A case study investigation of the neuropsychological profile of a rugby player with a history of multiple concussions
- Authors: Case, Stephanie
- Date: 2006
- Subjects: Rugby football injuries , Brain -- Concussion -- Complications , Neuropsychological tests , Head -- Wounds and injuries -- Complications , Sports injuries -- Psychological aspects
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3165 , http://hdl.handle.net/10962/d1007727 , Rugby football injuries , Brain -- Concussion -- Complications , Neuropsychological tests , Head -- Wounds and injuries -- Complications , Sports injuries -- Psychological aspects
- Description: sustained multiple concussions may be at risk of cumulative impairment. The role of neuropsychological testing in the management of sports-related concussion is a contentious and challenging issue which has gained credibility given the lack of clear and well-established guidelines pertaining to the diagnosis, assessment and return-to-play decisions following concussion. Despite various traditional paper and pencil tests being shown to be effective indicators of postconcussive neuropsychological dysfunction, testing has not been widely implemented, due to time- and labour-demands. ImPACT, a computer-based neuropsychological assessment instrument, has been recognised as a valid and reliable tool in the monitoring of athletes' symptoms and neurocognitive functioning preseason and postconcussion. As a part of larger-scale concussion research conducted on top-team university rugby players, this is an in-depth case study conducted on a 20-year old participant with a history of multiple concussions, who was referred following a concussion sustained during the season. The objectives of the study were: (i) to determine the sensitivity of ImPACT versus WAIS-III Digit Span and Trail Making Test during the acute postconcussive phase; and (ii) to examine the sensitivity of ImPACT versus a comprehensive battery of neuropsychological tests to possible residual deficits as a result of the multiple concussions. ImPACT was determined to be more sensitive to acute postconcussive impairment following concussion than Digit Span and Trail Making Test. Furthermore, the ImPACT preseason baseline scores appear to be sensitive to neurocognitive dysfunction, possibly due to cumulative concussive injuries.
- Full Text:
The establishment of normative data on Xhosa-speaking high school learners using the ImPACT 3.0 programme
- Authors: Salman-Godlo, Noluthando Cikizwa
- Date: 2006
- Subjects: Brain -- Concussion -- South Africa , Sports -- Psychological aspects -- South Africa , Sports injuries -- Psychological spects , Neuropsychological tests , ImPACT 3.0
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:3048 , http://hdl.handle.net/10962/d1002557 , Brain -- Concussion -- South Africa , Sports -- Psychological aspects -- South Africa , Sports injuries -- Psychological spects , Neuropsychological tests , ImPACT 3.0
- Description: Concussion is a common form of brain injury, especially amongst sports players of all age groups. ImPACT is a valid and reliable measure of a variety of cognitive functions commonly affected by such injuries, which allows for objective return-to-play decision making (Iverson, Lovell, & Collins, 2003). However, studies show that the transfer of such tests from one ethnic group to another without appropriate standardization is highly problematic (Ardila, 1995). Thus, the relative absence of South African normative data for the ImPACT 3.0 programme is an issue for concern. Consequently, this study aimed to establish norms for semi-rural Xhosa-speaking schoolboys with an advantaged education (ages 14, 16 and 18) for the ImPACT 3.0 programme as administered in English. Administrative and linguistic difficulties that were experienced by individuals during completion of the battery were also identified. Finally, the study included a comparison of the percentile scores of this sample to the USA norms for boys of a similar age group. Subtests scores were generated for 70 schoolboys and the data were then subjected to statistical analysis. A significant difference between English proficiency of the Grade 8 and Grade 12 boys was found. This indicates the importance of including an English proficiency test with the ImPACT battery when assessing such populations. No other significant differences were found between these age group samples. Although this requires further investigation, the comparison of the USA and SA percentiles suggests the use of local norms for this population. South African boys in this study consistently scored lower than the USA sample. Finally, it is recommended that symptom selfreports should be verbally investigated with each boy after testing, given indications of comprehension problems. In closing, limitations and future possible studies are discussed.
