Citation

Brett BL, Kuhn AW, Yengo-Kahn AM, Jeckell AS, Solomon GS, Zuckerman SL. J. Int. Neuropsychol. Soc. 2018; 24(5): 476-485.

Affiliation

Vanderbilt Sports Concussion Center,Vanderbilt University School of Medicine,Nashville,Tennessee.

Copyright

(Copyright © 2018, Cambridge University Press)

DOI

10.1017/S1355617717001321

PMID

29307322

Abstract

OBJECTIVES: This study investigated the relationship between on-field, objective signs immediately following sport-related concussion and self-reported symptom endorsement within 1 day post injury.

METHODS: A retrospective case series of 237 concussed high school athletes was performed. On-field signs were evaluated immediately post injury. Self-reported symptoms (2 clusters) were collected within 1 day post injury. A two-step structural equation model and follow-up bivariate regression analyses of significant on-field signs and symptom clusters were performed.

RESULTS: Signs of immediate memory, β=0.20, p=.04, and postural instability, β=0.19, p <.01, significantly predicted a greater likelihood of endorsing the cognitive-migraine-fatigue symptom cluster within 1 day post injury. Regarding signs correlated with specific symptoms, immediate memory was associated with symptoms of trouble remembering, χ 2 =37.92, p <.001, odds ratio (OR)=3.89 (95% confidence interval (CI) [2.47, 6.13]), and concentration difficulties, χ 2 =10.84, p=.001, OR=2.13 (95% CI [1.37, 3.30]). Postural instability was associated with symptom endorsement of trouble remembering, χ 2 =12.08, p <.001, OR=1.76 (95% CI [1.29, 2.40]).

CONCLUSIONS: Certain post-concussion on-field signs exhibited after injury were associated with specific symptom endorsement within 1 day post injury. Based on these associations, individualized education-based interventions and academic accommodations may help reduce unanticipated worry from parents, students, and teachers following a student-athlete's sport-related concussion, especially in cases of delayed onset symptoms. (JINS, 2018, 23, 1-10).

Language: en

Keywords

Head injuries; Mild traumatic brain injury; Sport-related concussion; Sports medicine; Structural equation modeling; Symptoms; Trauma