Physiological and Performance Measures for Baseline Concussion Assessment

in Journal of Sport Rehabilitation
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Context: Baseline testing is a common strategy for concussion assessment and management. Research continues to evaluate novel measures for potential to improve baseline testing methods. Objectives: The primary objective was to (1) determine the feasibility of including physiological, neuromuscular, and mood measures as part of baseline concussion testing protocol, (2) describe typical values in a varsity athlete sample, and (3) estimate the influence of concussion history on these baseline measures. Design: Prospective observational study. Setting: Ryerson University Athletic Therapy Clinic. Participants: One hundred varsity athletes. Main Outcome Measures: Frequency and domain measures of heart rate variability, blood pressure, grip strength, profile of mood states—short form, and the Sport Concussion Assessment Tool-2. Results: Physiological, neuromuscular performance, and mood measures were feasible at baseline. Participants with a history of 2 or more previous concussions displayed significantly higher diastolic blood pressure. Females reported higher total mood disturbance compared with males. Conclusions: Physiological and neuromuscular performance measures are safe and feasible as baseline concussion assessment outcomes. History of concussion may have an influence on diastolic blood pressure.

Dobney is with the Department of Rehabilitation Science, McGill University, Montreal, Quebec, Canada. Thomas and Taha are with the Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada. Keightley is with Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada; Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Ontario, Canada; and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.

Dobney (danielle.dobney@mail.mcgill.ca) is corresponding author.
  • 1.

    McCrory P, Meeuwisse WH, Aubry M, et al. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Br J Sports Med. 2013;47(5):250258. doi:10.1136/bjsports-2013-092313

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Boake C, McCauley SR, Levin HS, et al. Diagnostic criteria for postconcussional syndrome after mild to moderate traumatic brain injury. J Neuropsychiatry Clin Neurosci. 2005;17:350356. PubMed ID: 16179657 doi:10.1176/jnp.17.3.350

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Broglio SP, Puetz TW. The effect of sport concussion on neurocognitive function, self-report symptoms and postural control: a meta-analysis. Sports Med. 2008;38(1):5367. PubMed ID: 18081367 doi:10.2165/00007256-200838010-00005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Giza CC, Hovda DA. The new neurometabolic cascade of concussion. Neurosurgery. 2014;75:2433. doi:10.1227/NEU.0000000000000505

  • 5.

    McLeod TCV, Register-Mihalik JK. Clinical outcomes assessment for the management of sport-related concussion. J Sport Rehabil. 2011;20(1):4660. doi:10.1123/jsr.20.1.46

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Covassin T, Elbin R, Kontos A, Larson E. Investigating baseline neurocognitive performance between male and female athletes with a history of multiple concussion. J Neurol Neurosurg Psychiatry. 2010;81(6):597601. PubMed ID: 20522868 doi:10.1136/jnnp.2009.193797

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Zimmer A, Marcinak J, Hibyan S, Webbe F. Normative values of major SCAT2 and SCAT3 components for a college athlete population. Appl Neuropsychol Adult. 2015;22(2):132140. PubMed ID: 25117270 doi:10.1080/23279095.2013.867265

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    McLeod TCV, Bay RC, Lam KC, Chhabra A. Representative baseline values on the Sport Concussion Assessment Tool 2 (SCAT2) in adolescent athletes vary by gender, grade, and concussion history. Am J Sports Med. 2012;40(4):927933. doi:10.1177/0363546511431573

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Mayfield R, Bay RC, McLeod TCV. Postconcussion deficits measured by the Sport Concussion Assessment Tool 2 among interscholastic athletes. Athl Train Sports Health Care. 2013;5:265271. doi:10.3928/19425864-20131017-01

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Giza CC, Hovda DA. The neurometabolic cascade of concussion. J Athl Train. 2001;36(3):228. PubMed ID: 12937489

  • 11.

    Gall B, Parkhouse W, Goodman D. Heart rate variability of recently concussed athletes at rest and exercise. Med Sci Sports Exerc. 2004;36:12691274. PubMed ID: 15292731 doi:10.1249/01.MSS.0000135787.73757.4D

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Gall B, Parkhouse W, Goodman D. Exercise following a sport induced concussion. Br J Sports Med. 2004;38(6):773777. PubMed ID: 15562179 doi:10.1136/bjsm.2003.009530

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Leddy JJ, Kozlowski K, Donnelly JP, Pendergast DR, Epstein LH, Willer B. A preliminary study of subsymptom threshold exercise training for refractory post-concussion syndrome. Clin J Sport Med. 2010;20(1):2127. PubMed ID: 20051730 doi:10.1097/JSM.0b013e3181c6c22c

