Rehabilitation of Persistent Neurocognitive Deficits Following Sports-Related Concussion in an Amateur Football Athlete: Case Study

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S25.2-S25
Author(s):  
Shaun Kornfeld ◽  
Emily Kalambaheti ◽  
Matthew Michael Antonucci
Keyword(s):  
Reaction Time ◽  
Choice Reaction Time ◽  
Simple Reaction Time ◽  
American Football ◽  
Whole Body ◽  
Meaningful Improvement ◽  
Contact Sports ◽  
Simple Reaction ◽  
Functional Neurology

ObjectiveDemonstrate neurocognitive improvements in an inactive, amateur football athlete following a functional neurology approach to multimodal neurorehabilitation.BackgroundAmerican Football has been reported to have one of the highest incidences of concussion in all contact sports. Given the high rate of concussive blows during play, the investigation of treatment modalities is warranted. This case study presents a 23-year-old male amateur football player who has sustained 3 diagnosed concussions with additional suspected concussions throughout his time participating in football. In addition, his symptoms persisted years after ceasing participation in all contact sports.Design/MethodsThe athlete was prescribed 10 treatment sessions over 5 consecutive days at an outpatient neurorehabilitation center specializing in functional neurology. The C3Logix neurocognitive assessment and Graded Symptom Checklist were utilized on intake and discharge. Multimodal treatment interventions included transcranial photobiomodulation, non-invasive neuromodulation of the lingual branch of the trigeminal nerve, neuromuscular reeducation of the limbs bilaterally, hand-eye coordination training, vestibular rehabilitation utilizing a three-axis whole-body off-axis rotational device, and cognitive training.ResultsOn intake, composite symptom score was reported as 10/162, Trails Making Test Part A was 20.8 seconds, Part B was 41.9 seconds, Digit Symbol Matching score was 53, Simple Reaction Time was 277 milliseconds, and Choice Reaction Time was 412 milliseconds. On discharge, the patient experienced a 70% in self-reported symptoms, Trails A improved to 14.8 seconds (+29%), Trails B improved to 30.3 seconds (+28%), Simple Reaction Time was 248 milliseconds (10% faster), and Choice Reaction Time was 340 milliseconds (17% faster).ConclusionsThe present case study demonstrates a meaningful improvement in symptoms and neurocognitive performance of a patient with multiple sports-related concussions. Therefore, the Press suggest further investigation into a functional neurology approach to multi-modal, intensive care to improve neurocognitive impairment in athletes that sustained concussions participating in footballs.

Postural Preparation to Making a Step: Is There a “Motor Program” for Postural Preparation?

2007 ◽  
Vol 23 (4) ◽  
pp. 261-274 ◽  
Author(s):  
Adriana M. Degani ◽  
Alessander Danna-Dos-Santos ◽  
Mark L. Latash
Keyword(s):  
Reaction Time ◽  
Simple Reaction Time ◽  
Center Of Pressure ◽  
Motor Program ◽  
Whole Body ◽  
Single Motor ◽  
Simple Reaction ◽  
Specific Manner ◽  
Young Subjects ◽  
Straight Ahead

We tested the hypothesis that a sequence of mechanical events occurs preceding a step that scales in time and magnitude as a whole in a task-specific manner, and is a reflection of a “motor program.” Young subjects made a step under three speed instructions and four tasks: stepping straight ahead, down a stair, up a stair, and over an obstacle. Larger center-of-pressure (COP) and force adjustments in the anteriorposterior direction and smaller COP and force adjustments in the mediolateral direction were seen during stepping forward and down a stair, as compared with the tasks of stepping up a stair and over an obstacle. These differences were accentuated during stepping under the simple reaction time instruction. These results speak against the hypothesis of a single motor program that would underlie postural preparation to stepping. They are more compatible with the reference configuration hypothesis of whole-body actions.

Study of Neuromotor Reaction Times under the Influence of Thyrotropin-Releasing Hormone

1987 ◽  
Vol 65 (2) ◽  
pp. 627-636 ◽  
Author(s):  
Dan Repperger ◽  
Tom Jennings ◽  
James Jacobson ◽  
Norman Michel ◽  
Chuck Goodyear ◽  
...  
Keyword(s):  
Reaction Time ◽  
Choice Reaction Time ◽  
Simple Reaction Time ◽  
Reaction Times ◽  
Thyrotropin Releasing Hormone ◽  
Double Blind Study ◽  
Experimental Conditions ◽  
Releasing Hormone ◽  
Simple Reaction ◽  
Decision Choice

Neuromotor reaction times (simple, choice, and decision) were measured when Thyrotropin-releasing hormone (TRH) was administered intravenously to nine healthy men in a double-blind study. Measurements were made of simple reaction time, choice reaction time, and decision time for each subject at various intervals over a 54-hr. period. Given the observed inherent interaction of the drug with the long time used (54 hr.), most analyses were conducted across separate time epochs. Injected subjects showed inhibition in the normal improvement of simple reaction time (which occurs with practice), and they reduced the time required to make a decision. Choice reaction time, however, remained unchanged across the drug-nondrug experimental conditions.

