine scale reliability using Cronbach’s alpha. A principal components analysis explored the underlying factor structure. Spearman’s correlation coefficients determined concurrent validity with the RPQ and SCAT-5 symptom scales. The 15 items were found to require a reading age of 6–8 years old using readability statistics. High concurrent validity was shown against the RPQ (r = 0.91) and SCAT-5 (r = 0.90). The BIST total symptom scale (α = 0.94) and the three factors identified demonstrated excellent internal consistency: physical/emotional (α = 0.90), cognitive (α = 0.92) and vestibular-ocular (α = 0.80). This study provides evidence to support the utility, internal consistency, factor structure and concurrent validity of the BIST. Further research is warranted to determine the utility of the BIST scoring criteria and responsiveness to change in patients.

show abstract

The Incidence, Cost, and Burden of Concussion in Women’s Rugby League and Rugby Union: A Systematic Review and Pooled Analysis

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background The extent of concussion injury in the rugby codes for women is unclear. Objective Our aim was to review all published studies reporting concussion injuries from match and training participation in rugby codes and report the pooled data estimates for rugby league and union concussion injury epidemiology. Methods We conducted a systematic literature analysis of concussion in rugby league and rugby union for published studies from January 1990 to July 2021. Data from 16 studies meeting the inclusion criteria were extracted for women’s concussion injuries and were subsequently pooled. Costs from Accident Compensation Corporation (ACC) data were attributed to the results to provide cost estimates. Results The pooled analysis match injury incidence of women’s concussion was higher for rugby league (10.3 per 1000 match hours) than rugby 15 s (2.8 per 1000 match hours) or rugby 7 s (8.9 per 1000 match hours). There was a fourfold difference in the pooled incidence of concussion in women’s rugby league (risk ratio [RR] 4.53, 95% confidence interval [CI] 1.8–11.3]; p = 0.0001) when compared with rugby 15 s. There was also a ninefold higher risk of a concussion during match participation compared with training participation for women’s rugby 15 s (RR 9.3, 95% CI 1.29–66.78; p = 0.0070). The total estimated costs for the concussions reported were NZ$1,235,101. For rugby 7 s, the pooled concussive injury burden was 33.2 days. Conclusions Our pooled analysis clarified the extent of concussion injury and the possible associated costs at several levels of the game for women’s rugby codes. The pooled mean days lost because of concussions was 33 days. As this was considerably longer than the 7- to 10-day expected timeframe outlined in the Concussion in Sport Consensus statement, these guidelines need to be updated to include sex-specific differences.

show abstract

Predicting Sport-related mTBI Symptom Resolution Trajectory Using Initial Clinical Assessment Findings: A Retrospective Cohort Study

Cited by 16 publications

References 41 publications

Concussion Recovery Evaluation Using the Inertial Sensor Instrumented Y Balance Test

Concussion Recovery Evaluation Using the Inertial Sensor Instrumented Y Balance Test

The Brain Injury Screening Tool (BIST): Tool development, factor structure and validity

The Incidence, Cost, and Burden of Concussion in Women’s Rugby League and Rugby Union: A Systematic Review and Pooled Analysis

Contact Info

Product

Resources

About