Association Between Vestibular/Ocular Motor Screening (VOMS) and Concussion Recovery Time in Collegiate Participants

2019 ◽  
Vol 34 (5) ◽  
pp. 744-744
Author(s):  
K M Petit ◽  
M Anderson ◽  
A C Bretzin ◽  
C P Tomczyk ◽  
J L Savage ◽  
...  

Abstract Purpose To evaluate the relationship between Vestibular/Ocular Motor Screening (VOMS) change scores and total scores with recovery time after a concussion in collegiate participants. Methods Participants completed the VOMS within 72 hours of concussion diagnosis. The VOMS consists of smooth pursuits, horizontal saccades, vertical saccades, near-point convergence (NPC), horizontal vestibular ocular reflex (VOR), vertical VOR, and visual motions sensitivity (VMS). Prior to the VOMS, athletes rate pre-provocation symptoms for headache, dizziness, nausea and fogginess, and again after each VOMS component on a scale from 0 (none) to 10 (severe) to obtain a total provocation score for each component. Change scores were calculated by subtracting total pre-provocation symptoms from total provocation for each component. Recovery time was defined as the number of days from injury to physician clearance. A Spearman’s rank correlation assessed relationships between recovery time and VOMS outcomes. Results Seventy-six participants (47 male, 29 female; 18.6±2.2 years old) completed the VOMS and took 13.5±5.4 days to recover. Total provocation scores for each VOMS component were associated with recovery time (smooth pursuits r=.36, p<.001; horizontal saccades r=.40, p<.001; vertical saccades r=.40, p<.001; NPC r=.40, p<.001; horizontal VOR r=.38, p=.001; vertical VOR rs=.31, p=.01; VMS rs=.38, p=.001). Only horizontal saccades (r=.37, p=.001), vertical saccades (r=.30, p=.01), and NPC (r=.27, p=.02) change scores were associated with recovery time. Conclusion VOMS total symptom provocation and change scores for vertical saccades, horizontal saccades, and convergence may provide insight into concussion recovery length. Future research should assess the utility of VOMS change scores when evaluating for a concussion.

2019 ◽  
Vol 34 (5) ◽  
pp. 769-769
Author(s):  
N Sandel Sherry ◽  
N Ernst ◽  
J Doman ◽  
C Holland ◽  
H Bitzer ◽  
...  

Abstract Purpose The Vestibular/Ocular Motor Screening (VOMS) tool for concussion evaluates symptom provocation (in a fixed order) across the following neuromotor tasks: smooth pursuits (SP), saccades-horizontal (Sac-H), saccades-vertical (Sac-V), near point of convergence (NPC), vestibular-ocular reflex-horizontal (VOR-H), vestibular-ocular reflex-vertical (VOR-V), and visual motion sensitivity (VMS). The current study evaluates the incremental validity of each VOMS component in consecutive order. Methods Retrospective record review of 193 subjects (49% male) aged 10–22 years old diagnosed with concussion (sport and non-sport injuries) and demonstrated an abnormal VOMS (defined by symptom provocation >2 or NPC >5cm) at initial evaluation in a specialty concussion clinic. Hierarchical regression was performed with VOMS total score (range: 0-320) as the dependent variable and each VOMS component as predictors in seven consecutive steps. Results The model was significant (p<.001) at each step; the final model including all seven VOMS components in order (SP, Sac-H, Sac-V, NPC, VOR-H, VOR-V, and VMS) was significant, F(7,185)= 6.87, p<.001 and accounted for 20.6% of the variance in total VOMS score. The only significant predictors in the final model included: SP (p=.01), NPC (p=.04), and VOR-H (p=.04). Conclusion Provocation of symptoms on SP, NPC, and VOR-H are the best predictors of total VOMS score. NPC and VOR-H symptom provocation provide unique value to vestibular screening beyond symptom provocation on SP and after completion of all other VOMS components. This information may be clinically useful when vestibular screening must be expedited (e.g., highly symptomatic patient, sideline assessment).


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Bogerd ◽  
M Karami ◽  
S.J Raasveld ◽  
D.M Ouweneel ◽  
W.K Lagrand ◽  
...  

