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Evaluation of physical examination elements in the diagnosis and prognosis of sports related concussion in adolescent athletes
  1. Barry Willer,
  2. John Baker,
  3. Andrea Hinds,
  4. Jeff Miecznikowski,
  5. Natalie Czuczman,
  6. Kevin Lesh,
  7. John Leddy
  1. University at Buffalo, Buffalo, NY, USA

Abstract

Objective To evaluate a brief physical examination (PE) for diagnosis and prognosis of sport-related concussion (SRC) in adolescents.

Design Prospective.

Setting UniversityConcussion clinics.

Subjects 53 adolescents with SRC (mean age 15.4; 70% male) and 30 uninjured controls (mean age 15.8; 73% male).

Interventions Participants received a brief PE (11 PE elements in three systems: cervical, oculomotor and vestibular). Concussed adolescents were assessed acutely (mean 4.5 days post-injury) and at follow up (mean 18.5 days).

Outcome measures Dependent variables 1: Concussion versus uninjured and 2: Standard versus slow recovery (>3 weeks). Recovery was defined as asymptomatic and exercise tolerant.

Results Table 1 shows the significant PE variables that distinguished concussed from uninjured (via Fisher’s exact test; significance p<0.05).

Abstract 136 Table 1

PE elements (Visit 1) with 95% CI for Odds ratio and p-value

Table 2 shows the significant PE variables distinguishing standard recovery from slow recovery at visit 2 (via Fisher’s exact test; significance p<0.05).

Abstract 136 Table 2

PE variables (Visit 2) with 95% CI for Odds ratio and p-value

Conclusions Easily administered physical exam reveals clinical findings that are important and sensitive for diagnosing acute concussion. Prognosis was less precise due to the heterogeneity of aetiology of slow recovery.

Competing interests No competing interests for any authors.

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