John Leddy1, Kevin Lesh1, Mohammad N Haider1,2, Natalie Czuczman3, John G Baker1,4, Jeffrey Miecznikowski5, Barry Willer6. 1. Department of Orthopedics and Sports Medicine, UBMD Orthopedics and Sports Medicine, SUNY at Buffalo, Buffalo, New York. 2. Department of Neuroscience, SUNY at Buffalo, Buffalo, New York. 3. SUNY at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York. 4. Departments of Nuclear Medicine. 5. Biostatistics; and. 6. Psychiatry, SUNY at Buffalo, Buffalo, New York.
Abstract
OBJECTIVE: To describe the derivation of a brief but pertinent physical examination (PE) for adolescents who have sustained sport-related concussion (SRC). DESIGN: Prospective cohort. SETTING: University concussion management clinic. PARTICIPANTS: Acutely concussed (AC, n = 52, 15.5 ± 1.4 years, 4.4 ± 2 days since injury, 26.2 ± 38 days to recovery, 71% males) and healthy control (HC) adolescents (n = 30, 15.8 ± 1.4 years, 73% males). INTERVENTION: Acutely concussed had a PE on visit 1 and were retested at visit 2 (13.6 ± 1 day after visit 1). Acutely concussed were further characterized as normal recovery (NR, n = 41, 15.5 ± 1.5 years, recovery time 13.0 ± 7 days) and delayed recovery (DR, n = 11, 15.5 ± 1.2 years, recovery time 75.4 ± 63 days). MAIN OUTCOME MEASURE: Physical examination findings, including cervical, vestibular, and oculomotor systems. RESULTS: Visit 1 abnormal PE signs were significantly greater in AC versus HC (2.79 ± 2.13 vs 0.07 ± 0.37, P < 0.0001) but not in NR versus DR (2.61 ± 2.2 vs 3.45 ± 1.8, P = 0.246). Visit 2 abnormal PE signs differentiated NR versus DR (0.17 ± 0.7 vs 2.45 ± 2.1, P < 0.0001). CONCLUSIONS: A brief focused PE can help to diagnose SRC, establish recovery, and may have prognostic value.
OBJECTIVE: To describe the derivation of a brief but pertinent physical examination (PE) for adolescents who have sustained sport-related concussion (SRC). DESIGN: Prospective cohort. SETTING: University concussion management clinic. PARTICIPANTS: Acutely concussed (AC, n = 52, 15.5 ± 1.4 years, 4.4 ± 2 days since injury, 26.2 ± 38 days to recovery, 71% males) and healthy control (HC) adolescents (n = 30, 15.8 ± 1.4 years, 73% males). INTERVENTION: Acutely concussed had a PE on visit 1 and were retested at visit 2 (13.6 ± 1 day after visit 1). Acutely concussed were further characterized as normal recovery (NR, n = 41, 15.5 ± 1.5 years, recovery time 13.0 ± 7 days) and delayed recovery (DR, n = 11, 15.5 ± 1.2 years, recovery time 75.4 ± 63 days). MAIN OUTCOME MEASURE: Physical examination findings, including cervical, vestibular, and oculomotor systems. RESULTS: Visit 1 abnormal PE signs were significantly greater in AC versus HC (2.79 ± 2.13 vs 0.07 ± 0.37, P < 0.0001) but not in NR versus DR (2.61 ± 2.2 vs 3.45 ± 1.8, P = 0.246). Visit 2 abnormal PE signs differentiated NR versus DR (0.17 ± 0.7 vs 2.45 ± 2.1, P < 0.0001). CONCLUSIONS: A brief focused PE can help to diagnose SRC, establish recovery, and may have prognostic value.
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