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concussion assessment

Gordon Ward Fuller, Matthew J Cross, Keith A Stokes, Simon P T Kemp
BACKGROUND: The King-Devick (KD) test is an objective clinical test of eye movements that has been used to screen for concussion. We characterised the accuracy of the KD test and the World Rugby Head Injury Assessment (HIA-1) screening tools as methods of off-field evaluation for concussion after a suspicious head impact event. METHODS: A prospective cohort study was performed in elite English rugby union competitions between September 2016 and May 2017. The study population comprised consecutive players identified with a head impact event with the potential to result in concussion...
March 21, 2018: British Journal of Sports Medicine
Vickie Plourde, Keith Owen Yeates, Brian L Brooks
OBJECTIVES: Individual differences in long-term psychosocial functioning after concussions in children and adolescents are poorly understood. The aim of the study was to investigate potential predictors of long-term psychosocial functioning and health-related quality of life in youth after prior concussion. METHODS: Participants (N=75; mean age=14.3 years old; 52% girls) with one prior concussion (n=24), multiple prior concussions (n=24), or a prior orthopedic injury and no concussion (n=27) were seen on average 2...
March 21, 2018: Journal of the International Neuropsychological Society: JINS
Nathan W Churchill, Michael G Hutchison, Simon J Graham, Tom A Schweizer
Concussion is associated with significant adverse effects within the first week post-injury, including physical complaints and altered cognition, sleep and mood. It is currently unknown whether these subjective disturbances have reliable functional brain correlates. Resting-state functional magnetic resonance imaging (rs-fMRI) has been used to measure functional connectivity of individuals after traumatic brain injury, but less is known about the relationship between functional connectivity and symptom assessments after a sport concussion...
2018: NeuroImage: Clinical
Breton M Asken, Russell M Bauer, Kevin M Guskiewicz, Michael A McCrea, Julianne D Schmidt, Christopher C Giza, Aliyah R Snyder, Zachary M Houck, Anthony P Kontos, Thomas W McAllister, Steven P Broglio, James R Clugston, Scott Anderson, Jeff Bazarian, Alison Brooks, Thomas Buckley, Sara Chrisman, Michael Collins, John DiFiori, Stefan Duma, Brian Dykhuizen, James T Eckner, Luis Feigenbaum, April Hoy, Louise Kelly, T Dianne Langford, Laura Lintner, Gerald McGinty, Jason Mihalik, Christopher Miles, Justus Ortega, Nicholas Port, Margot Putukian, Steve Rowson, Steven Svoboda
BACKGROUND: Timely removal from activity after concussion symptoms remains problematic despite heightened awareness. Previous studies indicated potential adverse effects of continuing to participate in physical activity immediately after sustaining a concussion. Hypothesis/Purpose: The purpose was to determine the effect of timing of removal from play after concussion on clinical outcomes. It was hypothesized that immediate removal from activity after sport-related concussion (SRC) would be associated with less time missed from sport, a shorter symptomatic period, and better outcomes on acute clinical measures...
March 1, 2018: American Journal of Sports Medicine
James T Eckner, Alireza Goshtasbi, Kayla Curtis, Aliaksandra Kapshai, Erik Myyra, Lea M Franco, Michael Favre, Jon A Jacobson, James A Ashton-Miller
Greater neck girth and strength may be associated with a lower risk of sport-related concussion due to mitigation of head accelerations by the neck. However, neck strengthening exercise remains unstudied in youth athletes. Therefore, this pilot study assessed the feasibility and effect of targeted neck strengthening exercises in youth athletes. Seventeen participants were allocated to perform 8-wk manual resistance-based neck strengthening (n = 13) or control resistance exercise (n = 4) programs. Before and after the intervention, participants completed laboratory-based assessments of neck size, strength, and head kinematics during standardized test loading in each plane of motion...
April 2018: American Journal of Physical Medicine & Rehabilitation
Richard Wennberg, Carmen Hiploylee, Peter Tai, Charles H Tator
BACKGROUND: Epidemiologic studies have suggested that concussion, or mild traumatic brain injury (mTBI), is associated with a twofold or greater increase in relative risk for the development of post-traumatic epilepsy. To assess the clinical validity of these findings, we analyzed the incidence of epilepsy in a large cohort of post-concussion patients in whom concussion was strictly defined according to international guidelines. METHODS: A retrospective cohort study of 330 consecutive post-concussion patients followed by a single concussion specialist...
