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Effect of Concussion on Reaction Time and Neurocognitive Factors: Implications for Subsequent Lower Extremity Injury
Authors:Tyler Ray  Daniel Fleming  Daniel Le  Mallory Faherty  Carolyn Killelea  Jeffrey Bytomski  Tracy Ray  Larry Lemak  Corina Martinez  Michael F. Bergeron  Timothy Sell
Affiliation:1. Duke Doctor of Physical Therapy Program ; 2. Michael W. Krzyzewski Human Performance Lab, Department of Orthopedic Surgery Duke University Medical Center ; 3. Department of Orthopedic Surgery Duke University ; 4. Piedmont Orthopedic Sports Medicine ; 5. Lemak Sports Medicine ; 6. WTA Performance Health and Sport Sciences & Medicine WTA Women’s Tennis Association ; 7. Atrium Health Musculoskeletal Institute
Abstract:
BackgroundRecent evidence has demonstrated that athletes are at greater risk for a lower extremity injury following a return-to-sport (RTS) after sport-related concussion (SRC). The reason for this is not completely clear, but it has been hypothesized that persistent deficits in neurocognitive factors may be a contributing factor.Hypothesis/PurposeThis study assessed simple reaction time, processing speed, attention, and concentration in a group of athletes, post-concussion upon clearance for RTS for potential deficits that may result in slower reaction time, processing speed, attention, and concentration. The researchers hypothesized that the concussion group would demonstrate worse scores on both assessments compared to a sex-, age-, and sport-matched cohort.Study DesignCase-controlled studyMethodsTwelve participants who had suffered a SRC and eight healthy individuals who were matched to the concussed group by age, sex, and sport were evaluated. Those with a concussion had been cleared for RTS by a licensed healthcare provider. Each participant underwent neurocognitive tests that included a simple reaction time test (SRT) and the King-Devick Test (K-D). Independent t-tests were performed to compare the groups with significance set a priori at p<0.05.ResultsThere was a significant difference (p =0.024) between groups for SRT with the concussed group demonstrating a better SRT than the control group. There were no significant differences (p =0.939) between the groups for the K-D.ConclusionWith no significant differences between groups in the K-D assessment and, surprisingly, the concussed group having a better SRT compared to the healthy group, our hypothesis was not supported.Clinical RelevanceThese specific measures, compounded with extensive post-concussion time lapse until RTS clearance, may have limited capacity in revealing potential persistent deficits in relevant neurocognitive characteristics.Level of EvidenceLevel of Evidence 3
Keywords:athletic injuries   injury prevention   postural balance   sport injuries
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