Investigation of Baseline Self-Report Concussion Symptom Scores

Abstract

Context: Self-reported symptoms (SRS) scales comprise one aspect of a multifaceted assessment of sport-related concussion. Obtaining SRS assessments before a concussion occurs assists in determining when the injury is resolved. However, athletes may present with concussion-related symptoms at baseline. Thus, it is important to evaluate such reports to determine if the variables that are common to many athletic environments are influencing them.Objective: To evaluate the influence of a history of concussion, sex, acute fatigue, physical illness, and orthopaedic injury on baseline responses to 2 summative symptom scales; to investigate the psychometric properties of all responses; and to assess the factorial validity of responses to both scales in the absence of influential variables.Design: Cross-sectional study. Setting: Athletic training facilities of 6 National Collegiate Athletic Association institutions.Patients or Other Participants: The sample of 1065 was predominately male (n 5 805) collegiate athletes with a mean age of 19.81 6 1.53 years.Main Outcome Measure(s): Participants completed baseline measures for duration and severity of concussion-related SRS and a brief health questionnaire.Results: At baseline, respondents reporting a previous concussion had higher composite scores on both scales (P # .01), but no sex differences were found for concussion-related symptoms. Acute fatigue, physical illness, and orthopaedic injury increased composite SRS scores on both duration and severity measures (P # .01). Responses to both scales were stable and internally consistent. Confirmatory factor analysis provided strong evidence for the factorial validity of the responses of participants reporting no fatigue, physical illness, or orthopaedic injury on each instrument.Conclusions: A history of concussion, acute fatigue, physical illness, and orthopaedic injury increased baseline SRS scores. These conditions need to be thoroughly investigated and controlled by clinicians before baseline SRS measures are collected.

Repeated mild traumatic brain injuries is not associated with volumetric differences in former high school football players

“…On the SAS, both participant groups reported experiencing a modest number of symptoms over the previous 24 h (previously concussed group M = 4.6; nonconcussed group M = 3.6) similar to rates of baseline symptom reporting in other studies (Piland et al 2010). However, there were no group differences in the total number of symptoms reported [t(38) = 0.85, p = 0.40], the duration of those symptoms over the past 24 h [t(38) = 1.17, p = 0.25], or the symptom severity [t(38) = 1.49, p = 0.14].…”

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

“…For these reasons and also because of the natural day-today presence of symptoms commonly associated with concussion, 34,35 some degree of symptom reporting is not unexpected. Clinicians, therefore, face the difficult task of interpreting which symptoms are directly related to concussion and which are related to other conditions.…”

Validity and Reliability of Baseline Testing in a Standardized Environment

“…In order to be able to assess internal reliability within constructs, all subtests scores were converted to z-scores. Scores for which a lower number indicates a better performance (such as reaction time scores) were reverse-scored to normalize directionality (Pallant, 2005). Summary scores based on subtest score combinations were not included (i.e., Word Memory Learning Percent Correct).…”