The influence of sport-related concussion on sensorimotor skills in collegiate athletes

Background: Recent research suggests that subtle deficits in sensorimotor skills may be present following recovery from sport-related concussion (SRC). These underlying issues are hypothesized to contribute to a greater risk of subsequent injury when an athlete returns to sport. However, little is known about which sensorimotor skills are affected throughout recovery following SRC in collegiate athletes and how other factors, such as SRC symptoms, are related.Purpose: The purpose of this dissertation was to 1) determine the reliability of 10 sensorimotor skills assessed by a computerized sensory station, 2) examine sensorimotor skills throughout recovery following SRC in collegiate athletes compared to healthy matched controls, and 3) examine the relationship between groups of symptoms and sensorimotor skills in collegiate athletes following SRC at the acute visit, followed by determining if symptoms or sensorimotor skills were associated with recovery time.Methods: For study one, 100 participants completed 10 sensorimotor skills on a computerized sensory station (Senaptec Sensory Station, Senaptec Inc., Beaverton, OR) at two testing sessions within one week of each other. For study two, 25 participants diagnosed with SRC by a physician completed an acute visit within 5 days of injury, a second visit at the time of medical clearance (+3 days), and a third visit at least one month post return to play (RTP). Control participants (n = 15), who were matched to SRC participants based on biologic sex, age, and sport, completed three visits according to the same schedule as their matched participant with SRC. All participants for study two completed demographic, injury, medical history, and recovery information, along with a symptom checklist and 10 sensorimotor skill assessments on a computerized sensory station at each visit. For study three, 64 participants who were diagnosed with SRC by a physician completed an acute visit within 5 days of injury and a second visit at℗ the time of medical clearance. All participants in study three completed the same procedures as participants in study two. Symptoms from the acute visit were grouped into migraine-fatigue, affective, and cognitive-ocular "factors" to determine relationships.Results: For study one, go/no-go, multiple-object tracking, eye-hand coordination, depth perception, and reaction time assessments demonstrated good reliability; target capture and perception span demonstrated moderate reliability; visual clarity, contrast sensitivity, and near-far quickness demonstrated poor reliability. For study two, reaction time was statistically significantly worse in the SRC group compared to the control group at the acute visit. In the SRC group, reaction time significantly improved between acute and medical clearance visits and between the acute and one-month post-RTP visits. For study three, statistically significant correlations were found between all three symptom factors with go/no-go, eye-hand coordination, and reaction time assessments. Scores on the symptom factors and sensorimotor assessments were not significantly associated with recovery time following SRC in collegiate athletes.Conclusion: Go/no-go, multiple-object tracking, eye-hand coordination, depth perception, and reaction time assessments from the computerized sensory station were reliable and can be administered clinically. An examination of these sensorimotor skills in collegiate athletes following SRC revealed significantly worse reaction time acutely and after RTP compared to healthy matched controls. Clinicians should be aware of these potential deficits and incorporate reaction time assessment in SRC management. Additionally, cognitive-ocular, migraine-fatigue, and affective symptom factors were significantly correlated with go/no-go, eye-hand coordination, and reaction time assessments at the acute visit in collegiate athletes following SRC. These findings further help inform SRC management and clinical decision-making.