Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.49
S. Patel, A. J. Zynda, M. Miller, C. Burley, J. French, N. Ramirez, H. Guercio, N. Kegel, N. Bunker, M. Collins, A. Kontos
Identify factors contributing to anxiety in individuals without a pre-existing anxiety history post-concussion. Patients (n = 264, aged 9–68) presented to a specialty concussion clinic post-concussion. They completed a clinical interview, Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), Post-Concussion Symptom Scale (PCSS), Concussion Clinical Profile Screening (CP-Screen), and Vestibular/Ocular-Motor Screening (VOMS). Anxiety group was determined by a positive anxiety/mood clinical profile on CP-Screen. Independent samples t-tests and chi-square tests examined differences in demographics, medical history, and injury characteristics between groups. Univariate logistic regressions (LR) informed a follow-up forward stepwise LR to identify best predictors of post-concussion anxiety group. Receiver operating characteristic (ROC) analysis of the area under the curve (AUC) was used to identify which predictors retained from the LR model best-discriminated anxiety status. Statistical significance was set a priori at p < 0.05. Results of forward stepwise LR identifying factors contributing to post-concussion anxiety were significant (p < 0.001) and accounted for 19% of the variance. The model accurately classified 82.2% of patients, with non-Sport Related Concussion (SRC) (OR = 2.94, 95%CI, 1.45–1.5.98, p = 0.003), history of ADHD/LD (OR = 2.85, 95%CI, 1.21–6.71, p = 0.02), positive vestibular profile (OR = 2.14, 95%CI, 1.06–4.33, p = 0.03), and days to first clinic visit (OR = 1.01, 95%CI, 1.01–1.015, p = 0.003) as significant predictors. ROC analysis of the AUC of this 4-factor model discriminated post-concussion anxiety from no anxiety (AUC, 0.77, 95%CI, 0.71–0.85, p < 0.001). Findings suggest that non-SRC, ADHD/LD history, positive vestibular profile, and delayed clinic visit, may contribute to post-concussion anxiety among patients without prior anxiety history. These predictors may guide clinicians in tailoring interventions to optimize recovery outcomes.
确定脑震荡后无焦虑病史的患者产生焦虑的因素。 患者（n = 264，年龄 9-68 岁）在脑震荡后前往脑震荡专科门诊就诊。他们完成了临床访谈、脑震荡后即时评估和认知测试（ImPACT）、脑震荡后症状量表（PCSS）、脑震荡临床特征筛查（CP-Screen）和前庭/眼球运动筛查（VOMS）。焦虑组由 CP-Screen 上的焦虑/情绪临床特征阳性决定。独立样本 t 检验和卡方检验检验了各组之间在人口统计学、病史和损伤特征方面的差异。单变量逻辑回归（LR）为后续的前向逐步 LR 提供了依据，以确定脑震荡后焦虑组的最佳预测因素。曲线下面积（AUC）的接收者操作特征（ROC）分析用于确定从 LR 模型中保留的哪些预测因子最能区分焦虑状态。统计显著性先验设定为 p < 0.05。 前向逐步 LR 确定脑震荡后焦虑的因素的结果具有显著性（p < 0.001），占方差的 19%。该模型对 82.2% 的患者进行了准确分类，其中包括非运动相关脑震荡 (SRC) (OR = 2.94, 95%CI, 1.45-1.5.98, p = 0.003)、ADHD/LD 病史 (OR = 2.85, 95%CI, 1.21-6.71, p = 0.02)。71，p = 0.02）、前庭特征阳性（OR = 2.14，95%CI，1.06-4.33，p = 0.03）和首次就诊天数（OR = 1.01，95%CI，1.01-1.015，p = 0.003）为显著预测因子。对该 4 因子模型的 AUC 进行 ROC 分析后发现，脑震荡后焦虑与无焦虑有明显区别（AUC, 0.77, 95%CI, 0.71-0.85, p < 0.001）。 研究结果表明，非 SRC、ADHD/LD 病史、阳性前庭特征和延迟就诊可能会导致无焦虑病史的患者出现脑震荡后焦虑。这些预测因素可指导临床医生调整干预措施，以优化康复效果。
{"title":"A - 49 Predictors of Post-Concussion Anxiety In Patients without Pre-Existing Anxiety History","authors":"S. Patel, A. J. Zynda, M. Miller, C. Burley, J. French, N. Ramirez, H. Guercio, N. Kegel, N. Bunker, M. Collins, A. Kontos","doi":"10.1093/arclin/acae052.49","DOIUrl":"https://doi.org/10.1093/arclin/acae052.49","url":null,"abstract":"\u0000 \u0000 \u0000 Identify factors contributing to anxiety in individuals without a pre-existing anxiety history post-concussion.\u0000 \u0000 \u0000 \u0000 Patients (n = 264, aged 9–68) presented to a specialty concussion clinic post-concussion. They completed a clinical interview, Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), Post-Concussion Symptom Scale (PCSS), Concussion Clinical Profile Screening (CP-Screen), and Vestibular/Ocular-Motor Screening (VOMS). Anxiety group was determined by a positive anxiety/mood clinical profile on CP-Screen. Independent samples t-tests and chi-square tests examined differences in demographics, medical history, and injury characteristics between groups. Univariate logistic regressions (LR) informed a follow-up forward stepwise LR to identify best predictors of post-concussion anxiety group. Receiver operating characteristic (ROC) analysis of the area under the curve (AUC) was used to identify which predictors retained from the LR model best-discriminated anxiety status. Statistical significance was set a priori at p < 0.05.\u0000 \u0000 \u0000 \u0000 Results of forward stepwise LR identifying factors contributing to post-concussion anxiety were significant (p < 0.001) and accounted for 19% of the variance. The model accurately classified 82.2% of patients, with non-Sport Related Concussion (SRC) (OR = 2.94, 95%CI, 1.45–1.5.98, p = 0.003), history of ADHD/LD (OR = 2.85, 95%CI, 1.21–6.71, p = 0.02), positive vestibular profile (OR = 2.14, 95%CI, 1.06–4.33, p = 0.03), and days to first clinic visit (OR = 1.01, 95%CI, 1.01–1.015, p = 0.003) as significant predictors. ROC analysis of the AUC of this 4-factor model discriminated post-concussion anxiety from no anxiety (AUC, 0.77, 95%CI, 0.71–0.85, p < 0.001).\u0000 \u0000 \u0000 \u0000 Findings suggest that non-SRC, ADHD/LD history, positive vestibular profile, and delayed clinic visit, may contribute to post-concussion anxiety among patients without prior anxiety history. These predictors may guide clinicians in tailoring interventions to optimize recovery outcomes.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.04
