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Christopher P. Tomczyk, George Shaver and Tamerah N. Hunt

the concussion assessment, it does not address potential cognitive changes associated with concussion. 8 The concussion management protocol calls for comprehensive neuropsychological assessment, both at baseline and postinjury in order to detect potential cognitive deficiencies. Despite the link

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Megan Elizabeth Evelyn Mormile, Jody L. Langdon and Tamerah Nicole Hunt

graded symptom checklists, sideline balance testing, and multiple cognitive tests that determine a neuropsychological assessment battery. All position statements recommend the use of baseline neuropsychological testing for thorough concussion assessment, which attempts to quantify the preinjury status of

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Jennifer L. Etnier and Yu-Kai Chang

The purpose of the present commentary is to introduce relevant issues with respect to the measurement of executive function in physical activity studies. Suggested definitions of executive function are introduced, and executive function tasks that are commonly used in the neuropsychological literature are presented and briefly described. The extant literature on physical activity and cognition is discussed, and issues relative to the limitations of this body of literature are raised. In summary, research on the effect of physical activity on executive function is still in its infancy. We encourage researchers in this field to provide a clear definition of executive function, to carefully consider the relevance of published effect sizes to their own research questions, and to consider either providing a logical rationale for their selection of particular executive function measures or to use multiple measures of executive function when exploring relationships between physical activity and executive function.

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Zachary C. Merz, Joanne E. Perry and Michael J. Ross

to the neuropsychological assessment of mild traumatic brain injury (mTBI), henceforth referred to as concussion, and subsequent concerns with both PCS and cognitive decline later in life, several experiences dramatically influenced my consultation philosophy. Chiefly, my conceptualization

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Robert W. Motl, Eduard Gappmaier, Kathryn Nelson and Ralph H.B. Benedict

Cognitive impairment is prevalent, disabling, and poorly managed in persons with multiple sclerosis (MS). This cross-sectional study examined the associations among physical activity, cognitive processing speed, and learning and memory in 33 persons with MS who underwent neuropsychological assessments and wore a physical activity monitor for 7 days. Cognitive impairment was greatest in cognitive processing speed. Physical activity was significantly correlated with cognitive processing speed (pr = .35), but not learning and memory (pr = .20), after controlling for sex, age, and education. Researchers should examine exercise training and physical activity effects on cognitive performance, particularly processing speed, in MS.

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Michael Hutchison, Paul Comper, Lynda Mainwaring and Doug Richards

The baseline / postconcussion neuropsychological (NP) assessment model has been shown to be of clinical value and currently contributes significant information in sport concussion evaluation. Computerized NP batteries are now widely used in elite sport environments and are rapidly becoming more commonly utilized at the community level. With the growth of computerized NP testing, it is important to identify and understand unique characteristics with respect to baseline NP performance. The Automated Neuropsychological Assessment Metrics (ANAM) is a library of computerized NP tests designed to detect speed and accuracy of attention, memory, and thinking ability. This article describes baseline ANAM test scores in a sample of Canadian university athletes and explores the following two factors: (a) performance differences between male and female student-athletes using ANAM tests and (b) the relationship between self-reported history of concussion and baseline NP performance.

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Paul Comper, Michael Hutchison, Doug Richards and Lynda Mainwaring

Along with the ever growing awareness among the scientific community and the general public that concussion is a serious health care issue at all levels of sport, with potentially devastating long term health effects, the number of concussion surveillance clinical monitoring programs has significantly increased internationally over the past 10–15 years. An effective concussion program (a “best practice” model) is clinically prudent and evidence-based, one that is an interdisciplinary model involving health professionals who manage, educate, and provide psychosocial support to athletes. The integration of neuropsychological assessment is a component of many present day programs, and therefore, the neuropsychologist is an integral member of the concussion management team. The University of Toronto Concussion Program, operational since 1999, integrates best practices and current evidence into a working model of concussion management for university athletes. The model uses an interdisciplinary approach to monitor and assess athletes with concussions, as well as to educate its athletes, coaches, and administrators. A research component is also integral to the program.

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Luke M. Ross, Johna K. Register-Mihalik, Jason P. Mihalik, Karen L. McCulloch, William E. Prentice, Edgar W. Shields and Kevin M. Guskiewicz

Context:

Recent evidence has revealed deficiencies in the ability to divide attention after concussion.

Objective:

To examine the effects of a single vs a dual task on cognition and balance in healthy subjects and to examine reliability of 2 dual-task paradigms while examining the overall feasibility of the tasks.

Design:

Pretest–posttest experimental design.

Setting:

Sports medicine research laboratory.

Patients:

30 healthy, recreationally active college students.

Intervention:

Subjects performed balance and cognitive tasks under the single- and dual-task conditions during 2 test sessions 14 d apart.

Main Outcome Measures:

The procedural reaction-time (PRT) test of the Automated Neuropsychological Assessment Metrics (eyes-closed tasks) and an adapted Procedural Auditory Task (PAT; eyes-open tasks) were used to assess cognition. The NeuroCom Sensory Organization Test (SOT) and the Balance Error Scoring System (BESS) were used to assess balance performance. Five 2-way, within-subject ANOVAs and a paired-samples t test were used to analyze the data. ICCs were used to assess reliability across 2 test sessions.

Results:

On the SOT, performance significantly improved between test sessions (F 1,29 = 35.695, P < .001) and from the single to the dual task (F 1,29 = 9.604, P = .004). On the PRT, performance significantly improved between test sessions (F 1,29 = 57.252, P < .001) and from the single to the dual task (F 1,29 = 7.673, P = .010). No differences were seen on the BESS and the PAT. Reliability across test sessions ranged from moderate to poor for outcome measure.

Conclusions:

The BESS appears to be a more reliable and functional tool in dual-task conditions as a result of its increased reliability and clinical applicability. In addition, the BESS is more readily available to clinicians than the SOT.

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Nicole L. Hoffman, Hannes Devos and Julianne D. Schmidt

symptom checklists, paper-and-pencil neuropsychological assessment battery, and driving simulator. He did not report a history of any neurologic disorder or injury, did not use drugs or alcohol heavily, and was not taking any medications that caused drowsiness at the time. He had not been involved in any

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Peiyuan Wang, Frank J. Infurna and Sydney Y. Schaefer

visuospatial function may be ( Schaefer & Duff, 2017 ; Lingo VanGilder, Hengge, Duff, & Schaefer, 2018 ). However, these studies only used one neuropsychological assessment (the Repeatable Battery for the Neuropsychological Status; RBANS) ( Randolph, 1998 ) and only tested adults age 65 years and older