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Am J Sports Med. 2017 Apr;45(5):1187-1194. doi: 10.1177/0363546516685061. Epub 2017 Feb 13.

Using Acute Performance on a Comprehensive Neurocognitive, Vestibular, and Ocular Motor Assessment Battery to Predict Recovery Duration After Sport-Related Concussions.

Author information

1
UPMC Sports Medicine Concussion Program, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
2
John G. Rangos Sr. School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA.
3
Office for Sport Concussion Research, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA.
4
Università degli Studi di Milano, Milan, Italy.

Abstract

BACKGROUND:

A sport-related concussion (SRC) is a heterogeneous injury that requires a multifaceted and comprehensive approach for diagnosis and management, including symptom reports, vestibular/ocular motor assessments, and neurocognitive testing.

PURPOSE:

To determine which acute (eg, within 7 days) vestibular, ocular motor, neurocognitive, and symptom impairments predict the duration of recovery after an SRC.

STUDY DESIGN:

Cohort study (prognosis); Level of evidence, 2.

METHODS:

Sixty-nine patients with a mean age of 15.3 ± 1.9 years completed a neurocognitive, vestibular/ocular motor, and symptom assessment within 7 days of a diagnosed concussion. Patients were grouped by recovery time: ≤14 days (n = 27, 39.1%), 15-29 days (n = 25, 36.2%), and 30-90 days (n = 17, 24.6%). Multinomial regression was used to identify the best subset of predictors associated with prolonged recovery relative to ≤14 days.

RESULTS:

Acute visual motor speed and cognitive-migraine-fatigue symptoms were associated with an increased likelihood of recovery times of 30-90 days and 15-29 days relative to a recovery time of ≤14 days. A model with visual motor speed and cognitive-migraine-fatigue symptoms within the first 7 days of an SRC was 87% accurate at identifying patients with a recovery time of 30-90 days.

CONCLUSION:

The current study identified cognitive-migraine-fatigue symptoms and visual motor speed as the most robust predictors of protracted recovery after an SRC according to the Post-concussion Symptom Scale, Immediate Post-concussion Assessment and Cognitive Testing, and Vestibular/Ocular Motor Screening (VOMS). While VOMS components were sensitive in identifying a concussion, they were not robust predictors for recovery. Clinicians may consider particular patterns of performance on clinical measures when providing treatment recommendations and discussing anticipated recovery with patients.

KEYWORDS:

concussion; neurocognitive; ocular motor; recovery; vestibular

PMID:
28192036
DOI:
10.1177/0363546516685061
[Indexed for MEDLINE]

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