Neurocognitive Assessment of Sports-Related Concussion
|
|
- April McLaughlin
- 6 years ago
- Views:
Transcription
1 Neurocognitive Assessment of Sports-Related Concussion AAN Concussion Summit June 20, 2014 Ruben J. Echemendía, Ph.D.
2 Disclosure Dr. Echemendia receives compensation as a consultant to:
3 Neuropsychology: Historical Perspectives Neuropsychology has been used in the evaluation of brain disorders since the early 1900 s. Significant impact in the assessment of Traumatic Brain Brain Injury following WWII. Early 1970 s applied to the assessment of MTBI. Late 1980 s, early 1990 s incorporated into sports concussion management
4 Neuropsychology: Historical Perspectives Early work in Europe using NP tests with professional soccer players. Early work in US and Europe in boxing. Gronwall & Wrightson (1974) in NZ looked at concussed pts PTA<24 hrs using PASAT. Found deficits resolved in < 35 days. Dikmen et al., 1986; Gentilini et al., 1985; Levin et al., 1987 examined MTBI and generally found deficit resolution in 3 days to 3 months.
5 Neuropsychology: Historical Perspectives Some studies did not find such rapid recovery among MTBI patients (Barth et al., 1983; Rimel, et al., 1981) Wrightson & Gronwall (1981) found nearly 20% of patients had neurocognitive deficits 90+ days past injury. Dacey & Dikmen (1987) noted possible premorbid confounds may account for disparate findings: premorbid intellectual, neurocognitive, psychiatric/psychological, trauma, substance abuse differences.
6 Sports Neuropsychology: Historical Perspectives Pivotal pioneering work by Jeff Barth at UVA using SLAM model (1989). Using college football players from 10 institutions Barth employed a pre-injury baseline testing paradigm followed by serial testing post-injury. 2,300 were tested at baseline. Concussed athletes evaluated at 24 hrs, 5 days, 10 days post injury. Found deficits resolved within 5-10 days.
7 Assessment
8 Assessment Neuroimaging Conventional neuroimaging is not very helpful in understanding the microstructure of the human brain and in the past had only limited utility in assessing the neural effects of concussion [The] structural and physiological imprint of the concussion is below the threshold of detection using conventional neuroimaging methods. Erin Bigler, 2012.
9 Neurocognitive Assessment The brain is the most complex organ in the body, controlling all of its functions. Fully assessing the functioning of the brain is equally complex. It cannot be done quickly, with one measure, or by people inadequately trained to do so.
10 Neuropsychological Testing Concussions are largely functional rather than structural. Neuropsychological testing examines what the brain does. Learning, Memory, Information Processing Speed, Problem Solving Skills, Cognitive Flexibility Emphasis on functional rather than structural assessment Can be repeated serially during recovery Provides quantitative indices of neurocognitive functioning.
11 Does Neuropsychological Testing work in the sports domain? YES!
12 Hopkins Verbal Learning Test Delayed Recall 12 Injured Control Control Test Intervals Baseline 2 Hour 48 Hour Number of Words Recalled 1 Week Month Injured Echemendia, et al., 2001
13 Meta Analysis Effect Sizes NP Effects Iverson, Gagnon & Griesbach, 2012
14 Value Added of Neuropsychological Testing Data Abnormal SYMPTOMS Normal Abnormal NEUROPSYCH Normal 116 (39%) 32 (11%) 91 (30%) 61 (20%) N=300 from merged Physician and NP database
15 Are there limitations to the use of neuropsychological assessment in the sports domain? YES!
16 Tests Used in Sports TBI.
17 Important to Remember ImPACT does NOT equal neuropsychological assessment. It is only one of many different instruments than can be used. Neuropsychological tests should NEVER be used in isolation to make RTP decisions.
18 Differentiating Between Brief Cognitive Screening and Neuropsychological Assessment Brief measures of cognitive functioning (e.g. SAC, SCAT) are designed as screening measures. They only assess isolated domains of functioning in very rudimentary ways. Typically have marked ceiling effects. Generally lose sensitivity within a short period of time (e.g. 72 hours). Good for identifying acute, significant neurocognitive dysfunction. Not good for RTP.
19 Differentiating Between Brief Cognitive Screening and Neuropsychological Assessment Sports Concussion Batteries are far less comprehensive than traditional NP batteries. But, much more comprehensive than screening batteries. Not practical in the acute phase of injury for most settings. More useful for management, determining severity of cognitive dysfunction, and assisting in RTP decisions.
20 Paper & Pencil Tests
21 Trail Making Test
22 TRAILS B
23 Paper & Pencil Tests Selected from tests already in use and validated for assessing MTBI Test Requirements: Short Easily administered by non NPs Easily scored Sensitive to changes in specified domain Acceptable psychometrics Alternate forms. Assess several cognitive domains. Typical Tests: HVLT. BVMT. Trails, Digit Span, SDMT, Verbal Fluency, LNS, Cancellation tests.
24 Paper & Pencil Tests Cont. Advantages: Direct observation of player behavior Direct monitoring of effort/motivation & task performance Superior assessment of memory Broad normative db with multiple samples. Disadvantages: Labor intensive (Expensive) Variability in standardized admin Less reliable assessment of info proc speed. Tests must be hand scored
25 Computerized Tests
26 Computerized Batteries Two approaches: Adapt existing P&P measures into computer platform Measure multiple cognitive functions (memory, proc speed, reaction time, etc.) Develop tests de novo for computers Limited assessment of domains (largely RT, Info Proc Speed) New Instruments are being developed rapidly Existing Instruments: ImPACT, ANAM/Vista, CNS Vital Signs, C3 Logix, CogSport.
