CONTEXT: Comprehensive, multidomain assessment is the standard of care after sport-related concussion. However, the relationship between performance on sideline concussion-assessment tools and in-office computerized neurocognitive testing has received little attention, and the prognostic utility of sideline measures is unknown. OBJECTIVE: To evaluate concurrent impairment on commonly used concussion measures 24 to 48 hours postinjury while also determining the predictive utility of sideline measures on computerized neurocognitive testing in the acute to subacute recovery periods postinjury. DESIGN: Case-control study. SETTING: High school and collegiate athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 125 high school and college-aged athletes (85 males, 40 females) 14 to 23 (16.8 ± 2.21) years old. MAIN OUTCOME MEASURE(S): Participants were administered sideline concussion-assessment measures (ie, Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT], Standardized Assessment of Concussion [SAC], and Balance Error Scoring System [BESS]) 24 to 48 hours postinjury and completed ImPACT and the Post-Concussion Symptom Scale 5 to 7 and 10 to 14 days postinjury. Outcome measures were the ImPACT composite (verbal memory, visual memory, reaction time, visual-motor speed), SAC, and BESS scores and total symptom score on the Post-Concussion Symptom Scale. RESULTS: Participants demonstrated heterogeneous patterns of impairment on measures 24 to 48 hours postinjury, with the most common pattern being impairment on ImPACT and the SAC. Performance on the SAC and BESS at 24 to 48 hours after injury did not distinguish between those with and those without impairment on ImPACT at 5 to 7 days postinjury (χ2 = 5.076, P = .079) or 10 to 14 days postinjury (χ2 = 2.04, P = .361). CONCLUSIONS: More than 90% of athletes were impaired on at least 1 sideline or neurocognitive measure 24 to 48 hours after sport-related concussion. Although sideline measures are useful for concussion diagnosis, they are not suitable for prognostication of impairment or the presence of symptoms 1 to 2 weeks postinjury.
CONTEXT: Comprehensive, multidomain assessment is the standard of care after sport-related concussion. However, the relationship between performance on sideline concussion-assessment tools and in-office computerized neurocognitive testing has received little attention, and the prognostic utility of sideline measures is unknown. OBJECTIVE: To evaluate concurrent impairment on commonly used concussion measures 24 to 48 hours postinjury while also determining the predictive utility of sideline measures on computerized neurocognitive testing in the acute to subacute recovery periods postinjury. DESIGN: Case-control study. SETTING: High school and collegiate athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 125 high school and college-aged athletes (85 males, 40 females) 14 to 23 (16.8 ± 2.21) years old. MAIN OUTCOME MEASURE(S): Participants were administered sideline concussion-assessment measures (ie, Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT], Standardized Assessment of Concussion [SAC], and Balance Error Scoring System [BESS]) 24 to 48 hours postinjury and completed ImPACT and the Post-Concussion Symptom Scale 5 to 7 and 10 to 14 days postinjury. Outcome measures were the ImPACT composite (verbal memory, visual memory, reaction time, visual-motor speed), SAC, and BESS scores and total symptom score on the Post-Concussion Symptom Scale. RESULTS:Participants demonstrated heterogeneous patterns of impairment on measures 24 to 48 hours postinjury, with the most common pattern being impairment on ImPACT and the SAC. Performance on the SAC and BESS at 24 to 48 hours after injury did not distinguish between those with and those without impairment on ImPACT at 5 to 7 days postinjury (χ2 = 5.076, P = .079) or 10 to 14 days postinjury (χ2 = 2.04, P = .361). CONCLUSIONS: More than 90% of athletes were impaired on at least 1 sideline or neurocognitive measure 24 to 48 hours after sport-related concussion. Although sideline measures are useful for concussion diagnosis, they are not suitable for prognostication of impairment or the presence of symptoms 1 to 2 weeks postinjury.
Authors: R J Elbin; Tracey Covassin; Luke Henry; Diana J Whalen; Jennine Wedge; Anthony P Kontos Journal: Transl Stroke Res Date: 2012-12-21 Impact factor: 6.829
Authors: Anthony P Kontos; R J Elbin; Phillip Schatz; Tracey Covassin; Luke Henry; Jamie Pardini; Michael W Collins Journal: Am J Sports Med Date: 2012-08-16 Impact factor: 6.202
Authors: Clinton D Morgan; Scott L Zuckerman; Young M Lee; Lauren King; Susan Beaird; Allen K Sills; Gary S Solomon Journal: J Neurosurg Pediatr Date: 2015-03-06 Impact factor: 2.375
Authors: R J Elbin; Anthony P Kontos; Nate Kegel; Eric Johnson; Scott Burkhart; Philip Schatz Journal: Arch Clin Neuropsychol Date: 2013-04-21 Impact factor: 2.813
Authors: Jacob E Resch; Cathleen N Brown; Julianne Schmidt; Stephen N Macciocchi; Damond Blueitt; C Munro Cullum; Michael S Ferrara Journal: BMJ Open Sport Exerc Med Date: 2016-01-19
Authors: Kimberly G Harmon; Jonathan A Drezner; Matthew Gammons; Kevin M Guskiewicz; Mark Halstead; Stanley A Herring; Jeffrey S Kutcher; Andrea Pana; Margot Putukian; William O Roberts Journal: Br J Sports Med Date: 2013-01 Impact factor: 13.800
Authors: Gian-Gabriel P Garcia; Steven P Broglio; Mariel S Lavieri; Michael McCrea; Thomas McAllister Journal: Sports Med Date: 2018-07 Impact factor: 11.136
Authors: Kristin Wilmoth; Benjamin L Brett; Natalie A Emmert; Carolyn M Cook; Jeffrey Schaffert; Todd Caze; Thomas Kotsonis; Margaret Cusick; Gary Solomon; Jacob E Resch; C Munro Cullum; Lindsay D Nelson; Michael McCrea Journal: Neuropsychol Rev Date: 2022-08-30 Impact factor: 6.940
Authors: Ed Daly; Alan J Pearce; Emma Finnegan; Ciara Cooney; Maria McDonagh; Grainne Scully; Michael McCann; Rónán Doherty; Adam White; Simon Phelan; Nathan Howarth; Lisa Ryan Journal: BMC Sports Sci Med Rehabil Date: 2022-07-10