Evaluation of physical examination elements in the diagnosis and prognosis of sports related concussion in adolescent athletes

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Abstract

Objective

To evaluate a brief physical examination (PE) for diagnosis and prognosis of sport-related concussion (SRC) in adolescents.

Design

Prospective.

Setting

UniversityConcussion clinics.

Subjects

53 adolescents with SRC (mean age 15.4; 70% male) and 30 uninjured controls (mean age 15.8; 73% male).

Interventions

Participants received a brief PE (11 PE elements in three systems: cervical, oculomotor and vestibular). Concussed adolescents were assessed acutely (mean 4.5 days post-injury) and at follow up (mean 18.5 days).

Outcome measures

Dependent variables 1: Concussion versus uninjured and 2: Standard versus slow recovery (>3 weeks). Recovery was defined as asymptomatic and exercise tolerant.

Results

Table 1 shows the significant PE variables that distinguished concussed from uninjured (via Fisher’s exact test; significance p<0.05).

Results

Table 2 shows the significant PE variables distinguishing standard recovery from slow recovery at visit 2 (via Fisher’s exact test; significance p<0.05).

Conclusions

Easily administered physical exam reveals clinical findings that are important and sensitive for diagnosing acute concussion. Prognosis was less precise due to the heterogeneity of aetiology of slow recovery.

Competing interests

No competing interests for any authors.

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