Hugentobler, Jason A; Gupta, Resmi; Slater, Robert; Paterno, Mark V; Riley, Michael A; Quatman-Yates, Catherine
Influence of Age on Postconcussive Postural Control Measures and Future Implications for Assessment Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 6, pp. 510–517, 2016, ISBN: 1050642X.
Abstract | BibTeX | Tags: ADOLESCENCE, AGE distribution (Demography), ATTENTION-deficit hyperactivity disorder, CORRELATION (Statistics), DATA analysis, DATA analysis -- Software, DESCRIPTIVE statistics, DISEASE complications, EQUILIBRIUM (Physiology), LONGITUDINAL method, MEDICAL history taking, MULTIPLE regression analysis, postconcussion syndrome, PROBABILITY theory, Questionnaires, SEVERITY of illness index, SEX distribution (Demography), STATISTICS
@article{Hugentobler2016,
title = {Influence of Age on Postconcussive Postural Control Measures and Future Implications for Assessment},
author = {Hugentobler, Jason A and Gupta, Resmi and Slater, Robert and Paterno, Mark V and Riley, Michael A and Quatman-Yates, Catherine},
isbn = {1050642X},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {6},
pages = {510--517},
abstract = {Objective: To examine the influence of age, sex, attention-deficit hyperactivity disorder (ADHD) status, previous history of concussion, and days since injury on postconcussion postural control assessment in adolescents who have suffered a concussion. Design: Prospective cohort study. Setting: Hospital-based outpatient clinic. Participants: Seventy-one participants (42 males; 29 females) with mean age 14.14 ± 2.44. Independent Variables: Age, sex, previous concussion history, ADHD status, total and severity of postconcussion symptoms, and days since injury. Main Outcome Measures: Total Balance Error Scoring System score, path length, center-of-pressure (COP) area, sample entropy, and Romberg quotient. Results: Pearson product-moment correlation coefficients were calculated to test for potential associations between the continuous participant characteristics and the postural control variables. Spearman correlation was used to test the association between symptom severity and the postural control variables. Standard multiple regression was used to model the extent to which participant characteristics accounted for the variance in the postural sway variables. Age was significantly associated with all of the postural sway variables except COP area for the eyes open condition and sample entropy in the anterior-posterior direction for the eyes closed condition. Sex, ADHD status, and previous concussion history did not significantly predict postural control scores. Conclusions: Age significantly influences scores on common postconcussion postural control assessments. Clinical Relevance: This study demonstrates that age is a critical factor that needs to be accounted for to improve the clinical appropriateness and utility of current postconcussion postural control assessments. [ABSTRACT FROM AUTHOR]},
keywords = {ADOLESCENCE, AGE distribution (Demography), ATTENTION-deficit hyperactivity disorder, CORRELATION (Statistics), DATA analysis, DATA analysis -- Software, DESCRIPTIVE statistics, DISEASE complications, EQUILIBRIUM (Physiology), LONGITUDINAL method, MEDICAL history taking, MULTIPLE regression analysis, postconcussion syndrome, PROBABILITY theory, Questionnaires, SEVERITY of illness index, SEX distribution (Demography), STATISTICS},
pubstate = {published},
tppubtype = {article}
}
Dematteo, Carol; Volterman, Kimberly A; Breithaupt, Peter G; Claridge, Everett A; Adamich, John; Timmons, Brian W
Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015, ISBN: 01959131.
