James MacDonald1, Neha Patel2, Julie Young3, Emily Stuart4. 1. Department of Pediatrics, Division of Sports Medicine, Nationwide Children's Hospital, Columbus, OH; Ohio State University College of Medicine, Columbus, OH. Electronic address: james.macdonald@nationwidechildrens.org. 2. Ohio State University College of Medicine, Columbus, OH. 3. Department of Pediatrics, Division of Sports Medicine, Nationwide Children's Hospital, Columbus, OH. 4. Orthopedic Institute, Children's Hospital Colorado, Sports Medicine Center, Aurora, CO; Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO.
Abstract
OBJECTIVE: To determine which data collected on an initial patient clinic visit for a sports-related concussion (SRC) might influence physicians to clear an adolescent to return to drive (RTD) after injury. STUDY DESIGN: Retrospective cohort study of 189 adolescents with a SRC referred to a hospital-based concussion clinic between June 1, 2015, and May 31, 2016. Subjects were ≥16 years with a valid driver's license (median age = 16, IQR [16, 17]). Concussion evaluations included Post-Concussion Symptom Scale, modified Balance Error Scoring System, and postinjury computerized neurocognitive testing (CNT). Clearance for RTD was the main outcome. Statistical comparisons were conducted with Mann-Whitney U and χ2 tests and logistic regression. RESULTS: In multivariable analysis, odds of being fully cleared to drive were 5.9-fold greater among patients who were administered CNT. Stated symptoms of "headache" and "sensitivity to light" were statistically significantly associated with RTD clearance. For a subset of 113 individuals undergoing CNT, each additional 10-millisecond decrease in simple reaction time was associated with 9% greater odds of being cleared to drive. Each additional 10-millisecond decrease in choice reaction time was associated with 4% greater odds of being cleared to drive. CONCLUSIONS: CNT and associated reaction time measures may facilitate a physician's objective decision-making. Making a RTD determination for adolescents recovering from an SRC should be a core component of a physician's assessment.
OBJECTIVE: To determine which data collected on an initial patient clinic visit for a sports-related concussion (SRC) might influence physicians to clear an adolescent to return to drive (RTD) after injury. STUDY DESIGN: Retrospective cohort study of 189 adolescents with a SRC referred to a hospital-based concussion clinic between June 1, 2015, and May 31, 2016. Subjects were ≥16 years with a valid driver's license (median age = 16, IQR [16, 17]). Concussion evaluations included Post-Concussion Symptom Scale, modified Balance Error Scoring System, and postinjury computerized neurocognitive testing (CNT). Clearance for RTD was the main outcome. Statistical comparisons were conducted with Mann-Whitney U and χ2 tests and logistic regression. RESULTS: In multivariable analysis, odds of being fully cleared to drive were 5.9-fold greater among patients who were administered CNT. Stated symptoms of "headache" and "sensitivity to light" were statistically significantly associated with RTD clearance. For a subset of 113 individuals undergoing CNT, each additional 10-millisecond decrease in simple reaction time was associated with 9% greater odds of being cleared to drive. Each additional 10-millisecond decrease in choice reaction time was associated with 4% greater odds of being cleared to drive. CONCLUSIONS: CNT and associated reaction time measures may facilitate a physician's objective decision-making. Making a RTD determination for adolescents recovering from an SRC should be a core component of a physician's assessment.
Authors: Catherine C McDonald; Divya Jain; Eileen P Storey; Madeline Gonzalez; Christina L Master; Kristy B Arbogast Journal: J Adolesc Health Date: 2020-12-15 Impact factor: 7.830
Authors: Landon B Lempke; Robert C Lynall; Nicole L Hoffman; Hannes Devos; Julianne D Schmidt Journal: J Sport Health Sci Date: 2020-09-19 Impact factor: 7.179