27 ImPACT PROGRAM
28 Computerized Tests Cont. Advantages: Can be used in groups (Less costly) Could be problematic Standardized administration (Maybe) Immediate scoring/data capture Finer assessment of RT/Proc Speed (altho other problems) Multiple languages Theoretically infinite alternate forms
29 Computerized Tests Cont. Disadvantages: Less complete assessment of memory Loss of observational data Less control of effort/motivation Diminished ability to assess understanding/track task performance Computer specific measurement issues Data loss
30 Hybrid Approaches Combine strengths of both P&P and Computerized tests Once adequate normative data have been established. Computer for baseline testing Computer plus P&P post-injury
31 The Hybrid Model: Do ImPACT and P&P Measure the same thing? P&P Only ImPACT only Both None N=114
32 Variability in Test Sensitivity 35 VerbMem Vis Mem VisMotor ReacTime HVLT Tot HVLT Mem SDMT Tot SDMT Mem 12 VFL PSU 8 8 BVMT Tot 5 4 BVMT Del 2 CTA 0 0 CTB
33 Baseline Testing: The Theory Pretest Posttest models are very strong methodological designs. Designed to limit confounding variability due to individual differences at baseline. First introduced into Sports by Barth, et al. Very strong intuitive appeal.
34 Establishing the Premorbid Baseline There is tremendous variability in cognitive functioning PRIOR to a head injury Premorbid Learning Disabilities Premorbid Head Injuries Drug/Alcohol Use Surgeries/General Anesthetics Complications with pregnancy or delivery Pre existing psychological/psychiatric dx. Amount and Quality of Education Cultural and Linguistic Differences
35 Baseline Testing Broadly Adopted Sports laboratory model Unique opportunity to examine cognitive and other domains of functioning prior to injury Endorsed by Consensus Groups CISG, NATA, Team Physicians Statement, NAN, NCAA Adopted by professional sports worldwide. Attempts have been made in the U.S. to legislate the use of baseline testing.
36 Baseline Testing Broadly Adopted Baseline testing has taken on a life of its own. Mass marketing of tests. Baseline testing = concussion program. Provides simple interpretation of post injury test data. Baselines can be taken at home, unsupervised. Results are printed and taken to PCP in case of concussion.
37 Mobile Baselines?
38 Assumptions in Baseline Testing Baseline assessment is equivalent to postinjury testing. Without intervening injury, baseline and postinjury test scores should be equivalent. Are they? Several authors have begun to question the widespread use of baseline testing models: Randolph & Kirkwood, 2009; Randolph, McCrea, & Barr, 2005; Echemendia, 2010.
39 Challenges to Baseline Testing Logistical Expensive, Large Numbers, equipment Psychometric Test retest reliability Motivation Differential motivation at baseline vs. post injury Sandbagging Administration Group vs. Individual Supervised vs. Unsupervised Instrumentation Variable timing across computers, mice, keyboards, etc.
40 Test Error Post Injury 3 Baseline Post Injury Post Injury 5 Post Injury 4
41 Test Retest Data
42
43 Utility of Baseline Data
44 Agreement between Normative Method (1.5 SD) and GLN Method ImPACT Composites Verbal Memory: Kappa =.71 Sensitivity 86%; Specificity 95%; Positive Predictive Value 66%. Negative Predictive Value.98%. Visual Motor Speed: Kappa =.76 Sensitivity.78%. Specificity.98%. Positive Predictive Value.78%. Negative Predictive Value.98%. Reaction Time: Kappa =.75 Sensitivity.80%. Specificity.96%. Positive Predictive Value.77%.Negative Predictive Value.97%.
45
46 Baseline vs. Normative Schmidt, et al., concussed college students tested with the Automated Neuropsychological Assessment Metrics (ANAM) Battery at baseline and following injury. Gender specific normative values were generated from a sample of 673 athletes. Two interpretive methods: Individualized baseline post injury comparison (Post Injury Baseline) Normative data baseline comparison (Post Injury Norm).
47 Baseline vs. Normative Schmidt, et al., 2012 cont. Individual baseline method identified 2.6 times more athletes with impairment than the normative method on the Simple Reaction Time subtest. Normative method identified athletes with impairment 7.6 times more often than the individual baseline method on the Mathematic Processing subtest. No differences occurred among the other ANAM measures, measures of postural control on the Sensory Organization Test (SOT), or a graded symptom checklist.
48 Summary/Questions These data are preliminary and limited to college samples. They do raise questions about the necessity for widespread baseline testing, particularly in situations of limited resources. Other important questions: Which groups of individuals are not identified using normative comparisons? LD? ADHD? Multiple Prior Concussions? Cognitively Gifted/Limited? Culturally/Linguistically Different? Educational differences?
49 Test administration is relatively routine and does not require extensive specialized knowledge. The administration of selected NP tests may be delegated to paraprofessionals who have been trained by the NP and are supervised by the NP. Interpretation of test data is complex and requires comprehensive knowledge of test theory, psychometric principles, statistics, individual test properties, the pathology being examined, etc. Clinical NPs are uniquely trained and qualified to interpret NP tests. Failure to consult with NPs may lead to inaccurate interpretation of data and present a medico-legal quandary.
