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

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ObjectiveTo evaluate a brief physical examination (PE) for diagnosis and prognosis of sport-related concussion (SRC) in adolescents.DesignProspective.SettingUniversityConcussion clinics.Subjects53 adolescents with SRC (mean age 15.4; 70% male) and 30 uninjured controls (mean age 15.8; 73% male).InterventionsParticipants 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 measuresDependent variables 1: Concussion versus uninjured and 2: Standard versus slow recovery (>3 weeks). Recovery was defined as asymptomatic and exercise tolerant.ResultsTable 1 shows the significant PE variables that distinguished concussed from uninjured (via Fisher’s exact test; significance p<0.05).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).ConclusionsEasily 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 interestsNo competing interests for any authors.

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