Is simple reaction time or choice reaction time an indicator of all-cause mortality or CVD mortality?

Public Health ◽  
2021 ◽  
Vol 199 ◽  
pp. 34-41
Author(s):  
T. Zou ◽  
S. Cao ◽  
W. Liu ◽  
L. Li ◽  
J. Jiang ◽  
...  
Keyword(s):  
Reaction Time ◽  
Choice Reaction Time ◽  
Simple Reaction Time ◽  
Simple Reaction ◽  
All Cause Mortality ◽  
Cvd Mortality

A Protocol for the Quantification of Simple Reaction Time: A Case Study

2019 ◽  
pp. 721-725
Author(s):  
Amanda Rabelo ◽  
Gabriel Jablonski ◽  
Luiza Maire ◽  
Samila Costa ◽  
Thaila Zaruz ◽  
...  
Keyword(s):  
Reaction Time ◽  
Simple Reaction Time ◽  
Simple Reaction

Decisions concerning the Rejected Channel

1966 ◽  
Vol 18 (3) ◽  
pp. 260-265 ◽  
Author(s):  
Everdina A. Lawson
Keyword(s):  
Reaction Time ◽  
Choice Reaction Time ◽  
Simple Reaction Time ◽  
Reaction Times ◽  
False Positives ◽  
Auditory Stimuli ◽  
Simple Reaction ◽  
The Third ◽  
Verbal Messages

It was thought that the physical aspects of auditory stimuli were possibly transmitted via separate pathways from those transmitting the verbal aspects. Three experiments were designed to test this hypothesis. In these experiments subjects had to perform a shadowing task and had to respond simultaneously on response keys to pips superimposed in either ear on verbal messages. The response to these pips was of increasing complexity, in that it was a simple reaction time which was measured in the first experiment, a choice reaction time in the second experiment and a more complex choice reaction time in the third experiment. Subjects were able to perform these tests although the increasing difficulty was reflected in longer reaction times and more errors. The reaction times to the pips presented to the ear which was not being shadowed were slower, and the errors, made to pips in both channels, were “false positives” rather than errors of omission. These results were taken as favouring the hypothesis.

Do Difficulties in Stimulus Discrimination Affect Luminance Processing?

Perception ◽  
1996 ◽  
Vol 25 (1_suppl) ◽  
pp. 124-124
Author(s):  
D Pins ◽  
M Treisman ◽  
R Johnston
Keyword(s):  
Reaction Time ◽  
Choice Reaction Time ◽  
Simple Reaction Time ◽  
Discrimination Task ◽  
Hyperbolic Function ◽  
Specific Time ◽  
Stimulus Discrimination ◽  
Simple Reaction ◽  
The Subject ◽  
Time Required

Simple reaction time is known to decay as a hyperbolic function of luminance (Piéron's function). An identical relationship has also been demonstrated recently (Pins and Bonnet, 1996 Perception & Psychophysics in press) with different choice-reaction-time tasks. Although mean choice reaction time increased with the complexity of the task, the exponents of the functions relating reaction time (RT) to luminance were found to be equal in each experiment. These results suggest that the task specific time required by the different tasks only adds to the time necessary for luminance processing. In these experiments, the different stimuli presented were easily discriminable. In the present study, we examined the effect of variation in luminance on a more difficult discrimination task involving variation in orientation. Five different luminance levels covering the entire mesopic range were used. In two conditions, tilted lines at nine different angles were used, at a spacing of 2°. In the first condition, the orientations were chosen on both sides of the vertical (the subject responded “left” or “right”); in the second condition, the orientations were on both sides of a line oriented at −40° to the vertical (the subject responded “high” or “low”). The results were compared to those of a second experiment in which only two easily discriminable orientations were used. The results show that RT is greater in the experiments in which nine orientations are used, while the effect of intensity on RT is lower. This effect does not depend on orientation.

