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Recovery of cognitive and dynamic motor function following concussion

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TLDR
In order to fully examine the effects of concussion and determine the optimal time for a safe return to activity, a multi-factorial approach, including both cognitive and motor tasks, should be employed.
Abstract
Objective: Neuropsychological testing has been advocated as an important tool of proper post-concussion management. Although these measures provide information that can be used in the decision of when to return an individual to previous levels of physical activity, they provide little data on motor performance following injury. The purpose of this investigation was to examine the relationship between measures of dynamic motor performance and neuropsychological function following concussion over the course of 28 days. Methods: Participants completed two experimental protocols: gait stability and neuropsychological testing. The gait stability protocol measured whole-body centre of mass motion as subjects walked under conditions of divided and undivided attention. Neuropsychological testing consisted of a computerised battery of tests designed to assess memory, reaction time, processing speed and concussion symptoms. Correlation coefficients were computed between all neuropsychological and gait variables and comparisons of neuropsychological and gait stability post-concussion recovery curves were assessed. Results: Dynamic motor tasks, such as walking under varying conditions of attention, are complex and demanding undertakings, which require a longer recovery time following a concussion than cognitive measures. Little statistical relationship was found between the neuropsychological and gait variables, and the recovery curves of neuropsychological and gait domains were observed to be independent. Conclusions: In order to fully examine the effects of concussion and determine the optimal time for a safe return to activity, a multi-factorial approach, including both cognitive and motor tasks, should be employed.

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Journal ArticleDOI

Using a dual-task protocol to investigate motor and cognitive performance in healthy children and youth

TL;DR: This study provides a normative dataset to be used during clinical management to identify functional deficits following concussion and acts as a starting point to explore dual-task protocols in children and youth following concussion.
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Reliability and Construct Validity of Limits of Stability Test in Adolescents Using a Portable Forceplate System

TL;DR: Clinicians should use dynamic balance measurement as part of their balance assessment and should not use static balance testing (eg, Balance Error Scoring System) to make inferences about dynamic balance, especially when balance assessment is used to determine rehabilitation outcomes, or when making return to play decisions after injury.
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Increasing task complexity and ice hockey skills of youth athletes.

TL;DR: Results revealed decreased performance on both cognitive and physical measures with increased task complexity, suggesting that adding complexity to an environment influences hockey skill performance.
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Clinical Utility of the Sport Concussion Assessment Tool 3 (SCAT3) Tandem-Gait Test in High School Athletes.

TL;DR: Functional movement deficits after concussion need to be accounted for, but the 14-second cutoff for the SCAT3 tandem-gait test does not appear to be an ideal way to assess these deficits in high school athletes.
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Cortical and Physical Function after Mild Traumatic Brain Injury.

TL;DR: While cognitive and motor functions were significantly impaired in the mTBI group acutely following injury, levels of intracortical inhibition were not associated with recovery in either functional domain.
References
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Book

Biomechanics and Motor Control of Human Movement

TL;DR: The Fourth Edition of Biomechanics as an Interdiscipline: A Review of the Fourth Edition focuses on biomechanical Electromyography, with a focus on the relationship between Electromyogram and Biomechinical Variables.
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Testing the Efficiency and Independence of Attentional Networks

TL;DR: A study with 40 normal adult subjects indicates that the ANT produces reliable single subject estimates of alerting, orienting, and executive function, and further suggests that the efficiencies of these three networks are uncorrelated.
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Acute Effects and Recovery Time Following Concussion in Collegiate Football Players: The NCAA Concussion Study

TL;DR: In this paper, a study of 1631 football players from 15 US colleges found that players with concussions exhibited more severe symptoms (mean GSC score 20.93 [95% confidence interval {CI, 15.65-26.21] points higher than that of controls), cognitive impairments (mean SAC score 2.94 [ 95% CI, 1.41 to 2.06], cognitive functioning improved to baseline levels within 5 to 7 days (day 7 SAC mean difference, −0.33;
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National Athletic Trainers' Association Position Statement: Management of Sport Concussion

TL;DR: The recommendations for concussion management provided here are based on the most current research and divided into sections on education and prevention, documentation and legal aspects, evaluation and return to play, and other considerations.
Journal ArticleDOI

A fortran package for generalized, cross-validatory spline smoothing and differentiation

TL;DR: A subroutine package is presented in which the amount of smoothing on a set of n noisy datapoints is determined from the data by means of the Generalized Cross-Validation or predicted Mean-Squared Error criteria of Wahba and her collaborators.
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