|
Citation
|
Barnes A, Smulligan K, Wingerson MJ, Little C, Lugade V, Wilson JC, Howell DR. J. Athl. Train. 2023; ePub(ePub): ePub. |
|
Abstract
|
CONTEXT: Reaction time (RT) is a critical element of return to participation (RTP), and impairments have been linked to subsequent injury following a concussion. Current RT assessments have limitations in clinical feasibility, and identification of subtle deficits after concussion symptom resolution.
OBJECTIVE: To examine the utility of RT measurements (clinical drop stick, simple stimulus-response, single-task Stroop, and dual-task Stroop) to differentiate between adolescents with concussion and uninjured control at initial assessment and RTP.
DESIGN: Prospective Cohort Study. SETTING: Pediatric sports medicine center associated with a regional tertiary care hospital. PATIENTS OR OTHER PARTICIPANTS: Twenty-seven adolescents with a concussion (mean age=14.8±2.1 years; 52% female; tested 7.0±3.3 days post-concussion) and twenty-one uninjured controls (mean age=15.5±1.6 years; 48% female). MAIN OUTCOME MEASURE(S): Participants completed the Post-Concussion Symptoms Inventory (PCSI) and battery of RT tests: clinical drop stick, simple stimulus-response, single-task Stroop, and dual-task Stroop.
RESULTS: The concussion group demonstrated significantly slower clinical drop stick (β=58.8; 95% CI= 29.2, 88.3, p<0.001) and dual-task Stroop RT (β=464.2; 95% CI= 318.4, 610.0, p<0.001) at the initial assessment than uninjured controls. At the one-month follow-up, the concussion group demonstrated significantly slower clinical drop stick (238.9±25.9 vs. 188.1±21.7 ms; p<0.001; d=2.10), single-task Stroop (1527.8±204.5 vs. 1319.8±133.5 ms; p=0.001; d=1.20), and dual-task Stroop (1549.9±264.7 vs. 1341.5±114.7; p=0.002; d=1.04) RT than controls, while symptom severity was similar between groups (7.4±11.2 vs. 5.3±6.5; p=0.44; d=0.24). Classification accuracy and AUC values were highest for the clinical drop stick (85.1% accuracy, AUC= 0.86, p<0.001) and dual-task Stroop RT (87.2% accuracy, AUC=0.92, p<0.002) measures at initial evaluation.
CONCLUSION: Adolescents recovering from concussion may have initial RT deficits which persist despite symptom recovery. Clinical drop stick and dual-task Stroop RT demonstrate high clinical utility given high classification accuracy, sensitivity, and specificity to detect post-concussion RT deficits, and may be considered for initial and RTP assessment.
Language: en |