Assessment of Concussion and Sub-Concussive Blows using Impact and Dual-Task Tests during a High School Football Season.
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2017-05
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Context: Laboratory-based Dual-Task (DT) tests have detected deficits from concussions past return to play using the current assessment battery. A clinically-viable DT test has yet to be investigated in the secondary school setting. Objective: (1) determine reliability and learning effects of DT testing in adolescents; and (2) examine effects of concussions on DT (ETGUG+APST). Design: Repeated measures. Setting: Local private secondary school. Participants: 118 athletes (12-17 years old) were used for between sport analysis, 18 multisport athletes were also identified, eight athletes were concussed. Interventions: Pre- and post-season and post-concussion DT and ImPACT tests were performed. The DT test consisted of the Expanded Timed-Get-Up-and-Go (ETGUG) and the Auditory Pure Switch Task (APST). Participants completed three trials of the ETGUG and APST separately before DT testing. Post-concussion DT data were collected with the ImPACT throughout the return to play protocol. Main Outcome Measures: ETGUG-time to completion; APST-percent accuracy and response rate; ImPACT-composite scores. Results: Overall, reliability trended upwards in all healthy athletes with fair to excellent reliability. Significant deficiencies were identified in concussed individuals in Single-Task A learning effect was identified through pre- and post-season assessment as well as multisport athletes 3 testing sessions. Response Rate (Baseline: .719±.076, Post-Concussion: .788±.094, p=.018) and DT Percent Accuracy (Baseline: .916±.051, Post-Concussion: .876±.067, p=.017). Conclusions: Results indicated that DT test identified deficits in athletes following concussion. Reliability increased in the older age groups. This clinically-viable DT test has the potential to be used for concussions assessment and management and is worthy of further investigation.
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