Concussion Outcome Measures

Question 1

what 3 things does the SCAT5 look at?

Answer 1

• red flags
• memory assessment
• GCS

Question 2

which outcome measure is the primary method of evaluation of neurocognitive impairments?

Answer 2

ImPACT Test (the sideline imPACT test is a modified version that can be used as a sideline assessment)

Question 3

what are the 4 components of the NFL Sideline Tool?

Answer 3

• Symptom evaluation (Post-Concussive Symptom Scale)
• Neuro screen
• Standardized Assessment of Concussion (SAC)
• Modified BESS

Question 4

what are the 5 components of the SAC? (NO IDC)

Answer 4

• Neuro screen
• Orientation
• Immediate memory
• Delayed recall
• Concentration

Question 5

what is included in the King-Devick test?

Answer 5

• 2 minute rapid naming assessment

- Eye movements, attention, language function

Question 6

what does a higher score on the Post Concussive Symptom Scale (PCSS) indicate?

Answer 6

worse symptoms

Question 7

what 5 tests/measures are included on the Vestibular/Ocular-Motion Screening (VOMS)?

Answer 7

• Smooth pursuits
• Saccades (horizontal/vertical)
• Convergence
• VOR (horizontal/vertical)
• Visual motion sensitivity test

Question 8

what are the cut-off scores for the Motion Sensitivity Quotient?

Answer 8

0-10 → mild vestib dysfunction
11-30 → moderate vestib dysfunction
31-100 → severe vestib dysfunction

Question 9

what are the 2 components of the Dynamic Exertional Testing (EXiT)?

Answer 9

Aerobic endurance + dynamic moving tasks

Question 10

what is the goal of EXiT?

Answer 10

• replicate sport movement, particular tasks that require spatial orientation
• “In order to exit the room, you have to be able to go fast and you don’t want to run into the door”

Question 11

what 4 things does EXiT measure?

Answer 11

• Time to complete task
• # of errors (rest, etc)
• Physiological response to activity (HR, BP, RPE)
• Symptoms

Question 12

the Balance Error Scoring System (BESS) evaluates ____ stability in ____ conditions

Answer 12

postural, static

Question 13

what does a lower score on the BESS indicate?

Answer 13

less errors, better balance

Question 14

the Star Excursion Balance Test evaluates ____ control and ____ function

Answer 14

postural, LE

Question 15

the Star Excursion Balance Test is a screening tool for ____ participation as well as a post-rehab test to ensure dynamic functional ____

Answer 15

sport, symmetry

Question 16

why is the Star Excursion Balance Test important?

Answer 16

athletes post-SRC have higher incidence of proprioceptive impairment and and are at greater risk of LE injury

Question 17

what is the minimum mobility requirement for the High-level Mobility Assessment Tool (HiMAT)?

Answer 17

pt must be able to independently ambulate 20m w/o gait deviations

Question 18

what is a limitation of the HiMAT?

Answer 18

Some concern for ceiling effects (male > female)

Question 19

what is the gold standard for investigating exercise tolerance in pts w/ post-concussive symptoms > 3 weeks?

Answer 19

Buffalo Concussion Treadmill Test (BCTT)

Question 20

what are 3 goals of the BCTT?

Answer 20

• Help establish appropriate levels of exercise to aid in return to play/activity
• Differentiate between possible diagnoses for concussive symptoms
• ID physiological variables associated w exacerbation of symptoms and the pt’s level of recovery

Question 21

what are the stopping criteria for the BCTT? (only one needs to be met!)

Answer 21

• Symptom exacerbation (inc in 3+ points on VAS)
• Voluntary exhaustion (RPE > 17)
• Pt demos rapid progression of complaints, appears faint, has stopped communicating, or continuing the test constitutes sig. health risk for the pt
• Pt reaches 90% or more of age-predicted HRmax

Question 22

what are the prescription guidelines for the BCTT?

Answer 22

• 80% of max HR reached w/o symptom exacerbation
• 20 min/day w/o exceeding time or HR constraints
• Swimming, walking, or stationary cycling → do NOT attempt resistance training
• If any post-concussion symptoms return along the progression, the pt must return to the previous asymptomatic stage/max HR