bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining the paralympic athlete: normative values for scat major components in healthy paralympic athletes
Authors: J Moreau William , Walden Taylor , Nabhan Dustin 
Published: November 2017

ObjectiveDescribe normative baseline SCAT 2 and 3 (SCAT) performance in elite Paralympic athletes.DesignRetrospective cohort.SettingUnited States Olympic Committee Sports Medicine Clinics.ParticipantsSixty-nine SCAT baseline evaluations were performed on a population of 60 elite athletes Paralympic (17 women and 43 men, mean age 30.1±7.3 years) representing 5 Summer and Winter Olympic sports as part of multimodal concussion programing.InterventionNo intervention was applied. The SCAT evaluations were administered as a component of a baseline testing on healthy athletes.Main outcome measurementsBaseline SCAT performance on major components is described. T-tests were used to compare differences in baseline performance by sex.ResultsDuring baseline evaluations, elite Paralympic athletes reported a mean (95%CI) of 2.2 (1.1–3.3) symptoms with an average symptom severity score of 4.7 (2.8–6.6). Mean scores on SCAT components in this population were; orientation 4.9 (4.8–5.0), immediate memory 14.3 (13.9–14.8), concentration 4.0 (3.7–4.2), tandem gait 15.4 (12.3–18.6), delayed recall 3.7 (3.4–4.0), balance 4.4 (1.9–7.06), SAC total 26.6 (25.8–27.4). This group reported a history of 2.6 (1.4–3.8) previous concussions. There were no significant differences between males and females in components of the SCAT.ConclusionsPopulation specific normative values for baseline SCAT performance in a population of elite Paralympic athletes are presented in this cohort study.Clinical relevanceParalympic athletes are an understudied population. Clinicians are encouraged to reference population specific normative values when interpreting SCAT performance. For athletes with impairments, individual baselines may be preferred to the wide distribution of functional capacity.AcknowledgementsNone.Competing interestsNone.
Do neurocognitive scat3 test scores differ between non-concussed national footballers living with and without disability? a cross-sectional study
Authors: Weiler Richard , Van Mechelen Willem , Fuller Colin , Ahmed Osman , Verhagen Evert 
Published: November 2017

ObjectiveTo determine if cross-sectional differences exist using SCAT3 scores for non-concussed England footballers with and without disability.DesignCross-sectional between group comparison of first-time collected SCAT3 scores.SettingAll England team doctors and physiotherapists commenced between 1st August 2013 and 31st July 2014 standardised annual SCAT3 testing on England footballers following the Zurich 2012 concussion guidelines.ParticipantsA convenience sample of England national football team players (total: 249; male: 174, female: 75), of whom 185 were athletes without disability (male: 119; female: 66) and 64 athletes with disability (male learning disability: 17; male cerebral palsy: 28; male blind: 10; female deaf: 9).Assessment and outcome measuresComparison between groups of median SCAT3 section scores was made with the non-parametric Mann-Whitney-Wilcoxon ranked-sum test.Main resultsCompared to male footballers without disability, male footballers with disability scored significantly higher for total number of symptoms and symptom severity. However, male footballers with learning disability demonstrated no difference with total number of symptoms and scored significantly lower on immediate memory and delayed recall . Male blind footballers scored significantly higher for total concentration and delayed recall. Male footballers with cerebral palsy scored significantly higher on balance testing and significantly lower on immediate memory.ConclusionsThe results of this study suggest that significant cross-sectional between-group variability exists in SCAT3 section scores when non-concussed footballers with disability are compared to footballers without disability. Future concussion consensus guidelines should recognise these between group differences and generate separate SCAT3 guidelines for the growing number of elite athletes living with disability.Competing interestsNone.
Neurocognitive changes as measured by impact and the scat3 in women’s soccer players without diagnosed concussion
Authors: Bowman Thomas G , Breedlove Katherine M , Leahy Theresa E 
Published: November 2017