March 20, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Shira Russell-Giller, Diana Toto, Mike Heitzman, Mustafa Naematullah, John Shumko
BACKGROUND: The King-Devick (K-D) test is a rapid number-naming task that has been well validated as a sensitive sideline performance measure for concussion detection. Patients with concussion take significantly longer to complete the K-D test than healthy controls. Previous research suggests that ocular motor deficits, specifically saccadic abnormalities, may be an underlying factor for the prolonged time. However, these findings have not been studied at length. HYPOTHESIS: K-D testing time of concussed adolescents at the initial clinical concussion visit will positively correlate with vestibular/ocular motor screening (VOMS) total scores...
March 1, 2018: Sports Health
Temitayo Oyefunmike Oyegbile, Bronson Elizabeth Delasobera, Nassim Zecavati
The objective was to characterize cognitive deficits and postconcussive symptoms in a pediatric population with no concussion, a single concussion, and ≥2 concussions, using a cross-sectional design. Cognitive function and postconcussive symptoms were assessed in participants (age 10-20) with no concussion (n = 1118), single concussion (n = 368), and repeated (≥2) concussions (n = 252). Analyses were adjusted for age and gender. Individuals with ≥2 concussions exhibited more total postconcussive symptoms; more loss of consciousness, amnesia and confusion; more headaches; and poorer cognitive function compared to no concussion and single concussion...
January 1, 2018: Journal of Child Neurology
Damien J Lazar, Jonathan D Lichtenstein, David J Tybor
Background: Ultimate Frisbee (ultimate) is a fast-growing, popular sport played nationally by over 4 million athletes. While several studies have examined injury rates in ultimate, no work has investigated the prevalence of concussions specifically or players' knowledge and management of those injuries. Purpose: To estimate the lifetime prevalence of concussions in ultimate and to assess players' knowledge of concussions as well as their concussion management behaviors...
March 2018: Orthopaedic Journal of Sports Medicine
Peter C Fino, Lucy Parrington, Will Pitt, Douglas N Martini, James C Chesnutt, Li-Shan Chou, Laurie A King
BACKGROUND: While a growing number of studies have investigated the effects of concussion or mild traumatic brain injury (mTBI) on gait, many studies use different experimental paradigms and outcome measures. The path for translating experimental studies for objective clinical assessments of gait is unclear. RESEARCH QUESTION: This review asked 2 questions: 1) is gait abnormal after concussion/mTBI, and 2) what gait paradigms (single-task, dual-task, complex gait) detect abnormalities after concussion...
March 8, 2018: Gait & Posture
Alessander Danna-Dos-Santos, Sambit Mohapatra, Maria Santos, Adriana M Degani
Understanding the long-term effects of concussive events remains a challenge for the development of modern medical practices and the prevention of recurrent traumas. In this study, we utilized indices of oculomotor performance and the ability to react to simple environmental stimuli to assess the long-term motor effects of traumatic brain injury in its mildest form (mTBI). We performed analysis of eye movement accuracy, investigated the presence of abnormal eye movements, and quantified time to react to simple environmental stimuli on long-term mTBI survivors...
March 15, 2018: Scientific Reports
Christopher P Tomczyk, Megan Mormile, Megan S Wittenberg, Jody L Langdon, Tamerah N Hunt
CONTEXT:   An estimated 15.3 million adolescent students are enrolled in U.S. high schools, with approximately 7.8 million participating in athletics. Researchers have examined various demographics in high school athletes; however, athletic participation may play a larger role in test performance than previously thought. Currently, investigations of concussion assessment may rely on uninjured athletes as controls. However, due to the intense nature of athletics, this may not be an appropriate practice...
March 15, 2018: Journal of Athletic Training
Derek Kellar, Sharlene Newman, Franco Pestilli, Hu Cheng, Nicholas L Port
Objectives: Though sub-concussive impacts are common during contact sports, there is little consensus whether repeat blows affect brain function. Using a "lifetime exposure" rather than acute exposure approach, we examined oculomotor performance and brain activation among collegiate football players and two control groups. Our analysis examined whether there are group differences in eye movement behavioral performance and in brain activation during smooth pursuit. Methods: Data from 21 off-season Division I football "starters" were compared with a) 19 collegiate cross-country runners, and b) 11 non-athlete college students who were SES matched to the football player group (total N  = 51)...
