TY  - JOUR
PY  - 2023//
TI  - A multifaceted approach to interpreting reaction time deficits after adolescent concussion
JO  - Journal of athletic training
A1  - Barnes, Alice
A1  - Smulligan, Katherine
A1  - Wingerson, Mathew J.
A1  - Little, Casey
A1  - Lugade, Vipul
A1  - Wilson, Julie C.
A1  - Howell, David R.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - CONTEXT: Reaction time (RT) is a critical element of return to participation (RTP), and impairments have been linked to subsequent injury following a concussion. Current RT assessments have limitations in clinical feasibility, and identification of subtle deficits after concussion symptom resolution. <br><br>OBJECTIVE: To examine the utility of RT measurements (clinical drop stick, simple stimulus-response, single-task Stroop, and dual-task Stroop) to differentiate between adolescents with concussion and uninjured control at initial assessment and RTP. <br><br>DESIGN: Prospective Cohort Study. SETTING: Pediatric sports medicine center associated with a regional tertiary care hospital. PATIENTS OR OTHER PARTICIPANTS: Twenty-seven adolescents with a concussion (mean age=14.8±2.1 years; 52% female; tested 7.0±3.3 days post-concussion) and twenty-one uninjured controls (mean age=15.5±1.6 years; 48% female). MAIN OUTCOME MEASURE(S): Participants completed the Post-Concussion Symptoms Inventory (PCSI) and battery of RT tests: clinical drop stick, simple stimulus-response, single-task Stroop, and dual-task Stroop. <br><br>RESULTS: The concussion group demonstrated significantly slower clinical drop stick (β=58.8; 95% CI= 29.2, 88.3, p<0.001) and dual-task Stroop RT (β=464.2; 95% CI= 318.4, 610.0, p<0.001) at the initial assessment than uninjured controls. At the one-month follow-up, the concussion group demonstrated significantly slower clinical drop stick (238.9±25.9 vs. 188.1±21.7 ms; p<0.001; d=2.10), single-task Stroop (1527.8±204.5 vs. 1319.8±133.5 ms; p=0.001; d=1.20), and dual-task Stroop (1549.9±264.7 vs. 1341.5±114.7; p=0.002; d=1.04) RT than controls, while symptom severity was similar between groups (7.4±11.2 vs. 5.3±6.5; p=0.44; d=0.24). Classification accuracy and AUC values were highest for the clinical drop stick (85.1% accuracy, AUC= 0.86, p<0.001) and dual-task Stroop RT (87.2% accuracy, AUC=0.92, p<0.002) measures at initial evaluation. <br><br>CONCLUSION: Adolescents recovering from concussion may have initial RT deficits which persist despite symptom recovery. Clinical drop stick and dual-task Stroop RT demonstrate high clinical utility given high classification accuracy, sensitivity, and specificity to detect post-concussion RT deficits, and may be considered for initial and RTP assessment.<p />  <p>Language: en</p>
LA  - en
SN  - 1062-6050
UR  - http://dx.doi.org/10.4085/1062-6050-0566.22
ID  - ref1
ER  -