Objective: To determine parameters accurately predicting recovery and return to sports from Sports-Related Concussion (SRC).
Design: Prospective cohort.
Setting: Outpatient specialist concussion clinic.
Participants: 164 subjects recovering from SRC, 143 of whom returned to sport.
Interventions (or Assessment of Risk Factors): Subjects with SRC were referred. Demographic information, clinical examination, neuropsychological testing (ImPACT), and objective assessment of balance (Equilibrate, Balance Engineering) were used to determine recovery.
Outcome Measures: Data from subjects returning to sports (’cleared’) were compared to subjects still recovering (’uncleared’). Using a Fisher Discriminant Analysis (FDA), 25 different parameters were assessed to determine which best predicted recovery. Type-I and Type-II error were calculated for each combination of variables to investigate which were most valuable discriminating between ‘cleared’ and ‘uncleared’.
Main Results: 307 serial assessments were conducted on 164 subjects. The model identified three key predictive parameters: time since injury (days), total symptom score, and balance score in tandem stance with non-dominant foot forward-eyes closed. Using this model, the Type-I & Type-II errors were 13.8% and 11.3%. Results probability density function is shown (figure 1).
Conclusions: Combining assessment of balance with time from injury and total symptoms was the best combination of variables to discriminate subjects ‘cleared’ to return to sports. A model using this combination predicted return to sports with excellent accuracy with Type-II error (subjects being ‘cleared’ when they should not) in 11.3% of cases.
Reference
British Journal of Sports Medicine 58, No. S1, pp. A37-A38 (2024)