ObjectiveNeurocognitive changes have been found in football players without documented concussion raising concerns regarding the long term consequences of subconcussive head impacts in sport. It remains unknown if similar neurocognitive changes are found in female soccer athletes without concussion. Females have been found to have higher concussion rates compared to males and soccer is the most popular sport internationally providing a compelling area of study.DesignObservational study.SettingAmerican collegiate women’s soccer team.Participants16 National Collegiate Athletic Association Division III women’s soccer athletes (19.88±1.1 years old, 163.7±4.9 cm, 61.2±4.9 kg) volunteered and provided consent for the study.Assessment of risk factorsWe measured head impacts during practices and games throughout the 15 week season with the xPatch (X2 Biosystems, Seattle, WA, USA). All participants completed ImPACT and the Sport Concussion Assessment Tool – 3rdEdition (SCAT3) prior to the season’s start and at the end of the season.Outcome measuresThe xPatch stored location, frequency, and magnitude (linear and rotational accelerations) of head impacts. Event film was used to verify each head impact. Changes in neurocognitive function were determined by comparing the baseline ImPACT and SCAT3 scores with the post-season scores.Main resultsA stepwise regression found a significant relationship between weekly head impact frequency during practices and the ImPACT measures of Visual Motor Speed (P=0.03) and Symptom Score (P=0.03).ConclusionsSoccer activity may lead to lower visual motor speed and higher symptom scores. Future studies should use additional screening tools to verify these preliminary findings.Competing interestsNone.
Stability of the scat3 and association with game day head impacts in non-concussed amateur australian rules football players
Authors: Wilmott Catherine , McIntosh Andrew S , Howard Teresa , Mitra Biswadev , Dimech-Betancourt Bleydy , Rosenfeld Jeffrey V 
Published: November 2017

ObjectiveThis pilot study investigated SCAT3 from baseline to post-game among non-concussed amateur Australian Rules footballers, and association with game day head impacts.DesignPeak linear acceleration (PLA) of the head (>10g) was measured by wearable impact sensor X2Biosytems xPatch. SCAT3 was administered at baseline and post-game.ParticipantsAmateur Australian Rules footballers n=68.Main resultsCommon symptoms at baseline: fatigue, trouble falling asleep & neck pain. N=57 sustained 2088 impacts>10g(Mean PLA=14.40g, range 10–115.78g). Measured PLA among males (M=15.11g, SD 3.51) and females (M=16.60g, SD 4.04), U=288.00, z=−1.24, p=0.217 did not differ, however, males (M=46.13, SD=50.4) sustained significantly more impacts than females (M=17.63, SD=13.20), U=214.00, z=−2.46, p=0.013. Greater symptom severity was found post-game (M=6.16, SD=8.17) compared to baseline (M=4.04, SD=6.34), z=−0.32, p=0.001, along with greater symptom total (p=0.011). Those with higher mean PLA demonstrated slower tandem gait. A similar pattern of SCAT change was observed for the No Impact group, and there were no significant group differences in SCAT change scores.ConclusionsConsistent with previous findings players were not asymptomatic at baseline. Increase in symptom severity post-game was generally independent of head impact. Furthermore, the lack of association between PLA and SCAT3 change scores in this non-concussed Impact group suggests that other factors may contribute to such changes.Competing interestsNone.
The effect of age on symptom reporting on the adult and child post concussion symptom scale in youth ice hockey players
Authors: Black Amanda M , Schneider Kathryn J , Palacios-Derflingher Luz , Meeuwisse Willem H , Emery Carolyn A 
Published: November 2017