2018: NeuroImage: Clinical
Betty Kollia, Corey H Basch, Christina Mouser, Aurea J Deleon
Background: Considering how many people obtain information about their health online, the aim of this study was to describe the content of the currently most widely viewed YouTube videos related to concussions and to test the hypothesis that consumer videos would be anecdotal, while other sources would be more informational. Methods: The term "concussion" was used to search for videos with 100,000 or more views on YouTube that were posted in English or Spanish...
2018: International Journal of Preventive Medicine
Christopher A Abeare, Isabelle Messa, Brandon G Zuccato, Bradley Merker, Laszlo Erdodi
Importance: Estimated base rates of invalid performance on baseline testing (base rates of failure) for the management of sport-related concussion range from 6.1% to 40.0%, depending on the validity indicator used. The instability of this key measure represents a challenge in the clinical interpretation of test results that could undermine the utility of baseline testing. Objectives: To determine the prevalence of invalid performance on baseline testing and to assess whether the prevalence varies as a function of age and validity indicator...
March 12, 2018: JAMA Neurology
James Rafferty, Craig Ranson, Giles Oatley, Mohamed Mostafa, Prabhat Mathema, Tom Crick, Isabel S Moore
OBJECTIVES: To investigate concussion injury rates, the likelihood of sustaining concussion relative to the number of rugby union matches and the risk of subsequent injury following concussion. METHODS: A four-season (2012/2013-2015/2016) prospective cohort study of injuries in professional level (club and international) rugby union. Incidence (injuries/1000 player-match-hours), severity (days lost per injury) and number of professional matches conferring a large risk of concussion were determined...
March 12, 2018: British Journal of Sports Medicine
Gregory J Tierney, Christopher Richter, Karl Denvir, Ciaran K Simms
There is mounting evidence of reduced long-term cognitive ability in rugby players, even in those without a reported history of concussion. The tackle height law is an area of controversy. However, little is known about the effects of repetitive inertial head loading in rugby. Furthermore, the magnitude and influencing factors for head kinematics are generally unknown. In this exploratory study, 45 multibody front-on shoulder tackles simulated with the MADYMO pedestrian model and 20 staged rugby tackles executed by professional rugby players in a marker-based 3D motion laboratory were used to assess the effect of tackle height on ball carrier head kinematics...
February 27, 2018: Journal of Biomechanics
Ryan N Moran, Tracey Covassin, R J Elbin, Dan Gould, Sally Nogle
BACKGROUND: The Vestibular/Ocular Motor Screening (VOMS) measure is a newly developed vestibular and ocular motor symptom provocation screening tool for sport-related concussions. Baseline data, psychometric properties, and reliability of the VOMS are needed to further understand the applications of this tool, especially in the youth population, where research is scarce. PURPOSE: The purpose of this study was to establish normative data and document the internal consistency and false-positive rate of the VOMS in a sample of nonconcussed youth athletes...
March 1, 2018: American Journal of Sports Medicine
Laura K Purcell, Gavin A Davis, Gerard A Gioia
OBJECTIVE: To evaluate the evidence regarding (1) factors affecting return to school (RTS) and (2) strategies/accommodations for RTS following a sport-related concussion (SRC) in children and adolescents. DESIGN: A systematic review of original studies specifically addressing RTS following concussion in the paediatric and sporting context. DATA SOURCES: MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid) electronic databases and the grey literature OpenGrey, ClinicalTrials...
March 2, 2018: British Journal of Sports Medicine
Barry P Katz, Maria Kudela, Jaroslaw Harezlak, Michael McCrea, Thomas McAllister, Steven P Broglio
BACKGROUND: Sport-related concussion and repetitive head impact exposure in contact sports continue to receive increased attention in public and medical spheres. The Concussion Assessment, Research and Education (CARE) Consortium, a multicenter cooperative, was established to study the natural history of concussion in National Collegiate Athletic Association (NCAA) collegiate student-athletes across 29 colleges and universities in the United States. The purpose of this investigation is to provide normative data from the CARE Consortium and evaluate for differences between sport categories...
March 1, 2018: Sports Medicine
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