S. Boucher, A. Datoc, A. S. Mathew, D. M. Choi, N. Sisneros, C. A. Jones, C. Ellis, J. P. Abt, S. Burkhart
Little has been done to investigate the impact of cheerleading season progression on recovery trajectories of sports-related concussions (SRC). The purpose of this study was to assess the impact of season progression on concussion recovery in All Star cheerleaders. Female All Star cheerleaders (n = 52) aged 8–18 (13.9.0¬ ± 2.5 years) were evaluated in a specialty concussion clinic for SRC during the 2020–2023 seasons. Cheerleaders were sorted into groups based on when their injury occurred (T1 = tryout/practice portion of season, T2 = beginning of competition season, T3 = end of season/coveted competitions). Mann–Whitney U Tests were used to evaluate differences between groups. Most All Star cheerleaders were evaluated for SRC during T2 (n = 32) compared to T1 (n = 12) and T3 (n = 8). Cheerleaders injured during T2 reported significantly lower PCSS scores (M = 21.0, IQR = 15.0–37.0) compared to T1 (M = 52.5, IQR = 27.5–60.8) and T3 (M = 46.9, IQR = 34.0–90.0), p = 0.01. There were no significant differences in days since injury (DSI; T1 M = 5.67, SD = 7.84; T2 M = 6.13, SD = 8.64; T3 M = 3.50, SD = 2.67) and evaluation of overall recovery time across groups (T1 M = 20.92, SD = 10.19; T2 M = 24.25, SD = 17.85; T3 M = 16.38, SD = 13.89; p > 0.05). Overall, cheerleaders injured during the beginning of competition season had the lowest PCSS scores upon evaluation, which may be due to presenting to clinic further from their injury. Though not significant, All Star cheerleaders were evaluated sooner during the coveted competitions portion of the season. Despite the small sample size, the pattern of results suggests that greater incentive and pressure to participate in coveted competitions may lead to quicker recovery times.
{"title":"A - 04 The Impact of Season Progression on Concussion Recovery In all Star Cheerleaders","authors":"S. Boucher, A. Datoc, A. S. Mathew, D. M. Choi, N. Sisneros, C. A. Jones, C. Ellis, J. P. Abt, S. Burkhart","doi":"10.1093/arclin/acae052.04","DOIUrl":"https://doi.org/10.1093/arclin/acae052.04","url":null,"abstract":"\u0000 \u0000 \u0000 Little has been done to investigate the impact of cheerleading season progression on recovery trajectories of sports-related concussions (SRC). The purpose of this study was to assess the impact of season progression on concussion recovery in All Star cheerleaders.\u0000 \u0000 \u0000 \u0000 Female All Star cheerleaders (n = 52) aged 8–18 (13.9.0¬ ± 2.5 years) were evaluated in a specialty concussion clinic for SRC during the 2020–2023 seasons. Cheerleaders were sorted into groups based on when their injury occurred (T1 = tryout/practice portion of season, T2 = beginning of competition season, T3 = end of season/coveted competitions). Mann–Whitney U Tests were used to evaluate differences between groups.\u0000 \u0000 \u0000 \u0000 Most All Star cheerleaders were evaluated for SRC during T2 (n = 32) compared to T1 (n = 12) and T3 (n = 8). Cheerleaders injured during T2 reported significantly lower PCSS scores (M = 21.0, IQR = 15.0–37.0) compared to T1 (M = 52.5, IQR = 27.5–60.8) and T3 (M = 46.9, IQR = 34.0–90.0), p = 0.01. There were no significant differences in days since injury (DSI; T1 M = 5.67, SD = 7.84; T2 M = 6.13, SD = 8.64; T3 M = 3.50, SD = 2.67) and evaluation of overall recovery time across groups (T1 M = 20.92, SD = 10.19; T2 M = 24.25, SD = 17.85; T3 M = 16.38, SD = 13.89; p > 0.05).\u0000 \u0000 \u0000 \u0000 Overall, cheerleaders injured during the beginning of competition season had the lowest PCSS scores upon evaluation, which may be due to presenting to clinic further from their injury. Though not significant, All Star cheerleaders were evaluated sooner during the coveted competitions portion of the season. Despite the small sample size, the pattern of results suggests that greater incentive and pressure to participate in coveted competitions may lead to quicker recovery times.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.27
K. Riegler, R. Scolaro Moser
