TY - JOUR
T1 - Beyond acute concussion assessment to office management
T2 - A systematic review informing the development of a Sport Concussion Office Assessment Tool (SCOAT6) for adults and children
AU - Patricios, Jon S.
AU - Schneider, Geoff M.
AU - Van Ierssel, Jacqueline
AU - Purcell, Laura K.
AU - Davis, Gavin A.
AU - Echemendia, Ruben J.
AU - Fremont, Pierre
AU - Fuller, Gordon Ward
AU - Herring, Stanley A.
AU - Harmon, Kimberly G.
AU - Holte, Kirsten
AU - Loosemore, Mike
AU - Makdissi, Michael
AU - McCrea, Michael
AU - Meehan, William P.
AU - O'Halloran, Patrick
AU - Premji, Zahra
AU - Putukian, Margot
AU - Shill, Isla Jordan
AU - Turner, Michael
AU - Vaandering, Kenzie
AU - Webborn, Nick
AU - Yeates, Keith Owen
AU - Schneider, Kathryn J.
PY - 2023/10/18
Y1 - 2023/10/18
N2 - Objectives To systematically review the scientific literature regarding the assessment of sport-related concussion (SRC) in the subacute phase (3-30 days) and provide recommendations for developing a Sport Concussion Office Assessment Tool (SCOAT6). Data sources MEDLINE, Embase, PsycINFO, Cochrane CENTRAL, CINAHL, SPORTDiscus and Web of Science searched from 2001 to 2022. Data extracted included study design, population, definition of SRC diagnosis, outcome measure(s) and results. Eligibility criteria (1) Original research, cohort studies, case-control studies, diagnostic accuracy and case series with samples >10; (2) SRC; (3) screening/technology that assessed SRC in the subacute period and (4) low risk of bias (ROB). ROB was performed using adapted Scottish Intercollegiate Guidelines Network criteria. Quality of evidence was evaluated using the Strength of Recommendation Taxonomy classification. Results Of 9913 studies screened, 127 met inclusion, assessing 12 overlapping domains. Results were summarised narratively. Studies of acceptable (81) or high (2) quality were used to inform the SCOAT6, finding sufficient evidence for including the assessment of autonomic function, dual gait, vestibular ocular motor screening (VOMS) and mental health screening. Conclusion Current SRC tools have limited utility beyond 72 hours. Incorporation of a multimodal clinical assessment in the subacute phase of SRC may include symptom evaluation, orthostatic hypotension screen, verbal neurocognitive tests, cervical spine evaluation, neurological screen, Modified Balance Error Scoring System, single/dual task tandem gait, modified VOMS and provocative exercise tests. Screens for sleep disturbance, anxiety and depression are recommended. Studies to evaluate the psychometric properties, clinical feasibility in different environments and time frames are needed. PROSPERO registration number CRD42020154787.
AB - Objectives To systematically review the scientific literature regarding the assessment of sport-related concussion (SRC) in the subacute phase (3-30 days) and provide recommendations for developing a Sport Concussion Office Assessment Tool (SCOAT6). Data sources MEDLINE, Embase, PsycINFO, Cochrane CENTRAL, CINAHL, SPORTDiscus and Web of Science searched from 2001 to 2022. Data extracted included study design, population, definition of SRC diagnosis, outcome measure(s) and results. Eligibility criteria (1) Original research, cohort studies, case-control studies, diagnostic accuracy and case series with samples >10; (2) SRC; (3) screening/technology that assessed SRC in the subacute period and (4) low risk of bias (ROB). ROB was performed using adapted Scottish Intercollegiate Guidelines Network criteria. Quality of evidence was evaluated using the Strength of Recommendation Taxonomy classification. Results Of 9913 studies screened, 127 met inclusion, assessing 12 overlapping domains. Results were summarised narratively. Studies of acceptable (81) or high (2) quality were used to inform the SCOAT6, finding sufficient evidence for including the assessment of autonomic function, dual gait, vestibular ocular motor screening (VOMS) and mental health screening. Conclusion Current SRC tools have limited utility beyond 72 hours. Incorporation of a multimodal clinical assessment in the subacute phase of SRC may include symptom evaluation, orthostatic hypotension screen, verbal neurocognitive tests, cervical spine evaluation, neurological screen, Modified Balance Error Scoring System, single/dual task tandem gait, modified VOMS and provocative exercise tests. Screens for sleep disturbance, anxiety and depression are recommended. Studies to evaluate the psychometric properties, clinical feasibility in different environments and time frames are needed. PROSPERO registration number CRD42020154787.
KW - adolescent
KW - athletes
KW - consensus
KW - head
UR - http://www.scopus.com/inward/record.url?scp=85161988498&partnerID=8YFLogxK
U2 - 10.1136/bjsports-2023-106897
DO - 10.1136/bjsports-2023-106897
M3 - Review article
C2 - 37316204
AN - SCOPUS:85161988498
SN - 0306-3674
VL - 57
SP - 737
EP - 748
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
IS - 11
ER -