Concussion Outcome Measures Flashcards
What is the # 1 neurocognitive impairment outcome measure?
ImPACT
What are the 5 sideline concussion assessments?
- SCAT5
- Sideline ImPACT test
- NFL Sideline Tool
- Standardized Assessment of Concussion (SAC)
- King-Devick Test
SCAT5 characteristics
- immediate on-field assessment and office-based assessment
- red flags, memory assessment, GCS
- symptom evaluation, cognition and neuro screen
NFL sideline tool characteristics
- symptom evaluation (Post-Concussive Symptom Scale)
- neuro screen
- standardized assessment of concussion
- modified BESS
Standardized Assessment of Concussion (SAC) characteristics
- orientation
- immediate memory
- neuro screen
- concentration
- delayed recall
King-Devick Test characteristics
- 2 min rapid naming assessment
- eye movements
- attention
- language function
What is the PCSS? What does it measure?
Post Concussive Symptom Scale
- measure types and length of concussive symptoms
- higher scores = worse symptoms
What is the VOMS? What does it measure?
Vestibular/Ocular-Motion Screening
- looks at symptom provocation as it related to tests and measures and compares them to baseline
What is visual motion sensitivity test? How do you perform it?
- part of VOMS and looks at eyes ability to stop movement when your vestibular system is working
- as a unit, patient extends arms and focuses on thumbs and moves head, neck, and trunk 80 degrees to R and L x5 reps at 50 bpm rate
What is the only concussion measure that has direct incorporation of evaluating for BPPV?
Motion Sensitivity Quotient
What is the Motion Sensitivity Quotient? What does it measure?
evaluates motion sensitivity related to functional tasks like sit to stand, etc.
Likely provoked S & S of motion sensitivity (8)
- episodic dizziness/vertigo
- pallor
- diaphoresis
- tiredness
- salivation
- N/V
- imbalance
- disorientation
What are the cutoffs available for the Motion Sensitivity Quotient?
0-10 - mild vestibular dysfunction
11-30 - moderate vestibular dysfunction
31-100 - severe vestibular dysfunction
What is the EXiT? What does it measure?
dynamic exertional testing
- looks at aerobic endurance + dynamic moving tasks
- takes agility into account - great for athletes
Measures
- time to complete task
- # of errors
- physiological response to activity (HR, BP, RPE)
- symptoms
What is the BESS Test? What does it measure? Scoring?
evaluates postural stability in static conditions
- sensory organization in static stance
- double, single, tandem stance on floor and foam surface (6 total conditions)
- scored 0-60 with lower scores = less errors and better balance
What is the Star Excursion Balance Test? What does it measure?
tests postural control + LE function
- tests dynamic functional symmetry due to increased risk for LE injury post concussion
Why is there an increased risk for LE injury post concussion?
increased incidence of proprioceptive impairment
What is the HiMAT? What does it measure?
High-Level Mobility Assessment tool
- looks at high level mobility skills like running, jumping, skipping, hopping, etc.
- higher score is better
What is required for HiMAT and what are some concerns?
independent 20m mobility w/ no gait deviations required
concern for ceiling effects (males > females)
What is the purpose of the Buffalo Concussion Treadmill Test?
exercise tolerance after concussion > 3 weeks
- gold standard
- speed and incline is progressed while physiological and symptoms are monitored
- helps differentiate between possible diagnoses for concussive symptoms b/c not all have exercise intolerance
List the 4 stopping criteria for the BCTT
- symtpom exacerbation (increase of 3 on visual analog scale)
- voluntary exhaustion (RPE > 17 w/o significant symptom exacerbation)
- pt has rapid progression of complaints, appears faint, stopped talking, or shows health risk
- pt reaches 90% or more of age-predicted HRmax
What type of exercise prescription can we make from the BCTT?
Can be used to create sub-max exercise levels for recovery/return to sport
How does symptom provocation factor into exercise prescription from the BCTT?
some subtypes of concussions shouldn’t have issues with the test because PA doesn’t bring on symptoms
- cervical