To explore the relationship between self-reported sleep symptoms and post-concussion cognitive test performance in adolescents on Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). 54 adolescents (ages 12–16) referred to a specialized sports concussion private practice completed post-concussion ImPACT. Five symptom clusters were derived from the post-concussion symptom scale: sleep, physical, cognitive, affective, and headache. Two-factor cognitive composites from the ImPACT (memory and speed) were the outcome variables. Multivariate linear regression was conducted to examine the relationship between cognitive variables and sleep symptoms. Post-hoc forward stepwise linear regressions were used to explore the following potential additional predictors of cognitive outcomes: age, number of previous concussions, sex, hours slept the night before, and five symptom clusters. Sleep symptoms were significantly associated with cognitive performance, F(1,52) = 9.95, p < 0.001, ƞ2 = 0.28. Higher sleep symptom cluster scores were associated with worse memory, F(1,53) = 13.68, p < 0.001, ƞ2 = 0.21, and speed performance, F(1,53) = 17.84, p < 0.001, ƞ2 = 0.26. Results of post-hoc forward stepwise linear regressions revealed that a final model for speed performance included only the sleep symptom cluster, explaining 16.6% of the variance. The final model for memory performance included only the headache rating, explaining 20.1% of the variance. Our results indicate that severity of self-reported sleep symptoms post-concussion are associated with cognitive performance in domains of memory and speed. After considering additional predictors, more severe sleep symptoms were significantly associated with worse speed performance and worse headache severity was significantly associated with memory performance.
{"title":"A - 27 A Preliminary Investigation of the Relationship between Sleep Symptoms and Post-Concussion Cognitive Performance in Adolescents","authors":"K. Riegler, R. Scolaro Moser","doi":"10.1093/arclin/acae052.27","DOIUrl":"https://doi.org/10.1093/arclin/acae052.27","url":null,"abstract":"\u0000 \u0000 \u0000 To explore the relationship between self-reported sleep symptoms and post-concussion cognitive test performance in adolescents on Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT).\u0000 \u0000 \u0000 \u0000 54 adolescents (ages 12–16) referred to a specialized sports concussion private practice completed post-concussion ImPACT. Five symptom clusters were derived from the post-concussion symptom scale: sleep, physical, cognitive, affective, and headache. Two-factor cognitive composites from the ImPACT (memory and speed) were the outcome variables. Multivariate linear regression was conducted to examine the relationship between cognitive variables and sleep symptoms. Post-hoc forward stepwise linear regressions were used to explore the following potential additional predictors of cognitive outcomes: age, number of previous concussions, sex, hours slept the night before, and five symptom clusters.\u0000 \u0000 \u0000 \u0000 Sleep symptoms were significantly associated with cognitive performance, F(1,52) = 9.95, p < 0.001, ƞ2 = 0.28. Higher sleep symptom cluster scores were associated with worse memory, F(1,53) = 13.68, p < 0.001, ƞ2 = 0.21, and speed performance, F(1,53) = 17.84, p < 0.001, ƞ2 = 0.26. Results of post-hoc forward stepwise linear regressions revealed that a final model for speed performance included only the sleep symptom cluster, explaining 16.6% of the variance. The final model for memory performance included only the headache rating, explaining 20.1% of the variance.\u0000 \u0000 \u0000 \u0000 Our results indicate that severity of self-reported sleep symptoms post-concussion are associated with cognitive performance in domains of memory and speed. After considering additional predictors, more severe sleep symptoms were significantly associated with worse speed performance and worse headache severity was significantly associated with memory performance.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.54
J. Dugan, J. Jo, C. C. Long, K. Williams, S. Zuckerman, D. Terry
The blink reflex may be affected by concussion, but psychometric analyses examining devices that measure the blink reflex are limited. This study assessed the test–retest reliability of the Blinkcns EyeStatTM device at two pre-season baseline time points in a cohort of healthy high school athletes. During pre-season, high school athletes completed the EyeStatTM scanning twice, 15-minutes apart. Pearson/Spearman correlations and Intraclass Correlation Coefficients (ICC, i.e., the measure of test re-test reliability) were calculated across 10 different parameters (e.g., latency, total blink time, oscillations, time to open/close). Additionally, t-tests examined if these parameters differed based on biological sex, sleep status (i.e., <8 vs. ≥8 hours the night before), and prior concussion history (i.e., 0 vs. ≥1 prior concussions). Of the 48 athletes (age, M = 16.0¬ ± 1.2 years), 35.4% were female. Correlations ranged from 0.45–0.82 (all p-values<0.001) between the two assessments, and ICCs were 0.46–0.87 (all p-values<0.02). Additionally, none of the Eyestat parameters were significantly associated with biological sex, sleep status, or prior concussion history (all p-values>0.05). This study suggests substantial test–retest reliability of the EyeStatTM device across 10 parameters in a cohort of healthy high school athletes. The findings support the potential utility of the EyeStatTM device as a reliable baseline measure for assessing the blink reflex among young athletes.
