Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: a systematic review

被引:36
作者
Echemendia, Ruben J. [1 ,2 ]
Burma, Joel S. [3 ]
Bruce, Jared M. [4 ]
Davis, Gavin A. [5 ,6 ]
Giza, Christopher C. [7 ,8 ]
Guskiewicz, Kevin M. [9 ]
Naidu, Dhiren [10 ,11 ]
Black, Amanda Marie [3 ]
Broglio, Steven
Kemp, Simon [12 ]
Patricios, Jon S. [13 ]
Putukian, Margot [14 ]
Zemek, Roger [15 ,16 ]
Arango-Lasprilla, Juan Carlos [17 ]
Bailey, Christopher M. [18 ,19 ]
Brett, Benjamin L. [20 ]
Didehbani, Nyaz [21 ]
Gioia, Gerry [22 ,23 ]
Herring, Stanley A. [24 ]
Howell, David [25 ]
Master, Christina L. [26 ]
Valovich McLeod, Tamara C. [27 ,28 ]
Meehan III, William P. [29 ,30 ]
Premji, Zahra [31 ]
Salmon, Danielle [32 ]
van Ierssel, Jacqueline [15 ]
Bhathela, Neil [33 ]
Makdissi, Michael [34 ,35 ]
Walton, Samuel R. [36 ]
Kissick, James [37 ]
Pardini, Jamie [38 ,39 ]
Schneider, Kathryn J. [40 ]
机构
[1] Univ Orthoped, Concuss Care Clin, State Coll, PA 16801 USA
[2] Univ Missouri, Kansas City, MO USA
[3] Univ Calgary, Fac Kinesiol, Calgary, AB, Canada
[4] Univ Missouri, Biomed & Hlth Informat, Kansas City, MO USA
[5] Murdoch Childrens Res Inst, Parkville, Vic, Australia
[6] Cabrini Hlth, Malvern, Vic, Australia
[7] UCLA Steve T BrainSPORT Program, Neurosurg, Los Angeles, CA USA
[8] Mattel Childrens Hosp UCLA, Pediat Pediat Neurol, Los Angeles, CA USA
[9] Univ N Carolina, Matthew Gfeller Ctr, Chapel Hill, NC USA
[10] Univ Alberta, Med, Edmonton, AB, Canada
[11] Univ Michigan, Michigan Concuss Ctr, Ann Arbor, MI USA
[12] Rugby Football Union, Sports Med, London, England
[13] Univ Witwatersrand, Fac Hlth Sci, Sch Clin Med, Wits Sport & Hlth WiSH, Johannesburg Braamfontein, South Africa
[14] Major League Soccer, New York, NY USA
[15] Childrens Hosp, Eastern Ontario Res Inst, Ottawa, ON, Canada
[16] Univ Ottawa, Dept Pediat, Ottawa, ON, Canada
[17] Virginia Commonwealth Univ, Dept Psychol, Richmond, VA USA
[18] Univ Hosp Cleveland, Med Ctr, Neurol, Cleveland, OH USA
[19] Case Western Reserve Univ, Neurol, Sch Med, Cleveland, OH USA
[20] Med Coll Wisconsin, Neurosurg Neurol, Milwaukee, WI USA
[21] UTSW Med Ctr, Psychiary, Dallas, TX USA
[22] Childrens Natl Hlth Syst, Dept Pediat, Washington, DC USA
[23] Childrens Natl Hlth Syst, Dept Psychiat & Behav Sci, Washington, DC USA
[24] Univ Washington, Dept Rehabil Med Orthopaed & Sports Med & Neurol S, Seattle, WA USA
[25] Childrens Hosp Colorado, Sports Med Ctr, Orthoped, Aurora, CO USA
[26] Univ Penn, Philadelphia, PA USA
[27] AT Still Univ, Dept Athlet Training, Mesa, AZ USA
[28] AT Still Univ, Sch Osteopath Med Arizona, Mesa, AZ USA
[29] Childrens Hosp Boston, Sports Med, Boston, MA USA
[30] Childrens Hosp Boston, Emergency Med, Boston, MA USA
[31] Univ Victoria, Lib, Victoria, BC, Canada
[32] World Rugby Ltd, Dublin, Ireland
[33] UCLA, Hlth Steve Tisch BrainSPORT Program, Los Angeles, CA USA
[34] Florey Inst Neurosci & Mental Hlth, Austin Campus, Heidelberg, Vic, Australia
[35] La Trobe Sport & Exercise Med Res Ctr, Melbourne, Vic, Australia
[36] Sch Med, Dept Phys Med & Rehabil, Richmond, VA USA
