bluuebunny/crossref_metadata_2025_split huggingface dataset:
A-42 Patient Perspectives and Attitudes Toward the Use of Virtual Reality in Pediatric Sports-Related Concussion
Authors: Mathew A , Datoc A , Boucher S , Choi D , Ellis C , Abt J , Worts P 
Published: June 2023

Abstract

Purpose
Virtual reality (VR) has garnered increased attention as a modality to evaluate sports-related concussion (SRC). The purpose of this study was to better understand patient perspectives and attitudes towards VR while in the acute phase of injury.

Methods
Pediatric SRC patients aged 12-18 and within 72 hours from injury to initial visit were recruited. After completion of a VR task, patients were asked to rate their attitudes and perceptions on a custom VR user experience survey, on a scale of 0 (strongly disagree) to 4 (strongly agree).

Results
A total of 21 patients were eligible (Age=14.9±1.7; Female 57.1%; White 61.9%). Patients reported that the VR task involved mental focus (3.14±.57), required eye movements in all directions (3.33±.97), and motivated them to “finish and win” (3.38±2.11). Patients were neutral in their evaluation of the strategic component of the VR task (2.48±.93). They denied any difficulties understanding task instructions (.67±.96).

Conclusions
Overall, VR may be a promising avenue of research to evaluate SRC in pediatric patients given the level of engagement, ease of administration, and rich data captured by the VR device. Future research should determine whether VR can be used to accurately diagnose SRC and gather user information about ways to amplify the game-like and strategic nature of the task.
A-43 Somatic and Cognitive Predictors of Concussion Recovery Length
Authors: Miller K , Costopoulos J , LoGalbo A 
Published: June 2023

Abstract

Purpose
This study explored the relationship between neurocognitive testing and symptom reporting before and after concussion and recovery duration. It was hypothesized that declines in cognition would predict length of recovery.

Methods
Neurocognitive data was collected from 257 college students at baseline and post-concussion using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT).

Results
Results revealed an increase in ImPACT Total Symptoms from baseline to post-injury predicted recovery time b=-.45, t(255)=4.25, p&lt;.01, explaining a significant portion of variance in recovery time R2=.07, F(1,255)=18.35, p&lt;.01. Meanwhile, changes in cognition were not significant predictors of recovery time. However, recovery time was longer among participants who declined in Verbal Memory (M=26.98, SD=37.80) compared to those with no decline (M=17.66, SD=24.38) t(249)=2.40, p&lt; 01. Similar findings were observed among those who declined in Visual Motor Speed (M=27.22, SD=33.77) versus no decline (M=19.06, SD=34.58) t(232)=1.80, p&lt;.05; decline in Reaction Time (M=28.55, SD= 39.67) versus no decline (M=16.71, SD=21.78) t(215)=2.91, p&lt;.01; and those who had an increase in Total Symptoms (M=25.53, SD=35.16) versus no increase (M=10.12, SD=12.23) t(193)=5.07, p&lt;.01.

Conclusions
ImPACT Total Symptom score appears to be the best predictor of length of recovery time after a concussion. However, declines in Verbal Memory, Visual Motor Speed, and Reaction time, and an increase in Total Symptom score, also appear to be related to a longer recovery time after a concussion.
A-46 MMA Athletes Demonstrate Different Brain Vital Sign Profiles Compared to Matched Controls at “Baseline”
Authors: Munce T A , Fickling S D , Poel D N , D’Arcy R C N 
Published: June 2023

Abstract

Purpose
We compared objective brain vital sign metrics derived from event-related potentials (ERPs) of mixed martial arts (MMA) athletes and matched control participants.

Methods
We recorded 101 successful EEG scans from 12 MMA athletes (24.8 ± 2.6 yr) and 18 matched control participants (26.5±3.5 yr). For this analysis, only “baseline” scans were considered (n=30). “Baseline” was at least 90 days from a previous fight and 90 days (MMA) or 1 year (control) following medical clearance from a previously diagnosed concussion. We derived objective, clinical metrics (brain vital signs) from ERPs for auditory sensation (N100), basic attention (P300), and cognitive processing (N400) evoked while participants listen to a 6-minute auditory stimulus sequence. EEG data were processed using standard methods. N100, P300, and N400 amplitudes and latencies were manually identified on evoked potential waveforms by a blinded reviewer. Differences between groups at the waveform level were evaluated with a mass-univariate analysis using non-parametric resampling. Brain vital signs were compared across groups with a Kruskal-Wallis H-test for independent samples, with FDR correction for multiple comparisons.

