Citation

Mang CS, Whitten TA, Cosh MS, Scott S, Wiley JP, Debert CT, Dukelow S, Benson BW. J. Neurotrauma 2019; 36(2): 308-321.

Affiliation

University of Calgary, Department of Family Medicine, Calgary, Alberta, Canada ; bbenson@csicalgary.ca.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2017.5587

PMID

30032700

Abstract

There is a need for better tools to objectively, reliably and precisely assess neurologic function after sport-related concussion (SRC). The purpose of this study was to use a robotic device (Kinesiological Instrument for Normal and Altered Reaching Movements, KINARM) to quantify neurologic impairments in athletes acutely and when clinically asymptomatic following SRC. Robotic assessments included five KINARM standard tasks that evaluate aspects of motor, sensory and cognitive function. We hypothesized that acutely concussed athletes would demonstrate significant rates of impairment on the robotic assessment, and that impairments would be associated with acute symptom severity. Pre-season assessments were conducted from 2011-2016 on 1,051 athletes. Eighty-four athletes were re-assessed acutely (≤10 days post-injury) and while symptomatic post-SRC and 89 when clinically asymptomatic. Forty-four parameters were measured from the KINARM assessment to characterize neurologic function. Reliable change indices (80% confidence interval) identified impairments in healthy and concussed individuals for each parameter. In concussed individuals, impairment rate varied across parameters from 4 to 27% at the acute time point and from 2 to 18% when clinically asymptomatic. Healthy athlete impairment rates were between 2 and 16% across all testing time points. We identified relationships between acute symptom severity and task performance for only two parameters, both of which evaluated attributes of motor function. Overall, the KINARM identified impairments in motor, sensory and cognitive function in athletes with SRC; however, impairment rates were low and largely did not relate to symptom severity. More complex tasks may be necessary to identify potentially subtle neurologic impairments post-SRC.

Language: en

Keywords

ASSESSMENT TOOLS; REHABILITATION; TRAUMATIC BRAIN INJURY