- Full Text:
A case study investigation into the utility of baseline data versus normative data using a computer-based concussion management programme
- Authors: Mitchell, Julia
- Date: 2005
- Subjects: Brain -- Concussion , Neuropsychological tests , Sports injuries -- Psychological aspects , Head -- Wounds and injuries -- Complications
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3021 , http://hdl.handle.net/10962/d1002530 , Brain -- Concussion , Neuropsychological tests , Sports injuries -- Psychological aspects , Head -- Wounds and injuries -- Complications
- Description: Neuropsychological testing is recognised as one of the cornerstones of concussion evaluation, contributing significantly to both an understanding of the injury as well as management of the recovery process. Despite the high incidence of concussion at school level, traditional paper-and-pencil neuropsychological testing has generally been absent from school concussion management programmes, largely due to time and cost constraints. Now, the recent development of computerised neuropsychological testing is providing the opportunity for including neurocognitive assessment in this process. The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a valid and reliable instrument of this type and normed on 13 - 18 year old North American high school athletes, as well as adult groups. The current recommendation is that athletes are baselined preseason in order to provide an individualised comparative level against which to monitor recovery and provide return-to-play recommendations. This in itself is quite a cumbersome process, thus the present study set out to ascertain whether baseline testing of all athletes is necessary, or whether the use of US or SA normative data alone would provide an appropriate standard against which to interpret the postinjury scores. From a leading South African rugby playing school, the 1st and 2nd rugby teams, (16 - 18 years) were baselined using ImPACT. Three athletes, who were subsequently referred with concussion during the rugby season, were followed up with serial testing on ImPACT. An analysis of the follow up scores was conducted to chart the athletes' recovery process, in relation to the athletes own baseline scores (using US and SA reliable change indices) and age appropriate US and SA normative ranges. The relative utility of individual baselines scores versus these normative ranges was then critically evaluated. It was concluded that a combination of both baseline and normative data provided optimal management of the athlete, with the methods complementing each other in the interpretation of post-injury results. Overall, the SA normative ranges seemed to provide slightly better management guidelines than the US normative ranges when used with this sample of South African high school athletes.
- Full Text:
The effects of age and education on selected cognitive tests: the trail making test, the digit symbol sub-test, and the finger tapping test
- Authors: Stewart, Maureen
- Date: 2003
- Subjects: Aging -- Psychological testing , Brain -- Aging , Neuropsychology , Neuropsychological tests
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3114 , http://hdl.handle.net/10962/d1004601 , Aging -- Psychological testing , Brain -- Aging , Neuropsychology , Neuropsychological tests
- Description: Numerous studies have suggested that neuropsychological test performance is affected by demographic variables such as age and education. This study examined the effects of age and education on the Trail Making Test, the Digit Symbol Sub-Test, and the Finger Tapping Test in a non-clinical sample of community dwellers with a relatively low level of education (8 to 12 years) in South Africa. The sample consisted of 161 participants across six age groups: 20-39, 40-59, 69-69, 70-79, 80-89 and 90-95 years. Results were examined for mean age effects and variability trends. Highly significant age effects were present across the age groups for all tests, however, there was no uniform pattern of variability across the tests. The Digit Symbol Substitution Test and the Finger Tapping Tests showed a pattern of increasing variability with increasing age, followed by a decrease in very old age while no trend was evident for the Digit Symbol extensions (the Immediate and Delayed Recall tests). The Trail Making Test, Parts A and B, showed a consistent trend of increasing variability across the age groups. Data from the present study was compared with existing data from two relatively high education samples, with equivalent age groupings, to examine education effects. Results showed an education effect for all tests with the high education groups outperforming the low education groups. Although the effects of education became less potent with advancing age, the mean performance of the oldest (80-89 years) high education age group was superior to that of the equivalent low education age group. Comparison of variability trends across both samples showed that the highest variability (the shuttle bulge) was present at the same point along the age axis, or at a later point, for the low education group, as that for the high education group. This finding is inconsistent with Jordan's (1997) 'shuttle model of variability' which predicts an earlier occurrence of the shuttle bulge (left shuttle shift effect) for a low education sample. This study demonstrated that performance on neuropsychological tests is influenced by age and education and highlighted the dangers inherent in unquestionably applying norms, which have not been corrected for age and education, when assessing the older adult.