50 Thank you!
NEUROCOGNITIVE ASSESSMENT OF SPORTS-RELATED CONCUSSION
NEUROCOGNITIVE ASSESSMENT OF SPORTS-RELATED CONCUSSION PROGRAM SYLLABUS All rights reserved. No part of this work can be reproduced, distributed, or otherwise used without the express permission from the
More informationRole of Neuropsychology Concussion Management. Aimee Custer, PsyD Clinical Sports Neuropsychologist
Role of Neuropsychology Concussion Management Aimee Custer, PsyD Clinical Sports Neuropsychologist Disclosures I have no disclosures Objectives Understand the differences between Neurocognitive test and
More informationRapid Mass Neuropsychological Testing
Rapid Mass Neuropsychological Testing Lindy Kilik, Ph.D., C.Psych. kilikl@queensu.ca Providence Care-MHS & Queens University, Kingston Brain Injury Association of Canada Annual Conference Sept. 30-Oct.
More informationMeasurement Issues in Concussion Testing
EVIDENCE-BASED MEDICINE Michael G. Dolan, MA, ATC, CSCS, Column Editor Measurement Issues in Concussion Testing Brian G. Ragan, PhD, ATC University of Northern Iowa Minsoo Kang, PhD Middle Tennessee State
More informationConcussion and neuropsychological testing (literature search) Dr Ryan Kohler December 2011
Concussion and neuropsychological testing (literature search) Dr Ryan Kohler December 2011 The Influence of Musculoskeletal Injury on Cognition: Implications for Concussion Research Hutchison, Michael;
More informationOptimizing Concussion Recovery: The Role of Education and Expectancy Effects
Rehabilitation Institute of Michigan Optimizing Concussion Recovery: The Role of Education and Expectancy Effects Robin Hanks, Ph.D., ABPP Chief of Rehabilitation Psychology and Neuropsychology Professor
More informationReading Based IQ Estimates and Actual Premorbid Cognitive Performance: Discrepancies in a College Athlete Sample
Journal of the International Neuropsychological Society (2012), 18, 139 143. Copyright E INS. Published by Cambridge University Press, 2011. doi:10.1017/s1355617711001275 BRIEF COMMUNICATION Reading Based
More informationDiagnostic Tools. Objectives UPDATES AND ADVANCES IN THE DIAGNOSIS AND MANAGEMENT OF SPORTS RELATED CONCUSSION
UPDATES AND ADVANCES IN THE DIAGNOSIS AND MANAGEMENT OF SPORTS RELATED CONCUSSION Summer D. Ott, Psy.D. Neuropsychologist & Assistant Professor Department of Orthopedics UT Medical School at Houston Director,
More informationA review of the validity of computerized neurocognitive assessment tools in mild traumatic brain injury assessment
For reprint orders, please contact: reprints@futuremedicine.com A review of the validity of computerized neurocognitive assessment tools in mild traumatic brain injury assessment Computerized neurocognitive
More informationConcussions in Soccer: Assessment and Management. Ruben J. Echemendía, Ph.D.
Concussions in Soccer: Assessment and Management Ruben J. Echemendía, Ph.D. Legalese All opinions expressed in this presentation are my own and do not necessarily represent the views of US Soccer unless
More informationSummary of evidence-based guideline update: Evaluation and management of concussion in sports
Summary of evidence-based guideline update: Evaluation and management of concussion in sports Report of the Guideline Development Subcommittee of the American Academy of Neurology Guideline Endorsements
More informationReview of: NATA Position Statement Management of Sport Concussion.
Review of: NATA Position Statement Management of Sport Concussion www.csm-institute.com Topics: Education and Prevention Documentation and Legal Aspects Evaluation and RTP Other Considerations Strength
More informationSports Neuropsychology: Definition, Qualifications, and Training Guidelines
Sports Neuropsychology: Definition, Qualifications, and Training Guidelines An Official Position of the Sports Neuropsychology Society Preamble Clinical neuropsychology has a long history, and clinical
More informationInstant Poll. Do you manage sport related concussions as a part of your medical practice?
