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Review article
peer-reviewed

Review of Assessment Scales for Diagnosing and Monitoring Sports-related Concussion



Abstract

Sports-related concussion has emerged as a public health crisis due to increased diagnosis of the condition and increased participation in organized and recreational athletics worldwide. Under-recognition of concussions can lead to premature clearance for athletic participation, leaving athletes vulnerable to repeat injury and subsequent short- and long-term complications. There is overwhelming evidence that assessment and management of sports-related concussions should involve a multifaceted approach. A number of assessment criteria have been developed for this purpose. It is important to understand the available and emerging diagnostic testing modalities for sports-related concussions. The most commonly used tools for evaluating individuals with concussion are the Post-Concussion Symptom Scale (PCSS), Standard Assessment of Concussion (SAC), Standard Concussion Assessment Tool (SCAT3), and the most recognized computerized neurocognitive test, the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The strengths and limitations of each of these tools, and the Concussion Resolution Index (CRI), CogSport, and King-Devick tests were evaluated. Based on the data, it appears that the most sensitive and specific of these is the ImPACT test. Additionally, the King-Devick test is an effective adjunct due to its ability to test eye movements and brainstem function.



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Review article
peer-reviewed

Review of Assessment Scales for Diagnosing and Monitoring Sports-related Concussion


Author Information

Alexa M. Dessy

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Frank J. Yuk

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Akbar Y. Maniya Corresponding Author

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Alex Gometz

Concussion Management of New York, Icahn School of Medicine at Mount Sinai

Jonathan J. Rasouli

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Mark R. Lovell

ImPACT Applications, Inc., UPMC

Tanvir F. Choudhri

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center


Ethics Statement and Conflict of Interest Disclosures

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Mark R. Lovell, PhD declare(s) employment from ImPACT Applications, Inc. Dr. Mark Lovell is the creator of the ImPACT concussion test and is the Chief Scientific Officer for ImPACT Applications, Inc. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Review article
peer-reviewed

Review of Assessment Scales for Diagnosing and Monitoring Sports-related Concussion


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Review article
peer-reviewed

Review of Assessment Scales for Diagnosing and Monitoring Sports-related Concussion

Alexa M. Dessy">Alexa M. Dessy, Frank J. Yuk">Frank J. Yuk, Akbar Y. Maniya">Akbar Y. Maniya , Alex Gometz">Alex Gometz, Jonathan J. Rasouli">Jonathan J. Rasouli, Mark R. Lovell">Mark R. Lovell, Tanvir F. Choudhri">Tanvir F. Choudhri

  • Author Information
    Alexa M. Dessy

    Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

    Frank J. Yuk

    Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

    Akbar Y. Maniya Corresponding Author

    Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

    Alex Gometz

    Concussion Management of New York, Icahn School of Medicine at Mount Sinai

    Jonathan J. Rasouli

    Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

    Mark R. Lovell

    ImPACT Applications, Inc., UPMC

    Tanvir F. Choudhri

    Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center


    Ethics Statement and Conflict of Interest Disclosures

    Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Mark R. Lovell, PhD declare(s) employment from ImPACT Applications, Inc. Dr. Mark Lovell is the creator of the ImPACT concussion test and is the Chief Scientific Officer for ImPACT Applications, Inc. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: December 07, 2017

    DOI

    10.7759/cureus.1922

    Cite this article as:

    Dessy A M, Yuk F J, Maniya A Y, et al. (December 07, 2017) Review of Assessment Scales for Diagnosing and Monitoring Sports-related Concussion. Cureus 9(12): e1922. doi:10.7759/cureus.1922

    Publication history

    Received by Cureus: October 20, 2017
    Peer review began: October 27, 2017
    Peer review concluded: November 30, 2017
    Published: December 07, 2017

    Copyright

    © Copyright 2017
    Dessy et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Sports-related concussion has emerged as a public health crisis due to increased diagnosis of the condition and increased participation in organized and recreational athletics worldwide. Under-recognition of concussions can lead to premature clearance for athletic participation, leaving athletes vulnerable to repeat injury and subsequent short- and long-term complications. There is overwhelming evidence that assessment and management of sports-related concussions should involve a multifaceted approach. A number of assessment criteria have been developed for this purpose. It is important to understand the available and emerging diagnostic testing modalities for sports-related concussions. The most commonly used tools for evaluating individuals with concussion are the Post-Concussion Symptom Scale (PCSS), Standard Assessment of Concussion (SAC), Standard Concussion Assessment Tool (SCAT3), and the most recognized computerized neurocognitive test, the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The strengths and limitations of each of these tools, and the Concussion Resolution Index (CRI), CogSport, and King-Devick tests were evaluated. Based on the data, it appears that the most sensitive and specific of these is the ImPACT test. Additionally, the King-Devick test is an effective adjunct due to its ability to test eye movements and brainstem function.



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Create a free account to continue reading this article.

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Alexa M. Dessy

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Frank J. Yuk

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Akbar Y. Maniya, Medical Student

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

For correspondence:
akbar.maniya@icahn.mssm.edu

Alex Gometz

Concussion Management of New York, Icahn School of Medicine at Mount Sinai

Jonathan J. Rasouli

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Mark R. Lovell

ImPACT Applications, Inc., UPMC

Tanvir F. Choudhri, M.D., Associate Professor

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Alexa M. Dessy

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Frank J. Yuk

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Akbar Y. Maniya, Medical Student

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

For correspondence:
akbar.maniya@icahn.mssm.edu

Alex Gometz

Concussion Management of New York, Icahn School of Medicine at Mount Sinai

Jonathan J. Rasouli

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center

Mark R. Lovell

ImPACT Applications, Inc., UPMC

Tanvir F. Choudhri, M.D., Associate Professor

Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center