[37] Univ Ottawa, Dept Family Med, Ottawa, ON, Canada
[38] Univ Arizona, Dept Internal Med, Coll Med, Phoenix, AZ USA
[39] Univ Arizona, Dept Neurol, Coll Med, Phoenix, AZ USA
[40] Univ Calgary, Fac Kinesiol, Sport Injury Prevent Res Ctr, Calgary, AB, Canada
基金
加拿大健康研究院; 加拿大自然科学与工程研究理事会;
关键词
Sports; Brain Concussion; Consensus; Sports medicine; KING-DEVICK TEST; ICE HOCKEY PLAYERS; ATHLETIC ASSOCIATION-DEPARTMENT; COLLEGIATE FOOTBALL PLAYERS; WHITE-MATTER ABNORMALITIES; TANDEM GAIT PERFORMANCE; TRAUMATIC BRAIN-INJURY; BASE-LINE PERFORMANCE; ERROR SCORING SYSTEM; HIGH-SCHOOL;
D O I
10.1136/bjsports-2022-106661
中图分类号
G8 [体育];
学科分类号
04 ; 0403 ;
摘要
ObjectivesTo systematically review the scientific literature regarding the acute assessment of sport-related concussion (SRC) and provide recommendations for improving the Sport Concussion Assessment Tool (SCAT6). Data sourcesSystematic searches of seven databases from 2001 to 2022 using key words and controlled vocabulary relevant to concussion, sports, SCAT, and acute evaluation. Eligibility criteria(1) Original research articles, cohort studies, case-control studies, and case series with a sample of >10; (2) & GE;80% SRC; and (3) studies using a screening tool/technology to assess SRC acutely (<7 days), and/or studies containing psychometric/normative data for common tools used to assess SRC. Data extractionSeparate reviews were conducted involving six subdomains: Cognition, Balance/Postural Stability, Oculomotor/Cervical/Vestibular, Emerging Technologies, and Neurological Examination/Autonomic Dysfunction. Paediatric/Child studies were included in each subdomain. Risk of Bias and study quality were rated by coauthors using a modified SIGN (Scottish Intercollegiate Guidelines Network) tool. ResultsOut of 12 192 articles screened, 612 were included (189 normative data and 423 SRC assessment studies). Of these, 183 focused on cognition, 126 balance/postural stability, 76 oculomotor/cervical/vestibular, 142 emerging technologies, 13 neurological examination/autonomic dysfunction, and 23 paediatric/child SCAT. The SCAT discriminates between concussed and non-concussed athletes within 72 hours of injury with diminishing utility up to 7 days post injury. Ceiling effects were apparent on the 5-word list learning and concentration subtests. More challenging tests, including the 10-word list, were recommended. Test-retest data revealed limitations in temporal stability. Studies primarily originated in North America with scant data on children. ConclusionSupport exists for using the SCAT within the acute phase of injury. Maximal utility occurs within the first 72 hours and then diminishes up to 7 days after injury. The SCAT has limited utility as a return to play tool beyond 7 days. Empirical data are limited in pre-adolescents, women, sport type, geographical and culturally diverse populations and para athletes. PROSPERO registration numberCRD42020154787.
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页码:722 / +
页数:18
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