Abstract Background Cardiogenic shock (CS) patients are frequently supported by mechanical devices, such as the Impella. The use of these devices is associated with device-related complications, such as hemolysis and bleeding, which may necessitate blood transfusion. Blood transfusion has been associated with worse clinical outcome. Information on the occurrence and impact of blood transfusion in these patients is scarce. Purpose To assess the incidences of hemolysis, bleeding and red blood cell (RBC) transfusion in CS patients receiving Impella support, to identify patients at risk for RBC transfusion and to assess mortality in transfused and non-transfused patients. Methods We performed a single center retrospective cohort study between August 2006 and April 2019, collecting data on all patients supported by an Impella device (type 2.5, CP or 5.0) for more than 24 hours. Patient baseline characteristics, clinical course and outcomes were compared between patients transfused with RBCs and non-transfused patients. Multivariate logistic regression analysis was used to identify factors associated with RBC transfusion. Correlations between patient characteristics and the number of units of RBCs administered were tested using the Spearman's Rank correlation coefficient. Results We included 122 CS patients who received Impella support for longer than 24 hours. Seventy-eight percent was male and the median age was 60.0 years. Transfused patients had a longer support duration compared with non-transfused patients (respectively; 97 (52–173) hours versus 51 (39–76) hours, p&lt;0.001). Of all included patients, 68% received RBC transfusion. Transfused patients received a median of 1.5 (0.6–2.8) units of RBCs per day. The incidence of hemolysis was 10% in transfused patients and 11% in non-transfused patients (p=NS). Bleeding occurred in 61% of the transfused patients and 11% of the non-transfused patients (p&lt;0.001). Higher age, lower hemoglobin level prior to Impella implant and longer support duration increased the odds of receiving RBC transfusion. The 30-day mortality was similar in transfused and non-transfused patients, respectively 58% and 42% (p=NS) (Figure 1. Kaplan-Meier Curve showing 30-day mortality of transfused and non-transfused patients). Conclusion RBC transfusion was required in more than two-third of the CS patients who received Impella support for longer than 24 hours. Higher age, lower hemoglobin level prior to implant and longer support duration were independent risk factors for RBC transfusion. In contrast to previous studies, transfusion was not associated with 30-day mortality. Future research should focus on the effects of RBC transfusion on morbidity and mortality and investigate the optimal transfusion criteria and aims. Funding Acknowledgement Type of funding source: None


2020 ◽  
Vol 35 (5) ◽  
pp. 645-645
Author(s):  
A J Zynda ◽  
K M Petit ◽  
M Anderson ◽  
C P Tomczyk ◽  
T Covassin

Abstract Objective To determine the influence of nap frequency on daily symptom severity and recovery time following concussion in college students. Method A prospective study of college students within 72 hours of a diagnosed concussion was performed. Participants reported nap occurrence (yes/no) and daily concussion symptoms using the Post-Concussion Symptom Scale (PCSS) for six days. Participants were categorized into frequent (&gt;2 naps) and infrequent (&lt;3 naps) nap groups. Recovery time was defined as total days from injury to unrestricted medical clearance. A mixed between-within ANOVA evaluated changes in daily symptom severity between nap groups, while Spearman’s Rank Correlation assessed the relationship between the number of days napping and recovery time. Results Thirty-four participants (23 female, 11 male; age = 19.91 ± 1.38 years) were included, with 22 in the infrequent nap group and 12 in the frequent nap group. Average recovery time for the infrequent nap group was 13.85 days compared to 18.8 days in the frequent nap group. There was no significant group x time interaction for daily symptom severity (Wilks’ λ = 0.85, F(5,24) = 0.85, p = 0.53, η2 = 0.15). There was a significant main effect for time, with daily symptom severity improving following concussion (Wilks’ λ = 0.31, F(5,24) = 10.66, p &lt; 0.001, η2 = 0.69), but there was no significant group effect (F(1,28) = 0.79, p = 0.38, η2 = 0.03). Overall, the more naps taken, the longer the recovery time (Rs = 0.46, p = 0.01). Conclusions Findings from the present study suggest that frequent napping does not affect symptom severity following concussion. Further research is needed to elucidate the association between the number of naps and recovery time.