A-171 An Evaluation of Remotely Administered Reaction Time Subtests

2021 ◽  
Vol 36 (6) ◽  
pp. 1226-1226
Author(s):  
Christina Nunez ◽  
Bailey McDonald ◽  
Samantha Spagna ◽  
Charles Golden
Keyword(s):  
Reaction Time ◽  
Choice Reaction Time ◽  
Simple Reaction Time ◽  
Medium Effect ◽  
Future Research ◽  
Neuropsychological Measures ◽  
Simple Reaction ◽  
Significant Difference ◽  
Medium Effect Size ◽  
Different Response

Abstract Objective Due to the COVID-19 pandemic, many services attempted to quickly transition to a remote format. A need to incorporate and evaluate a remote delivery of neuropsychological measures arose. TestMyBrain (TMB) from the Many Brains Project has been utilizing teleneuropsychology in research since 2017. Method Volunteer research participants (N = 176, Mage = 29, Medu = 15 years, 64.7% white, 54.2% female, 83.2% right-handed) were administered TMB Simple Reaction Time and Choice Reaction Time subtest as part of a larger battery via zoom. Participants were able to choose between completing these measures using a keyboard, mouse, or a touch screen. There were no significant differences among demographic variables across the different completion methods. Results An ANCOVA indicated there was not a significant difference in simple reaction time across the different response F(2,168) = 0.482, p = 0.618, ηp2 = 0.006. There was however a significant difference in choice reaction time across the different response methods F(2,168) = 11.486, p < 0.001, ηp2 = 0.120. Conclusion Results suggest different response methods maybe suitable for simpler tasks, yet there lacks consistency in response methods for more complex tasks. This medium effect size may have occurred as a result of the lack of sensitivity for devices to detect taps on different portions of the screen as effectively as various keys on a keyboard. Administrators must be aware of the limitations response methods may introduce into results. Limitation to this analysis include limited samples and not controlling for other factors that may potentially influence reaction time such as internet connection. Future research should focus on creating a standardized method for teleneuropsychology administration.

Rehabilitation of Persistent Post-Concussion Symptoms in Retired and Active NHL Players: Clinical Case Series

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S23.3-S24
Author(s):  
Matthew Michael Antonucci ◽  
Emily Kalambaheti ◽  
Derek Barton ◽  
Shaun Kornfeld ◽  
Kenneth Jay
Keyword(s):  
Reaction Time ◽  
Choice Reaction Time ◽  
Case Series ◽  
Effect Sizes ◽  
Return To Play ◽  
Whole Body ◽  
Symptom Duration ◽  
Digit Symbol ◽  
Persistent Symptoms ◽  
Functional Neurology

ObjectiveTo present the evaluation of 12 rehabilitation cases as a case series in sports-related concussion.BackgroundSport-related concussion is a common injury in the NHL. While most athletes recover within few weeks of sustaining a mild head injury, some still experience persistent symptoms for months or years after following recommended recovery and return to play guidelines.Design/MethodsTwelve male NHL athletes (6/6 active/retired; mean age/height/weight/symptom duration/#concussions [SD]: 33.4 years [7.9]: 185.8 cm [5.1]: 94.8 kg [14.6]; 121 wks: [156]; 4.3 [2.3]) with persistent but mild post-concussion symptoms were treated for 10 sessions at an outpatient neurorehabilitation center specializing in functional neurology. The athletes were evaluated before- and after treatment utilizing the C3 Logix platform. The interventions included joint manipulation, neuromuscular re-education, vestibular rehabilitation in a whole-body off-axis rotational device, orthoptic exercises, and cognitive training. Graded Symptoms Checklist (0–162), Digit-Symbol Coding, Simple- and Choice Reaction Time, and Trail Making Test A/B were analyzed in Graphpad PRISM. 9.1.0 by multiple paired t-tests with Holm-Šídák corrections. Results are reported as differences-of-means pre- to post-treatment (SE) with Cohen's d effect sizes [ES] (0.2, 0.5, 0.8 represents small, medium, and large effect sizes, respectively). p-values <0.05 were considered significant.ResultsGraded Symptom Checklist score (p < 0.001): −25.1 (4.0) [1.83]; Digit-Symbol Matching speed (#symbols) (p = 0.03): 6.2 (1.9) [0.92]; Simple reaction time (ms) (p = 0.03): −74.7 (22.9) [0.94]; Choice reaction time (ms) (p = 0.009): −106.1 (26.0) [1.18]; Trails A (s) (p = 0.04) [0.80]: −2.6 (0.9); and Trails B (s) (p = 0.04): −6.0 (2.2) [0.79].ConclusionsThe present case series shows that a functional neurology approach of multimodal short duration intensive therapies can produce clinically meaningful improvements with large and very large effect sizes, in both the concussion symptoms and neurocognitive performance, of 12 professional NHL players experiencing symptom stagnation.

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