Instant Poll Do you manage sport related concussions as a part of your medical practice? (1) Yes, frequently (5-10 patients per week) (2) Yes, occasionally (5-10 patients per month) (3) Yes, infrequently
More informationNeuropsychological Management of Pediatric Concussion
Neuropsychological Management of Pediatric Concussion John B. Fulton University of Utah School of Medicine Department of Pediatrics Primary Children s Hospital Department of Psychiatry and Behavioral Health
More informationThe Impact of Mild Traumatic Brain Injury on Cognitive Functioning Following Co-occurring Spinal Cord Injury
Archives of Clinical Neuropsychology 28 (2013) 684 691 The Impact of Mild Traumatic Brain Injury on Cognitive Functioning Following Co-occurring Spinal Cord Injury Abstract Stephen N. Macciocchi 1,2, *,
More informationBasis for Our Research
The Concussion Discussion: An Evidence Based Approach to Clinical Decision Making for Mild Traumatic Brain Injury Basis for Our Research Clinical Outcomes and Decision Making Communication and Standard
More informationThe University of North Carolina at Chapel Hill Sport Concussion Policy
The University of North Carolina at Chapel Hill Sport Concussion Policy Developed by the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center and Division of Sports Medicine Updated August
More informationImproving the Methodology for Assessing Mild Cognitive Impairment Across the Lifespan
Improving the Methodology for Assessing Mild Cognitive Impairment Across the Lifespan Grant L. Iverson, Ph.D, Professor Department of Physical Medicine and Rehabilitation Harvard Medical School & Red Sox
More informationThe Sport Concussion Assessment Tool-Second Edition and its Relationship with Attention and Verbal Learning in a Pediatric Population
J Pediatr Neuropsychol (2015) 1:14 20 DOI 10.1007/s40817-015-0003-7 The Sport Concussion Assessment Tool-Second Edition and its Relationship with Attention and Verbal Learning in a Pediatric Population
More informationWhat is concussion? DR MARTIN RAFTERY CHIEF MEDICAL OFFICER NOVEMBER 2016
What is concussion? DR MARTIN RAFTERY CHIEF MEDICAL OFFICER NOVEMBER 2016 2 WHAT IS RUGBY? Short video CONCUSSION WHY IMPORTANT? 1. Can mimic more serious intra-cranial injury 2. Can lead to persistent
More informationPEDIATRIC SPORTS RELATED CONCUSSIONS
Anna Mazur, PhD PEDIATRIC SPORTS RELATED CONCUSSIONS Disclosure No financial interests or funding 1 Presentation Outline Prevalence Predicting recovery: Post Traumatic Amnesia and Loss of Consciousness
More informationDr Simon Kemp Chief Medical Officer - The Rugby Football Union. Acute sideline assessment & the role of the SCAT5
Dr Simon Kemp Chief Medical Officer - The Rugby Football Union Acute sideline assessment & the role of the SCAT5 What do I do? Chief Medical Officer Rugby Football Union, UK Team Physician Sports Physician
More informationTwo-year Test Retest Reliability of ImPACT in High School Athletes
Archives of Clinical Neuropsychology 31 (2016) 105 111 Two-year Test Retest Reliability of ImPACT in High School Athletes William T. Tsushima 1, *, Andrea M. Siu 2, Annina M. Pearce 3, Guangxiang Zhang
More informationPre and Post Concussion Management
Pre and Post Concussion Management Timothy A. Tolbert, Ph.D., ATC Clinical Coordinator Marshall University Athletic Training Program 1 Concussion A complex pathophysiological process affecting the brain,
More informationNo relevant financial relationships to be discussed, directly or indirectly, referred to or illustrated with or without recognition within the
No relevant financial relationships to be discussed, directly or indirectly, referred to or illustrated with or without recognition within the presentation. 24 year old Olympic ice hockey player gets hit
More informationADHD and Concussion. Mary Alexis Iaccarino, MD
ADHD and Concussion Mary Alexis Iaccarino, MD Department of Physical Medicine and Rehabilitation Harvard Medical School Spaulding Rehabilitation Hospital MassGeneral Hospital for Children Sport Concussion
More informationConcussion Management: A Multidimensional & Interdisciplinary Approach
: A Multidimensional & Interdisciplinary Approach Jacob E. Resch, Ph.D., ATC Department of Kinesiology Exercise Sport and Injury Laboratory University of Virginia Disclosures: Sponsors: Biocore LLC Study:
More informationMonitoring Resolution of Postconcussion Symptoms in Athletes: Preliminary Results of a Web-Based Neuropsychological Test Protocol
Journal of Athletic Training 2001;36(3):280 287 by the National Athletic Trainers Association, Inc www.journalofathletictraining.org Monitoring Resolution of Postconcussion Symptoms in Athletes: Preliminary
More informationand present Date: Amended January 2015
and present Concussionn Guidelines in the GAA 2013 2016 Adopted by LGFA Date: Amended January 2015 Table of Contents Summary Principles... 2 What is Concussion?... 3 Signs and Symptoms... 3 Pitch Assessment
More informationConcussion in Youth Athletes: Where Are We Heading?
Concussion in Youth Athletes: Where Are We Heading? Thomas L. Pommering, D.O. Division Chief, NCH Sports Medicine Assistant Clinical Professor, Departments of Pediatrics and Family Medicine The Ohio State
More informationClinical Practice of a Vision Based Concussion Tool MATT FRANTZ, M.ED., LAT, ATC LAFAYETTE COLLEGE
Clinical Practice of a Vision Based Concussion Tool MATT FRANTZ, M.ED., LAT, ATC LAFAYETTE COLLEGE Disclosure No financial COI No non-financial COI No corporate bias or sponsorship Your Concussion Toolbag
More informationDirector of Athletics
3341-8-1 Concussion Management Policy. Applicability Intercollegiate Athletics Responsible Unit Policy Administrator Intercollegiate Athletics/Director of Athletics Director of Athletics (A) Policy Purpose
More informationCase reports. Computerised cognitive assessment of concussed Australian Rules footballers
354 Br J Sports Med 1;35:354 360 Case reports Centre for Sports Medicine Research Education, University of Melbourne, Parkville, Victoria, Australia M Makdissi P McCrory K Bennell Neuropsychology Laboratory,
More informationSports Related Concussion. Joshua T. Williams, PT, DPT, OCS, SCS, CSCS
Sports Related Concussion Joshua T. Williams, PT, DPT, OCS, SCS, CSCS Concussion & Traumatic Brain Injury Glasgow Coma Scale Minimal Mild Mod Severe? Sports concussion Severe GCS 8 Moderate GCS 9-12 Mild
More informationContact Sports and Concussion. Get your head in the game keep your head in the game!
