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- Title
An Investigation of School Socioeconomic Status on Adolescent Athletes' Baseline and Post-Injury Concussion Assessments.
- Authors
Werner, Jennifer L.; Propst, Matthew; Reed, Christy; Foster, Tim; Logan, Kelsey; Kiefer, Adam W.; Gubanich, Paul
- Abstract
OBJECTIVE Multifaceted assessments are imperative when managing sports-related concussions. Furthermore, culturally competent knowledge and skills are crucial for clinicians to provide effective concussion prevention, assessment, and management of the whole athlete. The purpose of this study is to determine if socioeconomic status (SES) differences affect baseline and postconcussion performance of adolescent athletes on the King-Devick test (KD), modified Balance Error Scoring System (mBESS), and Post-Concussive Symptom Inventory (PCSI). DESIGN AND SETTING Retrospective cross-sectional study. PARTICIPANTS Concussed adolescent athletes were recruited from a pre-existing concussion surveillance program (n = 377) conducted in 7 high schools. 20 athletes were included for analysis: 11 athletes from high-SES schools (age = 15.31 ± 1.3 years, 6 females and 5 males, time-since-injury = 7.09 ± 8.26 days) and 9 athletes from low-SES schools (age = 16.17 ± 1.05 years, 3 females and 6 males, time-since-injury = 6.11 ± 2.73 days). Intervention: KD, mBESS, and PCSI. MAIN OUTCOME MEASUREMENT The two groups were categorized on the SES of that school. SES of each school was determined by the percentage of students with free or reduced-cost lunches: high-SES as < 50% free or reduced lunches and low-SES as > 75% free and reduced lunches. The concussion surveillance program established baseline scores that included a history and risk factor questionnaire, KD, mBESS, and PCSI. Athletes diagnosed with a concussion repeated these assessments after injury in a hospital based sports medicine clinic. Differences between baseline and postconcussion scores in concussed athletes from low-SES and high-SES schools were assessed for KD, mBESS, and PCSI. RESULTS Age (P = .15) and time-since-injury (P = .75) were not significant between groups. At baseline, there was a difference in mBESS between groups (high-SES 28 ± 1, low-SES 25 ± 3, P = .01). There were no other between group differences identified on baseline or post-injury assessments. CONCLUSION The comparison of baseline and post-injury assessments such as the KD, mBESS, and PSCI have previously been advocated to provide more accurate diagnosis and a safer return-toplay from concussion in athletic populations. Several studies have attempted to provide normative data on all three measures we included in this study. While limited by sample size, our study found mBESS differences at baseline. Otherwise, SES did not affect performance on these concussion assessments, in this cohort of patients, at baseline and approximately 1 week post injury. As further investigation needs to continue to evaluate for these differences, clinicians should recognize that there may be differences in physical-function and selfreported symptoms that can be influenced by additional extrinsic factors, such as socioeconomic disparities.
- Publication
Journal of Sports Medicine & Allied Health Sciences: Official Journal of the Ohio Athletic Trainers' Association, 2019, Vol 5, Issue 1, p1
- ISSN
2376-9289
- Publication type
Academic Journal
- DOI
10.25035/jsmahs.05.01.02