The variance associated with the double-leg stance was very small, and when removed, the intraclass reliability coefficient of the BESS increased. Removal of the double-leg stance and addition of 3 trials of 4 conditions provided an easily administered, cost-effective, time-efficient tool that provides reliable objective information for clinicians to base clinical decisions upon.

Context Concussion management is potentially complicated by the lack of reporting due to poor educational intervention in youth athletics. Objective Determine if a concussion-education video developed for high school athletes will increase the reporting of concussive injuries and symptom recognition in this group. Design Cross-sectional, between groups. Setting Athletes participating in South Carolina interscholastic athletics. Patients or Other Participants High school athletes (N = 68; males n = 42; females n = 26; mean age = 14.78 ± 1.38 years) participated in this study. The athletes were randomly assigned into 2 groups: concussion education (n = 34) and control (n = 34). Main Outcome Measures Participants were administered a survey before and after watching a video about concussion incidence, symptoms, and reporting conditions (intervention group) or a nutrition video (control group). Total symptom score and survey items served as dependent variables. Examination of group differences was performed through χ2 analyses and repeated-measures analysis of variance (ANOVA) calculations in SPSS 19.0 (SPSS Inc, Chicago, IL). Significance levels were set a priori at .05. Results Of all participants, 70.5% (48/68) reported not knowing the signs and symptoms of concussion before the study, and 26.5% (n = 18) reported having had at least 1 prior concussion. A statistically significant difference existed between those reporting having vs. not having knowledge of the signs and symptoms of concussion on total symptom score at baseline (t1,66 = 2.17, P = .038). Repeated-measures ANOVA calculated a statistically significant difference for concussion symptom recognition before and after the intervention (F1,66 = 7.47, P = .008) Conclusions A large percentage of high school athletes do not know the signs and symptoms of concussion. After an educational video, participants' symptom knowledge and previous concussions reported increased. Education of those involved in athletics using a standardized tool may increase reporting and aid in the assessment and management of concussion in this population.

Clinicians have questioned the need to obtain annual baseline neuropsychological tests in high school athletes. If no difference among academic grades exists, annual baseline testing may not be necessary.Context: To examine differences at baseline testing on pencil-and-paper neuropsychological tests among grade levels in high school athletes.Objective: Cross-sectional, between-groups design.Design: Schools participating in a Georgia high school athletics association.Setting: High school football players (n  =  198) in the 9th through 12th grades, with a mean age of 15.78 ± 1.16 years.Patients or Other Participants: Participants were divided into 4 groups by grade and were administered a symptom checklist and brief neuropsychological test battery. Grade level served as the independent variable. Symptom and individual test scores within the neuropsychological test battery served as dependent variables.Main Outcome Measure(s): Differences were noted among grades on the Trail Making Test A (F3,194  =  3.23, P  =  .024, η2  =  0.048), Trail Making Test B (F3,194  =  3.93, P  =  .009, η2  =  0.057), Symbol Digit Modalities Test (F3,194  =  4.38, P  =  .005, η2  =  0.064), dominant tap (F3,194  =  3.14, P  =  .026, η2  =  0.046), and nondominant tap (F3,194  =  4.902, P  =  .003, η2  =  0.070). Using the Bonferroni correction (P ≤ .00625), we found differences between the 9th grade and 11th and 12th grades.Results: Baseline neuropsychological test scores in high school athletes improved as a function of age, with differences between the 9th grade and 11th and 12th grades. Because the differences were driven by 9th-grade test scores, baseline testing should be completed, at minimum, upon entrance into 9th and 10th grades; however, annual testing is still recommended until additional research is conducted.Conclusions:

Poor effort was observed in the athletic population during baseline testing and athletes with poor effort displayed statistically significant differences in performance on neuropsychological tests. Adding an effort test to baseline examinations may improve post-concussion test score interpretations.