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198 Testing neurocognitive function and balance following sport concussion – do we need baselines?

Background While evaluating balance and neurocognitive function following concussion is clinically valuable for both diagnosis and treatment, it is unclear if these assessments are best employed in reference to a pre-injury evaluation, or to normative results sampled from a healthy population. Objective To evaluate the performance of a computerized assessment of balance and neurocognitive function in athletes following a sport-related concussion (SRC) compared to either their own pre-injury test scores, or the scores of a normative sample of uninjured athletes. Hypothesis SRC test scores would discriminate better from athlete’s own pre-injury scores compared to those of an uninjured cohort. Design Prospective observational study design. Setting Sport medicine clinic at a Canadian University. Participants One hundred and forty Canadian Interuniversity athletes (n=73 male, n=67 female) from 12 different sports. Seventy non-injured athletes (n=31 male, n=39 female) were assessed prior to the start of their competitive season, while 70 athletes (n=42 male, n=28 female) with SRC were assessed within one week of injury. Assessment of risk factors At the time of testing, fourteen measures of neurocognitive function (n=6) and balance (n=8) were assessed using the C3 Logix application (NeuroLogix Technologies, Cleveland, Ohio). Main outcome measures Presence or absence of SRC, as diagnosed by a sport medicine doctor. Results Partial least squares discriminant analyses followed by the evaluation of model classification accuracy (Accur) revealed better discriminative performance when test scores in athletes with SRC were compared to an uninjured cohort (Accur=0.74), as opposed to their own pre-injury test scores (Accur=0.61). Conclusions Contrary to our hypothesis, these initial results suggest that neurocognitive and balance testing following SRC may benefit from comparison to normative reference values sampled from a healthy population.