Abstract | BibTeX | Tags: *BRAIN -- Concussion, *BRAIN -- Wounds & injuries, *EXERCISE, *EXERCISE tests, *POSTCONCUSSION syndrome, *SPORTS participation, ADOLESCENCE, adolescents, brain concussion, children, DATA analysis, DATA analysis -- Software, DECISION making in clinical medicine, DESCRIPTIVE statistics, head injury, MULTIPLE regression analysis, ONE-way analysis of variance, postconcussion syndrome, RESEARCH -- Finance, Return to Play, SAMPLING (Statistics), STATISTICS
@article{Dematteo2015b,
title = {Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion},
author = {Dematteo, Carol and Volterman, Kimberly A and Breithaupt, Peter G and Claridge, Everett A and Adamich, John and Timmons, Brian W},
isbn = {01959131},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose: The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods: Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results: Participants had a mean T SD symptom duration of 6.3 T 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions: Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. ABSTRACT FROM AUTHOR},
keywords = {*BRAIN -- Concussion, *BRAIN -- Wounds \& injuries, *EXERCISE, *EXERCISE tests, *POSTCONCUSSION syndrome, *SPORTS participation, ADOLESCENCE, adolescents, brain concussion, children, DATA analysis, DATA analysis -- Software, DECISION making in clinical medicine, DESCRIPTIVE statistics, head injury, MULTIPLE regression analysis, ONE-way analysis of variance, postconcussion syndrome, RESEARCH -- Finance, Return to Play, SAMPLING (Statistics), STATISTICS},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult},
pubstate = {published},
tppubtype = {article}
}
van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje
Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.
Abstract | BibTeX | Tags: *ANXIETY, *BRAIN -- Wounds & injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work
@article{VanderHorn2013,
title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},
author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},
isbn = {00039993},
year = {2013},
date = {2013-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {94},
number = {5},
pages = {867--874},
abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},
keywords = {*ANXIETY, *BRAIN -- Wounds \& injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work},
pubstate = {published},
tppubtype = {article}
}
Resch, Jacob E; Brown, Cathleen N; Baumgartner, Ted A; Macciocchi, Stephen N; Walpert, Kimberly P; Ferrara, Michael S
Influence of Mood State on the ImPACT Journal Article
In: Athletic Training & Sports Health Care, vol. 5, no. 6, pp. 272–281, 2013, ISBN: 19425864.
Abstract | BibTeX | Tags: *COLLEGE students, *PSYCHOLOGICAL tests, *SELF-evaluation, AFFECT (Psychology), ANALYSIS of variance, Clinical Trials, COGNITIVE testing, COMPUTER-assisted medical diagnosis, CORRELATION (Statistics), DATA analysis, DATA analysis -- Software, DESCRIPTIVE statistics, Neuropsychological Tests, RANDOMIZED controlled trials, REPEATED measures design, RESEARCH -- Evaluation, RESEARCH -- Methodology, RESEARCH methodology evaluation, SAMPLING (Statistics), STATISTICS, T-test (Statistics)
@article{Resch2013b,
title = {Influence of Mood State on the ImPACT},
author = {Resch, Jacob E and Brown, Cathleen N and Baumgartner, Ted A and Macciocchi, Stephen N and Walpert, Kimberly P and Ferrara, Michael S},
isbn = {19425864},
year = {2013},
date = {2013-01-01},
journal = {Athletic Training \& Sports Health Care},
volume = {5},
number = {6},
pages = {272--281},
abstract = {The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is reported to possess variable reliability potentially due to a variety of factors, including mood. This study examined the influence of mood on ImPACT performance. A repeated measures design was used to assess 104 healthy, college-aged students. Participants completed the Profile of Mood States-Brief (POMS-B) and the ImPACT at days 1, 45, and 50. Pearson correlation coefficients were calculated for the POMS-B and ImPACT composite scores. At day 1, the ImPACT's Impulse Control composite score was significantly correlated to POMS-B Fatigue-Inertia mood state (-0.23},
keywords = {*COLLEGE students, *PSYCHOLOGICAL tests, *SELF-evaluation, AFFECT (Psychology), ANALYSIS of variance, Clinical Trials, COGNITIVE testing, COMPUTER-assisted medical diagnosis, CORRELATION (Statistics), DATA analysis, DATA analysis -- Software, DESCRIPTIVE statistics, Neuropsychological Tests, RANDOMIZED controlled trials, REPEATED measures design, RESEARCH -- Evaluation, RESEARCH -- Methodology, RESEARCH methodology evaluation, SAMPLING (Statistics), STATISTICS, T-test (Statistics)},
pubstate = {published},
tppubtype = {article}
}
Hugentobler, Jason A; Gupta, Resmi; Slater, Robert; Paterno, Mark V; Riley, Michael A; Quatman-Yates, Catherine
Influence of Age on Postconcussive Postural Control Measures and Future Implications for Assessment Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 6, pp. 510–517, 2016, ISBN: 1050642X.
@article{Hugentobler2016,
title = {Influence of Age on Postconcussive Postural Control Measures and Future Implications for Assessment},
author = {Hugentobler, Jason A and Gupta, Resmi and Slater, Robert and Paterno, Mark V and Riley, Michael A and Quatman-Yates, Catherine},
isbn = {1050642X},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {6},
pages = {510--517},
abstract = {Objective: To examine the influence of age, sex, attention-deficit hyperactivity disorder (ADHD) status, previous history of concussion, and days since injury on postconcussion postural control assessment in adolescents who have suffered a concussion. Design: Prospective cohort study. Setting: Hospital-based outpatient clinic. Participants: Seventy-one participants (42 males; 29 females) with mean age 14.14 ± 2.44. Independent Variables: Age, sex, previous concussion history, ADHD status, total and severity of postconcussion symptoms, and days since injury. Main Outcome Measures: Total Balance Error Scoring System score, path length, center-of-pressure (COP) area, sample entropy, and Romberg quotient. Results: Pearson product-moment correlation coefficients were calculated to test for potential associations between the continuous participant characteristics and the postural control variables. Spearman correlation was used to test the association between symptom severity and the postural control variables. Standard multiple regression was used to model the extent to which participant characteristics accounted for the variance in the postural sway variables. Age was significantly associated with all of the postural sway variables except COP area for the eyes open condition and sample entropy in the anterior-posterior direction for the eyes closed condition. Sex, ADHD status, and previous concussion history did not significantly predict postural control scores. Conclusions: Age significantly influences scores on common postconcussion postural control assessments. Clinical Relevance: This study demonstrates that age is a critical factor that needs to be accounted for to improve the clinical appropriateness and utility of current postconcussion postural control assessments. [ABSTRACT FROM AUTHOR]},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Dematteo, Carol; Volterman, Kimberly A; Breithaupt, Peter G; Claridge, Everett A; Adamich, John; Timmons, Brian W
Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015, ISBN: 01959131.
@article{Dematteo2015b,
title = {Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion},
author = {Dematteo, Carol and Volterman, Kimberly A and Breithaupt, Peter G and Claridge, Everett A and Adamich, John and Timmons, Brian W},
isbn = {01959131},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose: The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods: Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results: Participants had a mean T SD symptom duration of 6.3 T 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions: Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. ABSTRACT FROM AUTHOR},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje
Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.
@article{VanderHorn2013,
title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},
author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},
isbn = {00039993},
year = {2013},
date = {2013-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {94},
number = {5},
pages = {867--874},
abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Resch, Jacob E; Brown, Cathleen N; Baumgartner, Ted A; Macciocchi, Stephen N; Walpert, Kimberly P; Ferrara, Michael S
Influence of Mood State on the ImPACT Journal Article
In: Athletic Training & Sports Health Care, vol. 5, no. 6, pp. 272–281, 2013, ISBN: 19425864.
@article{Resch2013b,
title = {Influence of Mood State on the ImPACT},
author = {Resch, Jacob E and Brown, Cathleen N and Baumgartner, Ted A and Macciocchi, Stephen N and Walpert, Kimberly P and Ferrara, Michael S},
isbn = {19425864},
year = {2013},
date = {2013-01-01},
journal = {Athletic Training \& Sports Health Care},
volume = {5},
number = {6},
pages = {272--281},
abstract = {The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is reported to possess variable reliability potentially due to a variety of factors, including mood. This study examined the influence of mood on ImPACT performance. A repeated measures design was used to assess 104 healthy, college-aged students. Participants completed the Profile of Mood States-Brief (POMS-B) and the ImPACT at days 1, 45, and 50. Pearson correlation coefficients were calculated for the POMS-B and ImPACT composite scores. At day 1, the ImPACT's Impulse Control composite score was significantly correlated to POMS-B Fatigue-Inertia mood state (-0.23},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hugentobler, Jason A; Gupta, Resmi; Slater, Robert; Paterno, Mark V; Riley, Michael A; Quatman-Yates, Catherine
Influence of Age on Postconcussive Postural Control Measures and Future Implications for Assessment Journal Article
In: Clinical Journal of Sport Medicine, vol. 26, no. 6, pp. 510–517, 2016, ISBN: 1050642X.
Abstract | BibTeX | Tags: ADOLESCENCE, AGE distribution (Demography), ATTENTION-deficit hyperactivity disorder, CORRELATION (Statistics), DATA analysis, DATA analysis -- Software, DESCRIPTIVE statistics, DISEASE complications, EQUILIBRIUM (Physiology), LONGITUDINAL method, MEDICAL history taking, MULTIPLE regression analysis, postconcussion syndrome, PROBABILITY theory, Questionnaires, SEVERITY of illness index, SEX distribution (Demography), STATISTICS
@article{Hugentobler2016,
title = {Influence of Age on Postconcussive Postural Control Measures and Future Implications for Assessment},
author = {Hugentobler, Jason A and Gupta, Resmi and Slater, Robert and Paterno, Mark V and Riley, Michael A and Quatman-Yates, Catherine},
isbn = {1050642X},
year = {2016},
date = {2016-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {26},
number = {6},
pages = {510--517},
abstract = {Objective: To examine the influence of age, sex, attention-deficit hyperactivity disorder (ADHD) status, previous history of concussion, and days since injury on postconcussion postural control assessment in adolescents who have suffered a concussion. Design: Prospective cohort study. Setting: Hospital-based outpatient clinic. Participants: Seventy-one participants (42 males; 29 females) with mean age 14.14 ± 2.44. Independent Variables: Age, sex, previous concussion history, ADHD status, total and severity of postconcussion symptoms, and days since injury. Main Outcome Measures: Total Balance Error Scoring System score, path length, center-of-pressure (COP) area, sample entropy, and Romberg quotient. Results: Pearson product-moment correlation coefficients were calculated to test for potential associations between the continuous participant characteristics and the postural control variables. Spearman correlation was used to test the association between symptom severity and the postural control variables. Standard multiple regression was used to model the extent to which participant characteristics accounted for the variance in the postural sway variables. Age was significantly associated with all of the postural sway variables except COP area for the eyes open condition and sample entropy in the anterior-posterior direction for the eyes closed condition. Sex, ADHD status, and previous concussion history did not significantly predict postural control scores. Conclusions: Age significantly influences scores on common postconcussion postural control assessments. Clinical Relevance: This study demonstrates that age is a critical factor that needs to be accounted for to improve the clinical appropriateness and utility of current postconcussion postural control assessments. [ABSTRACT FROM AUTHOR]},
keywords = {ADOLESCENCE, AGE distribution (Demography), ATTENTION-deficit hyperactivity disorder, CORRELATION (Statistics), DATA analysis, DATA analysis -- Software, DESCRIPTIVE statistics, DISEASE complications, EQUILIBRIUM (Physiology), LONGITUDINAL method, MEDICAL history taking, MULTIPLE regression analysis, postconcussion syndrome, PROBABILITY theory, Questionnaires, SEVERITY of illness index, SEX distribution (Demography), STATISTICS},
pubstate = {published},
tppubtype = {article}
}
Dematteo, Carol; Volterman, Kimberly A; Breithaupt, Peter G; Claridge, Everett A; Adamich, John; Timmons, Brian W
Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 11, pp. 2283–2290, 2015, ISBN: 01959131.
Abstract | BibTeX | Tags: *BRAIN -- Concussion, *BRAIN -- Wounds & injuries, *EXERCISE, *EXERCISE tests, *POSTCONCUSSION syndrome, *SPORTS participation, ADOLESCENCE, adolescents, brain concussion, children, DATA analysis, DATA analysis -- Software, DECISION making in clinical medicine, DESCRIPTIVE statistics, head injury, MULTIPLE regression analysis, ONE-way analysis of variance, postconcussion syndrome, RESEARCH -- Finance, Return to Play, SAMPLING (Statistics), STATISTICS
@article{Dematteo2015b,
title = {Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion},
author = {Dematteo, Carol and Volterman, Kimberly A and Breithaupt, Peter G and Claridge, Everett A and Adamich, John and Timmons, Brian W},
isbn = {01959131},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {11},
pages = {2283--2290},
abstract = {Purpose: The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA. Methods: Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion. Results: Participants had a mean T SD symptom duration of 6.3 T 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion. Conclusions: Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth. ABSTRACT FROM AUTHOR},
keywords = {*BRAIN -- Concussion, *BRAIN -- Wounds \& injuries, *EXERCISE, *EXERCISE tests, *POSTCONCUSSION syndrome, *SPORTS participation, ADOLESCENCE, adolescents, brain concussion, children, DATA analysis, DATA analysis -- Software, DECISION making in clinical medicine, DESCRIPTIVE statistics, head injury, MULTIPLE regression analysis, ONE-way analysis of variance, postconcussion syndrome, RESEARCH -- Finance, Return to Play, SAMPLING (Statistics), STATISTICS},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult},
pubstate = {published},
tppubtype = {article}
}
van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje
Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.
Abstract | BibTeX | Tags: *ANXIETY, *BRAIN -- Wounds & injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work
@article{VanderHorn2013,
title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},
author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},
isbn = {00039993},
year = {2013},
date = {2013-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {94},
number = {5},
pages = {867--874},
abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},
keywords = {*ANXIETY, *BRAIN -- Wounds \& injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work},
pubstate = {published},
tppubtype = {article}
}
Resch, Jacob E; Brown, Cathleen N; Baumgartner, Ted A; Macciocchi, Stephen N; Walpert, Kimberly P; Ferrara, Michael S
Influence of Mood State on the ImPACT Journal Article
In: Athletic Training & Sports Health Care, vol. 5, no. 6, pp. 272–281, 2013, ISBN: 19425864.
Abstract | BibTeX | Tags: *COLLEGE students, *PSYCHOLOGICAL tests, *SELF-evaluation, AFFECT (Psychology), ANALYSIS of variance, Clinical Trials, COGNITIVE testing, COMPUTER-assisted medical diagnosis, CORRELATION (Statistics), DATA analysis, DATA analysis -- Software, DESCRIPTIVE statistics, Neuropsychological Tests, RANDOMIZED controlled trials, REPEATED measures design, RESEARCH -- Evaluation, RESEARCH -- Methodology, RESEARCH methodology evaluation, SAMPLING (Statistics), STATISTICS, T-test (Statistics)
@article{Resch2013b,
title = {Influence of Mood State on the ImPACT},
author = {Resch, Jacob E and Brown, Cathleen N and Baumgartner, Ted A and Macciocchi, Stephen N and Walpert, Kimberly P and Ferrara, Michael S},
isbn = {19425864},
year = {2013},
date = {2013-01-01},
journal = {Athletic Training \& Sports Health Care},
volume = {5},
number = {6},
pages = {272--281},
abstract = {The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is reported to possess variable reliability potentially due to a variety of factors, including mood. This study examined the influence of mood on ImPACT performance. A repeated measures design was used to assess 104 healthy, college-aged students. Participants completed the Profile of Mood States-Brief (POMS-B) and the ImPACT at days 1, 45, and 50. Pearson correlation coefficients were calculated for the POMS-B and ImPACT composite scores. At day 1, the ImPACT's Impulse Control composite score was significantly correlated to POMS-B Fatigue-Inertia mood state (-0.23},
keywords = {*COLLEGE students, *PSYCHOLOGICAL tests, *SELF-evaluation, AFFECT (Psychology), ANALYSIS of variance, Clinical Trials, COGNITIVE testing, COMPUTER-assisted medical diagnosis, CORRELATION (Statistics), DATA analysis, DATA analysis -- Software, DESCRIPTIVE statistics, Neuropsychological Tests, RANDOMIZED controlled trials, REPEATED measures design, RESEARCH -- Evaluation, RESEARCH -- Methodology, RESEARCH methodology evaluation, SAMPLING (Statistics), STATISTICS, T-test (Statistics)},
pubstate = {published},
tppubtype = {article}
}