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Shutter LA, Narayan RK. Blood pressure management in traumatic brain injury. Ann Emerg Med. 2008;51(3):S37S38. doi:10.1016/j.annemergmed.2007.11.013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Len T, Neary J. Cerebrovascular pathophysiology following mild traumatic brain injury. Clin Physiol Funct Imaging. 2011;31(2):8593. PubMed ID: 21078064 doi:10.1111/j.1475-097X.2010.00990.x

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Parker TM, Osternig LR, van Donkelaar P, Chou LS. Recovery of cognitive and dynamic motor function following concussion. Br J Sports Med. 2007;41(12):868873. PubMed ID: 17517857 doi:10.1136/bjsm.2006.033761

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Haaland KY, Temkin N, Randahl G, Dikmen S. Recovery of simple motor skills after head injury. J Clin Exp Neuropsychol. 1994;16(3):448456. PubMed ID: 7929712 doi:10.1080/01688639408402655

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    McCrory P, Meeuwisse W, Johnston K, et al. Consensus statement on concussion in sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. J Sports Med 2009;43(suppl 1):i76i84.

    • Search Google Scholar
    • Export Citation
  • 19.

    Mainwaring L, Bisschop S, Green R, et al. Emotional reaction of varsity athletes to sport-related concussion. J Sport Exerc Psychol. 2004;26(1):119135. doi:10.1123/jsep.26.1.119

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ. 2001;79(4):373.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Choe MC, Giza CC. Diagnosis and management of acute concussion. Semin Neurol. 2015;35(1):2941. PubMed ID: 25714865 doi:10.1055/s-0035-1544243

  • 22.

    Padwal RS, Hemmelgarn BR, Khan NA, et al. The 2009 Canadian Hypertension Education Program recommendations for the management of hypertension: part 1—blood pressure measurement, diagnosis and assessment of risk. Can J Cardiol. 2009;25(5):279286. PubMed ID: 19417858 doi:10.1016/S0828-282X(09)70491-X

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Niebuhr BR, Marion R, Fike ML. Reliability of grip strength assessment with the computerized Jamar dynamometer. OTJR Occup Particip Health. 1994;14(1):318. doi:10.1177/153944929401400101

    • Search Google Scholar
    • Export Citation
  • 24.

    Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg Am. 1984;9(2):222226. doi:10.1016/S0363-5023(84)80146-X

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Curran SL, Andrykowski MA, Studts JL. Short form of the profile of mood states (POMS-SF): psychometric information. Psychol Assess. 1995;7(1):8083. doi:10.1037/1040-3590.7.1.80

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Chan M, Vielleuse JV, Vokaty S, Wener MA, Pearson I, Gagnon I. Test-retest reliability of the Sport Concussion Assessment Tool 2 (SCAT2) for uninjured children and young adults. Br J Sports Med. 2013;47(5):e1. doi:10.1136/bjsports-2012-092101.18

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Academic Press; 2013.

  • 28.

    Hilz MJ, DeFina PA, Anders S, et al. Frequency analysis unveils cardiac autonomic dysfunction after mild traumatic brain injury. J Neurotrauma. 2011;28(9):17271738. PubMed ID: 21355816 doi:10.1089/neu.2010.1497

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    La Fountaine MF, Heffernan KS, Gossett JD, Bauman WA, De Meersman RE. Transient suppression of heart rate complexity in concussed athletes. Auton Neurosci. 2009;148(1):101103. doi:10.1016/j.autneu.2009.03.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Nunan D, Sandercock GR, Brodie DA. A quantitative systematic review of normal values for short-term heart rate variability in healthy adults. Pacing Clin Electrophysiol. 2010;33(11):14071417. PubMed ID: 20663071 doi:10.1111/j.1540-8159.2010.02841.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Žemva A, Rogel P. Gender differences in athlete’s heart: association with 24-h blood pressure. A study of pairs in sport dancing. Int J Cardiol. 2001;77(1):4954. PubMed ID: 11150625 doi:10.1016/S0167-5273(00)00417-4

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Hutchison M, Mainwaring LM, Comper P, Richards DW, Bisschop SM. Differential emotional responses of varsity athletes to concussion and musculoskeletal injuries. Clin J Sport Med. 2009;19(1):1319. PubMed ID: 19124978 doi:10.1097/JSM.0b013e318190ba06

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Boyle GJ. Sex differences in reported mood states. Pers Individ Diff. 1989;10(11):11791183. doi:10.1016/0191-8869(89)90083-4

  • 34.

    Widmaier EP, Raff H, Strang KT. Vander’s Human Physiology: The Mechanisms of Body Function. Boston, MA: McGraw-Hill Higher Education; 2011.

    • Search Google Scholar
    • Export Citation
  • 35.

    Wilkins K, Campbell N, Joffres MR, et al. Blood pressure in Canadian adults. Health Rep. 2010;21:3746. PubMed ID: 20426225

  • 36.

    McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players: implications for prevention. Clin J Sport Med. 2004;14(1):1317. PubMed ID: 14712161 doi:10.1097/00042752-200401000-00003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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