Citation

Leddy J, Lesh K, Haider MN, Czuczman N, Baker JG, Miecznikowski J, Willer B. Clin. J. Sport. Med. 2018; ePub(ePub): ePub.

Affiliation

Psychiatry, SUNY at Buffalo, Buffalo, New York.

Copyright

(Copyright © 2018, Canadian Academy of Sport Medicine, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/JSM.0000000000000686

PMID

30418219

Abstract

OBJECTIVE: To describe the derivation of a brief but pertinent physical examination (PE) for adolescents who have sustained sport-related concussion (SRC).

DESIGN: Prospective cohort. SETTING: University concussion management clinic. PARTICIPANTS: Acutely concussed (AC, n = 52, 15.5 ± 1.4 years, 4.4 ± 2 days since injury, 26.2 ± 38 days to recovery, 71% males) and healthy control (HC) adolescents (n = 30, 15.8 ± 1.4 years, 73% males). INTERVENTION: Acutely concussed had a PE on visit 1 and were retested at visit 2 (13.6 ± 1 day after visit 1). Acutely concussed were further characterized as normal recovery (NR, n = 41, 15.5 ± 1.5 years, recovery time 13.0 ± 7 days) and delayed recovery (DR, n = 11, 15.5 ± 1.2 years, recovery time 75.4 ± 63 days). MAIN OUTCOME MEASURE: Physical examination findings, including cervical, vestibular, and oculomotor systems.

RESULTS: Visit 1 abnormal PE signs were significantly greater in AC versus HC (2.79 ± 2.13 vs 0.07 ± 0.37, P < 0.0001) but not in NR versus DR (2.61 ± 2.2 vs 3.45 ± 1.8, P = 0.246). Visit 2 abnormal PE signs differentiated NR versus DR (0.17 ± 0.7 vs 2.45 ± 2.1, P < 0.0001).

CONCLUSIONS: A brief focused PE can help to diagnose SRC, establish recovery, and may have prognostic value.

Language: en