Contact Sports and Concussion Get your head in the game keep your head in the game! Contact sports with concussion potential at UMW http://www.youtube.com/watch?v=yiqzdbk3m40 Safety First Safety First
More informationRESEARCH OBJECTIVE(S) List study objectives.
CRITICALLY APPRAISED PAPER (CAP) Zickefoose, S., Hux, K., Brown, J., & Wulf, K. (2013). Let the games begin: A preliminary study using Attention Process Training-3 and Lumosity brain games to remediate
More informationThe Pennsylvania State University. The Graduate School. College of the Liberal Arts
The Pennsylvania State University The Graduate School College of the Liberal Arts INTRAINDIVIDUAL COGNITIVE VARIABILITY IN SPORTS-RELATED CONCUSSION: IMPLICATIONS FOR MOTIVATION AND NEUROLOGICAL VULNERABILITY
More informationDetecting neurocognitive impairment in HIV-infected youth: Are we focusing on the wrong factors?
Detecting neurocognitive impairment in HIV-infected youth: Are we focusing on the wrong factors? Jennifer Lewis, PsyD; Mathew Hirsch, PsyD & Susan Abramowitz, PhD NYU School of Medicine, New York, NY Friday,
More informationAdult Neuropsychological Issues: Impact on Intellectual Functioning and Return to Work. Kenneth Perrine, Ph.D., ABPP-CN Weill Cornell Medical College
Adult Neuropsychological Issues: Impact on Intellectual Functioning and Return to Work Kenneth Perrine, Ph.D., ABPP-CN Weill Cornell Medical College Disclosures I receive compensation from the New York
More informationMild Traumatic Brain Injury in Sports, Daily Life, and Military Service
Mild Traumatic Brain Injury in Sports, Daily Life, and Military Service Grant L. Iverson, Ph.D. Professor, Department of Physical Medicine and Rehabilitation, Harvard Medical School; Director, MassGeneral
More informationVersion of record first published: 25 Apr 2012.
This article was downloaded by: [Dr William T. Tsushima] On: 23 October 2012, At: 13:21 Publisher: Psychology Press Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office:
More informationThe Changing Landscape of Sports Concussions
The Changing Landscape of Sports Concussions Anthony G. Alessi MD, FAAN Director, UConn NeuroSport Sports Medicine Symposium August 2, 2016 Overview Significance Diagnosis Sideline diagnosis v Management
More informationCurrent Concepts in Sports Concussion: Opportunities for the Physical Therapist. Concussion in Sport
Current Concepts in Sports Concussion: Opportunities for the Physical Therapist Concussion in Sport Current Concepts in Sports Concussion: Opportunities for the Physical Therapist Concussion Management:
More informationCase Study. Assessment of Mild Head Injury Using Measures of Balance and Cognition: A Case Study
Journal of Sport Rehabilitation, 1997,6, 283-289 0 1997 Human Kinetics Publishers, Inc. Case Study Assessment of Mild Head Injury Using Measures of Balance and Cognition: A Case Study Bryan L. Riemann
More informationThe Use of Brief Assessment Batteries in Multiple Sclerosis. History of Cognitive Studies in MS
This is the html version of the file http://wwwvagov/ms/library/managing/robert_kane_brief_assessment_batteries_in_msppt Google automatically generates html versions of documents as we crawl the web 1
More informationPrognosticating Protracted Recoveries from Sports Concussion: What are we Learning?
Prognosticating Protracted Recoveries from Sports Concussion: What are we Learning? Associate Professor UPMC Department of Orthopaedic Surgery UPMC Department of Neurological Surgery Director UPMC Sports
More informationINTRODUCTION. Abstract
Journal of the International Neuropsychological Society (2016), 22, 24 37. Copyright INS. Published by Cambridge University Press, 2015. doi:10.1017/s1355617715001101 Prospective, Head-to-Head Study of
More informationA Statistical Examination of Impaired Performances Across Concussion Screening Instruments
Marquette University e-publications@marquette Master's Theses (2009 -) Dissertations, Theses, and Professional Projects A Statistical Examination of Impaired Performances Across Concussion Screening Instruments
More informationProlonged Issues with Cognitive Function. Julie Miller, Psy.D., ABPP-CN Neuropsychologist Wallace-Kettering Neuroscience Institute
Prolonged Issues with Cognitive Function Julie Miller, Psy.D., ABPP-CN Neuropsychologist Wallace-Kettering Neuroscience Institute Presentation Outline Basics of human brain development Vulnerability of
More informationCognitive rehabilitation: assessment. Dawn Langdon PhD
Cognitive rehabilitation: assessment Dawn Langdon PhD 1 Assessment for cognitive rehabilitation Patient context Individual Family Work Insight Mood Motivation Observation of patient performance Rehabilitation
More informationUNDERSTANDING ATHLETIC TRAINERS BELIEFS TOWARD IMPLEMENTING A MULTIFACETED MANAGEMENT APPROACH AFTER A SPORT-RELATED
UNDERSTANDING ATHLETIC TRAINERS BELIEFS TOWARD IMPLEMENTING A MULTIFACETED MANAGEMENT APPROACH AFTER A SPORT-RELATED CONCUSSION: VALIDITY AND RELIABILITY MEASUREMENTS OF AN APPLICATION OF THE THEORY OF
More informationProcess of a neuropsychological assessment
Test selection Process of a neuropsychological assessment Gather information Review of information provided by referrer and if possible review of medical records Interview with client and his/her relative
More informationConcussion Management and Update. Objectives
Concussion Management and Update Ricardo Guirola MD M Ed Pediatric Rheumatology Primary Care Sports Medicine Objectives Review definition, signs and symptoms Discuss the initial evaluation of a patient
More informationCigna Medical Coverage Policy
Cigna Medical Coverage Policy Subject Neuropsychological Testing Table of Contents Coverage Policy... 1 General Background... 2 Coding/Billing Information... 17 References... 28 Effective Date... 7/15/2015
More informationBaseline Concussion Testing: The Effects of Learning Disabilities and Sleep
Grand Valley State University ScholarWorks@GVSU Honors Projects Undergraduate Research and Creative Practice 2015 Baseline Concussion Testing: The Effects of Learning Disabilities and Sleep Amy Jedele
More informationmtbi/concussion in Children, Adolescents & Young Adults: What it is and Why we should be Concerned Ronald C. Savage, Ed.D.
