Does the Preparticipation Examination Aid in Identifying Future Risk of Concussion?

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Context: A pre-participation examination (PPE) has become standard practice among the athletic community. This examination commonly includes a multifaceted baseline concussion assessment and an injury history survey. Recent evidence suggests that neuropsychological testing can aid in predicting individuals at an increased risk of lower extremity injury. However, no known previous study has investigated the relationship between neuropsychological function and potential risk of sustaining a concussion. Objective: This study sought to identify a relationship between components of a standard PPE and an elevated risk of concussion. Design: All data was extracted from the institution concussion database. Setting: A large university in Southeast Georgia. Participants: One hundred and sixty-six participants were recruited for this study, of these participants eighty-two were in the concussed experimental group and eighty-two were in the matched healthy control group, with two excluded for invalid or incomplete ImPACT data. Main Outcome Measurements: Statistics included a descriptive analyses of gender, sport, and concussion history, a frequency analysis of the four ImPACT composites, total BESS score, total SAC score, gender, sport, and injury history, a series of one-way ANOVAs, a ROC analysis, and a discriminant function analysis. Results: The frequency analysis determined that there was some missing data, the descriptive analysis determined the following group means, verbal memory composite: 85.7 +/- 11, visual memory composite: 73.1 +/- 16.3, reaction time composite: 0.577 +/- 0.080, processing speed composite: 39.8 +/- 7.7, BESS: 13.1 +/- 6.1, SAC: 27+/- 2. The series of nine one-way ANOVAs showed no significant group differences. The ROC analysis determined the following cut off values for each PPE component, verbal memory composite: 83.5, visual memory composite: 81.5, reaction time composite: 0.63, processing speed composite: 33.05, BESS: 13, and SAC: 26. The discriminant function analysis revealed no significant predictors. Discussion: This study began to show that the basic components of the PPE may not be clinical predictors of concussions. This is clinically significant because it rules out the baseline assessment approach as something that could help identify individuals at an increased risk.


National Athletic Trainers Association National Conference (NATA)


St. Louis, MO