2021 ◽  
pp. 036354652110123
Author(s):  
Anthony P. Kontos ◽  
Shawn R. Eagle ◽  
Gregory Marchetti ◽  
Aaron Sinnott ◽  
Anne Mucha ◽  
...  

Background: Vestibular and ocular motor screening tools, such as the Vestibular/Ocular Motor Screening (VOMS), are recognized as important components of a multifaceted evaluation of sport-related concussion. Previous research has supported the predictive utility of the VOMS in identifying concussion, but researchers have yet to examine the predictive utility of the VOMS among collegiate athletes in the first few days after injury. Purpose: To determine the discriminative validity of individual VOMS item scores and an overall VOMS score for identifying collegiate athletes with an acute sport-related concussion (≤72 hours) from healthy controls matched by age, sex, and concussion history. Study Design: Case-control study; Level of evidence, 3. Methods: Participants (N = 570) aged 17 to 25 years were included from 8 institutions of the National Collegiate Athletic Association–Department of Defense CARE Consortium (Concussion Assessment, Research, and Education): 285 athletes who were concussed (per current consensus guidelines) and 285 healthy controls matched by age, sex, and concussion history. Participants completed the VOMS within 3 days of injury (concussion) or during preseason (ie, baseline; control). Symptoms are totaled for each VOMS item for an item score (maximum, 40) and totaled across items for an overall score (maximum, 280), and distance (centimeters) for near point of convergence (NPC) is averaged across 3 trials. Receiver operating characteristic analysis of the area under the curve (AUC) was performed on cutoff scores using Youden index ( J) for each VOMS item, overall VOMS score, and NPC distance average. A logistic regression was conducted to identify which VOMS scores identified concussed status. Results: A symptom score ≥1 on each VOMS item and horizontal vestibular/ocular reflex ≥2 significantly discriminated concussion from control (AUC, 0.89-0.90). NPC distance did not significantly identify concussion from control (AUC, 0.51). The VOMS overall score had the highest accuracy (AUC, 0.91) for identifying sport-related concussion from control. Among the individual items, vertical saccades ≥1 and horizontal vestibular/ocular reflex ≥2 best discriminated concussion from control. Conclusion: The findings indicate that individual VOMS items and overall VOMS scores are useful in identifying concussion in collegiate athletes within 3 days of injury. Clinicians can use the cutoffs from this study to help identify concussion in collegiate athletes.


2021 ◽  
Vol 11 (1) ◽  
pp. 1-8
Author(s):  
Ranti Taibat Adebiyi ◽  
Abdulkadir Shehu Rasheed

AbstractAccidents are common problems on construction sites globally. The occurrence of these accidents usually leads to loss of time and productivity of site personnel, payments for treatment of the injured and burial expenses for the dead. Previous studies identified poor communication of information on Health and Safety as one of the major causes of accidents on construction sites. This study examined and analyzed the strategies for communication. Mean and standard deviations were used to analyze the strategies. The opinions of supervisors and operatives were tested through an independent t-test and Spearman’s rank correlation. Findings revealed project briefings, operating procedures, and safety manuals as the most frequently used communication strategies. No significant differences exist between the two groups of respondents in their rankings. The correlation coefficient revealed a positive relationship. In other words, respondents concurred in their opinions regarding these communication strategies. This paper, therefore, recommends the adoption of significant strategies identified in this study. In addition, future research can be conducted in other countries in order to explore the research area globally.


Author(s):  
Fu-Ju Tsai ◽  
Cheng-Yu Chen ◽  
Gwo-Liang Yeh ◽  
Yih-Jin Hu ◽  
Chie-Chien Tseng ◽  
...  

