Evaluation of neuropsychological domain scores and postural stability following cerebral concussion in sports

Connie L Peterson, Michael S Ferrara, Marty Mrazik, Scott Piland, Ronald Elliott
Clinical Journal of Sport Medicine 2003, 13 (4): 230-7

CONTEXT: With increasing knowledge and research about concussion, there have been few objective studies that have used neuropsychological domain scores and postural stability to assess concussion.

OBJECTIVE: To evaluate the recovery curve of athletes who incur sport-related concussion from repeated serial testing of neuropsychological and posturography testing.

DESIGN: A prospective epidemiological model was used for the course of the study.

SETTING: Division I intercollegiate athletics.

PARTICIPANTS: Athletes participating in football, soccer, basketball, softball, and cheerleading.

MAIN OUTCOME MEASURES: Neuropsychological scores and posturography measures were obtained preseason and serially at day 1, day 2, day 3, and day 10 postconcussion. Control participants were tested at the same intervals. Neuropsychological scores were converted to standards score and then into domains of attention, learning, speed of information processing, concentration, memory, and verbal fluency. Analysis of covariance with the baseline test as the covariate was used to analyze the data with univariate post hoc tests performed.

RESULTS: Significant group differences were found for self reported symptoms (P = 0.001), speed of information processing (P = 0.005), mean stability (P = 0.002), and vestibular function (P = 0.003) between injured and control participants. A group, by day, planned comparison found that speed of information processing and composite balance measures demonstrated significant differences through day 10 postinjury, while symptoms and the vestibular ratio remained significant only through day 3.

CONCLUSIONS: The concussion recovery curve demonstrated short-term neuropsychological and posturography deficits following injury. A comprehensive approach to concussion management should be used to assess the injury and make return-to-play decisions.

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