mtbi/concussion in Children, Adolescents & Young Adults: What it is and Why we should be Concerned Ronald C. Savage, Ed.D. rcsavage@comcast.net 1 How Common Are mtbi/concussions? CDC reports indicate that
More informationThe relation between post concussion symptoms and neurocognitive performance in concussed athletes
NeuroRehabilitation 22 (2007) 207 216 207 IOS Press The relation between post concussion symptoms and neurocognitive performance in concussed athletes Vanessa C. Fazio, Mark R. Lovell, Jamie E. Pardini
More informationDr. Paul Comper. Toronto Rehabilitation Institute. with PIA LAW
with PIA LAW and Toronto ABI Network Dr. Paul Comper Toronto Rehabilitation Institute Dr. Paul Comper is a clinical neuropsychologist at the Toronto Rehabilitation Institute University Health Network,
More informationThe Pennsylvania State University. The Graduate School. Department of Psychology
The Pennsylvania State University The Graduate School Department of Psychology BASE RATES AND CORRELATES OF ABNORMAL NEUROPSYCHOLOGICAL TEST PERFORMANCE ON A CONCUSSION ASSESSMENT BATTERY AMONG HEALTHY
More informationDayna Geiger DPT Concussion Education Specialist January 2015
Dayna Geiger DPT Concussion Education Specialist January 2015 Understand and implement at least 2 balance assessments Capable of being done in any environment Require minimal equipment Implement at least
More informationDisclosures 7/22/2015 MANAGEMENT OF SPORTS RELATED CONCUSSION. Brad Herskowitz MD Neurologist Baptist Hospital
MANAGEMENT OF SPORTS RELATED CONCUSSION Brad Herskowitz MD Neurologist Baptist Hospital Disclosures I have no relevant financial conflicts of interest. I will not discuss off label or unapproved usage.
More informationA THESIS SUBMITTED TO THE GRADUATE DIVISION OF THE UNIVERSITY OF HAWAI I AT MĀNOA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF
PRELIMINARY INVESTIGATION OF THE EFFICACY OF CLINICALLY PRACTICAL DUAL-TASK TESTS AS A CONCUSSION ASSESSMENT TOOL: A COMPARISON OF SINGLE- AND DUAL-TASK TESTS ON HEALTHY YOUNG ADULTS A THESIS SUBMITTED
More informationTHE CHALLENGES OF CHANGE
THE CHALLENGES OF CHANGE Brian Hainline, MD NCAA Chief Medical Officer Clinical Professor of Neurology Indiana University School of Medicine New York University School of Medicine Sport Science Institute
More informationMobile Reaction Time. Overview and Scoring System of the Sway Reaction Time Beta. September 12 th, Copyright 2014 Sway Medical LLC
Mobile Reaction Time Overview and Scoring System of the Sway Reaction Time Beta September 12 th, 2014 Copyright 2014 Sway Medical LLC WHAT IS REACTION TIME? Reaction time is a measure of sensory and neuromotor
More informationMulti-disciplinary TBI evaluation
Multi-disciplinary TBI evaluation Date: September 16, 2017 Ryan Rockwood, ATC Jennifer Wilhelm, PT, DPT, NCS Kyla Laraway, OT, DOT Haley Landau, M.S., CCC- SLP Adapted from Collins MW et al; Knee Surg
More informationSport-Related Concussion. Daniel Seidman DO 6 August 2016
Sport-Related Concussion Daniel Seidman DO 6 August 2016 My Pertinent Qualifications - Current Fellow, PCSM - Henry Ford Hospital - Recent Graduate, FM - St. John Macomb-Oakland Hospital - Involved in
More informationThe Need for Baseline Concussion Testing. Brandie Messer, DNP, RN DNP Coordinator Assistant Professor Saint Anthony College of Nursing
Traumatic Head Injuries: The Need for Baseline Concussion Testing Brandie Messer, DNP, RN DNP Coordinator Assistant Professor Saint Anthony College of Nursing TRAUMATIC BRAIN INJURIES PROBLEM STATEMENT
More informationParamus Athletics. Paramus High School Athletic Department Protocol and Procedures for Management of Sports - Related Concussion
Paramus Athletics Paramus High School Athletic Department Protocol and Procedures for Management Medical management of sports-related concussions is evolving. In recent years, there has been significant
More informationNew Study Confirms the Clinical Usefulness of the ImPACT Baseline ImPACT Testing Model VOL. 2 - FALL 2014
VOL. 2 - FALL 214 New Study Confirms the Clinical Usefulness of the ImPACT Baseline ImPACT Testing Model Authors: Philip Schatz, Stacey obertshaw. Archives of Clinical Neuropsychology. doi: 1.19/arclin/acu41.