Background: Nursing educators should train nursing students to pursue physical, psychological, spiritual, and social health promotion. The purpose of this study was to explore relationships between nursing students’ meaning of life, positive beliefs, and well-being. Methods: A cross-sectional correlational study with a quantitative approach was adopted. Purposive sampling was used. A total of 170 nursing students voluntarily participated in this study. A 56-item questionnaire was used to examine nursing students’ meaning of life (1-25 items), positive beliefs (1-11 items), and well-being (1-20 items). The content validity index (CVI) of the study questionnaire was established as 0.95 by seven expert scholars. The reliability values for the three parts of the measure were as follows: meaning of life, Cronbach’s α 0.96; positive beliefs, Cronbach’s α 0.93; and well-being, Cronbach’s α 0.95. Percentages, frequencies, means, SDs, Kruskal-Wallis one-way analysis of variance by rank, Spearman’s rank correlation, one-way analysis of variance, Spearman’s rho correlation, and regression analysis were used for the data analysis. Results: Nursing students had the following mean scores: meaning of life with 4.02 (SD 0.56); positive beliefs with 3.92 (SD 0.62); and well-being with 3.95 (SD 0.57). The results indicate that for all nursing students, meaning of life was positively correlated with positive beliefs, r=0.83 (P<.01); similarly, all nursing students had positive beliefs that were positively correlated with meaning of life, r=0.83 (P<.01). In the results of the study, the nursing students’ background, meaning of life and positive beliefs explained 63% of the variance in well-being (Adjusted R2 squared =0.63, F=33.41, P<.001). Conclusions: Nursing students’ sense of meaning of life and positive beliefs may impact their well-being. Therefore, nursing educators can promote meaning of life and positive beliefs to nursing students as a way to increase their well-being for physical, psychological, spiritual, and social health promotion.


2019 ◽  
Vol 23 (4) ◽  
pp. 465-470 ◽  
Author(s):  
Ryan N. Moran ◽  
Tracey Covassin ◽  
Jessica Wallace

OBJECTIVEMigraine history has recently been identified as a risk factor for concussion and recovery. The authors performed a cross-sectional study examining baseline outcome measures on newly developed and implemented concussion assessment tools in pediatrics. The purpose of this study was to examine the effects of premorbid, diagnosed migraine headaches as a risk factor on vestibular and oculomotor baseline assessment in pediatric athletes.METHODSPediatric athletes between the ages of 8 and 14 years with a diagnosed history of migraine headache (n = 28) and matched controls without a history of diagnosed migraine headache (n = 28) were administered a baseline concussion assessment battery, consisting of the Vestibular/Ocular Motor Screening (VOMS), near point of convergence (NPC), and the King-Devick (K-D) tests. Between-groups comparisons were performed for vestibular symptoms and provocation scores on the VOMS (smooth pursuit, saccades, convergence, vestibular/ocular reflex, visual motion sensitivity), NPC (average distance), and K-D (time).RESULTSIndividuals diagnosed with migraine headaches reported greater VOMS smooth pursuit scores (p = 0.02), convergence scores (p = 0.04), vestibular ocular reflex scores (p value range 0.002–0.04), and visual motion sensitivity scores (p = 0.009). Differences were also observed on K-D oculomotor performance with worse times in those diagnosed with migraine headache (p = 0.02). No differences were reported on NPC distance (p = 0.06) or headache symptom reporting (p = 0.07) prior to the VOMS assessment.CONCLUSIONSPediatric athletes diagnosed with migraine headaches reported higher baseline symptom provocation scores on the VOMS. Athletes with migraine headaches also performed worse on the K-D test, further illustrating the influence of premorbid migraine headaches as a risk factor for elevated concussion assessment outcomes at baseline. Special consideration may be warranted for post-concussion assessment in athletes with migraine headaches.


Author(s):  
Mateusz Iwo Dubaniowski ◽  
Hans Rudolf Heinimann

A system-of-systems (SoS) approach is often used for simulating disruptions to business and infrastructure system networks allowing for integration of several models into one simulation. However, the integration is frequently challenging as each system is designed individually with different characteristics, such as time granularity. Understanding the impact of time granularity on propagation of disruptions between businesses and infrastructure systems and finding the appropriate granularity for the SoS simulation remain as major challenges. To tackle these, we explore how time granularity, recovery time, and disruption size affect the propagation of disruptions between constituent systems of an SoS simulation. To address this issue, we developed a high level architecture (HLA) simulation of three networks and performed a series of simulation experiments. Our results revealed that time granularity and especially recovery time have huge impact on propagation of disruptions. Consequently, we developed a model for selecting an appropriate time granularity for an SoS simulation based on expected recovery time. Our simulation experiments show that time granularity should be less than 1.13 of expected recovery time. We identified some areas for future research centered around extending the experimental factors space.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Hui Jiang ◽  
Peian Lou ◽  
Xiaoluo Chen ◽  
Chenguang Wu ◽  
Shihe Shao

