concussion baseline testing

The present study examined the short-term test-retest reliability of the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) variables with healthy 11- to 14-year-old athletes. 53 young athletes (Mage = 12.4 years, 9 female) were administered the ImPACT on two separate occasions two weeks apart. Participants were instructed to complete the Post-Concussion Symptom Scale (PCSS) and the baseline computerized neurocognitive test during both the baseline and retest phases. Intraclass correlation (ICC), standard error of measurement (SEM), and reliable change index (RCI) were used as reliability metrics...

This technical report details the results of an uncontrolled study of EyeGuide Focus, a 10-second concussion management tool which relies on eye tracking to determine the potential impairment of visual attention, an indicator often of mild traumatic brain injury (mTBI). Essentially, people who can visually keep steady and accurate attention on a moving object in their environment likely suffer from no impairment. However, if after a potential mTBI event, subjects cannot keep attention on a moving object in a normal way as demonstrated on their previous healthy baseline tests...

BACKGROUND: Clinicians typically rely on neuropsychological and balance tests to track concussion recovery. The aforementioned tests imply impairments that are based on performance, but these tests do not directly measure brain physiology throughout concussion recovery. Because of these issues, an objective biomarker that can index severity and the recovery timeline is needed. Moreover, the number of concussions occurring at a recreational level requires the biomarker to be easily administered in a cost effective manner, and the results easily interpreted...

BACKGROUND: One common component of concussion rehabilitation is a computerized cognitive test free of concomitant physical demands. Healthcare professionals may be able to provide more patient-centered care after a diagnosed concussion if specific areas of impairment are identified and treated, such as the physical aspect of neurocognitive function. Hypothesis/Purpose: To evaluate the test-retest reliability of a unique combination of neurocognitive assessment tools currently utilized in concussion assessments into one single, inclusive instrument that measures both neurocognitive function and physical capability...

OBJECTIVE: The purpose of this study was to investigate anticipatory postural adjustments (APA) during the transitional movement task of gait initiation (GI) in individuals acutely following a concussion. DESIGN: Cohort Study. SETTING: University Research Center. PARTICIPANTS: A population based sample of 84 participants divided into two equal groups of acutely post-concussion (CONC) and healthy student athletes. INTERVENTION: Participants were tested on two occasions - a pre-injury baseline test and then the CONC group was retested acutely post-concussion and the control group again at a similar time...

In an effort to understand the factors that contribute to heterogeneity in outcomes often associated with mTBI in youth, this study examined the role of premorbid differences in cognitive reserve on post-concussive symptoms (PCS), molecular markers, and treatment response. Male and female rats matured in one of three environmental conditions (Stress, Enrichment, Control), received a mTBI in adolescence, and were randomized to melatonin or placebo treatment. All animals underwent a behavioural test battery designed to examine PCS...

OBJECTIVE: To evaluate the effectiveness of the electroencephalographic (EEG) Brain Function Index (BFI) for characterizing sports-related concussive injury and recovery. PARTICIPANTS: Three hundred fifty-four (354) male contact sport high school and college athletes were prospectively recruited from multiple locations over 6 academic years of play (244 control baseline athletes and 110 athletes with a concussion). METHODS: Using 5 to 10 minutes of eyes closed resting EEG collected from frontal and frontotemporal regions, a BFI was computed for all subjects and sessions...

BACKGROUND: Baseline visual acuity (VA) loss from static to dynamic head conditions assessed using the Dynamic Visual Acuity Testing (DVAT) have not been established in NCAA football players. DVAT assesses the Vestibulo-Ocular Reflex (VOR) which is measured in Logarithm of the Minimum Angle of Resolution (logMAR). Decreased VA beyond baseline measures may detect VOR impairment and impact treatment protocols and assist in return to play decisions post-concussion. HYPOTHESIS/PURPOSE: To establish normative VA mean scores during a static head posture as well as dynamically during the DVAT with a head speed of 150 deg/s in the pitch (vertical) and yaw (horizontal) planes rotating 20 degrees in each direction...

CONTEXT: Baseline testing is a common strategy for concussion assessment and management. Research continues to evaluate novel measures for potential to improve baseline testing methods. OBJECTIVES: The primary objective was to; 1) determine the feasibility of including physiological, neuromuscular and mood measures as part of baseline concussion testing protocol, 2) describe typical values in a varsity athlete sample, and 3) estimate the influence of concussion history on these baseline measures...

Importance: The Child Sport Concussion Assessment Tool (SCAT3) is a postconcussion sideline assessment tool measuring symptoms, cognition, and balance in preadolescent children. Minimal normative baseline data exist to aid decision making in clinical and athletic settings. Objective: To collect normative baseline data for the Child SCAT3 in a large cohort of young athletes. Design, Setting, and Participants: A cross-sectional study was conducted from May 31 to August 12, 2014, at various sporting events (basketball, soccer, baseball, and swimming) in Central Wisconsin among children 5 to 13 years of age who were English-speaking and did not report a lower leg injury within the past 2 months or a concussion within the past month...