More informationVestibular Rehabilitation for Dizziness and Balance. Disorders after Concussion
Vestibular Rehabilitation for Dizziness and Balance Disorders after Concussion by Bara Abdel Majid Alsalaheen Bachelor of Science in Physiotherapy, University of Jordan, 2006 Masters of Science, University
More informationCONCUSSION UPDATE 2017
CONCUSSION UPDATE 2017 Shannon Woods MD Medical Director CoxHealth Sports Medicine Team Physician Evangel University Team Physician Drury University 1 Cognitive Fogginess Difficulty concentrating Memory
More informationPsychometric and Measurement Properties of Concussion Assessment Tools in Youth Sports
Journal of Athletic Training 2006;41(4):399 408 by the National Athletic Trainers Association, Inc www.journalofathletictraining.org Psychometric and Measurement Properties of Concussion Assessment Tools
More informationAshley Cameron Littleton
The Effects of Attention Deficit Hyperactivity Disorder (ADHD) and Stimulant Medication on Clinical Measures of Concussion Ashley Cameron Littleton A thesis submitted to the faculty of the University of
More informationConcussion: Recognizing, Managing and Assisting Athletes to Return to Play Safely
Concussion: Recognizing, Managing and Assisting Athletes to Return to Play Safely Todd Barron, MD Medical Director, WellSpan Neurosciences Medical Director, WellSpan Pediatric Neurology Agenda Safety in
More informationFinnish practices: Cognitive assessment and interventions
Finnish practices: Cognitive assessment and interventions Kati Peltonen, psychologist, MSc, MA University of Helsinki, Clinical Neuropsychology Research Group Cognitive assessment and interventions 1.
More informationPOLICY / PROCEDURE DOCUMENT Effective Date 08/19/2010. Concussion Assessment, Management, and Return to Play Guidelines
Beacon Medical Group Sports Medicine POLICY / PROCEDURE DOCUMENT Effective Date 08/19/2010 TITLE: Document of (Entity) POLICY: PATIENT POPULATION: Concussion Assessment, Management, and Return to Play
More informationThe sensitivity and specificity of clinical measures of sport concussion: three tests are better than one
To cite: Resch JE, Brown CN, Schmidt J, et al. The sensitivity and specificity of clinical measures of sport concussion: three tests are better than one. BMJ Open Sport Exerc Med 2016;2: e000012. doi:10.1136/
More informationAshley N. Figaro University of Nevada, Las Vegas, UNLV Theses, Dissertations, Professional Papers, and Capstones
UNLV Theses, Dissertations, Professional Papers, and Capstones 5-1-2016 Assessing Clinical Significance of the Immediate Post-Concussion Assessment and Cognitive Testing Battery When Comparing Adjusted
More informationMild Traumatic Brain Injury (mtbi): An Occupational Dilemma
Mild Traumatic Brain Injury (mtbi): An Occupational Dilemma William H. Cann, MD MPH Occupational Medicine Trainee Occupational Medicine Trainee University of Washington Disclosures None This presentation
More informationCRITICALLY APPRAISED PAPER (CAP)
CRITICALLY APPRAISED PAPER (CAP) Couillet, J., Soury, S., Lebornec, G., Asloun, S., Joseph, P., Mazaux, J., & Azouvi, P. (2010). Rehabilitation of divided attention after severe traumatic brain injury:
More informationDEVELOPMENT AND USE OF THE MULTI-TASK HEAD INJURY ASSESSMENT TEST IN ATHLETES WITH CONCUSSIONS CONNIE LEE PETERSON
DEVELOPMENT AND USE OF THE MULTI-TASK HEAD INJURY ASSESSMENT TEST IN ATHLETES WITH CONCUSSIONS by CONNIE LEE PETERSON (Under the direction of Michael S. Ferrara) ABSTRACT Brief neuropsychological testing
More informationAlternative approaches to the assessment of mild head injury in athletes. By: KEVIN GUSKIEWICZ, BRYAN RIEMANN, DAVID PERRIN, and LEWIS NASHNER
Alternative approaches to the assessment of mild head injury in athletes By: KEVIN GUSKIEWICZ, BRYAN RIEMANN, DAVID PERRIN, and LEWIS NASHNER Guskiewicz, K.M., Riemann, B.L., Perrin, D.H., Nashner, L.M.
