26
Concussion Management for Healthcare Professionals: Summary
ASSESSMENTS
SCAT 6 • Enhanced observable signs • Glasgow Coma Scale • Cervical spine assessment
Neuropsychological Tests 1. Reaction Time Tests : The ability to make the right choice as fast as you can, factoring in mistakes that may occur by going quickly: ○ Having learning disabilities such as ADD, ADHD, or dyslexia can affect the results of these tests 2. Visual Memory Processing Tests 3. Visual Motor Testing : Refers to an individual’s ability to see a shape, number, or drawing and be able to remember the visual and replicate it quickly: ○ Example: An individual remembers a shape they saw either immediately or with delayed recall 4. Verbal Memory Testing : An individual’s ability to recall words both immediately and delayed: ○ Example: Give a person 5 words and immediately ask them to repeat them to you 3 times. Then wait 5 minutes and ask if they remember all the words 5. Concentration Testing : A person's ability to be able to focus on something without getting distracted: ○ Some easy tests are a person's ability to focus on an object, recite a string of numbers in reverse order, count down from 100 subtracting 7’s, or performing dual task activities (e.g., walking in a straight line while saying the month's of the year in reverse order) The ability to pass all of these tests suggests that the mind is functioning appropriately. Speed is really important in determining how well the brain functions. SCAT 5 and SCAT 6 These tests are considered to be the gold standard of concussion assessment. To assist in determining a patient’s balance ability using the SCAT 5 or SCAT 6, mBESS has been used more recently as opposed to the original BESS. SCAT 5 • Mentions Red Flags • Observable Signs • Maddocks Questions Memory Assessment • Cervical Spine Assessment • Demographics • Symptom Evaluation • Orientation - Standard Assessment of Concussion (SAC) • Immediate Memory Recall • Concentration - Digits Backwards • Months in Reverse Order • Neurological Screening • Modified Balance Error Scoring System (mBESS) • Delayed Recall Memory
• Revised coordination and ocular/motor screen • Memory assessment/Maddocks questions • An enhanced Red Flags section ImPACT • A computer-based test used to assess memory, reaction time, and motor processing skills • Used as the gold standard for computer neuropsychological testing for the past couple of decades King Devick • The practitioner asks the patient to read numbers on 3 index cards • Each card has random numbers spaced unequally apart across 8 lines • The recommended function for the test is to be timed and do a baseline while comparing future exams to the baseline data • If the post injury test is 5 seconds slower than the baseline, it may suggest that the patient has a concussion • Other names for the test are: 1-minute or 2-minute concussion test Sway • This test is based on software on your cell phone that can determine where your body is in space • It is a good objective measure and easy to administer • The Sway Balance Mobile Application assesses postural stability using the tri-axial accelerometer built into mobile devices • The patient performs five balance stances while holding the mobile device at mid-sternum. An algorithm detects and interprets motion using the accelerometers built into the mobile device and generates a balance score • Demonstrates similar conditions to the BESS test. Except for the single leg and tandem stances, tests are performed with both dominant and non- dominant legs while all tests are performed with eyes closed and on a firm surface only Balance Error Scoring System (BESS) • Postural stability is the last sense to return after the concussion • Sway is a similar application as the BESS and the use of the mBESS
Powered by FlippingBook