Abstract
Objectives
This cohort study was conducted to examine patterns of symptom reporting in concussed
athletes in two different testing environments.
Design
A prospective cohort study was conducted with repeated measures.
Methods
Self-reported symptoms collected by team athletic trainers using the ImPACT Post-Concussion
Scale (PCS) were compared to symptoms collected in a confidential setting using structured
interviews for depression and anxiety. Ratings were scaled to match scoring of the
PCS and categorized into symptom-domains. Scores collected 2 days post-concussion
were compared across different rating scales. Confidential self-report scores approximately
9 days post-concussion in cleared athletes were compared to PCS scores collected during
return-to-play decisions. Finally, confidential self-report scores collected 9 days
post-concussion were compared between cleared and not cleared athletes.
Results
Athletes self-reported significantly fewer symptoms to team athletic trainers using
the ImPACT test compared to self-reported symptoms collected in a confidential setting
during the acute phase of concussion using standard psychiatric interviews. Athletes
cleared to play continued to underreport symptoms 9 days post-concussion, particularly
psychiatric symptoms. Finally, cleared athletes self-reported similar magnitude of
symptoms than non-cleared athletes 9 days post-concussion in confidential research
setting.
Conclusions
The systematic underreporting of post-concussion symptoms may represent motivated
behavior or differences in self-reporting data acquisition. By underreporting symptoms,
many cleared athletes are still symptomatic over 1-week post-concussion. This study
highlights the need for objective measures for somatic and psychiatric symptoms.
Keywords
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Article info
Publication history
Published online: July 24, 2014
Accepted:
July 14,
2014
Received in revised form:
July 8,
2014
Received:
February 16,
2014
Identification
Copyright
© 2014 Sports Medicine Australia. Published by Elsevier Inc. All rights reserved.