Abstract Background Type 2 diabetes mellitus (T2DM) is mainly affected by genetic and environmental factors; however, the correlation of long noncoding RNAs (lncRNAs) with T2DM remains largely unknown. Methods Microarray analysis was performed to identify the differentially expressed lncRNAs and messenger RNAs (mRNAs) in patients with T2DM and healthy controls, and the expression of two candidate lncRNAs (lnc-HIST1H2AG-6 and lnc-AIM1-3) were further validated using quantitative real-time polymerase chain reaction (qRT-PCR). Spearman’s rank correlation coefficient was used to measure the degree of association between the two candidate lncRNAs and differentially expressed mRNAs. Furthermore, the KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway and GO (Gene Ontology) enrichment analysis were used to reveal the biological functions of the two candidate lncRNAs. Additionally, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed. Results The microarray analysis revealed that there were 55 lncRNAs and 36 mRNAs differentially expressed in patients with T2DM compared with healthy controls. Notably, lnc-HIST1H2AG-6 was significantly upregulated and lnc-AIM1-3 was significantly downregulated in patients with T2DM, which was validated in a large-scale qRT-PCR examination (90 controls and 100 patients with T2DM). Spearman’s rank correlation coefficient revealed that both lncRNAs were correlated with 36 differentially expressed mRNAs. Furthermore, functional enrichment (KEGG and GO) analysis demonstrated that the two lncRNA-related mRNAs might be involved in multiple biological functions, including cell programmed death, negative regulation of insulin receptor signal, and starch and sucrose metabolism. Multivariate logistic regression analysis revealed that lnc-HIST1H2AG-6 and lnc-AIM1-3 were significantly correlated with T2DM (OR = 5.791 and 0.071, respectively, both P = 0.000). Furthermore, the ROC curve showed that the expression of lnc-HIST1H2AG-6 and lnc-AIM1-3 might be used to differentiate patients with T2DM from healthy controls (area under the ROC curve = 0.664 and 0.769, respectively). Conclusion The profiles of lncRNA and mRNA were significantly changed in patients with T2DM. The expression levels of lnc-HIST1H2AG-6 and lnc-AIM1-3 genes were significantly correlated with some features of T2DM, which may be used to distinguish patients with T2DM from healthy controls and may serve as potential novel biomarkers for diagnosis in the future.


Author(s):  
Rei Nakamichi ◽  
Toshiaki Taoka ◽  
Hisashi Kawai ◽  
Tadao Yoshida ◽  
Michihiko Sone ◽  
...  

Abstract Purpose To identify magnetic resonance cisternography (MRC) imaging findings related to Gadolinium-based contrast agent (GBCA) leakage into the subarachnoid space. Materials and methods The number of voxels of GBCA leakage (V-leak) on 3D-real inversion recovery images was measured in 56 patients scanned 4 h post-intravenous GBCA injection. Bridging veins (BVs) were identified on MRC. The numbers of BVs with surrounding cystic structures (BV-cyst), with arachnoid granulations protruding into the superior sagittal sinus (BV-AG-SSS) and the skull (BV-AG-skull), and including any of these factors (BV-incl) were recorded. Correlations between these variables and V-leak were examined based on the Spearman’s rank correlation coefficient. Receiver-operating characteristic (ROC) curves were generated to investigate the predictive performance of GBCA leakage. Results V-leak and the number of BV-incl were strongly correlated (r = 0.609, p < 0.0001). The numbers of BV-cyst and BV-AG-skull had weaker correlations with V-leak (r = 0.364, p = 0.006; r = 0.311, p = 0.020, respectively). The number of BV-AG-SSS was not correlated with V-leak. The ROC curve for contrast leakage exceeding 1000 voxels and the number of BV-incl had moderate accuracy, with an area under the curve of 0.871. Conclusion The number of BV-incl may be a predictor of GBCA leakage and a biomarker for waste drainage function without using GBCA.


Sign in / Sign up

Export Citation Format

Share Document