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Title:Headache does not predict sideline neurostatus or balance in high school football players
Author(s):Nohren, Matthew W.
Advisor(s):Broglio, Steven P.
Department / Program:Kinesiology & Community Health
Degree Granting Institution:University of Illinois at Urbana-Champaign
Abstract:ABSTRACT Context: Headache is reported to be the most common concussion related symptom. This has resulted in a heavy reliance on symptoms for the sideline assessment of concussive injuries. It is unclear however, if all athletes reporting headache demonstrate impairment in other commonly evaluated concussion domains. Objective: To determine the relationship between those with and without a headache resulting from football participation on neurostatus and balance. Design: A two group repeated-measures design. Setting: Three high schools in central Illinois. Participants: Varsity football athletes (N=32; age 16.3±0.8 years, range 16-18; weight 82.8±21.8 kg; height 177.0±7.5 cm), participated in this study. Interventions: All athletes completed a baseline evaluation of the Graded Symptom Checklist (GSC), Balance Error Scoring System (BESS) and Standardized Assessment of Concussion (SAC). Athletes reporting a headache (n=16) following a game or practice were re-administered the same test battery, as well control participants (non-headache: n=16) matched for age, playing position, weight and height. Main Outcome Measures: Performance on the GSC, BESS and SAC were evaluated using group by time repeated measures analysis of variance. Significance was noted when p<0.05. Results: Following football participation, total GSC scores increased significantly (p=.004) in the headache group (8.1±8.9 to 16.1±15.3), but significantly decreased (p=.01) in the non-headache group (6.1±7.0 to 3.1±4.4). A significant decrease (p<.000) in BESS performance was noted in both groups: headache (15.0+7.4 to 20.3+8.9) and non-headache (13.3+6.7 to 18.1+6.7). No significant differences were noted on SAC performance (p>0.05). Conclusions: Performance on common concussion assessment tools does not appear to be influenced by athlete reports of football related headache. These findings indicate that the use of headache, exclusively or in combination with other concussion related symptoms, is not a valid marker of the injury. This supports previous works suggesting clinicians should adopt a multifaceted approach to concussion management. Further, physical exertion appears to have an effect on BESS performance independent of symptoms, suggesting careful interpretation of BESS scores when administered on the sideline.
Issue Date:2010-05-19
Rights Information:Copyright 2010 Matthew W. Nohren
Date Available in IDEALS:2010-05-19
Date Deposited:May 2010

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