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Journal Article

Citation

Auerbach PS, Baine JG, Schott ML, Greenhaw A, Acharya MG, Smith WS. Clin. J. Sport. Med. 2014; 25(2): 126-132.

Affiliation

*Division of Emergency Medicine, Department of Surgery, Stanford University School of Medicine, Stanford, California; †Department of Orthopedic Surgery, Stanford University School of Medicine, Stanford, California; ‡Stanford-Kaiser Affiliated Residency in Emergency Medicine, Stanford University School of Medicine, Stanford, California; §Los Altos High School, Los Altos, California; and ¶Department of Neurology, School of Medicine, University of California, San Francisco, San Francisco, California.

Copyright

(Copyright © 2014, Canadian Academy of Sport Medicine, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/JSM.0000000000000117

PMID

25010149

Abstract

OBJECTIVE:: To determine whether skull motion produced by pulsatile cerebral blood flow, as measured by cranial accelerometry, is altered during concussion.

DESIGN:: In phase 1, to identify a specific pattern indicative of concussion, cranial accelerometry of subjects who sustained a concussion underwent analysis of waveforms, which was compared with accelerometry from subjects without a concussion (baseline). In phase 2, this concussion pattern was tested against prospectively acquired, blinded data. SETTING:: High school tackle football practice and game play. PARTICIPANTS:: Eighty-four football players. INTERVENTIONS:: Subjects had accelerometry measurements and concurrent 2-lead electrocardiograms. In players with a concussion, multiple sequential measurements were obtained. Sport Concussion Assessment Tool 2 was used to assist clinical determination of concussion. MAIN OUTCOME MEASURES:: Whether a characteristic waveform pattern of cranial accelerometry occurs in subjects with concussion.

RESULTS:: Phase 1 demonstrated a consistent pattern correlated to concussion. Phase 2 found this pattern in 10 of 13 subjects with concussion (76.9% sensitivity). Seventy-nine of 82 baseline plus nine postseason (total = 91) recordings from nonconcussed subjects did not show the concussion pattern (87% specificity).

CONCLUSIONS:: In subjects with concussion, we observed a unique pattern determined by cranial accelerometry. This may provide a method to noninvasively detect and longitudinally observe concussion. CLINICAL RELEVANCE:: There is no objective, real-time, noninvasive, and easily accessible measure for concussion. If accelerometry is validated, it could provide a critical diagnostic tool for sports medicine physicians.

Keywords: American football;


Language: en

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