The sensitivity and specificity of commonly implemented sideline assessment tools are generally good to very good , especially for symptom scores and cognitive evaluations performed within 48 hours of injury , and they are improved when a baseline evaluation is available for comparison .
CONTEXT The sideline assessment of concussion is challenging , given its variable presentations , the limited sensitivity and specificity of sideline assessment tools , and how the presentation of the injury evolves over time .
In addition , the diagnostic process , as well as the tools used to assess and manage concussion , continue to progress as research and what we know about concussion advance .
This paper focuses on the initial assessment on the sideline by review ing the concussion-evaluation literature , drawing from clinical experience to emphasize a st and ardized approach , and underscoring the importance of both familiarity with the athlete and clinical judgment .
OBJECTIVE To review the evidence regarding the clinical assessment of sport-related concussion on the sideline .
Additional considerations included making same-day return-to-play decisions , the sensitivity and specificity of sideline testing , and the importance of ongoing assessment and follow-up of injured athletes .
CONCLUSIONS The sideline assessment of sport-related concussion is challenging given the elusiveness and variability of presentation , reliance on athlete-reported symptoms , and the varying specificity and sensitivity values of sideline assessment tools .
In addition , the recognition of injury and assessment often occur in a time-pressured environment , requiring rapid disposition and decision making .
Neuropsychological Test Performance Prior To and Following Sports-Related Mild Traumatic Brain Injury
Objective To examine the utility of neuropsychological tests in assessing college athletes prior to and following a sports-related mild Traumatic Brain Injury ( mTBI ) . Design A prospect i ve study of college athletes who sustained mTBI while engaged in sport . Preinjury baseline neuropsychological test data were obtained for athletes at risk for mTBI . Following an mTBI , the athlete and his or her matched noninjured control were evaluated at 2 hours , 48 hours , 1 week , and 1 month postinjury . Setting Male and female athletes from a Division I college . Participants Male and female athletes from the football , men 's ice hockey , men 's and women 's soccer , and men 's and women 's basketball teams at Penn State University . A total of 29 injured and 20 noninjured athletes participated in the study . Interventions Neuropsychological test batteries were administered at baseline and serially following mTBI . Main Outcome Measures Post-Concussion Symptom Checklist , Hopkins Verbal Learning Test , Symbol Digit Modalities Test , Stroop Color-Word Test , Trail Making Test , VIGIL/W , List Learning , Digit Span , Penn State Cancellation Test , and Controlled Oral Word Association . Results Neuropsychological test data yielded significant differences between injured athletes and controls at 2 hours and 48 hours following cerebral concussion ; injured athletes performing significantly worse than controls . Injured athletes reported a significantly greater number of postconcussion symptoms 2 hours following injury but not at the 48-hour assessment . No multivariate group differences were found at 1 week , but univariate analyses suggested significant differences on a few measures . At 1 month postinjury , a statistically significant difference was found on one measure with injured athletes marginally outperforming controls . Conclusions Neuropsychological tests are useful in the detection of cognitive impairment following mTBI . The test data appear to be more effective than subjective report of symptoms in differentiating between injured and noninjured athletes at 48 hours postinjury . Although significant individual variability existed , most injured athletes recovered within 1 week of injury . A battery of tests , rather than any single test , is necessary to capture the variability that exists among injured athletes
The sensitivity and specificity of commonly implemented sideline assessment tools are generally good to very good , especially for symptom scores and cognitive evaluations performed within 48 hours of injury , and they are improved when a baseline evaluation is available for comparison .
CONTEXT The sideline assessment of concussion is challenging , given its variable presentations , the limited sensitivity and specificity of sideline assessment tools , and how the presentation of the injury evolves over time .
In addition , the diagnostic process , as well as the tools used to assess and manage concussion , continue to progress as research and what we know about concussion advance .
This paper focuses on the initial assessment on the sideline by review ing the concussion-evaluation literature , drawing from clinical experience to emphasize a st and ardized approach , and underscoring the importance of both familiarity with the athlete and clinical judgment .
OBJECTIVE To review the evidence regarding the clinical assessment of sport-related concussion on the sideline .
Additional considerations included making same-day return-to-play decisions , the sensitivity and specificity of sideline testing , and the importance of ongoing assessment and follow-up of injured athletes .
CONCLUSIONS The sideline assessment of sport-related concussion is challenging given the elusiveness and variability of presentation , reliance on athlete-reported symptoms , and the varying specificity and sensitivity values of sideline assessment tools .
In addition , the recognition of injury and assessment often occur in a time-pressured environment , requiring rapid disposition and decision making .