- Full Text:
Cumulative mild head injury in contact sport: a comparison of the cognitive profiles of rugby players and non-contact sport controls with normative data
- Authors: Bold, Lisa Clare
- Date: 2000
- Subjects: Head -- Wounds and injuries -- Psychology , Neuropsychological tests , Head -- Wounds and injuries , Sports injuries -- Psychological aspects
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2935 , http://hdl.handle.net/10962/d1002444 , Head -- Wounds and injuries -- Psychology , Neuropsychological tests , Head -- Wounds and injuries , Sports injuries -- Psychological aspects
- Description: This study investigates the effects of cumulative mild head injury on the cognitive functioning of elite rugby players. A comprehensive battery of neuropsychological tests was administered to top national (Springbok) rugby players (n=26), national Under 21 rugby players (n= 19), and a non-contact sport control group of national hockey players (n=21). The test results of the Total Rugby group (Springbok Rugby and Under 21 Rugby players), the Under 21 Rugby group, the hockey controls, and the Total Rugby and Under 21 Rugby forward and backline players respectively, were each compared with established normative data. Results showed significant differences in the direction of a poorer performance relative to the norms for the Total Rugby and Under 21 Rugby groups, and for the Total Rugby Forwards and Under 21 Rugby Forwards, on tests sensitive to the effects of diffuse brain damage. On the other hand, the Hockey Control group and the Total Rugby Backs and Under 21 Rugby Backs tended to perform within the normal range or better than the norm on some tests. These results confirm the hypothesis that rugby players, and the forward players in particular, are at risk of adverse cognitive effects consequent on cumulative mild head injury. The theoretical implications are that the aggregate effects of multiple exposures to mild head injuries in the rugby players served to reduce their brain reserve capacities and acted as a threshold-lowering influence associated with symptom onset.
- Full Text:
The scrum-down on brain damage effects of cumulative mild head injury in rugby: a comparison of group mean scores between national rugby players and non-contact sport controls
- Authors: Finkelstein, Melissa
- Date: 2000
- Subjects: Sports injuries , Head -- Wounds and injuries , Sports injuries -- Psychological aspects , Neuropsychological tests , Rugby football injuries
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:2976 , http://hdl.handle.net/10962/d1002485 , Sports injuries , Head -- Wounds and injuries , Sports injuries -- Psychological aspects , Neuropsychological tests , Rugby football injuries
- Description: The present study comprises the second phase of a larger and ongoing research study investigating the brain damage effects of cumulative mild head injury in rugby. The purpose of this study was to determine whether cumulative mild head injury sustained in the game of rugby would cause brain injury as evidenced by impaired performance on sensitive neuropsychological tests. Participants were Springbok professional rugby players (n = 26), Under 21 rugby players (n = 19), and a non-contact sport control of national hockey players (n = 21). Comparisons of performance were carried out across a spectrum of neuropsychological tests for the three rugby groups (Total Rugby, Springbok Rugby, and Under 21 Rugby) versus the performance of the non-contact sport control group (Hockey Control), as well as comparisons of performance f9r the subgroups of Rugby Forwards versus Rugby Backs. Comparisons revealed a consistent pattern of poorer performance across all rugby groups relative to the performance of the controls on tests highly sensitive to the effects of diffuse brain damage. Within rugby group comparisons (Forwards versus Backs) showed significantly poorer performance for Total Rugby Forwards and Springbok Rugby Forwards relative to the performance of the respective Total Rugby Backs and Springbok Rugby Backs on sensitive, as well as on somewhat less sensitive, neuropsychological tests. The performance of Under 21 Rugby Forwards relative to Under 21 Rugby Backs demonstrated similar trends. Brain reserve capacity theory was used as a conceptual basis for discussing the implications of these findings.
