Citation

Reyes J, Mitra B, Makdissi M, Clifton P, Nguyen JVK, Harcourt P, Horward TS, Cameron P, Rosenfeld JV, Major BP, Willmott C. J. Neurotrauma 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2020.7425

PMID

unavailable

Abstract

Video surveillance and detection of players with observable signs of concussion by experienced medical staff facilitates rapid on-field screening of suspected concussion in professional sports. This method, however has not been validated in community sports where video footage is unavailable. This study aimed to explore the utility of observable signs of concussion to identify players with decrements in performance on concussion screening measures. In this observational prospective cohort study, personnel with basic training observed live matches across a season (60 matches) of community male and female Australian football for signs of concussion outlined in the community-based Head Injury Assessment form (HIAf). Players identified to have positive signs of concussion (CoSign+) following an impact were compared to players without signs (CoSign-). Outcome measures, the Sport Concussion Assessment Tool (SCAT3) and Cogstate, were administered at baseline and post-match. CoSign+ (n = 22) and CoSign- (n = 61) groups were similar with respect to age, sex, education, baseline mood, and medical history. CoSign+ players exhibited worse orientation, concentration, recall, and slower reaction time in attention and working memory tasks. Comparing individual change from baseline to post-match assessment revealed 100% (95% CI: 84%- 100%) of CoSign+ players demonstrated clinically-significant deficits on SCAT3 or Cogstate tasks, compared to 59% (95% CI: 46% to 71%) of CoSign- players. All CoSign+ players observed to have a blank/vacant look demonstrated clinically-significant decline on the Standardized Assessment of Concussion (SAC). Detection of observable signs of concussion represents a rapid, real-time method to screen players suspected of concussion in community sports where video technology and medical personnel are rarely present. Consistent with community guidelines, it is recommended that all CoSign+ players are immediately removed from play for further concussion screening.

Language: en

Keywords

HEAD TRAUMA; TRAUMATIC BRAIN INJURY; COGNITIVE FUNCTION; ADULT BRAIN INJURY