Abstract Details

Title Standardized Neurologic Exam Findings Following Sports Related Concussion

Topic

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-004

Background

It is estimated that over half of all children participate in a sports team, with almost 8 million participating in high school sports and 500,000 college students participating in the NCAA. Athletes are at higher risk for mild traumatic head injury or concussion, from direct or indirect head trauma. Attempts to characterize physical exam findings after concussion often lack comprehensive reporting across multiple domains, which may prevent accurate patient characterization and examination of recovery patterns throughout the normal recovery window.

Objective

To identify and standardize neurologic exam findings after a sports related concussion.

Design/Methods

We report the physical and neurologic exam findings in 500 unique patients over 987 visits, following concussion. Data was collected from a retrospective chart review under IRB approval at an Academic Medical Center from July 2018 to March 2020.

Results

The components of the exam with greatest frequency of abnormal findings at the initial visit were 5-second single leg stance with eyes closed, vestibular-ocular reflex, visual motion sensitivity, neck exam, tandem stance with eyes closed, convergence testing, 5-second single leg stance with eyes open, horizontal alternating saccades, tandem stance with eyes open, tandem gait, horizontal pursuits, and Romberg test. Vestibular ocular reflex and visual motion sensitivity were statistically significant more frequently abnormal in females than males. The frequency of abnormal exam findings tended to decrease over post-injury weeks 1-4 for all 12 exam components analyzed, with differences reaching statistical significance for vestibular ocular reflex, 5-second single leg stance with eyes closed, and tandem stance with eyes closed.

Conclusions

We have identified elements of the neurologic exam that are abnormal during recovery from concussion in pediatric, adolescent, and adult populations. Our study identifies objective neurologic exam elements within 30 days of injury. These data also identified significant difference in exam elements over time, between sexes, and between age groups.

Authors/Disclosures
Nicholas S. Streicher, MD PRESENTER	Dr. Streicher has nothing to disclose.
Andrea Almeida, MD (University of Michigan Department of Neurology)	Dr. Almeida has nothing to disclose.
	No disclosure on file
Michael Popovich, MD (NCAC)	Dr. Popovich has nothing to disclose.
James T. Eckner, MD (University of Michigan Dept of PM&R)	An immediate family member of Dr. Eckner has received personal compensation for serving as an employee of Autism Alliance of Michigan. The institution of Dr. Eckner has received research support from NIH. Dr. Eckner has received intellectual property interests from a discovery or technology relating to health care. Dr. Eckner has received personal compensation in the range of $500-$4,999 for serving as a CARE Consortium Publication Committee Member with Indiana University.
Matthew T. Lorincz, MD, PhD (University of Michigan-NCAC Neurology)	Dr. Lorincz has received personal compensation for serving as an employee of Alexion. Dr. Lorincz has received personal compensation for serving as an employee of Orphalon . Dr. Lorincz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Lorincz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Orphalon . Dr. Lorincz has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink Neurology. The institution of Dr. Lorincz has received research support from Alexion.