Article

Psychometric and measurement properties of concussion assessment tools in youth sports.

Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, USA.
Journal of athletic training (Impact Factor: 1.51). 01/2006; 41(4):399-408.
Source: PubMed

ABSTRACT Establishing psychometric and measurement properties of concussion assessments is important before these assessments are used by clinicians. To date, data have been limited regarding these issues with respect to neurocognitive and postural stability testing, especially in a younger athletic population.
To determine the test-retest reliability and reliable change indices of concussion assessments in athletes participating in youth sports. A secondary objective was to determine the relationship between the Standardized Assessment of Concussion (SAC) and neuropsychological assessments in young athletes.
We used a repeated-measures design to evaluate the test-retest reliability of the concussion assessments in young athletes. Correlations were calculated to determine the relationship between the measures. All subjects underwent 2 test sessions 60 days apart.
Sports medicine laboratory and school or home environment. Patients or Other Participants: Fifty healthy young athletes between the ages of 9 and 14 years.
Scores from the SAC, Balance Error Scoring System, Buschke Selective Reminding Test, Trail Making Test B, and Coding and Symbol Search subsets of the Wechsler Intelligence Scale for Children were used in the analysis.
Our test-retest indices for each of the 6 scores were poor to good, ranging from r = .46 to .83. Good reliability was found for the Coding and Symbol Search tests. The reliable change scores provided a way of determining a meaningful change in score for each assessment. We found a weak relationship ( r < .36) between the SAC and each of the neuropsychological assessments; however, stronger relationships ( r > .70) were found between certain neuropsychological measures.
We found moderate test-retest reliability on the cognitive tests that assessed attention, concentration, and visual processing and the Balance Error Scoring System. Our results demonstrated only a weak relationship between performance on the SAC and the selected neuropsychological tests, so it is likely that these tests assess somewhat different areas of cognitive function. Our correlational findings provide more evidence for using the SAC along with a more complex neuropsychological assessment battery in the evaluation of concussion in young athletes.

0 Bookmarks
 · 
77 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Primary objective: To review relevant literature regarding the effect of concussion on vestibular function, impairments, assessments and management strategies. Reasoning: Dizziness and balance impairments are common following sport-related concussion. Recommendations regarding the management of sport-related concussion suggest including tests of balance within the multifactorial assessment paradigm for concussive injuries. Analysis: The literature was searched for guidelines and original studies related to vestibular impairments following concussion, oculomotor and balance assessments and treatment or rehabilitation of vestibular impairments. The databases searched included Medline, CINAHL, Sport Discus and the Cochrane Database of Systematic Reviews through October 2013. Main outcomes and results: Dizziness following concussion occurs in ∼67–77% of cases and has been implicated as a risk factor for a prolonged recovery. Balance impairments also occur after concussion and last 3–10 days post-injury. Assessments of balance can be done using both clinical and instrumented measures with success. Vestibular rehabilitation has been shown to improve outcomes in patients with vestibular impairments, with one study demonstrating success in decreasing symptoms and increasing function following concussion. Conclusions: Best practices suggest that the assessment of vestibular function through cranial nerve, oculomotor and balance assessments are an important aspect of concussion management. Future studies should evaluate the effectiveness of vestibular rehabilitation for improving patient outcomes.
    Brain Injury 10/2014; · 1.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Postural control assessments can provide a powerful means of detecting concussion-related neurophysiological abnormalities and are considered an important part of the concussion management processes. Studies with college athletes indicate that postural sway analyzed using complexity metrics may provide a sensitive and novel way to detect post-concussion postural control impairments. The purpose of this study was to determine if a postural sway assessment protocol (PSAP) measured using a force plate system can serve as a reliable assessment tool for adolescent athletes. The short-term and long-term test-retest reliability of the PSAP was examined in a group of adolescent female athletes under eyes open and eyes closed conditions. Detrended fluctuation analysis was used to evaluate the complexity of the times series data (i.e., degree of self-similarity across time scales). Conventional measures of standard deviation and total path length (distance traveled by the center-of-pressure) were also assessed. The complexity and conventional measures generally demonstrated good reliability coefficients for short-term and long-term test-retest reliability with both eyes open and eyes closed conditions. Intra-class Correlation Coefficient (ICC) values ranged from .38-.90 The highest ICC values corresponded with the short-term reliability for the eyes open condition, while the lower ICC values corresponded with the long-term reliability for the eyes closed condition. The results of this study indicate that the PSAP demonstrated good short-term and long-term test-retest reliability. In addition, no evidence of learning effects was elicited through this study. Future studies should further explore the validity and feasibility of the use of this protocol for different age groups, different types of athletes, and longitudinal evaluations of post-concussion impairments. This study provides preliminary support for the utility of a postural sway assessment protocol measured using a force plate for use with adolescent athletes. Level III.
    International journal of sports physical therapy. 12/2013; 8(6):741-8.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective : To provide athletic trainers, physicians, and other health care professionals with best-practice guidelines for the management of sport-related concussions. Background : An estimated 3.8 million concussions occur each year in the United States as a result of sport and physical activity. Athletic trainers are commonly the first medical providers available onsite to identify and evaluate these injuries. Recommendations : The recommendations for concussion management provided here are based on the most current research and divided into sections on education and prevention, documentation and legal aspects, evaluation and return to play, and other considerations.
    Journal of athletic training 03/2014; · 1.51 Impact Factor

Full-text (2 Sources)

Download
5 Downloads
Available from
Jul 3, 2014