The stability of engagement over comprehensive neuropsychological assessment in student athletes diagnosed with sports related concussion

Chase, Danielle; Schatz, Philip; Smyk, Nathan; Franks, R Robert

doi:10.1080/87565641.2018.1428326

Cited by 5 publications

(2 citation statements)

References 51 publications

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“…20,44 In addition to postural instability assessment, the Romberg test may also serve as a method to determine if patients are exaggerating their postinjury deficits in a manner that reflects balance dysfunction. 42 The idea that some youths may exaggerate or feign symptoms after concussion has been studied in the context of neuropsychological testing and symptom reporting, 1,7,26 but it has not received substantial attention with regard to postural stability tests. Previous work suggests that approximately 23% of children failed a well-validated performance validity test after a concussion.…”

Section: Discussionmentioning

confidence: 99%

Clinical predictors of symptom resolution for children and adolescents with sport-related concussion

Howell¹,

Potter²,

Kirkwood

et al. 2019

Journal of Neurosurgery: Pediatrics

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OBJECTIVEThe goal of this study was to determine which variables assessed during an initial clinical evaluation for concussion are independently associated with time until symptom resolution among pediatric patients.METHODSData collected from a prospective clinical registry of pediatric patients with concussion were analyzed. The primary outcome variable was time from injury until symptom resolution. Predictor variables assessed within 10 days after injury included preinjury factors, Health and Behavior Inventory scores, headache severity, and balance, vestibular, and oculomotor test performances. The researchers used univariate Cox proportional models to identify potential predictors of symptom resolution time and constructed a multivariate Cox proportional hazards model in which total duration of concussion symptoms remained the outcome variable.RESULTSThe sample consisted of 351 patients (33% female, mean age 14.6 ± 2.2 years, evaluated 5.6 ± 2.6 days after concussion). Univariate Cox proportional hazards models indicated that several variables were associated with a longer duration of symptoms, including headache severity (hazard ratio [HR] 0.90 [95% CI 0.85–0.96]), headache frequency (HR 0.83 [95% CI 0.71–0.96]), confusion (HR 0.79 [95% CI 0.69–0.92]), forgetfulness (HR 0.79 [95% CI 0.68–0.92]), attention difficulties (HR 0.83 [95% CI 0.72–0.96]), trouble remembering (HR 0.84 [95% CI 0.72–0.98]), getting tired often (HR 0.86 [95% CI 0.76–0.97]), getting tired easily (HR 0.86 [95% CI 0.76–0.98]), dizziness (HR 0.86 [95% CI 0.75–0.99]), and abnormal performance on the Romberg test (HR 0.59 [95% CI 0.40–0.85]). A multivariate Cox proportional hazards model indicated that an abnormal performance on the Romberg test was independently associated with a longer duration of symptoms (HR 0.65 [95% CI 0.44–0.98]; p = 0.038).CONCLUSIONSFor children and adolescents evaluated within 10 days after receiving a concussion, abnormal performance on the Romberg test was independently associated with a longer duration of symptoms during recovery. In line with findings of other recent studies investigating predictors of symptom resolution, postural stability tests may provide useful prognostic information for sports medicine clinicians.

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Section: Discussionmentioning

confidence: 99%

Clinical predictors of symptom resolution for children and adolescents with sport-related concussion

Howell¹,

Potter²,

Kirkwood

et al. 2019

Journal of Neurosurgery: Pediatrics

View full text Add to dashboard Cite

show abstract

“…Sports physicians and other health professionals should be trained in the evaluation and management of concussion, either because they have personal knowledge when it comes to specific athletes or because they are often in the best position to perform a correct diagnosis of an athlete suspected of having experienced concussion. Physicians should be prepared to provide counseling regarding potential long-term consequences of a concussion and recurrent concussions [53,54]. Primary prevention of some injuries may be possible with modification and enforcement of the rules and fair play.…”

Section: Discussionmentioning

confidence: 99%

Concussion in Sports

Musumeci

Ravalli

Amorini

et al. 2019

JFMK

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Concussion, a peculiar type of mild traumatic brain injury (mTBI), is an injury frequently encountered in various contact and noncontact sports, such as boxing, martial arts, American football, rugby, soccer, ice hockey, horse riding, and alpine skiing. Concussion occurs anytime external forces of specific intensities provoke acceleration–deceleration of the brain, and it is characterized by the rapid onset of short-lived impairment of neurologic functions, spontaneously resolving within weeks, persisting for longer times only in a small percentage of cases. A wide range of molecular alterations, including mitochondrial dysfunction, energy deficit, and gene and protein expression changes, is triggered by concussion and lasts longer than clinical symptoms. In recent years, concussion has become a primary issue of discussion among sports medicine professionals, athletes, media, and sports sponsors in relation to athletes’ return to play, after a concussion. Continued improvement in prevention and management of concussed athletes requires extensive research from different disciplines. Research work needs to focus on both prevention and management. Researchers and clinicians’ efforts should be dedicated to a better understanding of the molecular changes occurring in the post-concussed brain and to clearly define healing after concussion for a safe return of athletes to play. It is essential for sports medicine professionals to stay informed about the advances in understanding concussions and how to rehabilitate each single player who sustained a concussion.

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Financial incentives influence ImPACT validity indices but not cognitive composite scores

Merritt

Rabinowitz

Guty

et al. 2018

Journal of Clinical and Experimental Neuropsychology

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The stability of engagement over comprehensive neuropsychological assessment in student athletes diagnosed with sports related concussion

Cited by 5 publications

References 51 publications

Clinical predictors of symptom resolution for children and adolescents with sport-related concussion

Clinical predictors of symptom resolution for children and adolescents with sport-related concussion

Concussion in Sports

Financial incentives influence ImPACT validity indices but not cognitive composite scores

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