RT Journal Article
SR Electronic
T1 Stratification of recovery from concussion using an objective multi-factorial approach to neurocognitive and motor performance assessment
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP A43
OP A44
DO 10.1136/bjsports-2016-097270.111
VO 51
IS 11
A1 Susan M Linder
A1 Andrew Russman
A1 Rick Figler
A1 Jason Cruickshank
A1 Bob Grey
A1 Maureen Lally
A1 Tanujit Dey
A1 Jay L Alberts
YR 2017
UL http://bjsm.bmj.com/content/51/11/A43.2.abstract
AB Objective To characterise neurologic impairment and recovery associated with concussion in youths and young adults using the Cleveland Clinic Concussion application (C3 app).Design Retrospective observational studySetting Concussion clinic at an academic medical centreParticipants 181 student-athletes aged 14–20 diagnosed with concussion by a Cleveland Clinic physician were included.Intervention C3 data were collected pre-season and at least once post-injury. At least one clinical examination by a physician was obtained to characterise clinical impairments. Individuals were stratified into two groups based on recovery time: typical <21 days (n=97) or protracted 21+ days (n=84).Outcome measures The following modules of the C3 app were administered across groups: 1) Graded symptom checklist (GSC); 2) Standardised Assessment of Concussion (SAC); 3) Trail Making Test; 4) Simple and Choice Reaction Time; 5) Processing Speed Test; 6) Biomechanical quantification of balance during the BESS.Main results At baseline, both groups performed similarly on all modules. However, significant differences were evident at 21 days post-injury in the protracted recovery group with worse performance in: simple and choice reaction time (p<0.001), Trail Making Test B (p=0.01), Biomechanical quantification of BESS (p<0.05), and GSC (p=0.0001). No difference between the groups at 21 days was found in BESS error scores, SAC or processing speed.Conclusions An approach that utilises objective and quantitative measures to characterise multiple aspects of neurocognitive and motor function are more sensitive than traditional measures of concussion assessment. These new outcomes provide value in the stratification of patients and their potential time to recovery. Competing interests JLA and SML have authored intellectual property associated with the mobile application presented in this study. The remaining authors declare no competing interest.None.