Benson, BrianDukelow, SeanBertagnolli, Jalena Ashley2024-04-242024-04-242024-04-19Bertagnolli, J. A. (2024). The clinical utility of a novel multi-modal assessment battery for acute sport-related concussion (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.https://hdl.handle.net/1880/118477https://doi.org/10.11575/PRISM/43319Objective: To determine the clinical utility of a novel, multimodal, assessment battery in detecting acute post-concussion impairment relative to baseline performance. Study Design: Prospective observational cohort study. Subjects: Four hundred thirty-one elite ice hockey, alpine and freestyle ski, artistic swimming and luge athletes (mean age: 15.7 years (range: 14-36 years), male: 349, female: 82) over one athletic season (2022-2023). Observation Technique: Standardized multimodal baseline assessments including electroencephalography (EEG) utilizing the NeuroCatch® 1.0 device, postural sway using the tri-axial accelerometer Protxx® device, cardiovascular exercise from a bicycle ergometer and sustained handgrip strength were completed in the pre-season and then repeated for any athlete sustaining a sport-related concussion within seven days of injury. Outcome Measures: Directional bootstrap paired t-tests and binomial tests adjusting for multiplicity using Bonferroni correction were used to assess changes in performance between baseline and post-concussion test results for the following four primary assessments of interest: 1) quantitative EEG event-related potentials (N100, P300, and N400 amplitude and latency) (NeuroCatch), 2) quantitative assessment of postural sway with eyes open and eyes closed using a physiological vibration acceleration (phybrata) sensor (Protxx), 3) concussion symptom exacerbation (≥1 on a 10-point visual analogue rating scale) during a submaximal bicycle ergometer assessment, and 4) change in heart rate during a 30-second, 30% maximal handgrip strength contraction. Results: Forty-six athletes were diagnosed with a concussion by a sport medicine physician during the study period. Neither amplitude nor latency for N100, P300 or N400 event-related potentials demonstrated a significant group difference between baseline and post-concussion assessments. Athletes demonstrated a significant group difference in postural sway between baseline and post-concussion timepoints using the phybrata sensor for sway power ratio, with a moderate effect size (dav= 0.491) (baseline: 1.4 ±0.5W, post-concussion: 1.9 ±1.4W, p=0.005). Fifteen (68.2%) of the 22 athletes completing post-concussion exercise assessments experienced worsening symptoms, with two additional athletes unable to initiate exercise due to significant symptom burden (p<0.001, large effect size PR= 0.972). Furthermore, no significant difference was observed for change in heart rate during the handgrip strength task. Conclusions: A novel phybrata motion sensor objectively evaluating postural sway and standardized submaximal cardiovascular assessment evaluating symptom exacerbation demonstrated significant clinical utility in detecting impairment within seven days of an acute sport-related concussion, while event-related potentials (N100, P300, N400) and heart rate change during a sustained handgrip task did not.enUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.ConcussionSport-Related ConcussionEEGBalanceExerciseAutonomic Nervous SystemNeurosciencemaster thesis