- Full Text:
Cumulative mild head injury in rugby: cognitive test profiles of professional rugby and cricket players
- Authors: Ancer, Ruth Lauren
- Date: 1999
- Subjects: Head -- Wounds and injuries , Rugby football injuries , Cricket injuries , Cognitive therapy , Neuropsychological tests
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2925 , http://hdl.handle.net/10962/d1002434 , Head -- Wounds and injuries , Rugby football injuries , Cricket injuries , Cognitive therapy , Neuropsychological tests
- Description: This study investigates the effects of cumulative concussive and subconcussive mild head injury on the cognitive functioning of professional rugby players. A comprehensive battery of neuropsychological tests was administered to 26 professional rugby players and a noncontact sport control group of 21 professional cricket players. The test performances of the rugby players were compared to those of the cricket players. Within the rugby group, forward and backline players were compared. An analysis of mean score differences between the rugby and cricket group failed to support the presence of brain damage effects in the rugby group. However, there was significantly increased variability of scores for the rugby players compared with the cricket players on tests particularly sensitive to cognitive deficit associated with mild head injury. This invalidates the null indications of average effects, indicating that a notable proportion of rugby players’ performances were falling off relative to the rest of the rugby players on tests vulnerable to the cognitive effects of diffuse brain damage. Mean score comparisons within the rugby group indicated that it was the subgroup of forward players, in particular, whose test performances revealed deficits suggestive of cerebral damage. Specifically, deficits were found in working memory, visuoperceptual tracking, verbal memory and visual memory, a pattern of deficits commensurate with cumulative mild head injury. The theoretical perspectives of Satz’s (1997) Brain Reserve Capacity Theory and Jordan’s (1997) ‘Shuttle’ model of variability are drawn upon in order to elucidate research findings and suggestions for future research are provided.
- Full Text:
Tackling mild head injury in rugby: a comparison of the cognitive profiles of professional rugby and cricket players
- Authors: Reid, Iain Robert
- Date: 1999
- Subjects: Head -- Wounds and injuries -- Complications , Rugby football injuries , Neuropsychological tests , Cricket -- Accidents
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3043 , http://hdl.handle.net/10962/d1002552 , Head -- Wounds and injuries -- Complications , Rugby football injuries , Neuropsychological tests , Cricket -- Accidents
- Description: The aim of this study was to investigate the effect of cumulative mild head injury on the cognitive functioning of professional rugby players. A comprehensive battery of neuropsychological tests was administered to 26 professional rugby players and to a comparison group of 21 professional cricket players. The group test results of the rugby, cricket, rugby forwards and rugby backline players were each compared with established normative data. Generally, the comparison of the rugby and cricket mean scores relative to the normative data did not reveal significant differences on tests known to be sensitive to the effects of mild head injury. However, the comparison of variability for each of the rugby and cricket playing groups relative to variability for the normative data, revealed a pattern of increased variability among the rugby players. This implies a bimodal distribution in which a significant number of rugby players were performing poorly across these tests whereas a significant proportion were not. This variability effect was accounted for by further mean score comparisons which revealed that, as a group, it was the forward players whose performances were disproportionately poor on tests sensitive to the effects of mild head injury. The implications of these results are developed theoretically within the context of brain reserve capacity theory and suggestions for future research are provided.
- Full Text:
The relative discriminatory power of a selection of neuropsychological tests in Alzheimer's disease
- Authors: Aronson, Steven
- Date: 1994
- Subjects: Alzheimer's disease -- Physiological aspects , Neuropsychological tests
- Language: English
- Type: Thesis , Masters , MSocSc
- Identifier: vital:3154 , http://hdl.handle.net/10962/d1007498 , Alzheimer's disease -- Physiological aspects , Neuropsychological tests
- Description: KMBT_363 , Adobe Acrobat 9.54 Paper Capture Plug-in
- Full Text: