Special Tests For Assessment Of Cognition

The cognitive evaluation should begin by giving the athlete three words (e.g., pig, blue, hat) to remember because he or she will be asked to recall the words at the conclusion of the assessment. A brief mental status examination should be conducted using the Standardized Assessment of Concussion (SAC). The SAC is a brief screening instrument designed for the neurocognitive assessment of concussion by a medical professional with no prior expertise in neuropsychological testing.35,36 Studies have demonstrated the psychometric properties and clinical sensitivity of the SAC in assessing concussion and tracking postinjury recovery.37-40 The SAC requires approximately 5 minutes to administer and assesses four domains: cognition including orientation, immediate memory, concentration, and delayed recall. A composite total score of 30 possible points is summed to provide an overall index of cognitive impairment and injury severity. The SAC also contains a brief neurologic screening and documentation of injury-related factors (e.g., LOC, post-traumatic amnesia, retrograde amnesia; Table 14-8). Equivalent alternate forms of the SAC are available and should be used to minimize practice effects from serial testing after an injury. The authors identified significant differences between concussed athletes and nonconcussed controls as well as between preseason baselines and postinjury scores.38,40 In lieu of using the SAC, the clinician can consider using a series of questions for concentration (Table 14-9) and recent memory (Table 14-10).

Figure 14-2 A-F, Six testing conditions for the Balance Error Scoring System.

Table 14-8 Standardized Assessment of Concussion

1. Orientation

Month:

_______ 0

1

Date:

_______ 0

1

Day of week:

_______ 0

1

Year:

_______ 0

1

Time (within 1hr.):

_______ 0

1

Orientation Total Score

_______ /

5

2. Immediate memory (all 3 trials are completed regardless of score on trials 1 and 2; total score equals sum across all 3 trials)

List

Trial 1

Trial 2

Trial 3

Word 1

0

1

0

1

0

1

Word 2

0

1

0

1

0

1

Word 3

0

1

0

1

0

1

Word 4

0

1

0

1

0

1

Word 5

0

1

0

1

0

1

Total

Immediate Memory Total Score

______ / 15

(Note: Subject is not informed of delayed recall testing of memory)

Loss of consciousness (occurrence, duration)

Pre- and post-traumatic amnesia (recollection of events pre- and postinjury) Strength: Sensation: Coordination:

3. Concentration

Digits backward (If correct, go to next string length; if incorrect, read trial 2. Stop if incorrect on both trials)

Months in reverse order (entire sequence correct for 1 point) Dec-Nov-Oct-Sep-Aug-Jul

Jun-May-Apr-Mar-Feb-Jan _

Concentration total score

Exertional maneuvers

(when appropriate) 5 jumping jacks 5 push-ups

5 sit-ups 5 knee-bends

4. Delayed recall

Word 1 Word 2 Word 3 Word 4 Word 5

Delayed recall total score_

Summary of total scores

Orientation_

Immediate Memory

Delayed Recall_

Data from McCrea, Kelly, Randolph, 1997.35

Was this article helpful?

0 0
Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

Get My Free Ebook


Post a comment