{"title":"A - 54 Changes in the Blink Reflex after a Sport-Related Concussion: Test–Retest Reliability of a Blink Reflexometer","authors":"J. Dugan, J. Jo, C. C. Long, K. Williams, S. Zuckerman, D. Terry","doi":"10.1093/arclin/acae052.54","DOIUrl":"https://doi.org/10.1093/arclin/acae052.54","url":null,"abstract":"\u0000 \u0000 \u0000 The blink reflex may be affected by concussion, but psychometric analyses examining devices that measure the blink reflex are limited. This study assessed the test–retest reliability of the Blinkcns EyeStatTM device at two pre-season baseline time points in a cohort of healthy high school athletes.\u0000 \u0000 \u0000 \u0000 During pre-season, high school athletes completed the EyeStatTM scanning twice, 15-minutes apart. Pearson/Spearman correlations and Intraclass Correlation Coefficients (ICC, i.e., the measure of test re-test reliability) were calculated across 10 different parameters (e.g., latency, total blink time, oscillations, time to open/close). Additionally, t-tests examined if these parameters differed based on biological sex, sleep status (i.e., <8 vs. ≥8 hours the night before), and prior concussion history (i.e., 0 vs. ≥1 prior concussions).\u0000 \u0000 \u0000 \u0000 Of the 48 athletes (age, M = 16.0¬ ± 1.2 years), 35.4% were female. Correlations ranged from 0.45–0.82 (all p-values<0.001) between the two assessments, and ICCs were 0.46–0.87 (all p-values<0.02). Additionally, none of the Eyestat parameters were significantly associated with biological sex, sleep status, or prior concussion history (all p-values>0.05).\u0000 \u0000 \u0000 \u0000 This study suggests substantial test–retest reliability of the EyeStatTM device across 10 parameters in a cohort of healthy high school athletes. The findings support the potential utility of the EyeStatTM device as a reliable baseline measure for assessing the blink reflex among young athletes.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.39
S. Amalfe, S. Jennings, M. Womble, K. Durfee, R. Elbin
Examine the effects of self-reported behavioral regulation adherence levels on post-concussion symptom burden in individuals with sport-related concussion (SRC). A retrospective chart review of patients (ages 15-25 yrs) seeking care for a SRC within 90 days post-injury were included in this study. Participants completed a self-report, 4-point Likert scale (0-Never, 3-Most of the Time) questionnaire that assessed the previous week’s frequency of Sleep, Physical Activity (PA), Diet, Hydration, and Stress Management (Stress) behavioral regulation domains. Scores were divided into HIGH (Most of the Time) and LOW (Some of the Time - Never) regulation groups for each domain. A series of independent samples t-tests and analyses of covariance (ANCOVA; controlling for sex, history of anxiety/depression) were used to compare groups on Post-Concussion Symptom Scale (PCSS) total score at first clinical visit. Five-hundred thirty-seven participants (M = 15.35, SD = 2.40 yrs, 54% female) completed the study measures at 9.38 days post-injury (SD = 10.33). Participants in the HIGH behavioral regulation groups for Sleep (F (1, 537) = 68.16, p < 0.001), Diet (F (1, 537) = 22.42, p < 0.001), PA (F (1, 537) = 15.47, p < 0.001), and Stress (F (1, 537) = 6.70, p < 0.01), demonstrated significantly lower total symptom scores than the LOW groups. There were no significant between-group differences for Hydration (F (1, 537) = 3.62, p = 0.06). Effectively engaging in light PA, stress management, and consistent sleep and diet following SRC affects post-concussion symptom severity and should be considered an acute treatment plan. Hydration appears less influential in reducing symptom burden at initial clinical visit.
