A Battery of Easily Accessible, Simple Tools for the Assessment of Concussion in Children.

OBJECTIVE: To determine whether a non-proprietary, novel testing battery can identify recently concussed children within 8 weeks of injury.

STUDY DESIGN: 568 clinic outpatients ages 10-18 years were sorted into three groups: 316 had never been concussed, 162 had ever been concussed prior to 8 weeks earlier, and 90 had been recently concussed within 8 weeks. At initial and any subsequent visits a neurological examination and four procedures were performed: Stick Drop, Wall Ball, Sharpened Modified Romberg (SMR), and Animal Naming. Analysis included inter-group and intra-person performance differences using a series of t-tests on the Stick Drop, Wall Ball, SMR and Animal Naming.

RESULTS: The recently concussed group performed worse (p<0.01 for all) on Stick Drop, total Wall Ball bounces and drops, and SMR compared with never concussed and ever concussed groups. This effect for Stick Drop, SMR, and Wall Ball but not Animal Naming persisted beyond the four weeks commonly stated to define recovery. Of 59 recently concussed subjects who returned for ≥ 1 visit, there were improvements in Stick Drop average (P = .004) and maxima (P = .02) as well as SMR (p=0.01) but not Animal Naming between initial and subsequent visits.

CONCLUSIONS: This novel, rapid testing battery distinguished groups of children ages 10-18 who had and had not experienced a recent concussion. A view that physical concussion symptoms resolve within a month of injury may be incomplete. Deployment of this readily available, inexpensive and non-proprietary battery should be compared with other tools and studied further in serial assessments.