Motion Sickness Susceptibility and Baseline Vestibular and Ocular-Motor Performance in Adolescent Athletes

Context High school athletes with a history of motion sickness susceptibility exhibit higher baseline vestibular and ocular-motor scores than those without a history of motion sickness susceptibility. Objective To examine the effects of motion sickness susceptibility on baseline vestibular and ocular-motor functioning, neurocognitive performance, and symptom scores. Design Cross-sectional study. Setting Preseason concussion testing. Patients or Other Participants A convenience sample of high school athletes (N = 308, age = 15.13 ± 1.21 years) involved in a variety of sports. Main Outcome Measure(s) Vestibular/Ocular Motor Screening, computerized neurocognitive assessment, symptom scale, and Motion Sickness Susceptibility Questionnaire-Short Form (MSSQ-S). Results Participants were categorized into 3 groups based on a median split of the scores (eg, NONE, LOW, and HIGH). The LOW (n = 95) and HIGH (n = 92) groups (ie, MSSQ-S score > 0) were 2.64 times more likely (χ21,257 = 7.94, P = .01, 95% confidence interval = 1.32, 5.26) to have baseline Vestibular/Ocular Motor Screening scores larger than the clinical cutoffs for the NONE group (n = 70). No between-groups main effects were present for the NONE (n = 52), LOW (n = 89), and HIGH (n = 90) MSSQ-S groups for verbal (F2,230 = .09, P = .91, η2 = .001) and visual (F2,230 = .15, P = .86, η2 = .001) memory, processing speed (F2,230 = .78, P = .46, η2 = .007), or reaction time (F2,230 = 2.21, P = .11, η2 = .002). The HIGH group exhibited higher total baseline symptom scores than the LOW (U = 3325.50, z = −1.99, P = .05, r = .15) and NONE (U = 1647.50, z = −2.83, P = .005, r = .24) groups. Conclusions Motion sickness should be considered a preexisting risk factor that might influence specific domains of the baseline concussion assessment and postinjury management.

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Self-Reported History of Seizure, Baseline Neurocognitive Performance, and Symptoms Reported in High School Athletes

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz026.47 ◽

2019 ◽

Vol 34 (5) ◽

pp. 777-777

Author(s):

A Datoc ◽

L Lashley

Keyword(s):

High School ◽

Visual Memory ◽

Cognitive Testing ◽

Group Differences ◽

Motor Speed ◽

Neurocognitive Performance ◽

High School Athletes ◽

History Of ◽

Visual Motor ◽

Literature Highlight

Abstract Purpose To examine whether a self-reported history of seizure is associated with differences in baseline neurocognitive performance and total reported symptoms. Methods Data was derived from a de-identified Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) database of high school athletes in Florida. After inclusion and exclusion criteria were applied, athletes were separated into groups dependent on self-reported history of seizure. 260 athletes (Mage=15.49, SD=1.26; 57.1% male) reported a history of seizure, and 260 athletes were randomly selected from those with no such history (Mage=15.64, SD=1.22; 61.1% male). Results ANOVA (alpha=.05) revealed significant differences between groups on the visual memory composite (F[1,559]=4.915, p=.027) and total symptom score (F[1,559]=28.596, p<.001) at baseline. Athletes with a self-reported history of seizure performed significantly worse than athletes without on visual memory and reported significantly higher total symptom scores. No significant between-group differences were found on the other composites of ImPACT. Conclusion The association between seizure history and decreased neurocognitive performance has been documented in the neuropsychological literature, and may be explained by differences at a microstructural level such as differences in white matter integrity (Yassine et al., 2018). While these microstructural differences have implications on cognitive functioning and symptomatology, the present study surprisingly found comparable scores between athletes with a history of seizure and those without. Previous researchers published similar findings; however, differences were observed on the visual-motor speed composite of ImPACT (Zalneraitis et al., 2017). The inconsistencies and small effect sizes in the present literature highlight the need for investigators to determine the clinical significance of these results in concussion evaluations.

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One-Year Test-Retest Reliability of the Online Version of ImPACT in High School Athletes

The American Journal of Sports Medicine ◽

10.1177/0363546511417173 ◽

2011 ◽

Vol 39 (11) ◽

pp. 2319-2324 ◽

Cited By ~ 118

Author(s):

R.J. Elbin ◽

Philip Schatz ◽

Tracey Covassin

Keyword(s):