Results
Mass-univariate waveform analyses showed significant differences (P &lt; 0.05) between MMA athletes and controls in both P300 and N400 ERPs. The Kruskal-Wallis test identified a significant difference in N400 amplitude (H=7.04, P=.008, Padj=.047) between MMA athletes and controls.

Conclusions
MMA athletes demonstrate significant differences in “baseline” brain vital signs compared to controls, indicating that exposure to repetitive head impacts in MMA may be associated with subconcussive changes in brain function.
A-47 Vestibular Symptoms and Recovery Time in Sport-Related Concussions among Collegiate Athletes
Authors: Nelson F , Clise E , LoGalbo A 
Published: June 2023

Abstract

Purpose
This study represents the initial phase in testing self-reported vestibular symptoms as potential predictive factors of protracted concussion recovery times among collegiate athletes.

Methods
Vestibular Symptoms Scale–Short Form (VSS-SF) was administered to 24 collegiate athletes (12 females, 12 males; ages=18-21) at baseline and post-injury. Participant data was grouped by number of days until symptom resolution post-concussion (1-10 days [N=13], 11-60 days [N=11]) and VSS-SF discrepancy scores (d-scores). To calculate d-scores, baseline scores were subtracted from post-injury scores for each athlete. Instances in which baseline scores were higher than post-injury were assigned a discrepancy score of 0. Concussion symptoms were documented using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and Sport Concussion Assessment Tool, 5th Edition (SCAT-5).

Results
Results from an independent samples t-test demonstrated that VSS-SF d-scores were significantly higher among athletes with 11+ post-concussive recovery days (M=9.64, SD=10.21) compared to those with 1-10 recovery days (M=2.92, SD=3.77), t(22)=2.21, p=.019). Additionally, a simple regression revealed that d-scores significantly predicted recovery time and explained 23.9% of the variance (b=.44, R2=.24, p=.015). Interaction and mediation results will be presented and discussed.

Conclusions
Results suggest that changes in VSS-SF pre- and post-concussion can differentiate athletes with relatively short versus longer recovery time and predict length of concussion recovery. Further research with a larger number of participants appears warranted.
A-49 Predictors of sleep quality among adolescents following concussion.
Authors: Perry C , Trbovich A M , Blaney N , Holland C L , Hirsh M , Reed A , Walzer K , Collins M W , Kontos A P 
Published: June 2023

Abstract

Purpose
To identify predictors of sleep quality following concussion in adolescents.

Methods
Ninety-four (47%-F) participants aged 11-17 (14.31±2.8) years within 7 days of injury were recruited from a specialty concussion clinic and emergency department. Participants completed demographics, mTBI and medical history, Adolescent Sleep-Wake Scale (ASWS), Concussion Clinical Profiles Screening (CP Screen), and Post-Concussion Symptom Scale (PCSS). Stepwise logistic regressions (LR) were used to identify predictors of ASWS scores. Results of the LR were used to create a probability test variable for receiver operating characteristic (ROC) curve analyses.

Results
Results of the LR for ASWS total sleep score were significant (p&lt;.001) and accurately identified 83.1% of adolescents with sensitivity of 76.7% and specificity of 89.1%, with history of anxiety (Adj OR=9.52, 95%CI=1.71-52.63, p=.01) and CP Screen anxiety domain total score (Adj OR=1.92, 95% CI=1.41-2.61, p&lt;.001) as significant predictors. ROC analysis of the combined probability test variable for total sleep score was significant with area under the curve (AUC)=.88 (95%CI=.80-.94, p&lt;.001). Similar findings were supported for history of anxiety and CP Screen anxiety domain scores on individual sleep domain scores.

