Beyond acute concussion assessment to office management: a systematic review informing the development of a Sport Concussion Office Assessment Tool (SCOAT6) for adults and children.
Journal: British journal of sports medicine
Volume: 57
Issue: 11
Year of Publication: 2023
Affiliated Institutions:
Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa jpat@mweb.co.za.
Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Psychology, University of Missouri, Kansas City, Missouri, USA.
Rehabilitation, Laval University, Quebec, Quebec, Canada.
School of Health and Related Research, University of Sheffield, Sheffield, UK.
Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine and Neurological Surgery, University of Washington, Seattle, Washington, USA.
Family Medicine, University of Washington, Seattle, Washington, USA.
University of Calgary, Calgary, Alberta, Canada.
Institute for Sport Exercise and Health, University Collage Hospital London, London, UK.
Florey Institute of Neuroscience and Mental Health - Austin Campus, Heidelberg, Victoria, Australia.
Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Sports Medicine, Children's Hospital Boston, Boston, Massachusetts, USA.
Neurotrauma and Ophthalmology Research Group, University of Birmingham, Birmingham, UK.
Libraries, University of Victoria, Victoria, British Columbia, Canada.
Medical, Major League Soccer, New York, New York, USA.
Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada.
International Concussion and Head Injury Research Foundation, London, UK.
University of Calgary Faculty of Kinesiology, Calgary, Alberta, Canada.
Medical Committee, International Paralympic Committee, Bonn, Germany.
Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
Abstract summary
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).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.(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.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.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.CRD42020154787.
Authors & Co-authors:
Patricios Jon S JS
Schneider Geoff M GM
van Ierssel Jacqueline J
Purcell Laura K LK
Davis Gavin A GA
Echemendia Ruben J RJ
Fremont Pierre P
Fuller Gordon Ward GW
Herring Stanley A SA
Harmon Kimberly G KG
Holte Kirsten K
Loosemore Mike M
Makdissi Michael M
McCrea Michael M
Meehan William P WP
O'Halloran Patrick P
Premji Zahra Z
Putukian Margot M
Shill Isla Jordan IJ
Turner Michael M
Vaandering Kenzie K
Webborn Nick N
Yeates Keith Owen KO
Schneider Kathryn J KJ
Study Outcome
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