Grant L Iverson1,2,3,4,5, Ryan Van Patten1,2,4, Andrew J Gardner6,7. 1. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States. 2. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States. 3. Spaulding Research Institute, Charlestown, MA, United States. 4. Sports Concussion Program, MassGeneral Hospital for Children, Boston, MA, United States. 5. Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, United States. 6. Hunter New England Local Health District Sports Concussion Program, Newcastle, NSW, Australia. 7. Priority Research for Stroke and Brain Injury, School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.
Abstract
Objective: To examine the relationship between video-identified onfield motor incoordination, the acute assessment of concussion, and recovery time during three seasons of National Rugby League (NRL) play. Methods: Blows to the head ("head impact events") were recorded by sideline video operators and medical staff. Any player with a suspected concussion underwent a Head Injury Assessment in which he was taken off the field and medically evaluated, including the administration of the Sports Concussion Assessment Tool, 5th Edition (SCAT5). Video footage was later examined to determine the presence or absence of onfield motor incoordination following the head impact event. Results: Motor incoordination was identified in 100/1,706 head impact events (5.9%); 65 of the 100 instances of motor incoordination (65.0%) were ultimately medically diagnosed with a concussion. In 646 athletes for whom SCAT5 data were available, those with motor incoordination were more likely to report both dizziness and balance problems than those without motor incoordination, but there were no group differences on an objective balance test. Additionally, there was no relationship between presence/absence of motor incoordination and number of games missed or time to medical clearance for match play. Conclusion: In NRL players, motor incoordination is a readily observable onfield sign that is strongly associated with a medical diagnosis of concussion and with self-reported dizziness/balance problems. However, onfield motor incoordination is not associated with objective balance performance and it is not predictive of time to recover following concussion.
Objective: To examine the relationship between video-identified onfield motor incoordination, the acute assessment of concussion, and recovery time during three seasons of National Rugby League (NRL) play. Methods: Blows to the head ("head impact events") were recorded by sideline video operators and medical staff. Any player with a suspected concussion underwent a Head Injury Assessment in which he was taken off the field and medically evaluated, including the administration of the Sports Concussion Assessment Tool, 5th Edition (SCAT5). Video footage was later examined to determine the presence or absence of onfield motor incoordination following the head impact event. Results:Motor incoordination was identified in 100/1,706 head impact events (5.9%); 65 of the 100 instances of motor incoordination (65.0%) were ultimately medically diagnosed with a concussion. In 646 athletes for whom SCAT5 data were available, those with motor incoordination were more likely to report both dizziness and balance problems than those without motor incoordination, but there were no group differences on an objective balance test. Additionally, there was no relationship between presence/absence of motor incoordination and number of games missed or time to medical clearance for match play. Conclusion: In NRL players, motor incoordination is a readily observable onfield sign that is strongly associated with a medical diagnosis of concussion and with self-reported dizziness/balance problems. However, onfield motor incoordination is not associated with objective balance performance and it is not predictive of time to recover following concussion.
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