AIM: To evaluate the evidence regarding the management of sport-related concussion (SRC) in children and adolescents. The eight subquestions included the effects of age on symptoms and outcome, normal and prolonged duration, the role of computerised neuropsychological tests (CNTs), the role of rest, and strategies for return to school and return to sport (RTSp). DESIGN: Systematic review. DATA SOURCES: MEDLINE (OVID), Embase (OVID) and PsycInfo (OVID)...

OBJECTIVE: To assess the efficacy of the modified Balance Error Scoring System (mBESS) compared with the Balance Error Scoring System (BESS) in an acutely concussed population. DESIGN: Prospective observational study. SETTING: University athletic training room. PATIENTS: Thirty-five collegiate student-athletes (18 Female, 18.9 ± 0.8 year old, height: 1.71 ± 0.12 m, weight: 76.3 ± 24.1 kg) with diagnosed concussions and baseline BESS/mBESS tests...

Athletes occasionally attempt to lower their baseline scores to mask the effects of a concussion during post-trauma assessment, a phenomenon known as sandbagging. In order to help prevent this from occurring, the Rey Dot Counting Test (DCT) was examined as a potential measure to be added to a Division II university screening battery. Investigators utilized samples of athletes at baseline and non-athlete students instructed to provide honest effort or suppressed effort, either naïvely or coached. The results support the use of the DCT as a valid measure of suboptimal performance when using modified norms established from collegiate populations...

Neuropsychologists regularly conduct sport-related concussion (SRC) evaluations, although research has not tracked these assessment practices. As part of a survey of neuropsychological test usage, we analyzed data from 215 neuropsychologists who conduct SRC evaluations. Only 15% reported conducting baseline assessments of athletes as part of a sports program and 92% evaluate athletes' post-concussion without baseline data. The majority of respondents use a full battery, considered the most reliable approach for assessing concussion symptoms in athletes...

Objective: This study examined the effects of total and partial sleep deprivation on subjective symptoms and objective neurocognitive performance, as measured by the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) in a sample of healthy adults. Method: One-hundred and two, right-handed, healthy participants (between ages 18 and 30 years old) completed three consecutive nights in the sleep laboratory with concurrent continuous polysomnography monitoring...

The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a computerized neuropsychological test battery commonly used to assess cognitive functioning after a concussion. It is recommended that application of ImPACT utilizes a baseline administration so athletes have an individualized baseline with which to compare post-injury results should they sustain a concussion. It has been suggested that athletes may provide suboptimal effort, called "sandbagging," in order to return to their baseline cognitive scores, and thus to play, more quickly...

OBJECTIVE: Youth with attention deficit hyperactivity disorder (ADHD) perform more poorly on preseason cognitive testing and report more baseline concussion-like symptoms but prior studies have not examined the influence of medication use on test performance or symptom reporting. This study investigated whether medication use is relevant when interpreting baseline ImPACT® results from student athletes with ADHD. METHOD: Participants were 39,247 adolescent athletes, ages 13-18 (mean age = 15...

OBJECTIVE: The Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) is commonly used to assess baseline and post-injury cognition among athletes in North America. Despite this, several studies have questioned the reliability of ImPACT when given at intervals employed in clinical practice. Poor test-retest reliability reduces test sensitivity to cognitive decline, increasing the likelihood that concussed athletes will be returned to play prematurely. We recently showed that the reliability of ImPACT can be increased when using a new composite structure and the aggregate of two baselines to predict subsequent performance...

CONTEXT: The sideline assessment of concussion is challenging, given its variable presentations, the limited sensitivity and specificity of sideline assessment tools, and how the presentation of the injury evolves over time. In addition, the diagnostic process, as well as the tools used to assess and manage concussion, continue to progress as research and what we know about concussion advance. This paper focuses on the initial assessment on the sideline by reviewing the concussion-evaluation literature, drawing from clinical experience to emphasize a standardized approach, and underscoring the importance of both familiarity with the athlete and clinical judgment...

CONTEXT: Recent changes to postconcussion guidelines indicate that postural-stability assessment may augment traditional neurocognitive testing when making return-to-participation decisions. The Balance Error Scoring System (BESS) has been proposed as 1 measure of balance assessment. A new, freely available software program to accompany the Nintendo Wii Balance Board (WBB) system has recently been developed but has not been tested in concussed patients. OBJECTIVE: To evaluate the feasibility of using the WBB to assess postural stability across 3 time points (baseline and postconcussion days 3 and 7) and to assess concurrent and convergent validity of the WBB with other traditional measures (BESS and Immediate Post-Concussion Assessment and Cognitive Test [ImPACT] battery) of assessing concussion recovery...