High School ◽

Verbal Memory ◽

Visual Memory ◽

Online Version ◽

Neurocognitive Performance ◽

High School Athletes ◽

Stable Measure ◽

Motor Processing ◽

Test Retest Reliability ◽

The Impact

Background: The ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) neurocognitive testing battery is a popular assessment tool used for concussion management. The stability of the baseline neurocognitive assessment is important for accurate comparisons between postconcussion and baseline neurocognitive performance. Psychometric properties of the recently released online version of ImPACT have yet to be established; therefore, research evaluating the reliability of this measure is warranted. Purpose: The authors investigated the 1-year test-retest reliability of the ImPACT online version in a sample of high school athletes. Study Design: Case series; Level of evidence, 4 Methods: A total of 369 varsity high school athletes completed 2 mandatory preseason baseline cognitive assessments approximately 1 year apart as required by their respective athletics program. No diagnosed concussion occurred between assessments. Results: Intraclass correlation coefficients (ICCs) for ImPACT online indicated that motor processing speed (.85) was the most stable composite score, followed by reaction time (.76), visual memory (.70), and verbal memory (.62). Unbiased estimates of reliability were consistent with ICCs: motor processing speed (.85), reaction time (.76), visual memory (.71), and verbal memory (.62). Conclusion: The online ImPACT baseline is a stable measure of neurocognitive performance across a 1-year time period for high school athletes. These reliability data for online ImPACT are higher than the 2-year ICCs previously reported from the desktop version. Clinical Relevance: It is recommended that the ImPACT baseline assessment (both desktop and online) continue to be updated every 2 years. The online version of ImPACT appears to be a stable measure of neurocognitive performance over a 1-year period, and systematic evaluation of its stability over a 2-year period is warranted.

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Association of Competition Volume, Club Sports, and Sport Specialization With Sex and Lower Extremity Injury History in High School Athletes

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738117714160 ◽

2017 ◽

Vol 9 (6) ◽

pp. 518-523 ◽

Cited By ~ 49

Author(s):

Eric G. Post ◽

David R. Bell ◽

Stephanie M. Trigsted ◽

Adam Y. Pfaller ◽

Scott J. Hetzel ◽

...

Keyword(s):

High School ◽

Lower Extremity ◽

Sport Participation ◽

Lower Extremity Injury ◽

Extremity Injury ◽

High School Athletes ◽

Level Of Evidence ◽

Increased Risk ◽

History Of ◽

Club Sport

Background: High school athletes are increasingly encouraged to participate in 1 sport year-round to increase their sport skills. However, no study has examined the association of competition volume, club sport participation, and sport specialization with sex and lower extremity injury (LEI) in a large sample of high school athletes. Hypothesis: Increased competition volume, participating on a club team outside of school sports, and high levels of specialization will all be associated with a history of LEI. Girls will be more likely to engage in higher competition volume, participate on a club team, and be classified as highly specialized. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: High school athletes completed a questionnaire prior to the start of their competitive season regarding their sport participation and previous injury history. Multivariable logistic regression analyses were used to investigate associations of competition volume, club sport participation, and sport specialization with history of LEI, adjusting for sex. Results: A cohort of 1544 high school athletes (780 girls; grades 9-12) from 29 high schools completed the questionnaire. Girls were more likely to participate at high competition volume (23.2% vs 11.0%, χ2 = 84.7, P < 0.001), participate on a club team (61.2% vs 37.2%, χ2 = 88.3, P < 0.001), and be highly specialized (16.4% vs 10.4%, χ2 = 19.7, P < 0.001). Athletes with high competition volume, who participated in a club sport, or who were highly specialized had greater odds of reporting a previous LEI than those with low competition volume (odds ratio [OR], 2.08; 95% CI, 1.55-2.80; P < 0.001), no club sport participation (OR, 1.50; 95% CI, 1.20-1.88; P < 0.001), or low specialization (OR, 2.58; 95% CI, 1.88-3.54; P < 0.001), even after adjusting for sex. Conclusion: Participating in high sport volume, on a club team, or being highly specialized was associated with history of LEI. Girls were more likely to participate at high volumes, be active on club teams, or be highly specialized, potentially placing them at increased risk of injury. Clinical Relevance: Youth athletes, parents, and clinicians should be aware of the potential risks of intense, year-round participation in organized sports.

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The Natural History of Postconcussion Recovery Among High School Athletes

Journal of Head Trauma Rehabilitation ◽

10.1097/htr.0000000000000469 ◽

2019 ◽

Vol 34 (5) ◽

pp. E36-E44 ◽

Cited By ~ 1

Author(s):

Jeanne E. Dise-Lewis ◽

Jeri E. Forster ◽

Karen McAvoy ◽

Kelly A. Stearns-Yoder ◽

Nazanin H. Bahraini ◽

...