ObjectiveTo determine symptom reporting differences for children completing the adult and child version of the Post-Concussion Symptom Scale (PCSS) on the Sport Concussion Assessment Tool 3 (SCAT3).DesignCross-Sectional study.SettingCommunity ice hockey teams, Alberta, Canada.ParticipantsYouth hockey players (n=891; 91.58% male, 10–14 years) who completed the PCSS on the Adult and Child version of the SCAT3 during a preseason baseline assessment.Assessment of risk factorsAdult versus child PCSS stratified by categorical age (10–12, 13–14).Outcome measuresTotal number of symptoms, symptoms reported, and proportion equally reporting symptoms (0, ≥1) on both PCSS scales.Main resultsParticipants reported a median of 2 symptoms [Interquartile Range (IQR):0–21] on the adult scale (/22) and 5 (IQR:0-20) on the child scale (/20). There was no evidence of a difference in the proportion of participants reporting symptoms (0, ≥1) on both scales between age groups 10–12 (525/729, 72.02%) and 13–14 (121/160, 75.63%) (difference: −3.61% (95% confidence interval (−11.40%, 4.18%)). The most frequent symptoms reported on the adult PCSS by participants with no symptoms on the child PCSS were nervousness (11.27%) and neck pain (10.56%). Participants with no symptoms on the adult PCSS most commonly reported being easily distracted (45.29%) and forgetful (39.49%) on the Child PCSS.ConclusionsA greater number of symptoms were endorsed for all 10-14 year old subjects when using the Child SCAT3 PCSS. Neck pain was a commonly reported symptom for all age groups on the Adult SCAT3 PCSS, but this symptom is absent from the Child SCAT3.Competing interestsNone.
The utility of individual baseline versus normative reference values for the scat3 following concussion in professional ice hockey players
Authors: Hänninen Timo , Parkkari Jari , Tuominen Markku , Iverson Grant L , Vartiainen Matti , Öhman Juha , Luoto Teemu M 
Published: November 2017

ObjectiveTo characterise whether individual SCAT3 baseline scores are more useful than normative reference values following acute concussion.DesignProspective cohort.SettingFinnish professional male ice hockey league.ParticipantsSCAT3 baseline testing has been mandatory in the league since 2013. The league recommends day of injury testing for all players with suspected concussion. Of the reported day of injury SCAT3s, between seasons 2013–2016, a total of 29 concussions were confirmed by the teams’ medical staff.Outcome measuresMeasures included: the individual baseline and day of concussion scores of the injured players; The league’s normative reference values [based on 2013–2014 preseason baselines (n=304)]; and the limits of normal variation on SCAT3 [based on league’s preseason baselines 2013–2014 and 2014–2015 (n=179)]. The post-injury performance was ruled as abnormal if (i) the player scored within the worst 10th percentile of the normative reference values or (ii) the score differed from the player’s own baseline more than the cut offs for 90% normal variation.Main resultsThe percentages of the players who performed abnormally on post-concussion testing (scores compared to individual baseline vs. normative reference values) were as follows: Symptoms: 96% vs. 100%; SAC: 31% vs. 22%; M-BESS: 50% vs. 50%; Tandem gait: 18% vs. 29%; Coordination: 7% vs. 7%.ConclusionsPost-concussion testing conducted with individual baseline seems to be as sensitive as assessment compared to normative reference values in acute concussion recognition. Symptoms were the most sensitive SCAT3 component.Competing interestsTimo Hnninen, Markku Tuominen, Jari Parkkari, Matti Vartiainen, Juha hman, Teemu M. Luoto: None.Grant L. Iverson has been reimbursed by the government, professional scientific bodies, and commercial organisations for discussing or presenting research relating to mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums. He has a clinical and consulting practice in forensic neuropsychology involving individuals who have sustained mild TBIs (including professional athletes). He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He has not received research support from a test publishing company in the past 5 years.
Use of the scat-3, child scat3, and king-devick in concussion assessment of youth hockey players
Authors: Herceg Mark 
Published: November 2017

ObjectiveCurrently youth sports hockey programs do not adhere to concussion protocols. The purpose of this study was to examine the relations between performance of two sideline assessments.DesignRetrospective analysis of two measures given as part of a youth travel hockey program.SettingIce hockey skating facility in Westchester County, NY (USA).ParticipantsA sample of 121 youth hockey players participated. All of the athletes were administered the King-Devick, SAC (ages 13-18) and Child SAC (ages 10-12) at baseline, sideline, and once symptom free.Main resultsMean age was 13.2 (SD=1.2) and there 118 were boys (97.5%). The majority of sample had zero self-reported past concussion (n=113; 93.3). Fourteen athletes sustained concussions. Worse King Devick scores were associated with overall worse SAC and Child SAC Concentration and Delayed Memory scores. For every 1-point reduction in SAC Delayed Memory Score, there was a worsening of King Devick time score of 5.3 seconds (95% CI 5.0, 9.5, p<0.001) for children ages 13–18, and a time score difference of 5.8 seconds for children ages 10–12 (95% CI 5.9, p<0.001). In examining SAC total score, a 1-point decrease was associated with King Devick score worsening of 2.0s (95% CI 0.5, 4.0, p=0.01). Most common symptoms were headache and fatigue for all ages. Once symptom free, there was a trend toward improvement on both measures compared to baseline.ConclusionsThis study reaffirms prior studies that both King Devick and SAC are effective combination clinical tools that assess athletes with suspected concussion.Competing interestsNone.
Impact monitoring and king-devick ocular testing provide a relatively simple process for objectively identifying and managing concussion in sports participants
Authors: Cohen Adrian , King Doug , Pearce Alan J 
Published: November 2017

