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 .
Effect of Mild Brain Injury on an Instrumented Agility Task
Objective To identify an objective evaluation technique to guide return-to-play decisions following mild brain injury ( MBI ) using an agility task that incorporates cognitive and motor performance . Design Prospect i ve , controlled , repeated measures study . Setting Collegiate athletic training facility . Participants 84 athletes ( 25 male rugby players , 34 female rugby players , 25 male ice hockey players ) from 3 intercollegiate club teams participated . 9 athletes who suffered MBI during their competitive seasons and 9 matched controls completed the entire study protocol . Main Outcome Measures Time to complete an agility task on the Cybex Reactor and a postconcussive symptoms scale score were assessed in all subjects during the preseason . Injured subjects and matched controls were also assessed 1 , 3 , 5 , and 10 days postinjury . Results Repeated measures analyses of variance revealed significant differences between injured subjects and controls in postconcussion symptoms , but not agility performance . Post hoc testing revealed that injured subjects reported significantly more postconcussion symptoms on Day 1 after injury . Conclusion The methods of agility assessment used in this study appear to not be sensitive enough to detect functional impairment following MBI
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 .