Rehabilitation of Persistent Symptoms and Neurocognitive Deficits Following Sports-Related Concussion in a Professional Hockey Player: Case Study

ObjectiveTo demonstrate decreased post-concussive symptomatology and neurocognitive improvements in a professional hockey player following a multimodal, functional neurology approach to neurorehabilitation.BackgroundHockey is one of the top 3 sports in which concussions occur and has one of the top 10 highest participation numbers of sports in the northern hemisphere. The investigation of treatment modalities is warranted given the prevalence of hockey throughout society. This case study presents a 31-year-old male professional hockey athlete who had sustained 5 diagnosed concussions with additional suspected concussions throughout his career. His symptoms remained after independently receiving physical therapy and vestibular rehabilitation, causing an inability to continue playing hockey at a professional level.Design/MethodsThe patient was prescribed 10 treatment sessions over 5 contiguous days at an outpatient neurorehabilitation center specializing in functional neurology. The C3Logix neurocognitive assessment and graded symptom checklist were utilized at intake and discharge. Multimodal treatment interventions included transcranial photobiomodulation, non-invasive neuromodulation of the lingual branch of the trigeminal nerve, hand-eye coordination training, vestibular rehabilitation utilizing a three-axis whole-body off-axis rotational device, and cognitive training.ResultsOn intake, their composite symptom score was reported as 16/162, Trail Making Test Part B was 24.1 seconds, Simple Reaction Time was 274 milliseconds, and Choice Reaction Time was 496 milliseconds. On discharge, the patient experienced an 81% in self-reported symptoms, Trail Making Test Part B improved to 17 seconds (+29.46%), Simple Reaction Time was 252 milliseconds (8% faster), and Choice Reaction Time was 465 milliseconds (24% faster).ConclusionsThe present case study results demonstrated meaningful improvements in both self-rated concussion symptoms and neurocognitive performance for this patient. The Press suggest further investigation into functional neurology-based, multimodal, intensive approaches to decrease chronic post-concussion symptoms and improve neurocognitive performance in athletes that engage in hockey.

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

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.

Reaction Times among Batik Workers: The Influence of Gender and Occupational Lead Exposure

(1) Background: Neglected occupational health and safety aspects in batik industries cause their workers to have an increased risk of lead exposure. The effect of occupational lead exposure on neurocognitive performance is inconclusive. Therefore, we conducted an observational study to examine the difference in simple reaction time between lead-exposed batik workers and non-exposed referents. (2) Methods: This cross-sectional study was conducted in seven batik enterprises in Lendah District, Indonesia, excluding workers with medical conditions impairing reaction time. Simple reaction time tests were conducted using an online tool. Two-way model ANCOVAs examined interactions between gender and job types on the mean differences in reaction time. (3) Results: After controlling for age and body mass index, we observed longer reaction times among lead-exposed batik workers than non-exposed referents with an adjusted mean difference of 0.19 (95% CI: 0.016–0.368) seconds. A more prominent detrimental effect of lead exposure on reaction time among female workers than among male workers was observed. (4) Conclusions: Our results suggest that occupational lead exposure could contribute to longer reaction time, notably among female workers. Thus, occupational health and safety precautions are vital to protect batik workers and preserve their important contributions to cultural heritage.

Moderate intensity cycling combined with cognitive dual-task improves selective attention

Physical and cognitive exercises have positive long-term effects on cognitive capacities. However, acute effects still are controversial. Here we determine the acute effects of physical exercise combined with concurrent cognitive exercise on cognitive performance in young adults. Simple reaction time, selective attention, and memory were evaluated in 23 young men before and after 30 min of stationary cycling exercise, 30 min of stationary cycling exercise combined with cognitive exercise, and 30 min of rest. Exercise intensity was continuously controlled to ensure exercise at moderate intensity. We found that physical exercise combined with cognitive dual-task improves selective attention. Both exercise conditions showed similar effects on simple reaction time, and memory was not affected by the different exercise conditions. We conclude that the combination of cycling exercise at moderate intensity with a cognitive exercise acutely improves selective attention in young adults. These results can be of particular interest for interventions aiming at improving selective attention in sports and for older adults and individuals with difficulty to suppress and filter out task-irrelevant information, like when receiving instruction or learning a new task or concept.

A-171 An Evaluation of Remotely Administered Reaction Time Subtests

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.

CORRELATION BETWEEN SMARTPHONE SCREEN TIME AND REACTION TIME IN YOUNG ADULTS OF AGE 18-25 YEARS

Due to ever increasing use of smartphones and increase dependency on it, it has been a topic of great interest among researchers to find out how mobile phones have an effect on human anatomy and human brains but there haven't been several studies regarding the same. And as reaction time is one amongst the tool to measure cognitive function in human beings. This study included males and females of age 18-25years within BMI 18.5- 22.9kg/m2 and having two weekly average screen-time of more than 4 hours. These individuals were asked to perform Deary Liewald’s test for Simple and Choice reaction time. The included 54 participants (3 males and 51 females) and data collected did not pass normality, hence Spearman’s test was used to find the correlation. The correlation coefficient (r value) and p value for the correlation between smartphone screen time and Simple reaction time is 0.070 and 0.61 and for Choice reaction time is -0.048 and 0.729 respectively. The study shows no significant correlation between the parameters screen time and reaction time (simple and choice reaction time) since p>0.05.

Computerized Simple Reaction Time and Balance in Nondemented Parkinson’s Patients

<b><i>Background:</i></b> Parkinson’s disease (PD) patients are known to suffer from subtle cognitive and balance deficits from the early stages although they usually manifest in advanced stages. Postural instability (PI) has been correlated with slower information processing speed. Simple reaction time (SRT) tasks can be used to measure the speed of information processing. The main objective of this study was to examine the usefulness of SRT as a valid predictor of balance in PD, thus providing a simple and complementary assessment method. <b><i>Methods:</i></b> This cross-sectional study included 52 PD patients without dementia who were evaluated for balance using the pull test (PT) maneuver and Biodex® limits of stability (LOS). In addition, a reaction time task was used to measure processing speed. Correlation and linear regression analyses were performed. <b><i>Results:</i></b> The performance of SRT tasks was correlated with the evaluation of LOS% and PT, suggesting that the SRT may be a predictor of balance performance. Longer reaction time and poorer postural stability were also associated with disease duration but not with age. <b><i>Conclusions:</i></b> Poor performance in a simple reaction task can predict altered PI and can complement staging and evaluation in PD patients.