{"title":"A - 39 Self-Reported Behavioral Regulation and Post-Concussion Symptom Burden","authors":"S. Amalfe, S. Jennings, M. Womble, K. Durfee, R. Elbin","doi":"10.1093/arclin/acae052.39","DOIUrl":"https://doi.org/10.1093/arclin/acae052.39","url":null,"abstract":"\u0000 \u0000 \u0000 Examine the effects of self-reported behavioral regulation adherence levels on post-concussion symptom burden in individuals with sport-related concussion (SRC).\u0000 \u0000 \u0000 \u0000 A retrospective chart review of patients (ages 15-25 yrs) seeking care for a SRC within 90 days post-injury were included in this study. Participants completed a self-report, 4-point Likert scale (0-Never, 3-Most of the Time) questionnaire that assessed the previous week’s frequency of Sleep, Physical Activity (PA), Diet, Hydration, and Stress Management (Stress) behavioral regulation domains. Scores were divided into HIGH (Most of the Time) and LOW (Some of the Time - Never) regulation groups for each domain. A series of independent samples t-tests and analyses of covariance (ANCOVA; controlling for sex, history of anxiety/depression) were used to compare groups on Post-Concussion Symptom Scale (PCSS) total score at first clinical visit.\u0000 \u0000 \u0000 \u0000 Five-hundred thirty-seven participants (M = 15.35, SD = 2.40 yrs, 54% female) completed the study measures at 9.38 days post-injury (SD = 10.33). Participants in the HIGH behavioral regulation groups for Sleep (F (1, 537) = 68.16, p < 0.001), Diet (F (1, 537) = 22.42, p < 0.001), PA (F (1, 537) = 15.47, p < 0.001), and Stress (F (1, 537) = 6.70, p < 0.01), demonstrated significantly lower total symptom scores than the LOW groups. There were no significant between-group differences for Hydration (F (1, 537) = 3.62, p = 0.06).\u0000 \u0000 \u0000 \u0000 Effectively engaging in light PA, stress management, and consistent sleep and diet following SRC affects post-concussion symptom severity and should be considered an acute treatment plan. Hydration appears less influential in reducing symptom burden at initial clinical visit.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.36
C. David, M. Mrazik, K. O. Yeates, J-M Galarneau, C. A. Emery
Concussion symptoms typically resolve within 30 days from injury; however, in up to 35% of cases, symptoms may be prolonged and continue months, or even years, and may be associated with longer-term mental health problems. This study aimed to assess long-term psychological and emotional symptoms in adolescent youth ice hockey players after medical clearance to return to play. This study used data collected prospectively as part of a larger longitudinal cohort study involving injury surveillance in hockey players (11-18 years), conducted over five seasons from 2013 through 2018. Pre-season baseline measures of psychological and emotional functioning were compared across two consecutive time points, for youth with an intervening concussion, musculoskeletal. (MSK) injury, or no intervening injury. Random intercept models with players nested by team and individuals, captured the effects of players contributing to the analysis multiple times. Covariates included age, sex, and body checking policy. Adolescent ice hockey players who sustained a concussion showed no evidence of worsening self-reported psychological and emotional symptoms after injury, compared to youth with MSK injury or no injury. Compared to athletes with MSK or no injury, athletes who sustained a concussion also showed no worsening symptoms based on parent ratings. The present study found no evidence of worsening psychological and emotional symptoms among adolescent ice hockey players up to one-year post-concussion, compared to youth with MSK injury or no injury. These findings support the expected recovery trajectory timeline of concussions and support current return-to-play policies for this group.
{"title":"A - 36 Long-Term Psychological Symptoms Following Concussion in Adolescent Ice Hockey Players","authors":"C. David, M. Mrazik, K. O. Yeates, J-M Galarneau, C. A. Emery","doi":"10.1093/arclin/acae052.36","DOIUrl":"https://doi.org/10.1093/arclin/acae052.36","url":null,"abstract":"\u0000 \u0000 \u0000 Concussion symptoms typically resolve within 30 days from injury; however, in up to 35% of cases, symptoms may be prolonged and continue months, or even years, and may be associated with longer-term mental health problems. This study aimed to assess long-term psychological and emotional symptoms in adolescent youth ice hockey players after medical clearance to return to play.\u0000 \u0000 \u0000 \u0000 This study used data collected prospectively as part of a larger longitudinal cohort study involving injury surveillance in hockey players (11-18 years), conducted over five seasons from 2013 through 2018. Pre-season baseline measures of psychological and emotional functioning were compared across two consecutive time points, for youth with an intervening concussion, musculoskeletal.\u0000 (MSK) injury, or no intervening injury. Random intercept models with players nested by team and individuals, captured the effects of players contributing to the analysis multiple times. Covariates included age, sex, and body checking policy.\u0000 \u0000 \u0000 \u0000 Adolescent ice hockey players who sustained a concussion showed no evidence of worsening self-reported psychological and emotional symptoms after injury, compared to youth with MSK injury or no injury. Compared to athletes with MSK or no injury, athletes who sustained a concussion also showed no worsening symptoms based on parent ratings.\u0000 \u0000 \u0000 \u0000 The present study found no evidence of worsening psychological and emotional symptoms among adolescent ice hockey players up to one-year post-concussion, compared to youth with MSK injury or no injury. These findings support the expected recovery trajectory timeline of concussions and support current return-to-play policies for this group.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.15
G. L. Iverson, J. Santangelo, J. E. Maietta, N. E. Cook
Social determinants of health, including socioeconomic status (SES) and neighborhood characteristics, are underrepresented in concussion research. We examined two measures of neighborhood advantage and opportunity among patients accessing a multidisciplinary sports concussion clinic in Greater Boston. We collected the Child Opportunity Index (COI) and Area Deprivation Index (ADI) state decile scores and national percentile ranks for all new patients who presented to our clinic in 2023. The COI is an index of neighborhood conditions that may impact childhood development (e.g., education quality, SES, access to healthy food) with ratings from Very Low to Very High. The ADI characterizes an area’s socioeconomic conditions (e.g., income, housing quality, employment, education), with higher scores representing more disadvantage. There were 247 new patients who visited the clinic (Mage = 17.5, SDage = 5.2, 47.8% Girls/Women, 81.4% White, 4.0% Black, 6.5% Asian, 4.9% Hispanic). The majority lived in an area with a High or Very High state COI (74%) and High or Very High national COI (88%). The median ADI state decile was 2.00 (IQR = 1.00–4.00) and the median national percentile was 10.00 (IQR = 5.00–18.00) (representing the highest 10% of advantage). The state deciles for the two measures were correlated (Spearman rho = 0.64), but not redundant. The COI and ADI are important, accessible measures of SES that can be included in future studies. Patients from low SES were greatly underrepresented in the clinic compared to the population of our metropolitan area. Patients were predominantly from higher SES, consistent with prior studies suggesting socioeconomic disparities accessing specialty concussion care.
