National Athletic Trainers' Association Position Statement: Management of Sport Concussion

Broglio, Steven P.; Cantu, Robert C.; Gioia, Gérard A.; Guskiewicz, Kevin M.; Kutcher, Jeffrey S.; Palm, Michael; McLeod, Tamara C. Valovich

doi:10.4085/1062-6050-49.1.07

Cited by 728 publications

(648 citation statements)

References 217 publications

(196 reference statements)

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“…While up to 90% of concussions resolve in 7–10 days, recovery time may be longer 2. The time to recover may reflect the extent of microscopic neuronal shearing3 and the impairment of cellular and metabolic function 4, 5. While these insights help elucidate the neurophysiology of acute concussive injuries, chronic concussion is still poorly understood and mechanisms explaining the neurobiology over a protracted time scale have not been well characterized.…”

Section: Introductionmentioning

confidence: 99%

Rapid number naming in chronic concussion: eye movements in the King–Devick test

Rizzo

Hudson

Dai³

et al. 2016

Ann Clin Transl Neurol

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ObjectiveThe King–Devick (KD) test, which is based on rapid number naming speed, is a performance measure that adds vision and eye movement assessments to sideline concussion testing. We performed a laboratory‐based study to characterize ocular motor behavior during the KD test in a patient cohort with chronic concussion to identify features associated with prolonged KD reading times.MethodsTwenty‐five patients with a concussion history (mean age: 31) were compared to control participants with no concussion history (n = 42, mean age: 32). Participants performed a computerized KD test under infrared‐based video‐oculography.ResultsAverage intersaccadic intervals for task‐specific saccades were significantly longer among concussed patients compared to controls (324.4 ± 85.6 msec vs. 286.1 ± 49.7 msec, P = 0.027). Digitized KD reading times were prolonged in concussed participants versus controls (53.43 ± 14.04 sec vs. 43.80 ± 8.55 sec, P = 0.004) and were highly correlated with intersaccadic intervals. Concussion was also associated with a greater number of saccades during number reading and larger average deviations of saccade endpoint distances from the centers of the to‐be‐read numbers (1.22 ± 0.29° vs. 0.98 ± 0.27°, P = 0.002). There were no differences in saccade peak velocity, duration, or amplitude.InterpretationProlonged intersaccadic intervals, greater numbers of saccades, and larger deviations of saccade endpoints underlie prolonged KD reading times in chronic concussion. The KD test relies upon a diffuse neurocognitive network that mediates the fine control of efferent visual function. One sequela of chronic concussion may be disruption of this system, which may produce deficits in spatial target selection and planning of eye movements.

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Section: Introductionmentioning

confidence: 99%

Rapid number naming in chronic concussion: eye movements in the King–Devick test

Rizzo

Hudson

Dai³

et al. 2016

Ann Clin Transl Neurol

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“…Return to play guidelines strongly recommend that athletes not be returned to play until they are completely asymptomatic and fully recovered cognitively (Broglio et al, 2014;Harmon et al, 2013), and baseline testing can help to operationalize the meaning of "fully recovered" for individual athletes (Piland et al, 2010). But, as pointed out by Erdal (2012), the utility of the comparison between post-injury and baseline test data in return-to-play decisions is based upon the integrity of the baseline data.…”

Section: Baseline Testing In Computerized Neurocognitive Testingmentioning

confidence: 99%

Validity and Reliability of Baseline Testing in a Standardized Environment

Higgins

Caze

Maerlender

2017

Archives of Clinical Neuropsychology

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Objective -The Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) is a computerized neuropsychological test battery commonly used to determine cognitive recovery from concussion based on comparing post-injury scores to baseline scores. This model is based on the premise that ImPACT baseline test scores are a valid and reliable measure of optimal cognitive function at baseline. Growing evidence suggests that this premise may not be accurate and a large contributor to invalid and unreliable baseline test scores may be the protocol and environment in which baseline tests are administered. This study examined the effects of a standardized environment and administration protocol on the reliability and performance validity of athletes' baseline test scores on ImPACT by comparing scores obtained in two different group-testing settings. Method -Three hundred-sixty one Division 1 cohort-matched collegiate athletes' baseline data were assessed using a variety of indicators of potential performance invalidity; internal reliability was also examined. Results -Thirty-one to thirty-nine percent of the baseline cases had at least one indicator of low performance validity, but there were no significant differences in validity indicators based on environment in which the testing was conducted. Internal consistency reliability scores were in the acceptable to good range, with no significant differences between administration conditions. Conclusions -These results suggest that athletes may be reliably performing at levels lower than their best effort would produce.

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“…The definition of a concussion is a brain injury caused by a blow to the head or a violent shaking of the head and body. 1,2,3 Strategies used to prevent concussions in the sport have included education, improved equipment, rule changes, and training devices. 5 There have been devices put on the market to help decrease improper form when making a tackle in football.…”

Section: Accuracy Of the "Helmet Halo" Device In Identifying Impropermentioning

confidence: 99%

Accuracy of the "Helmet Halo" Device in Identifying Improper Tackling form in Division III College Football Players

Marshall¹,

Troyer²,

Payne³

2018

JSMAHS

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National Athletic Trainers' Association Position Statement: Management of Sport Concussion

Cited by 728 publications

References 217 publications

Rapid number naming in chronic concussion: eye movements in the King–Devick test

Rapid number naming in chronic concussion: eye movements in the King–Devick test

Validity and Reliability of Baseline Testing in a Standardized Environment

Accuracy of the "Helmet Halo" Device in Identifying Improper Tackling form in Division III College Football Players

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