More informationSTUDIES IN BASIC NEUROSCIENCE
ORIGINAL CONTRIBUTION Acute Effects and Recovery Time Following Concussion in Collegiate Football Players The NCAA Concussion Study Michael McCrea, PhD Kevin M. Guskiewicz, PhD, ATC Stephen W. Marshall,
More informationAbstract. To assess the effects of two sports-related concussions on neuropsychological functioning
1 Abstract To assess the effects of two sports-related concussions on neuropsychological functioning and symptom reporting, the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) was administered
More informationCurrent Recommendations for the Diagnosis and Treatment of Concussion in Sport: A Comparison of Three New Guidelines
JOURNAL OF NEUROTRAUMA 31:159 168 (January 15, 2014) ª Mary Ann Liebert, Inc. DOI: 10.1089/neu.2013.3031 Original Articles Current Recommendations for the Diagnosis and Treatment of Concussion in Sport:
More informationTHE RELATIONSHIP BETWEEN SUBCONCUSSIVE IMPACTS AND CONCUSSION HISTORY ON CLINICAL MEASURES OF CONCUSSION IN COLLEGIATE FOOTBALL PLAYERS
THE RELATIONSHIP BETWEEN SUBCONCUSSIVE IMPACTS AND CONCUSSION HISTORY ON CLINICAL MEASURES OF CONCUSSION IN COLLEGIATE FOOTBALL PLAYERS Sonia Mae Gysland A thesis submitted to the faculty of the University
More informationAnne Stevens, Ph.D., Morgan Middlebrooks, BA Integrated Neuroscience Services, Fayetteville, Arkansas
THE USE OF FOUR CHANNEL MULTIVARIATE COHERENCE TRAINING ON MILD TRAUMATIC BRAIN INJURY: A COMPARISON OF NEWLY CONCUSSED AND REMOTELY CONCUSSED INDIVIDUALS Anne Stevens, Ph.D., Morgan Middlebrooks, BA Integrated
More informationn OVER 20 SIDELINE TOOLS n USE OF SMART PHONES n SOME ARE PAIDS APPS n FOLLOWING 10 SAMPLES n NOT ENDORSING ANY PARTICULAR ONE
Sideline Concussion Assessment Tools Aaron Galpert, AT, ATC Akron Children s Hospital SIDELINE TOOLS OVER 20 SIDELINE TOOLS USE OF SMART PHONES SOME ARE PAIDS APPS FOLLOWING 10 SAMPLES NOT ENDORSING ANY
More informationBrain-based disorders in children, teens, and young adults: When to know there is a problem and what to do
Brain-based disorders in children, teens, and young adults: When to know there is a problem and what to do Timothy A. Fratto, Ph.D. Neuropsychology Associates of Fairfax What is Neuropsychology? The study
More informationThe Pennsylvania State University. The Graduate School. College of the Liberal Arts PREDICTORS OF POST-CONCUSSION SYMPTOMS IN COLLEGIATE ATHLETES
The Pennsylvania State University The Graduate School College of the Liberal Arts PREDICTORS OF POST-CONCUSSION SYMPTOMS IN COLLEGIATE ATHLETES A Thesis in Psychology by Victoria C. Merritt 2013 Victoria
More informationRIDGEWOOD BOARD OF EDUCATION PROGRAM /page 1 of 8 Management of Sports-Related Concussion M Management of Sports-Related Concussion
2431.4/page 1 of 8 M 2431.4 Medical management of sports-related concussions is evolving. In recent years, there has been significant research into sports-related concussions in high school athletes. As
More informationASHA Comments* (ASHA Recommendations Compared to DSM-5 Criteria) Austism Spectrum Disorder (ASD)
DSM-5 (Criteria and Major Changes for SLP-Related Conditions) Individuals meeting the criteria will be given a diagnosis of autism spectrum disorder with three levels of severity based on degree of support
More informationConcussion Vital Signs. Peter C. Entwistle PhD Brian Coley ATC, LAT Tim McLane MBA, ATC, LAT
How to Effectively Use and Interpret Computerized Neurocognitive Testing: Case studies from Certified Athletic Trainers Presenters: Peter C. Entwistle PhD Brian Coley ATC, LAT Tim McLane MBA, ATC, LAT
More informationDr Mark Fulcher Sports and Exercise Medicine Physician Axis Sports Medicine Specialists
Dr Mark Fulcher Sports and Exercise Medicine Physician Axis Sports Medicine Specialists 16:30-17:25 WS #163: ACC Sports Concussion Guidelines 17:35-18:30 WS #175: ACC Sports Concussion Guidelines (Repeated)
More informationPlenary Session 2 Psychometric Assessment. Ralph H B Benedict, PhD, ABPP-CN Professor of Neurology and Psychiatry SUNY Buffalo
Plenary Session 2 Psychometric Assessment Ralph H B Benedict, PhD, ABPP-CN Professor of Neurology and Psychiatry SUNY Buffalo Reliability Validity Group Discrimination, Sensitivity Validity Association
More informationDetermining causation of traumatic versus preexisting. conditions. David Fisher, Ph.D., ABPP, LP Chairman of the Board PsyBar, LLC
Determining causation of traumatic versus preexisting psychological conditions David Fisher, Ph.D., ABPP, LP Chairman of the Board PsyBar, LLC 952 285 9000 Part 1: First steps to determine causation Information
More informationBaseline Neurocognitive Performance and Clearance for Athletes to Return to Contact
Journal of Athletic Training 2017;52(1):51 57 doi: 10.4085/1062-6050-51.12.27 Ó by the National Athletic Trainers Association, Inc www.natajournals.org original research Baseline Neurocognitive Performance
More informationConcussion Guidelines in the GAA
And present Concussion Guidelines in the GAA 2013 2016 Page 1 of 13 Position Statement Concussion Guidelines 2013 2016 Summary Principles... 3 What is Concussion?... 3 Signs and Symptoms... 3 Pitch Assessment
More information