Conclusions
History of anxiety and higher CP Screen anxiety score were predictive of poor sleep among adolescents following concussion. Surprisingly, age, sex, mTBI and migraine history, as well as total higher symptoms burden were not associated with poor sleep following concussion. The findings suggest that clinicians should focus on interventions to reduce anxiety to enhance sleep among adolescents following concussion.
A-54 Increased Symptoms During a Post-Concussion Neuropsychological Evaluation are Associated with Intraindividual Cognitive Variability and Anxiety
Authors: Riegler K E , Thomas G A , Bradson M L , Arnett P A 
Published: June 2023

Abstract

Purpose
To examine the relationship between self-reported affect, cognitive functioning, and increased symptoms during a post-concussion neuropsychological evaluation.

Methods
46 collegiate athletes (M=34, F=12) completed a comprehensive neuropsychological evaluation within 14 days of concussion, including measures of depression (Beck Depression Inventory-Fast Screen (BDI-FS)) and anxiety (NEO Five Factor Inventory (NEO-FFI) Anxiety Subscale). Suggested cutoffs for significant depression (BDI-FS ≥4) and anxiety (NEO-FFI Anxiety Subscale ≥10) symptomatology were utilized. The 21-item Post-Concussion Scale (PCS) was administered at the beginning (Pre-PCS) and end (Post-PCS) of testing. A difference score was calculated by subtracting Post-PCS from Pre-PCS. Composites of mean neuropsychological performance and two intraindividual variability (IIV) indices (average standard deviation and maximum discrepancy score) were created separately for two domains: memory and attention/processing speed (APS).

Results
Cognitive functioning explained a significant amount of the variance in Pre-Post PCS difference scores, F(6,39)=5.13, p&lt;.001, R2=.44. Both IIV indices for memory and APS (all p’s&lt;.02) significantly predicted difference scores, with cognitive variability increasing as Pre-Post PCS difference scores increased, but traditional mean composites did not (p’s&gt;.05). Athletes who reported significant anxiety symptomatology (M=-4.33, SD=4.41) were significantly more likely than those who did not (M=.21, SD=3.75) to experience an increase in PCS symptoms, t(37)=2.66, p=.01, 95% CI [1.09,8.00]. There were no significant Pre-Post PCS symptom changes between athletes reporting significant depression symptomatology (M=.43, SD=5.19) or not (M=-.15, SD=4.61).

Conclusions
Higher IIV in cognitive functioning and worse anxiety symptomatology, but not traditional mean differences in cognitive functioning or depression symptomatology, were associated with an increase in symptoms during a post-concussion evaluation.
A-56 Post-Concussion Depression Presents in Distinct and Unique Factors
Authors: Schatz P , D'Andrea A , Durfee K , Dollar C , Jennings S , Womble M , Elbin R J 
Published: June 2023

Abstract

Purpose
Post-concussion depression is a commonly endorsed symptom, and a key component of both the Emotional Cluster of the Post-Concussion Symptom Scale and also the Anxiety/Mood Clinical Profile. The purpose of this study was to explore the overlap between the PCSS and items on a widely used measure of depression, the PHQ9, in concussed athletes.

Methods
A sample of 365 athletes (mean age=15.10±2.25 years; 46% female) seeking care for a concussion at a specialty clinic within 30 days of injury (M= 7.79±7.1 days) were enrolled in the study. The PCSS and PHQ9 were administered to all participants. Two factor analyses were conducted, using: 1) all items from the PCSS and PHQ9, and 2) only the items from the PHQ9.

Results
The PCSS/PHQ9 FA identified only “Sadness” and “More Emotional” as sharing variance with PHQ9 items, including symptoms of “Feeling Down/Depressed/Hopeless”, “Feeling Bad About Self”, “Suicidal Thoughts” and “Little Interest/Pleasure in Doing Things”. PHQ9 items of “Trouble Concentrating”, “Moving/Speaking Slowly or Fidgety/Restless” and “Feeling Tired/Low Energy” loaded on a unique factor with no shared variance with PCSS items. Factor Analysis of only the PHQ9 items retained all but the “Poor Appetite or Overeating” item, yielding two distinct post-concussion depression factors: a Cognitive/Fatigue Factor and a Depressive/Rumination Factor.