ObjectiveThis study presents data using multimodal assessment via impact sensors and oculomotor function to quantify neurophysiological changes in the acute period following concussion.DesignCohort study.ParticipantsData on impact magnitude and frequency were collected with a wireless head impact sensor (XPatch1) worn by senior amateur rugby players participating in a domestic season. King-Devick Tests2 were performed pre-season and after significant impact scores (PLA>100 g, PRA>10,000 rads/sec/sec).). Participants underwent a one hour baseline assessment of balance, cognition and transcranial magnetic stimulation testing. Following concussive episodes or significant head impacts (as measured by impact sensors), players were re-tested to elicit any differences and to assist in providing objective criteria for the return to play process.InterventionsAny impact that resulted in a witnessed concussion or that was suspected on the basis of significant impact scores required post-match testing utilising the King-Devick test to help determine appropriate return to play readiness.Outcome measuresImpact number, peak linear and peak rotational acceleration, risk weighted exposure. Time and errors completing the King-Devick test.Main result20 concussions were detected in all, of which only 3 were witnessed (2 players unconscious on the field, one with balance disturbance resulting in removal from play).ConclusionsA combination of regular impact monitoring and King-Devick Ocular testing provides a relatively simple process for objectively identifying and managing concussion in sports participants.Competing interestsAJP is supported, in part, by a research grant by the Australian Football League
Pre-season concussion testing in high school students with academic difficulties or attention deficit hyperactivity disorder
Authors: Herceg Mark , Wojtowicz Magdalena , Iverson Grant 
Published: November 2017

ObjectiveLearning disabilities and/or ADHD are considered to be important risk factors or modifiers for concussion assessment and management. The purpose of this study was to examine cognition and symptom reporting in high school students with academic difficulties or ADHD and compare to those without at baseline.DesignRetrospective analysis of three measures routinely given as part of a high school yearly concussion baseline protocol.SettingThe library of a high school in Westchester County, NY.ParticipantsA sample of 143 high school students who participate in collision/contact sports [Age M (SD)=15.4 (1.2); Boys=78, 54.5%] completed baseline testing.Main resultsNon-parametric tests were used because of violations of normality. High school students with academic difficulties or ADHD (n=21) were compared to controls (n=122) on King- Devick, SAC, ImPACT Cognitive Composite scores, and Total Symptom ratings. Students with LD or ADHD performed significantly more poorly on King-Devick (p=0.003; d=0.79), Visual Motor Speed Composite of ImPACT (p=0.007; d=0.79), and reported more symptoms at baseline on the Post-Concussion Scale (p=0.005; d=0.59). No significant differences found between groups on SAC (p=0.11; d=0.36) or ImPACT Verbal Memory (p=0.54; d=0.16), Visual Memory (p=0.20; d=0.26), or Reaction Time (p=0.14; d=0.55) Composites.ConclusionsTo our knowledge this is the first study to examine performance on three different baseline measures. High school students with academic difficulties or ADHD performed more poorly on King-Devick, the Visual Motor Speed Composite of ImPACT, and reported more symptoms at baseline. Findings suggest these students need to be monitored for specific post injury changes.This study was approved by the Committee for Human Rights Research, Burke Rehabilitation Hospital, White Plains, NY, USA. Protocol # BRC-455.Competing interestsNone.
Video analysis of the evidence of concussive signs in national rugby league (nrl) match play
Authors: Gardner Andrew J , Levi Christopher R , Iverson Grant L 
Published: November 2017

