Department of Physical Medicine & Rehabilitation, University of Michigan, , Ann Arbor, Michigan, USA.
Br J Sports Med. 2014 Jan;48(2):112-8. doi: 10.1136/bjsports-2012-091579. Epub 2013 Jan 11.
Reaction time (RT) is a valuable component of the sport concussion assessment battery. RT is typically measured using computers running specialised software, which limits its applicability in some athletic settings and populations. To address this, we developed a simple clinical test of RT (RTclin) that involves grasping a falling measuring stick.
To determine the effect of concussion on RTclin and its sensitivity and specificity for concussion.
Concussed athletes (n=28) and non-concussed control team-mates (n=28) completed RTclin assessments at baseline and within 48 h of injury. Repeated measures analysis of variance compared mean baseline and follow-up RTclin values between groups. Sensitivity and specificity were calculated over a range of reliable change confidence levels.
RTclin differed significantly between groups (p<0.001): there was significant prolongation from baseline to postinjury in the concussed group (p=0.003), with a trend towards improvement in the control group (p=0.058). Sensitivity and specificity were maximised when a critical change value of 0 ms was applied (ie, any increase in RTclin from baseline was interpreted as abnormal), which corresponded to a sensitivity of 75%, specificity of 68% and a 65% reliable change confidence level.
RTclin appears sensitive to the effects of concussion and distinguished concussed and non-concussed athletes with similar sensitivity and specificity to other commonly used concussion assessment tools. Given its simplicity, low cost and minimal time requirement, RTclin should be considered a viable component of the sports medicine provider's multifaceted concussion assessment battery.
反应时间(RT)是运动性脑震荡评估工具包中的一个有价值的组成部分。RT 通常使用运行专门软件的计算机进行测量,这限制了其在某些运动环境和人群中的适用性。为了解决这个问题,我们开发了一种简单的 RT 临床测试(RTclin),它涉及抓住下落的测量棒。
确定脑震荡对 RTclin 的影响及其对脑震荡的敏感性和特异性。
脑震荡运动员(n=28)和非脑震荡对照组队友(n=28)在基线和受伤后 48 小时内完成了 RTclin 评估。重复测量方差分析比较了两组之间的平均基线和随访 RTclin 值。在一系列可靠变化置信水平上计算了敏感性和特异性。
RTclin 在组间差异显著(p<0.001):脑震荡组从基线到受伤后有明显的延长(p=0.003),对照组有改善的趋势(p=0.058)。当应用 0 毫秒的临界变化值(即,从基线开始 RTclin 的任何增加都被解释为异常)时,敏感性和特异性最大,此时敏感性为 75%,特异性为 68%,可靠变化置信水平为 65%。
RTclin 似乎对脑震荡的影响敏感,并以与其他常用脑震荡评估工具相似的敏感性和特异性区分脑震荡和非脑震荡运动员。鉴于其简单性、低成本和最小的时间要求,RTclin 应被视为运动医学提供者多方面脑震荡评估工具包的一个可行组成部分。