Conclusions
Post-concussion depression presents as a unique two-factor construct, with some shared variance with PCSS items. Use of an additional measure of depression is recommended to identify post-concussion depressive symptoms beyond “sadness” and “more emotional” and help clinicians determine an appropriate treatment plan.
A-59 Sport-related concussion in para athletes: A scoping review of concussion assessment and management
Authors: Smetana R M , Kaplan D T , Magill R T , Denton A H , Broshek D K 
Published: June 2023

Abstract

Purpose
Current guidelines have lagged in addressing sport-related concussion (SRC) in athletes with disabilities, or para athletes. Concussion assessments may not accurately capture symptoms in para athletes or be appropriately accessible, resulting in challenges managing SRCs in these athletes. The objective of this scoping review was to summarize the current literature on SRC in para athletes, including assessment procedures and management of SRC.

Data Selection
This review was registered with Open Science Framework and adhered to PRISMA-ScR guidelines. Searches of electronic databases (CINAHL, Google Scholar, MEDLINE, SPORTDiscus, and Web of Science) were conducted from database inception to 02/01/2023. Articles selected examined SRC assessment and management in adaptive sports.

Data Synthesis
Reviewers screened 202 title-abstracts and 32 articles qualified for full-text review, with 9 articles qualifying for data extraction for information on SRC assessment and management. Most articles addressed baseline assessment (N=6), some addressed both assessment and management (N=2), and only one article addressed SRC management (N=1). Results identified discrepancies in the results of baseline data in para athletes. Differences in baseline composite scores and symptom reporting in para vs. non-adaptive athletes were also found. The literature acknowledged lack of validated assessment tools and SRC management guidelines for para athletes.

Conclusions
There is limited literature on the assessment and management of SRC in para athletes at both elite and non-elite levels, indicating a lag in research on para athletes as compared to non-adaptive athletes. Development or standardization of current baseline assessment procedures for SRC and subsequent management guidelines for para athletes is needed.
A-61 Exploring The Role Of Acculturation In The Development Of Post-Concussive Symptoms In Minority College Athletes
Authors: Tavares A 
Published: June 2023

Abstract

Purpose
This review explored the role acculturative stress may have in the development of post-concussive symptoms of minority college athletes.

Data Selection
The data was collected via scientific journals accessed library databases, google scholar, and PubMed. Criteria for the selection included: published since the year 2011, focus on college students, studies that were parsimonious and examined post-concussive symptoms, acculturation, and sports related concussions. Guidelines for abstracting data included comparing study abstract to text to confirm accuracy, and being aware of bias by selecting relevant research and interpreting results based on context and available evidence. Nine (N=9) studies were reviewed.

Results
The results showed that college athletes are at higher risk for developing PCS if they had experienced multiple concussions, pre-morbid mood disorders, and/or if they were experiencing co-morbid psychosocial stressors. Concerning acculturation among college students, the literature suggests that acculturative stress puts this population at an increased risk for the development of mood disorders like depression.

Conclusions
There may be a relationship between acculturation and the development of post-concussive symptoms in college students but more studies should be conducted that test the direct relationship.
A-63 Adolescent Males Demonstrate Greater Reduction in Dizziness Compared to Females after Vestibular Therapy Post-Concussion
Authors: Trbovich A M , Fazio-Sumrok V , Kegel N , Mucha A , Holland C , Siibo A M , Collins M W , Kontos A P 
Published: June 2023

Abstract

Purpose
To examine sex differences in treatment response to vestibular therapy following subacute concussion.

Methods
This secondary analysis of a double-blind RCT recruited adolescent concussion patients with vestibular dysfunction and randomized to either a vestibular intervention group (VESTIB) or a behavioral management group (CONTROL). Participants completed The Dizziness Handicap Inventory (DHI) at initial evaluation, 2, and 4 weeks (±5 days) postintervention. The intervention was administered by concussion specialized vestibular therapists. A 2x2x3 repeated-measures GLM was conducted to examine sex differences (male, female) on DHI score at 3 time points (initial evaluation, 2 and 4 weeks postintervention) for both groups (CONTROL, VESTIB).

Results
VESTIB (n=12, 6F/6M) and CONTROL (n=15, 10F/5M) participants were 15.39+/-1.57 years old, injured within 21 days of initial evaluation. Results of the repeated-measures GLM supported a main effect for decrease in DHI (F[2,22]=30.47, p&lt;.001, Wilks'Λ=.27, partial η2=.74) across visits. There was a significant group x gender x time interaction for DHI (F[2,22]=4.45, p=.024, Wilks'Λ=0.71, partial η2=.29), in which the males in the VESTIB group had a more significant decrease in DHI, while similar change in DHI was observed across genders for the CONTROL group. A main effect for group on DHI score fell short of significance (p=.06).

