Evaluating the predictive utility of the World Health Organization\u27s diagnostic criteria for postconcussion syndrome: A longitudinal and controlled study.

Postconcussion syndrome (PCS) is the term used to describe the cluster of affective, somatic, and cognitive symptoms commonly reported by individuals following head injury. The International Classification of Diseases and Related Health Problems, 10th edition (ICD-10) provides a set of currently recommended diagnostic criteria for PCS. However, no study to date has investigated the incidence of ICD-10 self-reported PCS symptoms in individuals following mild traumatic brain injury (MTBI). The vast majority of individuals who have sustained a MTBI report essentially a full recovery within 3 months of injury; however, a small percentage of individuals report persisting symptom complaints beyond the typical time frame following MTBI. PCS symptom persistence beyond 3 months post-MTBI is considered a poor outcome and appears to be related to variety of non-neurological factors. The present study compared endorsement rates of the ICD-10 self-reported PCS symptoms in MTBI patients and healthy control subjects at 1 month and 3 months post-injury. Results showed that seven of the nine PCS symptoms differentiated the MTBI group from the control group at baseline, with only two symptoms differentiating the groups at the 3-month follow-up; symptom endorsements were higher in the MTBI group at both time periods of interest. Collectively, the PCS symptoms significantly classified the MTBI and control participants into their respective groups at 1-month post-injury, with an optimal positive test threshold of endorsement of five symptoms coinciding with a sensitivity and specificity of 73 and 61%, respectively. The ICD-10 PCS symptoms were not able to accurately classify the MTBI and control participants into their respective groups at 3 months post-injury.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2005 .K37. Source: Masters Abstracts International, Volume: 44-03, page: 1514. Thesis (M.A.)--University of Windsor (Canada), 2005

A longitudinal investigation of neuropsychological and functional outcome after complicated mild traumatic brain injury

The current study investigated the extent to which neuropsychological and functional outcome after complicated mild traumatic brain injury (MTBI) parallels that of moderate traumatic brain injury (TBI) recovery. A longitudinal design was employed to compare the neuropsychological and functional status of individuals with complicated MTBI and moderate TBI at discharge from inpatient rehabilitation and at 1-year postinjury. The complicated MTBI group was comprised of 102 participants, each with an intracranial brain lesion documented via neuroimaging and a highest Glasgow Coma Scale (GCS) score in the Emergency Department between 13 and 15. The moderate TBI group was comprised of 127 participants, each with a highest GCS score in the Emergency Department between 9 and 12. The outcome measures of interest included the Functional Independence Measure, Disability Rating Scale, Community Integration Questionnaire, Logical Memory Test I and II, Rey Auditory Verbal Learning Test, Trail Making Test (A and B), Controlled Oral Word Association Test, Oral Symbol Digit Modalities Test, Wisconsin Card Sorting Test, and the Block Design Test. Statistical analysis revealed few differences in neuropsychological performance between the TBI groups. Qualitative examination of levels of cognitive impairment revealed less severely impaired information processing speed and verbal learning in the complicated MTBI group at rehabilitation discharge and at 1-year post-injury. Despite overall improvement across cognitive domains within the complicated MTBI group, some degree of impairment remained at 1-year post-injury on those measures identified as impaired soon after injury. No differences on measures of functional ability were found between the TBI groups at either time period post-injury, with both groups exhibiting incomplete recovery of functional status at the 1-year follow-up. Overall, sufficient parallels in outcome after complicated MTBI and moderate TBI were found to indicate that when classifying severity of TBI based on GCS scores, consideration of a moderate injury designation should be given to persons with an intracranial bleed and a GCS score between 13 and 15

Interpersonal Relatedness and Psychological Functioning following Traumatic Brain Injury: Implications for Marital and Family Therapists

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92451/1/j.1752-0606.2011.00231.x.pd

An Intervention Program Designed to Improve Balance and Power in U14 Alpine Ski-Racers

Purpose: To investigate if a neuromuscular training (NMT) warm-up program during preseason improved lower limb balance and maximal muscular power compared to a standard preseason program in alpine ski-racers 10-13-years-old (U14) after 8-weeks. Methods: Quasi-experimental study design. Participants included n=73 skiers from five Alberta Alpine Ski Association (AASA) ski-clubs. Ski-clubs in the intervention group (n=3) completed 2 15-min coach-delivered NMT warm-ups a week, while the standard of care (SOC) (n=2) ski-clubs completed their standard training; NMT warm-up program included balance, strength, and agility exercises. Performance outcome measures completed at baseline and post –testing included: vertical jump (VJ), star excursion balance test (SEBT) reach distances, and predicted VO2max. Results: Participants in the intervention group demonstrated significant improvements on the VJ and SEBT. Conclusions: Dynamic balance and peak leg power improved post implementation of the NMT warm-up program in U14 alpine ski-racers

Postconcussive symptom overreporting in Iraq/Afghanistan Veterans with mild traumatic brain injury

A comprehensive evaluation, including the assessment of neurobehavioral symptoms, has been instituted at the Department of Veterans Affairs (VA) healthcare system to address the large number of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans returning with mild traumatic brain injuries (mTBIs). The Validity-10 is measure of symptom overreporting embedded within the Neurobehavioral Symptom Inventory, a component of the comprehensive evaluation that assesses postconcussive symptom severity. The Validity-10 is composed of 10 unlikely/low-frequency items and a validated cutoff score to identify postconcussive symptom overreporting. We examined the items and cutoff used in the initial development and validation study of the Validity-10 through retrospective chart reviews of 331 treatment-seeking Veterans who sustained an mTBI. The Validity-10 exhibited significant relationships with psychiatric variables, VA service connection, and neuropsychological performance validity (all p < 0.01), but nonsignificant relationships with demographic and injury variables (all p > 0.05). Furthermore, the Validity-10 modestly predicted neuropsychological performance validity test failure over and above psychiatric comorbidities and VA service connection. The present study supports the use of the Validity-10 to assess symptom validity in treatment-seeking OIF/OEF Veterans with a history of mTBI