title: Using Acute Performance on a Comprehensive Neurocognitive, Vestibular, and Ocular Motor Assessment Battery to Predict Recovery Duration After Sport-Related Concussions.
abstract: BACKGROUND
  A sport-related concussion (SRC) is a heterogeneous injury that requires a multifaceted and comprehensive approach for diagnosis and management, including symptom reports, vestibular/ocular motor assessments, and neurocognitive testing.
  
  
  OBJECTIVE
  To determine which acute (eg, within 7 days) vestibular, ocular motor, neurocognitive, and symptom impairments predict the duration of recovery after an SRC.
  
  
  METHODS
  Cohort study (prognosis); Level of evidence, 2.
  
  
  METHODS
  Sixty-nine patients with a mean age of 15.3 ± 1.9 years completed a neurocognitive, vestibular/ocular motor, and symptom assessment within 7 days of a diagnosed concussion. Patients were grouped by recovery time: ≤14 days (n = 27, 39.1%), 15-29 days (n = 25, 36.2%), and 30-90 days (n = 17, 24.6%). Multinomial regression was used to identify the best subset of predictors associated with prolonged recovery relative to ≤14 days.
  
  
  RESULTS
  Acute visual motor speed and cognitive-migraine-fatigue symptoms were associated with an increased likelihood of recovery times of 30-90 days and 15-29 days relative to a recovery time of ≤14 days. A model with visual motor speed and cognitive-migraine-fatigue symptoms within the first 7 days of an SRC was 87% accurate at identifying patients with a recovery time of 30-90 days.
  
  
  CONCLUSIONS
  The current study identified cognitive-migraine-fatigue symptoms and visual motor speed as the most robust predictors of protracted recovery after an SRC according to the Post-concussion Symptom Scale, Immediate Post-concussion Assessment and Cognitive Testing, and Vestibular/Ocular Motor Screening (VOMS). While VOMS components were sensitive in identifying a concussion, they were not robust predictors for recovery. Clinicians may consider particular patterns of performance on clinical measures when providing treatment recommendations and discussing anticipated recovery with patients.
authors.affiliation: UPMC Sports Medicine Concussion Program, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Sufrinko
authors.affiliation: John G. Rangos Sr. School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA.
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Marchetti
authors.affiliation: UPMC Sports Medicine Concussion Program, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Cohen
authors.affiliation: Office for Sport Concussion Research, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Elbin
authors.affiliation: Università degli Studi di Milano, Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Re
authors.affiliation: UPMC Sports Medicine Concussion Program, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Kontos
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000209:etiology / Q000534:rehabilitation*; D001924:Brain Concussion / Q000209:etiology / Q000534:rehabilitation*; D003071:Cognition; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D011597:Psychomotor Performance; D020127:Recovery of Function; D014724:Vestibular Function Tests
keywords: concussion; neurocognitive; ocular motor; recovery; vestibular