Conclusions
Our preliminary study suggests adolescent males may experience a faster resolution of dizziness compared to females' post-concussion when receiving vestibular therapy, but behavioral management supported similar dizziness reduction rates between sexes. Future research should examine mechanisms for differences in treatment response, such as adherence to treatment or underlying physiological differences.
A-64 The Impact of a Sports-Related Concussion on Emotional Beliefs of Collegiate Athletes.
Authors: Uhren A , Breitmeyer A , Virden T 
Published: June 2023

Abstract

Purpose
The purpose of this review is to summarize the current literature on the effects of sports-related concussion on an athlete’s emotional beliefs. Emotional beliefs are an individual’s beliefs on whether emotions are controllable, as well as useful or unwanted. Understanding how a concussion affects an athlete’s emotional beliefs can assist in determining appropriate interventions for treatment. Data Selection: The informal literature search was conducted through EBSCOhost and PsychINFO databases from August 2022 through February 2023 for articles containing CONCUSSIONS plus one of the following: EMOTIONAL BELIEFS, COLLEGIATE ATHLETES, EMOTIONS. Inclusion criteria included data collected from a collegiate sample, article presented original research, articles published in 2000 or later, and articles contained relevant information regarding emotional beliefs in collegiate athletes. Due to the dearth in the literature regarding emotional beliefs, only five studies were reviewed.

Results
Currently within the literature, there is debate about the construct of emotional beliefs. The literature is mixed on how to define emotional beliefs as well as how to distinguish emotional beliefs from cognition. Within the literature there is agreement that emotional beliefs are additionally influenced by a myriad of factors. Although emotional changes are observed in concussed athletes, there has been little research on how concussions impact athlete's beliefs about their emotions. Baseline concussion testing often does not include any mood measures, thus limiting post-injury assessment to strictly cognitive domains.

Conclusions
Sustaining a concussion can lead to increased stress and exacerbate pre-existing psychological disturbances. Changes in emotional beliefs can affect an athlete’s mental well-being, which in turn can affect their athletic and academic performance. In sum, there is a need for further research on the effects of concussions on cognitive and emotional beliefs in the field of sports neuropsychology.
A-65 Early Academic Stress and Problems are Associated with Concussion Symptom Burden Across Recovery
Authors: Terheyden van S , Richie R , Vaughan C , Gioia G 
Published: June 2023

Abstract

Purpose
Concussion symptoms are associated with initial academic concerns in youth. We hypothesized that early academic stress and difficulty would be associated with greater symptom burden across recovery visits.

Methods
200 patients aged 8 to 18 (M age=14.4±2.2, 51% female, 67% white) with a concussion completed the Concussion Learning Assessment and School Survey, 3rd Edition (CLASS-3) at first visit, a validated self-reported rating scale of academic problems (AP; 14 items) and school stresses (SS; 6 items) along with the developmentally appropriate Post-Concussion Symptom Inventory-2 (PCSI-2), which generates Retrospectively-Adjusted Post-Injury Difference (RAPID) symptom scores by 8-12 and 13-18 age groups. Subgroups of participants completed the PCSI-2 only at visit 2 (n=128) and at visit 3 (n=29).

Results
There were significant positive partial correlations (p&lt;.05), controlling for age and sex, between CLASS-3 scores and the PCSI-2 RAPID scores in the 8-12 age group for AP (V1 r=.60 and V2 r=.42) and SS (V1 r=.33 and V2 r=.34) and in the 13-18 group for AP (V1 r=.72, V2 r=.51, V3 r=.52) and SS (V1 r=.50, V2 r=.49). The effect was moderate, but not statistically significant due small sample sizes, at visit 3 in 8-12 group (AP V3 r=.50; SS r= .41) and in the 13-18 group for SS (r=.34).

Conclusions
Students with higher early academic problems and school stresses reported higher symptom burden over time. These results suggest that early academic supports to mitigate school problems and stress may subsequently lessen symptom burden across the course of recovery.