The Effect of Sport-related Concussion on Cognition, Balance, Symptoms and Health-related Quality of Life in Adolescent Athletes.

Principle Investigators: Tamara C. Valovich McLeod, Ph.D., ATC, Associate Professor, Athletic Training

Institution: A.T. Still University

Title: The Effect of Sport-related Concussion on Cognition, Balance, Symptoms and Health-related Quality of Life in Adolescent Athletes

Sport-related concussion is a significant concern at all levels of athletic participation. Clinicians currently have several tools for assessment of concussion impairment (symptomatology, neurocognitive testing, and balance testing); however, it is unclear at this time how concussion affects an individual’s health-related quality of life (HRQOL). HRQOL is important because it assesses functional loss or disability which is thought to be more important to a person’s subjective experience of health.

This project aims to:

  1. assess the immediate and prolonged effects of concussion on HRQOL in adolescent athletes,
  2. assess the relationship between the measures of impairment (cognition, balance and symptoms) and disability (HRQOL),
  3. compare the effect of sport-related concussion and musculoskeletal injury on HRQOL in adolescent athletes within the first 10 days post-injury and
  4. collect “sport concussion impact” narratives from adolescents with sport-related concussion, identify the meanings they attribute to that concussion, and qualitatively determine the affects of concussion on their HRQOL.

Study Design:
A case-control, repeated measures design will be used to assess the immediate and prolonged effects of concussion on measures of impairment and disability. A qualitative approach will be utilized to determine the individual effects of concussion on HRQOL.

Materials and Methods:
Adolescent athletes will complete the following assessments during a pre-season baseline session: concussion history questionnaire, Sport Concussion Assessment Tool 2 (SCAT2), Pediatric Quality of Life Inventory (PedsQL), Peds QL Multidimensional Fatigue Scale (MFS), Headache Impact Test (HIT-6), and ImPACT. Following a concussion, subjects will be assessed with the SCAT2 within 24 hours of the injury. The SCAT2 will also be given on post-injury day 3. ImPACT will be given on days 1, 3, 10 & 30 post-injury. The PedsQL, MFS, and HIT-6 will be administered on days 3, 10, and 30 post-injury. Athletes who remain out of play on day 10 following concussion will be contacted to participate in a narrative interview to assess the meaning given to their concussion and how it affects their quality of life.

Main Outcome Measures:
Scores on the SCAT2, PedsQL, and HIT-6, and ImPACT. A grounded, iterative analytic process will be used to analyze the narratives.

It is known that concussion results in increased symptom reports and impairments in cognition and postural stability during the first week following injury. Additionally, reports have shown decreased HRQOL in mild traumatic brain injured patients and different emotional responses to concussion in collegiate athletes. There is also speculation that concussion may have long-term physical and emotional impact on the lives of athletes. The broad, long-term objective of this research is to provide a more thorough understanding of the global impact of concussion on the health of pediatric athletes.