Utility of 1 Measurement Versus Multiple Measurements of Near Point of Convergence After Concussion
| Autor: | Nathan Ernst, Philip Schatz, Anne Mucha, Kouros Emami, Alicia M Trbovich, Michael W. Collins, Shawn R. Eagle, Anthony P. Kontos |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Adolescent Intraclass correlation Concussion Poison control Physical Therapy Sports Therapy and Rehabilitation Context (language use) 03 medical and health sciences symbols.namesake Young Adult 0302 clinical medicine Cognition Consistency (statistics) Cutoff Medicine Humans Mass Screening Orthopedics and Sports Medicine Child Brain Concussion Retrospective Studies 030222 orthopedics business.industry Retrospective cohort study 030229 sport sciences General Medicine Convergence Ocular Physical Functional Performance Vestibular Function Tests Confidence interval Pearson product-moment correlation coefficient Athletic Injuries symbols Female Nuclear medicine business Psychomotor Performance |
| Zdroj: | J Athl Train |
| Popis: | Context Increased near point of convergence (NPC) distance is a common finding after concussion and is associated with physical symptoms and worsened neurocognitive performance. Vestibular/Ocular Motor Screening measures NPC distance across 3 trials and uses the average measurement to inform clinical care. However, whether 3 trials are necessary, are consistent, or add clinical utility is unknown. Objective To investigate the consistency across 3 trials of NPC and establish the classification accuracy (ie, clinical utility) of 1 or 2 trials compared with the standardized average of 3 trials. Design Retrospective cohort study. Setting Sports medicine clinic and research laboratory. Patients or Other Participants Consecutively enrolled patients aged 10 to 22 years with diagnosed concussions (74% sport related; n = 380). Main Outcome Measure(s) The previously reported clinical cutoff value of ≥5 cm across 3 trials was used. Pearson correlation and intraclass correlation coefficients were used to evaluate agreement between trials and average scores. Reliable change indices (RCIs) using 95% confidence intervals were also calculated. Results The Pearson correlation (r = .98) and intraclass correlation (0.98) coefficients revealed excellent agreement between the first measurement and average NPC distance across 3 measurements. The RCI across all trials was 2 cm. When the first NPC measurement was ≤3 cm or ≥7 cm, agreement existed within the RCI between the first measurement and the average of 3 measurements in 99.6% of cases. When we averaged the first and second measurements, 379/380 (99.7%) participants had the same classification (ie, Conclusions Our findings suggest limited utility of multiple or average NPC distance measurements when the initial NPC distance is outside of RCI clinical cutoffs (ie, ≤3 cm or ≥7 cm). Given the high consistency between the first measurement and average NPC distance across 3 trials, only 1 measurement of NPC distance is warranted unless the first measurement is between 3 and 7 cm. |
| Databáze: | OpenAIRE |
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