Collegiate Adapted Athlete Baseline Performance on the Vestibular/Ocular Motor Screening

CONTEXT

Concussion assessment in adapted and para-sport athletes has continued to evolve with growing considerations in para-sports, but little is known about vestibular/ocular performance assessment in this sample.

OBJECTIVE

To examine baseline performance on the Vestibular/Ocular Motor Screening (VOMS) in collegiate adapted athletes. A secondary objective was to investigate the role of sex, history of concussion, and functional classification on baseline measures.

DESIGN

Cross-sectional study.

SETTING

University adapted athletics facility.

PATIENTS OR OTHER PARTICIPANTS

54 collegiate adapted athletes (age=21.19±2.6 years) from multiple institution's adapted athletics programs across the United States.

MAIN OUTCOME MEASURES

Adapted athletes completed a baseline VOMS assessment while at the host university for in-season competition and tournaments. Independent variables were sex, history of concussion and functional classification (1.0-4.5 at 0.5 intervals). VOMS performance consisted of pre-test symptoms (headache, dizziness, nausea, and fogginess) and post-item (e.g., smooth pursuits, saccades) symptom provocation/change from pre-test scores.

RESULTS

50.9% reported 0 symptom provocation on the VOMS, with 72% having no pre-test symptoms. No sex differences were noted on the VOMS (p>0.05); However, adapted athletes with a history of concussion reported greater VOMS provocation on horizontal saccades (p=0.008) than those with no history. Higher functional classifications (2.0-4.5) reported greater provocation on horizontal saccades (p=0.010), horizontal and vertical saccades (p=0.043 and 0.048) vestibular ocular reflex (VOR), and VOR cancellation (p=0.036) than 1.0-1.5 athletes.

CONCLUSIONS

Our findings provide context for baseline VOMS performance in collegiate adapted athletes and identifying modifiers at baseline. Special consideration is warranted on vestibular and oculomotor assessment in adapted and para-sport athletes with a history of concussion and higher functional classifications.

Level of Agreement Between Child and Parent Reporting on the Child Sport Concussion Assessment Tool (SCAT5)

CONTEXT

The Child Sport Concussion Assessment Tool, fifth edition (SCAT5), remains the consensus instrument for concussion evaluation in youth athletes. Both child and parent are recommended to complete the athlete background and symptom reporting.

OBJECTIVE

To determine the level of agreement between child and parent medical history and symptom reporting and quantify their performance on the Child SCAT5 in male football athletes.

DESIGN

Cross-sectional study.

SETTING

National Collegiate Athletic Association Division I college football facility.

PATIENTS OR OTHER PARTICIPANTS

A total of 157 youth male football athletes (age = 10.7 ± 1.3 years) participating in a university-sanctioned youth football camp and their parent or legal guardian.

MAIN OUTCOME MEASURE(S)

Youth athletes and their parent completed the athlete background (demographics, diagnosed medical history) and symptom evaluation (symptom items, total number of symptoms, and symptom severity score) of the Child SCAT5 and were instructed not to discuss reporting with each other during testing. Cronbach α tests were conducted to determine the internal consistency, and descriptive statistics determined the level of agreement between medical history, symptom reporting, and baseline performance.

RESULTS

The internal consistency of the symptom items was high for both child (Cronbach α = 0.91) and parent (α = 0.92). Agreement on medical history ranged from 67% (learning disability or dyslexia) to 85% (attention-deficit/hyperactivity disorder), with 82% agreement on sustaining a previous concussion. Fourteen youth athletes reported having been hospitalized for a head injury, with zero matched parent confirmations. Individual symptom agreement ranged from 70.7% (gets distracted easily) to 94.9% (going to faint). Agreement was 35% on total number of symptoms and severity. Abnormal scoring ranged from 2% (going to faint) to 25% (headache) for child and 2% (double vision) to 28% (gets distracted easily) for parent reporting.

CONCLUSIONS

Fair agreement was shown between children and their parent on medical history and self-reported symptoms on the Child SCAT5 at baseline. When available, child and parent reporting should be used for concussion assessment and clinical decision-making.

Baseline Computerized Neurocognitive Testing and Oculomotor Measures are not Altered by Hormonal Contraceptive Use

OBJECTIVE

Neurocognitive testing and oculomotor assessment have been an integral component to provide objective measures for sport-related concussion (SRC) detection and management. Hormonal contraceptive (HC) use is common among collegiate female athletes and may modify baseline SRC performance. The purpose was to examine the effects of HC use on baseline computerized neurocognitive testing (CNT) and oculomotor testing in college-aged individuals.

METHOD

A total of 63 participants (22 HC using females, 22 non-HC using females, 19 males) completed a baseline SRC battery consisting of CNT, near point of convergence (NPC), and the King-Devick (KD) test. CNT measures were composite scores of verbal and visual memory, visual motor processing speed and reaction time, impulse control, and cognitive efficiency index (CEI). NPC was measured as the average convergence distance across three trials. KD time was recorded as total time for each of the two trials and best trial marked as baseline.

RESULTS

There were no group differences between HC, non-HC, and male control groups on all baseline CNT composite scores (p = .13-.98), impulse control (p = .47), and CEI (p = .49). NPC distance was similar between groups (p = .41), as well as KD time by trial (Trial 1 p = .65; 2 p = .48) and best time (p = .49).

CONCLUSIONS

HC use does not appear to influence baseline SRC measures of neurocognition and oculomotor assessment. Clinicians should continue to consider the effects of modifying factors at baseline and post-concussion. Additional research is needed to better understand sex hormone levels and SRC performance measures.