{"title":"A - 15 Incorporating the Child Opportunity Index and Area Deprivation Index in Sport Concussion Research","authors":"G. L. Iverson, J. Santangelo, J. E. Maietta, N. E. Cook","doi":"10.1093/arclin/acae052.15","DOIUrl":"https://doi.org/10.1093/arclin/acae052.15","url":null,"abstract":"\u0000 \u0000 \u0000 Social determinants of health, including socioeconomic status (SES) and neighborhood characteristics, are underrepresented in concussion research. We examined two measures of neighborhood advantage and opportunity among patients accessing a multidisciplinary sports concussion clinic in Greater Boston.\u0000 \u0000 \u0000 \u0000 We collected the Child Opportunity Index (COI) and Area Deprivation Index (ADI) state decile scores and national percentile ranks for all new patients who presented to our clinic in 2023. The COI is an index of neighborhood conditions that may impact childhood development (e.g., education quality, SES, access to healthy food) with ratings from Very Low to Very High. The ADI characterizes an area’s socioeconomic conditions (e.g., income, housing quality, employment, education), with higher scores representing more disadvantage.\u0000 \u0000 \u0000 \u0000 There were 247 new patients who visited the clinic (Mage = 17.5, SDage = 5.2, 47.8% Girls/Women, 81.4% White, 4.0% Black, 6.5% Asian, 4.9% Hispanic). The majority lived in an area with a High or Very High state COI (74%) and High or Very High national COI (88%). The median ADI state decile was 2.00 (IQR = 1.00–4.00) and the median national percentile was 10.00 (IQR = 5.00–18.00) (representing the highest 10% of advantage). The state deciles for the two measures were correlated (Spearman rho = 0.64), but not redundant.\u0000 \u0000 \u0000 \u0000 The COI and ADI are important, accessible measures of SES that can be included in future studies. Patients from low SES were greatly underrepresented in the clinic compared to the population of our metropolitan area. Patients were predominantly from higher SES, consistent with prior studies suggesting socioeconomic disparities accessing specialty concussion care.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.55
C. C. Long, J. Dugan, J. Jo, K. Williams, S. Zuckerman, D. Terry
Examining quantitative parameters of the blink reflex may improve sport-related concussion (SRC) diagnosis and management because it may serve as an objective measure of injury severity and recovery. However, the psychometric properties of several FDA-cleared devices assessing the blink reflex are understudied. The current study compared blink reflex parameters pre- and post-season using the BlinkTBI EyeStatTM device to assess its reliability in non-concussed athletes. A cohort of high school athletes underwent pre- and post-season BlinkTBI EyeStatTM testing. Statistical analysis included Spearman correlations, Wilcoxon signed-rank tests, and interclass correlations for ten blink parameters. Multivariable linear regressions assessed the influence of contact (i.e., soccer, football) vs. non-contact sports (i.e., baseball, softball, basketball) on changes in blink parameters. Among 32 athletes with pre- and post-season testing (age: mean = 15.3, SD = 1.1; 53.1% female), 19 played non-contact and 21 played contact sports. Most parameters were not statistically different between pre- and post-season, except for delta 30 (W = 229.5, p = 0.015), time under threshold (W = 191.0, p = 0.003), and oscillations (W = 667.0, p < 0.001). Parameters exhibited moderate to excellent reliability (interclass correlations = 0.575–0.872, p-values = 0.001–0.004). Spearman’s rho values ranged from 0.435 to 0.828 (p-values = 001–0.005). Participation in contact vs. non-contact sports was not associated with changes in blink parameters (all p-values>0.05). Preliminary evidence suggest stable blink parameters across a sports season in non-concussed athletes when measured by the BlinkTBI EyeStatTM device. Contact sport participation was not significantly associated with changes in blink parameters. The findings add to the psychometric evidence that the blink reflex can be reliably measured, warranting further study on its utility in concussion.
