Measuring Dynamic Symptom Response in Concussion: Children's Exertional Effects Rating Scale.
Maegan D Sady, Christopher G Vaughan, Gerard A Gioia
PMID 30169434WHAT IT FOUND
Four symptoms rated before and after cognitive testing and questionnaires separated children still recovering from concussion from uninjured and recovered children.
Symptom increases were common in not-recovered children, but use cautiously at ages 5-7.
Key findings
01Children who were still recovering from concussion reported higher symptoms before testing and larger symptom increases afterward than uninjured or recovered children.
02The change score after testing was weakly related to the standard symptom total, while pre-test ratings were strongly related to it.
03A large change score (EEI 4 or more) was reported by 33% of not-recovered children, while fewer than 10% of recovered children reached that level.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was cross-sectional, so it cannot show how exertional symptoms change over the course of recovery. The data came from a specialty concussion clinic, so base rates in concussed groups may not apply to other settings. Recovered and Not-Recovered status was assigned by the treating clinician rather than by a fixed study definition. The testing session varied in content and duration, although change scores were not related to session length or test type. Internal consistency was lower than optimal for the four-item scale. Children aged 5-7 had less stable ratings, especially for headache, and clinical use in that age group needs caution. Younger children were more likely to be excluded than older participants.
Declared interests
The authors declared no conflicts of interest. The publication types indicate NIH extramural and U.S. government PHS research support.
The easy way to misread this
Do not read the symptom increases after testing as proof that a treatment works or fails. This study evaluated a rating scale and compared groups at one testing session; it did not test treatment.