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The utility of the Sports Concussion Assessment Tool in hospitalized traumatic brain injury patients

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Title: The utility of the Sports Concussion Assessment Tool in hospitalized traumatic brain injury patients
Authors: Sargeant, M
Sykes, E
Saviour, M
Sawhney, A
Calzolari, E
Arthur, J
McGoldrick, A
Seemungal, BM
Item Type: Journal Article
Abstract: The Sports Concussion Assessment Tool 3rd version is a sports screening tool that is often used to support return to play decisions following a head injury. The Sports Concussion Assessment Tool 3rd version is presumed to identify brain dysfunction (implying a degree of brain injury); however, the Sports Concussion Assessment Tool has never been validated with patients with definite acute brain injury. In this study, we found that all three Sports Concussion Assessment Tool 3rd version domains – symptoms, cognitive and balance assessments – were sensitive in discriminating traumatic brain injury patients (all with abnormal acute neuroimaging) from healthy controls. Through a correlation matrix (Bonferroni corrected), we found no correlation between the subjective (symptoms) and objective (examination) Sports Concussion Assessment Tool 3rd version assessments, e.g. complaints of imbalance and memory dysfunction were not correlated, respectively, with performance on testing balance and memory function. When relaxing the correction for multiple comparisons we found that of all Sports Concussion Assessment Tool 3rd version symptoms, a feeling of ‘pressure in the head’ had the largest number of co-correlations (including affective symptoms) and overwhelmingly in a pattern indicative of migraine. Taken together, that objective and subjective assessments in the Sports Concussion Assessment Tool 3rd version are poorly correlated, could suggest that symptoms in the Sports Concussion Assessment Tool 3rd version poorly reflect brain injury but rather indicate non-brain injury processes such as migraine. It follows that the current prominent orthodoxy of resting athletes following a head injury until their symptoms settle for fear of exacerbating brain injury may be unfavourable for their recovery – at least in some cases. Prospective clinical studies would be required to assess patient recovery from concussion with early active investigation and treatment versus rest – a notion supported by recent international consensus.
Issue Date: 29-Oct-2018
Date of Acceptance: 12-Sep-2018
URI: http://hdl.handle.net/10044/1/65056
DOI: https://dx.doi.org/10.1177/2059700218808121
ISSN: 2059-7002
Publisher: SAGE Publications
Journal / Book Title: Journal of Concussion
Volume: 2
Copyright Statement: © 2018 The Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Sponsor/Funder: The Academy of Medical Sciences
Medical Research Council (MRC)
National Institute for Health Research
Imperial Health Charity
Funder's Grant Number: N/A
MR/P006493/1
RDA26
GG1516\100028
Publication Status: Published
Open Access location: https://journals.sagepub.com/doi/pdf/10.1177/2059700218808121
Online Publication Date: 2018-10-29
Appears in Collections:Department of Medicine



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