{"title":"A - 55 Pre- to Post-Season Reliability of Blink Reflex Parameters in Non-Concussed Athletes","authors":"C. C. Long, J. Dugan, J. Jo, K. Williams, S. Zuckerman, D. Terry","doi":"10.1093/arclin/acae052.55","DOIUrl":"https://doi.org/10.1093/arclin/acae052.55","url":null,"abstract":"\u0000 \u0000 \u0000 Examining quantitative parameters of the blink reflex may improve sport-related concussion (SRC) diagnosis and management because it may serve as an objective measure of injury severity and recovery. However, the psychometric properties of several FDA-cleared devices assessing the blink reflex are understudied. The current study compared blink reflex parameters pre- and post-season using the BlinkTBI EyeStatTM device to assess its reliability in non-concussed athletes.\u0000 \u0000 \u0000 \u0000 A cohort of high school athletes underwent pre- and post-season BlinkTBI EyeStatTM testing. Statistical analysis included Spearman correlations, Wilcoxon signed-rank tests, and interclass correlations for ten blink parameters. Multivariable linear regressions assessed the influence of contact (i.e., soccer, football) vs. non-contact sports (i.e., baseball, softball, basketball) on changes in blink parameters.\u0000 \u0000 \u0000 \u0000 Among 32 athletes with pre- and post-season testing (age: mean = 15.3, SD = 1.1; 53.1% female), 19 played non-contact and 21 played contact sports. Most parameters were not statistically different between pre- and post-season, except for delta 30 (W = 229.5, p = 0.015), time under threshold (W = 191.0, p = 0.003), and oscillations (W = 667.0, p < 0.001). Parameters exhibited moderate to excellent reliability (interclass correlations = 0.575–0.872, p-values = 0.001–0.004). Spearman’s rho values ranged from 0.435 to 0.828 (p-values = 001–0.005). Participation in contact vs. non-contact sports was not associated with changes in blink parameters (all p-values>0.05).\u0000 \u0000 \u0000 \u0000 Preliminary evidence suggest stable blink parameters across a sports season in non-concussed athletes when measured by the BlinkTBI EyeStatTM device. Contact sport participation was not significantly associated with changes in blink parameters. The findings add to the psychometric evidence that the blink reflex can be reliably measured, warranting further study on its utility in concussion.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.51
I. J. Sewell, T. Romeas, J. Deslauriers, S. Leclerc, M. Wojtowicz
Recent evidence suggests a relationship between cognitive performance and the risk of lower extremity musculoskeletal (LEMSK) injury, and that concussion may also increase the risk of subsequent LEMSK injury, though these relationships have been largely examined in isolation. This study examined associations between pre-season cognitive performance and the risk of subsequent LEMSK injury and concussion among elite athletes. An observational study of elite/international-level athletes from a Canadian national sport institute. 146 athletes (female = 87) across six different sports completed pre-season cognitive testing (Vienna Test System) between 2018 and 2023. Subsequent LEMSK injuries and concussions during the year following pre-season cognitive testing were documented via an injury surveillance program. Pre-season cognitive performance was similar in athletes with (n = 24) and without (n = 122) a subsequent concussion, and those with (n = 100) and without (n = 46) a subsequent LEMSK (ps > 0.05). Athletes with both a subsequent LEMSK and concussion had slower baseline reaction time on a task of stress reactivity (n = 16; median RT = 0.74 s) compared to athletes with only a subsequent LEMSK (n = 84; median RT = 0.69 s; V = 900.5, p = 0.019). Concussion history was a significant predictor of both subsequent LEMSK (B = 0.94, p = 0.017) and the number of subsequent LEMSK (B = 1.23, p < 0.01). Faster RTs on inhibition tests were predictors of subsequent number of LEMSK, while controlling for concussion history (B = -10.21, p = 0.045; B = -10.60, p = 0.017). Identifying risk factors for LEMSK injuries and concussions is critical for preventing future injuries. These preliminary results suggest a relationship between baseline reaction time performance and combined subsequent LEMSK and concussion injury.
{"title":"A - 51 Examining the Role of Cognition in Lower Extremity Musculoskeletal Injury and Concussion Risk in Elite Athletes","authors":"I. J. Sewell, T. Romeas, J. Deslauriers, S. Leclerc, M. Wojtowicz","doi":"10.1093/arclin/acae052.51","DOIUrl":"https://doi.org/10.1093/arclin/acae052.51","url":null,"abstract":"\u0000 \u0000 \u0000 Recent evidence suggests a relationship between cognitive performance and the risk of lower extremity musculoskeletal (LEMSK) injury, and that concussion may also increase the risk of subsequent LEMSK injury, though these relationships have been largely examined in isolation. This study examined associations between pre-season cognitive performance and the risk of subsequent LEMSK injury and concussion among elite athletes.\u0000 \u0000 \u0000 \u0000 An observational study of elite/international-level athletes from a Canadian national sport institute. 146 athletes (female = 87) across six different sports completed pre-season cognitive testing (Vienna Test System) between 2018 and 2023. Subsequent LEMSK injuries and concussions during the year following pre-season cognitive testing were documented via an injury surveillance program.\u0000 \u0000 \u0000 \u0000 Pre-season cognitive performance was similar in athletes with (n = 24) and without (n = 122) a subsequent concussion, and those with (n = 100) and without (n = 46) a subsequent LEMSK (ps > 0.05). Athletes with both a subsequent LEMSK and concussion had slower baseline reaction time on a task of stress reactivity (n = 16; median RT = 0.74 s) compared to athletes with only a subsequent LEMSK (n = 84; median RT = 0.69 s; V = 900.5, p = 0.019). Concussion history was a significant predictor of both subsequent LEMSK (B = 0.94, p = 0.017) and the number of subsequent LEMSK (B = 1.23, p < 0.01). Faster RTs on inhibition tests were predictors of subsequent number of LEMSK, while controlling for concussion history (B = -10.21, p = 0.045; B = -10.60, p = 0.017).\u0000 \u0000 \u0000 \u0000 Identifying risk factors for LEMSK injuries and concussions is critical for preventing future injuries. These preliminary results suggest a relationship between baseline reaction time performance and combined subsequent LEMSK and concussion injury.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.48
