If You're Not Measuring, You're Guessing: The Advent of Objective Concussion Assessments

Abstract

Sport-related concussion remains one of the most complex injuries presented to sports medicine professionals. Although the injury has been recognized since ancient times, the concussion-assessment process has seen significant advances over the last 30 years. This review outlines the addition of objective measures to the clinical evaluation of the concussed athlete, beginning in the 1980s and continuing through the modern age. International and domestic organizations now describe standardized symptom reports, neurostatus and neurocognitive-function evaluations, and postural-control measures as standards of medical care, a significant shift from a short time ago. Despite this progression, much about the injury remains unknown, including new clinical and research-based assessment techniques and how the injury may influence the athlete's cognitive health over the long term.

Ubiquinol treatment for TBI in male rats: Effects on mitochondrial integrity, injury severity, and neurometabolism

“…Serum concentrations of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-LI) were associated with the severity of the injury in both TBI patients and animal models (Papa & Wang, 2017;Zoltewicz et al, 2013). Clinicians are beginning to use these biomarkers to evaluate the severity of TBI (Broglio, Guskiewicz, & Norwig, 2017;Papa & Wang, 2017). Our overall aim in this study was to investigate the effects of administering ubiquinol before and after TBI in rats on mitochondrial damage, apoptosis, and translational imaging and blood biomarkers of TBI.…”

Acute Sport-Related Concussion Screening for Collegiate Athletes Using an Instrumented Balance Assessment

“…They highlighted increased sample sizes, inclusion of baseline testing, and improved recruitment of control participants as potential areas for improving SRC research designs. 14,36,37 Our study had several limitations. We used a crosssectional cohort design in the absence of baseline testing.…”

“…Other assessments, such as neurocognitive testing or qEEG, may add to the balance testing described here for use in an SRC screening battery. Barr A number of authors 14,36,37 have emphasized the importance of high-quality SRC research as an advancing field of study. They highlighted increased sample sizes, inclusion of baseline testing, and improved recruitment of control participants as potential areas for improving SRC research designs.…”

“…The standardized balance assessment used most often across sports and athletic environments remains a set of static balance tests. 11,13,14 A common test protocol, the Balance Error Scoring System (BESS), consists of six 20-second trials in 3 stances. 15 The 3 stances are completed on the ground and on a foam pad.…”

Athletic Trainers' Perceptions of Academic Adjustment Procedures for Student-Athletes With Concussion

“…Concussions affect skills needed to be successful in the classroom, such as attention and concentration, working memory, memory consolidation and retrieval, and processing speed and fatigue. [19][20][21][22] However, these cognitive tasks are often assessed by the medical providers and information from them is not always provided to school personnel to aid in the implementation of academic adjustments, resulting in a fragmented system. 3 This further demonstrates the need for a multidisciplinary concussion management team and aligns with current best practice recommendations.…”