Objective Assess sideline utility of clinical measures to detect sport related concussion (SRC).

Design Prospective cohort study. American football student-athletes with a SRC completed sideline assessment within 15 minutes of injury. Sport/age matched controls completed assessment within 2 weeks.

Setting Sideline.

Participants 26 participants (13 SRC, 13 controls; age=15.7±1.2 years, 100% male). Exclusion criteria: >2 prior concussions, prior brain surgery, and vestibular and/or oculomotor disorders.

Interventions (or Assessment of Risk Factors) For primary analyses, Vestibular Ocular Motor Screening (VOMS) symptom provocation, Near Point Convergence, King-Devick (KD) Time, SCAT-3 Total Symptom Score, Standard Assessment of Concussion (SAC) Score, and modified Balance Error Scoring System (mBESS) Score were independent variables.

Outcome Measures To describe differences between the SRC and control groups, Mann-Whitney U-tests and Fisher’s exact tests were used. Univariable logistic regression was utilized to investigate relationships between clinical outcomes and concussion status (primary outcome).

Main Results Total symptom score was worse in the SRC group. KD time was slower/worse in the controls (Exact p<0.05). Total symptom score was associated with greater odds of having sideline detected SRC (OR=1.165; 95%CI: 1.004, 1.352). mBESS score (OR=1.356; 95%CI: 0.945, 1.946), SAC score (OR=0.813; 95%CI: 0.613, 1.077), NPC Average (OR=1.246; 95%CI: 0.924, 1.679) and KD time (OR=0.975; 95%CI: 0.919, 1.036) were not associated with concussion status. All 6 individuals with VOMS symptom provocation were in the concussion group.

Conclusions While symptoms are subjective, they provide valuable sideline information in determining suspected concussion. VOMS symptom provocation may also be useful in detecting sideline abnormalities.