Sports-Related Concussion: Assessment and Management

Ma, Richard; Miller, Chealon D.; Hogan, MaCalus V.; Diduch, B. Kent; Carson, Eric W.; Miller, Mark D.

doi:10.2106/jbjs.k.01127

Cited by 22 publications

(17 citation statements)

References 77 publications

(1 reference statement)

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“…Neuropsychological testing has become routine in the management of SRC and provides an objective, reproducible measure to dictate recovery patterns and returnto-play decisions. 21 Available tests include ImPACT, [28][29][30] CogState, 23 the Automated Neuropsychological Assessment Metrics (ANAM) test, 7 and HeadMinder, 12 which have all been previously validated. However, nearly all published studies of neurocognitive status in SRC have excluded athletes with ADHD and/or LD (see GL Iverson, MW Collins, MC Roberge, et al, presentation to the International Neuropsychological Society, 2008).…”

mentioning

confidence: 99%

Baseline neurocognitive scores in athletes with attention deficit–spectrum disorders and/or learning disability

Zuckerman

Lee

Odom

et al. 2013

PED

110

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Object Up to 16% of children in the US between the ages of 3 and 17 years have either attention deficit–spectrum disorder or a learning disability (LD). Sports-related concussions among youth athletes represent a significant public health concern, and neurocognitive testing is a method to evaluate the severity of cognitive impairment and recovery after a sports-related concussion. The goal of this study was to assess baseline neurocognitive differences between athletes with attention deficit hyperactivity disorder (ADHD) and/or LD versus those with neither disorder and to establish normative data for these special populations. Methods Between August 2007 and March 2012, 6636 young athletes underwent baseline neurocognitive testing performed using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery. Of these participants, 90 had self-reported LD only, 262 had self-reported ADHD only, and 55 reported both. Those with ADHD and/or LD were matched with 407 participants with no history of ADHD or LD by age, sex, and number of prior concussions. The mean scores and SDs were calculated for each group to obtain normative values. A pairwise comparison between each diagnostic group was done to assess whether LD and/or ADHD diagnostic status predicted participants' baseline neurocognitive scores. Results Participants with ADHD had significantly lower verbal memory, visual memory, and visual motor processing speed scores, along with significantly higher reaction time, impulse control, and symptom scores compared with those without LD or ADHD. Participants with LD had similar results, with significantly lower verbal memory, visual memory, and visual motor processing speed scores, higher reaction time and symptom score, but did not differ in their impulse control score compared with those without LD or ADHD. Participants with both LD and ADHD had a significantly lower visual motor speed score and a significantly higher reaction time and symptom score than those without LD or ADHD, but did not differ with regard to the other composite scores. Conclusions Athletes with ADHD and/or LD have lower baseline ImPACT neurocognitive scores compared with athletes without ADHD and LD. Preliminary normative neurocognitive data for these special populations are provided.

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mentioning

confidence: 99%

Baseline neurocognitive scores in athletes with attention deficit–spectrum disorders and/or learning disability

Zuckerman

Lee

Odom

et al. 2013

PED

110

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“…Cognitive recovery from sports-related concussion in this age group also seems to require a longer period than that required of college or professional athletes (Ma et al, 2012).…”

Section: Agementioning

confidence: 83%

Concussion Evaluation and Management in Pediatrics

Rivera

Roberson

Whelan

et al. 2015

McN: The American Journal of Maternal/Child Nursing

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Concussions are among the most complex injuries to assess and manage in sports medicine and primary care. Sports concussion in youth has received much attention in recent years because research shows that improperly managed concussion can lead to long-term cognitive deficits and mental health problems. There are several notable risk factors affecting the incidence and severity of concussion in school-age children and adolescents, including a history of a previous concussion. A more conservative approach for return to activities following concussion has been proposed for children and adolescents. Programs of individualized, stepwise increases in physical activity have largely replaced use of algorithms for assigning a grade and activity expectations to concussions. Although validity and reliability testing is ongoing to support use of concussion assessment instruments in pediatric patients, it is practical and appropriate that clinicians incorporate symptom checklists, sideline and balance assessment tools, and neurocognitive assessment instruments into their practice in accordance with evidence-based guidelines.

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“…Approximately 44 million adolescents and 170 million adults in the United States make up this group, which places many participants at risk for sports-related concussions ( Ma et al, 2012 ).…”

Section: Prevalencementioning

confidence: 99%

It's Just a Game

Melander

Moen

2014

Orthopaedic Nursing

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Every year, millions of athletes of all ages participate in recreational activities, putting many at risk for sports-related concussions. This topic has gained national attention and placed pressure on governing bodies to hold the healthcare industry responsible for identifying, managing, and clearing athletes. As we gather more information about the mechanism and pathophysiological process of concussions, it is clear that no single factor plays a role in prevention. Preconcussion clinical assessment and education are paramount to identify risk factors and reduce the risk of long-term complications. Some experts consider computerized baseline neuropsychological testing as the "cornerstone" in the evaluation and management of sports-related concussions and may be a valuable future tool. To ensure the safety of athletes, individualized graduated return-to-play protocols have been developed. This article provides an overview of the newest guidelines and education regarding preconcussion baseline assessments and provides consistency in the evaluation and management of return-to-play recommendations.

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Sports-Related Concussion: Assessment and Management

Cited by 22 publications

References 77 publications

Baseline neurocognitive scores in athletes with attention deficit–spectrum disorders and/or learning disability

Baseline neurocognitive scores in athletes with attention deficit–spectrum disorders and/or learning disability

Concussion Evaluation and Management in Pediatrics

It's Just a Game

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