Category: Brain Injury; Cross-Cutting; Athlete Development & Sports Rehabilitation
To investigate individual differences of recovery in the multimodal auditory-visual-motoric task after sport-related concussion (Bialunska and Salvatore 2017). To test, using logistic regression modeling, whether a variable outcome of reaction time (RT) in Computerized-Revised Token Test (C-RTT) 20 days after injury (DAI) across athletes depends on relatively spared or faster recovery of an individual's cognitive capacities, or/and other factors.
Design : Inception/validation cohort study, mixed-design. Group of athletes with a concussion were administered three assessments following injury (within 72 hours, 2 weeks, and 3 weeks). C-RTT RT results from first and third evaluation were expressed in z-scores (relative to the performance of controls tested once) and distribution based (the half-standard deviation) difference between first and third evaluation (minimally important difference) was calculated to create two categories of athletes with a concussion: Positive Change – (1) if RT decreased, and the difference was bigger than 0.5 SD, and No Positive Change – (0) if RT increased and/or was less than 0.5 SD. Athletes' category was entered as a binary dependent variable to the logistic regression model.
Setting : Concussion Management Clinic
Participants (or Animals, Specimens, Cadavers) : athletes with concussion (N = 85; male = 64; age = 18.1) and matched controls (N = 143; male = 99; age = 20.4)
Interventions : Not applicable
Main Outcome Measure(s) :
A variety of potential predictors - results obtained from three consecutive evaluation following an injury on VIII Subtest of C-RTT, ImPACT, and Post-Concussion Symptoms Scale (Bialunska and Salvatore 2017), together with additional data from other clinical tools (fluency and balance tests), and demographic variables
Results : Different models were tested and an optimal, leading to the most satisfactory fit to the data was selected. It provides a significant fit as compared to a null model (−2LL = 84.01, χ2 = 23.73, p < 0.001; Nagelkerke R2 = 0.34). A positive change was predicted by visual processing capacities and visual-motor speed on second evaluation (performance in X's and O's Module, and interference task of Three Letters Module ImPACT), as well as by impulse control (ImPACT) and efficiency in C-RTT from first evaluation. None of the examined verbal scores was significant.
The impulse control right after the injury and promptly recovering visual-motor processing (10 DAI) foster a positive C-RTT RT outcome on 20 DAI.
Anita Bialunska– Assistant Professor, University of Texas at El Paso, El Paso, Texas