R. Smetana, D. Broshek, D. J. Rosenblum, J. E. Resch
To investigate predictors of prolonged recovery after concussion in collegiate athletes. Data for this cross-sectional, retrospective chart review of collegiate athletes diagnosed with concussion (n = 1044 concussions), who were on average 20-years of age, were collected during the 2015–16 to 2019–20 athletic seasons. The majority (92% [959/1044]) of athletes achieved symptom resolution at rest and made an unrestricted return-to-sport by 23 days after injury. The remaining athletes (8% n = 85[36.5% female]), with symptoms that lasted beyond 23 days after concussion were considered to have prolonged recovery. Linear regression was used to determine predictors of prolonged recovery; times to symptom-freedom and unrestricted return-to-sport were dependent variables and variables associated with medical and psychiatric history, and some post-concussion symptoms, were independent variables. Athletes with prolonged recovery generally recovered on median (interquartile range) 32 (17) days after injury. The majority (42% [36/84]) participated in football. A self-reported history of anxiety [Β = 0.577, p = 0.01], depression [Β = 0.462, p = 0.04], a history of headache [Β = 0.84, p < 0.001], and migraine [Β = 0.761, p < 0.001] were predictors of prolonged recovery. A history of prior concussion and higher symptom burden immediately after concussion did not predict prolonged recovery (all p > 0.05). Similar to related research, our findings suggest a self-reported history of psychiatric conditions, headache, and migraine associate with prolonged recovery in collegiate athletes. Our findings highlight the importance of mood symptom monitoring, early psychological intervention, and management of headache following concussion. Importantly, the majority of our sample, inclusive of collegiate athletes with prolonged recovery, recovered approximately one-month after injury.
研究大学生运动员脑震荡后恢复期延长的预测因素。 这项横断面回顾性病历审查收集了 2015-16 年至 2019-20 年运动赛季期间被诊断为脑震荡的大学生运动员（n = 1044 例脑震荡）的数据，这些运动员平均年龄为 20 岁。大多数运动员（92% [959/1044]）在休息时症状得到缓解，并在受伤后 23 天内不受限制地重返赛场。其余运动员（8% n = 85[36.5%为女性]）的症状持续时间超过了脑震荡后 23 天，被认为是恢复时间过长。采用线性回归法确定延长恢复期的预测因素；无症状和无限制恢复运动的时间是因变量，与病史和精神病史相关的变量以及一些脑震荡后症状是自变量。 恢复期延长的运动员一般在受伤后 32（17）天恢复。大多数人（42% [36/84]）参加了足球运动。自我报告的病史包括焦虑[Β = 0.577, p = 0.01]、抑郁[Β = 0.462, p = 0.04]、头痛[Β = 0.84, p 0.05]。 与相关研究相似，我们的研究结果表明，自我报告的精神病史、头痛和偏头痛与大学生运动员恢复期的延长有关。我们的研究结果突显了脑震荡后情绪症状监测、早期心理干预和头痛治疗的重要性。重要的是，在我们的样本中，包括恢复期较长的大学生运动员在内的大多数人都是在受伤后一个月左右恢复的。
{"title":"A - 48 Predictors of Prolonged Recovery after Concussion in Collegiate Athletes: a LIMBIC MATARS Consortium Investigation","authors":"R. Smetana, D. Broshek, D. J. Rosenblum, J. E. Resch","doi":"10.1093/arclin/acae052.48","DOIUrl":"https://doi.org/10.1093/arclin/acae052.48","url":null,"abstract":"\u0000 \u0000 \u0000 To investigate predictors of prolonged recovery after concussion in collegiate athletes.\u0000 \u0000 \u0000 \u0000 Data for this cross-sectional, retrospective chart review of collegiate athletes diagnosed with concussion (n = 1044 concussions), who were on average 20-years of age, were collected during the 2015–16 to 2019–20 athletic seasons. The majority (92% [959/1044]) of athletes achieved symptom resolution at rest and made an unrestricted return-to-sport by 23 days after injury. The remaining athletes (8% n = 85[36.5% female]), with symptoms that lasted beyond 23 days after concussion were considered to have prolonged recovery. Linear regression was used to determine predictors of prolonged recovery; times to symptom-freedom and unrestricted return-to-sport were dependent variables and variables associated with medical and psychiatric history, and some post-concussion symptoms, were independent variables.\u0000 \u0000 \u0000 \u0000 Athletes with prolonged recovery generally recovered on median (interquartile range) 32 (17) days after injury. The majority (42% [36/84]) participated in football. A self-reported history of anxiety [Β = 0.577, p = 0.01], depression [Β = 0.462, p = 0.04], a history of headache [Β = 0.84, p < 0.001], and migraine [Β = 0.761, p < 0.001] were predictors of prolonged recovery. A history of prior concussion and higher symptom burden immediately after concussion did not predict prolonged recovery (all p > 0.05).\u0000 \u0000 \u0000 \u0000 Similar to related research, our findings suggest a self-reported history of psychiatric conditions, headache, and migraine associate with prolonged recovery in collegiate athletes. Our findings highlight the importance of mood symptom monitoring, early psychological intervention, and management of headache following concussion. Importantly, the majority of our sample, inclusive of collegiate athletes with prolonged recovery, recovered approximately one-month after injury.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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