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:
- Date Issued: 2005
- 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:
- Date Issued: 2005
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:
- Date Issued: 2006
- 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:
- Date Issued: 2006
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:
- Date Issued: 1999
- 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:
- Date Issued: 1999
Cumulative mild head injury in rugby: a comparison of cognitive deficit and postconcussive symptomatology between schoolboy rugby players and non-contact sport controls
- Authors: Beilinsohn, Taryn
- Date: 2001
- Subjects: Rugby football injuries , Head -- Wounds and injuries -- Psychology , Head -- Wounds and injuries -- Complications , Brain damage
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2931 , http://hdl.handle.net/10962/d1002440 , Rugby football injuries , Head -- Wounds and injuries -- Psychology , Head -- Wounds and injuries -- Complications , Brain damage
- Description: This study investigates the cumulative effects of concussive and subconcussive mild head injury on the cognitive functioning of schoolboy rugby players. A comprehensive battery of neuropsychological tests and a self-report postconcussive questionnaire were administered to top level schoolboy rugby players (n=47), and a non-contact sport control group of top level schoolboy hockey players (n=34). Group comparisons of the percentage of individuals with cognitive deficit were carried out between i) the schoolboy rugby and the schoolboy hockey players, ii) the rugby forward and the rugby backline players; iii) the rugby forward and the schoolboy hockey players and, iv) the rugby backline and the schoolboy hockey players. Results on the neuropsychological test battery did not provide any substantial evidence of a higher level of neuropsychological impairment in the rugby players relative to the control group, or in the rugby forward players relative to the rugby backline players. Results obtained on the postconcussive symptom questionnaire provided tentative indications that the rugby players do report a greater frequency of postconcussive symptomatology. The symptoms most frequently reported were being easily angered, memory problems, clumsy speech and sleep difficulties. It was hypothesized that the absence of cognitive impairment in the schoolboy rugby players compared with that noted for professional players was due to their younger age, relatively high IQ and education level and a less intensive level of physical participation in the sport, and hence less accumulated exposure to the game, thereby decreasing their exposure to mild head injuries. From a theoretical perspective, these pre-existing conditions were considered to act as protective factors against reductions in brain reserve capacity and concomitant susceptibility to the onset of neuropsychological dysfunction.
- Full Text:
- Date Issued: 2001
- Authors: Beilinsohn, Taryn
- Date: 2001
- Subjects: Rugby football injuries , Head -- Wounds and injuries -- Psychology , Head -- Wounds and injuries -- Complications , Brain damage
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2931 , http://hdl.handle.net/10962/d1002440 , Rugby football injuries , Head -- Wounds and injuries -- Psychology , Head -- Wounds and injuries -- Complications , Brain damage
- Description: This study investigates the cumulative effects of concussive and subconcussive mild head injury on the cognitive functioning of schoolboy rugby players. A comprehensive battery of neuropsychological tests and a self-report postconcussive questionnaire were administered to top level schoolboy rugby players (n=47), and a non-contact sport control group of top level schoolboy hockey players (n=34). Group comparisons of the percentage of individuals with cognitive deficit were carried out between i) the schoolboy rugby and the schoolboy hockey players, ii) the rugby forward and the rugby backline players; iii) the rugby forward and the schoolboy hockey players and, iv) the rugby backline and the schoolboy hockey players. Results on the neuropsychological test battery did not provide any substantial evidence of a higher level of neuropsychological impairment in the rugby players relative to the control group, or in the rugby forward players relative to the rugby backline players. Results obtained on the postconcussive symptom questionnaire provided tentative indications that the rugby players do report a greater frequency of postconcussive symptomatology. The symptoms most frequently reported were being easily angered, memory problems, clumsy speech and sleep difficulties. It was hypothesized that the absence of cognitive impairment in the schoolboy rugby players compared with that noted for professional players was due to their younger age, relatively high IQ and education level and a less intensive level of physical participation in the sport, and hence less accumulated exposure to the game, thereby decreasing their exposure to mild head injuries. From a theoretical perspective, these pre-existing conditions were considered to act as protective factors against reductions in brain reserve capacity and concomitant susceptibility to the onset of neuropsychological dysfunction.
- Full Text:
- Date Issued: 2001
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