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}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Asplund, C A; Kutcher, J S
Syncope in athletes of neurological origin: 2B. From personal history and physical examination sections Journal Article
In: Current Sports Medicine Reports, vol. 14, no. 3, pp. 256–257, 2015.
BibTeX | Tags: *Athletes, *Brain Concussion/di [Diagnosis], *Heat Stroke/di [Diagnosis], *Psychophysiologic Disorders/di [Diagnosis], *Seizures/di [Diagnosis], *Syncope, Accidental Falls, Adolescent, Brain Concussion/co [Complications], DIAGNOSIS, Differential, Female, football, Heat Stroke/co [Complications], Humans, Male, MEDICAL history taking, Psychophysiologic Disorders/co [Complications], Running, Seizures/co [Complications], Vasovagal/et [Etiology], Young Adult
@article{Asplund2015,
title = {Syncope in athletes of neurological origin: 2B. From personal history and physical examination sections},
author = {Asplund, C A and Kutcher, J S},
year = {2015},
date = {2015-01-01},
journal = {Current Sports Medicine Reports},
volume = {14},
number = {3},
pages = {256--257},
keywords = {*Athletes, *Brain Concussion/di [Diagnosis], *Heat Stroke/di [Diagnosis], *Psychophysiologic Disorders/di [Diagnosis], *Seizures/di [Diagnosis], *Syncope, Accidental Falls, Adolescent, Brain Concussion/co [Complications], DIAGNOSIS, Differential, Female, football, Heat Stroke/co [Complications], Humans, Male, MEDICAL history taking, Psychophysiologic Disorders/co [Complications], Running, Seizures/co [Complications], Vasovagal/et [Etiology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
Abstract | BibTeX | Tags: Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness},
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}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Asplund, C A; Kutcher, J S
Syncope in athletes of neurological origin: 2B. From personal history and physical examination sections Journal Article
In: Current Sports Medicine Reports, vol. 14, no. 3, pp. 256–257, 2015.
@article{Asplund2015,
title = {Syncope in athletes of neurological origin: 2B. From personal history and physical examination sections},
author = {Asplund, C A and Kutcher, J S},
year = {2015},
date = {2015-01-01},
journal = {Current Sports Medicine Reports},
volume = {14},
number = {3},
pages = {256--257},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
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}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Asplund, C A; Kutcher, J S
Syncope in athletes of neurological origin: 2B. From personal history and physical examination sections Journal Article
In: Current Sports Medicine Reports, vol. 14, no. 3, pp. 256–257, 2015.
BibTeX | Tags: *Athletes, *Brain Concussion/di [Diagnosis], *Heat Stroke/di [Diagnosis], *Psychophysiologic Disorders/di [Diagnosis], *Seizures/di [Diagnosis], *Syncope, Accidental Falls, Adolescent, Brain Concussion/co [Complications], DIAGNOSIS, Differential, Female, football, Heat Stroke/co [Complications], Humans, Male, MEDICAL history taking, Psychophysiologic Disorders/co [Complications], Running, Seizures/co [Complications], Vasovagal/et [Etiology], Young Adult
@article{Asplund2015,
title = {Syncope in athletes of neurological origin: 2B. From personal history and physical examination sections},
author = {Asplund, C A and Kutcher, J S},
year = {2015},
date = {2015-01-01},
journal = {Current Sports Medicine Reports},
volume = {14},
number = {3},
pages = {256--257},
keywords = {*Athletes, *Brain Concussion/di [Diagnosis], *Heat Stroke/di [Diagnosis], *Psychophysiologic Disorders/di [Diagnosis], *Seizures/di [Diagnosis], *Syncope, Accidental Falls, Adolescent, Brain Concussion/co [Complications], DIAGNOSIS, Differential, Female, football, Heat Stroke/co [Complications], Humans, Male, MEDICAL history taking, Psychophysiologic Disorders/co [Complications], Running, Seizures/co [Complications], Vasovagal/et [Etiology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Register-Mihalik, J K; De Maio, V J; Tibbo-Valeriote, H L; Wooten, J D
Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, no. 6, pp. 502–508, 2015.
Abstract | BibTeX | Tags: Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness
@article{Register-Mihalik2015,
title = {Characteristics of pediatric and adolescent concussion clinic patients with postconcussion amnesia},
author = {Register-Mihalik, J K and {De Maio}, V J and Tibbo-Valeriote, H L and Wooten, J D},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
number = {6},
pages = {502--508},
abstract = {Objective: The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design: Cross-sectional, retrospective clinical cohort. Setting: Concussion services clinic. Patients: Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors: Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injuryrelated visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures: Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results: Factors associated with amnesia (univariate, P \< 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity \>75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, amnesia, anamnesis, Article, brain concussion, Child, complication, Concussion, Concussive injury, Cross-Sectional Studies, cross-sectional study, Demography, disease severity, emergency ward, ethnology, Female, head injury, human, Humans, major clinical study, Male, MEDICAL history taking, Memory, ODDS ratio, outcome assessment, postconcussion symptoms, priority journal, race, Retrospective Studies, retrospective study, Risk, risk factor, Risk Factors, unconsciousness},
pubstate = {published},
tppubtype = {article}
}