ObjectiveA video analysis of 201 National Rugby League (NRL) matches to document all signs of possible concussion during the 2014 season.SettingAll match play from the 2014 NRL season.ParticipantsAll professional players participating in the 2014 seasonOutcome measuresThe total frequency of six concussion signs (unresponsiveness/loss of consciousness, slow to get up, clutching head, unsteadiness of gait, vacant stare, and seizure).Main resultsThe concussion interchange rule was used 156 times, with 60 medically diagnosed concussions. The incidence rate for concussion was 17.26 (95% CI=13.44–22.16) per 1,000 player match hours, or approximately one concussion every 3.35 games. There were 127,062 tackles reviewed in the 201 matches, for an average of 632.1 tackles per match. Being slow to get up was observed 2,240 times, clutching the head 361 times, unsteadiness of gait 102 times, vacant stare 98 times, possible loss of consciousness (LOC) 52 times, and a seizure 4 times. Of the 2,240 instances of being slow to get up following a tackle, only 2.7% of those cases involved a medically diagnosed concussion. Of the 52 instances in which a player appeared to have brief LOC, 50 players were removed under the concussion interchange rule (96.2%). Of those 50, 24 were medically diagnosed as having sustained a concussion (48%).ConclusionsReviewing match video footage can be a useful addition to the sideline assessment of concussion.Competing interestsAndrew Gardner has a clinical practice in neuropsychology involving individuals who have sustained sport-related concussion (including current and former athletes). He serves, in a voluntary capacity, as a member of the Australia Rugby Union (ARU) concussion advisory group. He has received travel funding from the Australian Football League (AFL) to present at the Concussion in Football Conference in 2013. Previous grant funding includes the NSW Sporting Injuries Committee, the Brain Foundation and the Hunter Medical Research Institute (HMRI), supported by Jennie Thomas. He is currently funded through the HMRI, supported by Anne Greaves.Grant Iverson has been reimbursed by the government, professional scientific bodies, and commercial organisations for discussing or presenting research relating to mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums. He has a clinical and consulting practice in forensic neuropsychology involving individuals who have sustained mild TBIs (including professional athletes).Christopher Levi none.
Relationship between king devick TEST, SCAR3 and 3D mot in cognitive assessment
Authors: Oslund Kimberly R , Cullen Hilary M , Kowalski Kristina , Christie Brian 
Published: November 2017

ObjectiveTo examine the relationship between aspects of the Sport Concussion Assessment Tool 3 (SCAT3), the King-Devick Test (KDT) and Three-Dimensional Multiple Object Tracking (3D MOT) at baseline.DesignProspective design.SettingUniversity resarch laboratory.ParticipantsA convenience sample of 304 healthy, non-concussed, athletic participants (101 females, 203 males) ranging in age from 11.69 20.41 years (mean age=16.05 + 4.36) were included in the analysis.Outcome measuresParticipants completed the SCAT3, KDT and 3D MOT in a single visit. A regression analysis was performed to see if any aspects of the SCAT3 (immediate memory (IM), coordination (COOR), and delayed recall (DR)), and/or the KDT, predicted 3D MOT scores.Main resultsA multiple linear regression was calculated to see if KDT, IM, DR and COOR predicted the speed of the 3D MOT. The assumptions of multivariate regression were tested and corrections were applied as needed. Using the stepwise method, it was found that KD, DR and COOR explain a significant amount of the variance in the speed of the 3D MOT (F(3, 256))=11.82, p<0.000 with an R2 of 0.12. Participants predicted 3D MOT score is equal to 1.05 –0.01 KD + 0.07 DR + 0.23 COOR, where KDT is measured in seconds, DR is measured in units between 0–5, and COOR is measured as 1=successful, 0?= not successful. The analysis shows that KD (Beta=–0.01, p?< 0.000), DR (Beta=0.07, p<0.02), and COOR (Beta=0.23, p<0.03), were significant predictors of 3D MOT scores.ConclusionsResults suggest that King Devick Test, Delayed Recall, and Coordination tests share predictive validity of the 3D MOT in an athletic population between the ages of 6-29 at baseline. Future studies should examine these relationships post-injury and through concussion recovery. This could provide valuable information to better inform clinicians responsible for making Return to Play determinations.Competing interestsNone.