Keyword(s):

High School ◽

Natural History ◽

High School Athletes ◽

History Of

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Relationship between Postconcussion Headache and Neuropsychological Test Performance in High School Athletes

The American Journal of Sports Medicine ◽

10.1177/03635465030310020301 ◽

2003 ◽

Vol 31 (2) ◽

pp. 168-173 ◽

Cited By ~ 164

Author(s):

Michael W. Collins ◽

Melvin Field ◽

Mark R. Lovell ◽

Grant Iverson ◽

Karen M. Johnston ◽

...

Keyword(s):

High School ◽

Test Performance ◽

Neuropsychological Test ◽

Anterograde Amnesia ◽

Test Results ◽

High School Athletes ◽

Symptom Scale ◽

Neurocognitive Test ◽

Composite Scores ◽

Study Participants

Background: The relevance of headache to outcome after sports-related concussion is poorly understood. Hypotheses: High school athletes reporting headache approximately 1 week after injury will have significantly more other concussion symptoms and will perform more poorly on neuropsychological tests than athletes not experiencing headache. Study Design: Prospective cohort study. Methods: Study participants included 109 high school athletes who had sustained concussion and who were divided into two groups: those reporting headache 7 days after injury and those reporting no headaches. The two groups were compared regarding on-field markers of concussion severity at the time of injury and symptoms and neurocognitive test results collected via ImPACT, a computerized neuropsychological test battery and postconcussion symptom scale, at a mean of 6.8 days after injury. Results: Athletes reporting posttraumatic headache demonstrated significantly worse performance on reaction time and memory ImPACT neurocognitive composite scores. These athletes also reported significantly more symptoms other than headache and were more likely to have demonstrated on-field anterograde amnesia. Conclusions: Findings suggest that any degree of postconcussion headache in high school athletes 7 days after injury is likely associated with an incomplete recovery after concussion.

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PATIENT REPORT OUTCOME MEASURE USE FOR CONCUSSION AMONG HIGH SCHOOL ATHLETIC TRAINERS

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00240 ◽

2020 ◽

Vol 8 (4_suppl3) ◽

pp. 2325967120S0024

Author(s):

Tamara Valovich McLeod ◽

Nicholas Hattrup ◽

Hayley J. Root

Keyword(s):

High School ◽

Short Form ◽

Athletic Trainers ◽

Distribution Analysis ◽

Patient Report ◽

Patient Report Outcome ◽

Convenience Sample ◽

Patient Report Outcome Measure ◽

Patient Reported ◽

Concussion Treatment

Background: Recent recommendations suggest incorporating patient-report outcome measures (PROMs) into concussion assessment batteries. Utilizing PROMs provides information on the patient’s perspective and how the concussion may influence the patient’s health status. Past studies evaluating PROM use among athletic trainers (ATs) found varying practices and barriers to implementation. However, there is limited data on use of PROMs in managing concussion among adolescent patients. Hypothesis/Purpose: To describe the use of PROMs as part of concussion assessment and treatment practices of ATs working in middle and high school settings. Methods: An online survey regarding concussion treatment perceptions and practices was distributed to a convenience sample of 5000 ATs through the NATA Survey Research Program. The survey included personal and institutional demographics, healthcare provider access and referral practices, perceptions of concussion treatment, clinical practice characteristics of concussion treatment and PROM use. The survey was pilot tested and validated in a sample of ATs prior to distribution. Analysis of the PROM section was conducted using descriptive statistics (percentages, frequencies) for this study. Results: The survey was accessed by 304 ATs (6.1% access rate) and completed by 153 ATs (58.3% completion rate). Of those, 27.2% (n=57) were employed in the middle school or high school setting and were analyzed for this study. Just over half of respondents had <10 years of experience (52.7%, n=30). Only 35.1% (n=20) of ATs reported they use PROMs as part of their clinical management of concussion. Of those who use PROMs, 75% (n=15) indicated that they use them always or almost always. The most commonly used generic PROMs were the Short Form 12 or 36 (25%, n=5) and Patient Reported Outcomes Measurement Information System (25%, n=5) and the most common specific PROMs were the Headache Impact Test (45%, n=9) and Dizziness Handicap Inventory (15%, n=3). Figure 1 shows the level of self-reported confidence of those utilizing PROMs. Barriers for PROM use included it being too time consuming (24.6%, n=14/57), lacking a support structure (15.8%, n=9/57), and not familiar with PROMs (14%, n=8/57). Close to one-fourth (22.8%, n=13/57) of respondents would be willing to use PROMs, but lacked time. Conclusion: While the use of PROMs is recommended in the evaluation and treatment of adolescent athletes, just over one-third of ATs providing care to these patients, use PROMs. Educational efforts for ATs should look to increase their familiarity and confidence when using PROMs for concussion while suggesting strategies to incorporate PROMs into practice. [Figure: see text]

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