Validity and Reliability of Methods to Assess Movement Deficiencies Following Concussion: A COSMIN Systematic Review
Abstract Background There is an increased risk of subsequent concussion and musculoskeletal injury upon return to play following a sports-related concussion. Whilst there are numerous assessments available for clinicians for diagnosis and during return to play following concussion, many may lack the...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-08-01
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| Series: | Sports Medicine - Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40798-023-00625-0 |
| _version_ | 1797452512101400576 |
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| author | Laura A. M. Dunne Michael H. Cole Stuart J. Cormack David R. Howell Rich D. Johnston |
| author_facet | Laura A. M. Dunne Michael H. Cole Stuart J. Cormack David R. Howell Rich D. Johnston |
| author_sort | Laura A. M. Dunne |
| collection | DOAJ |
| description | Abstract Background There is an increased risk of subsequent concussion and musculoskeletal injury upon return to play following a sports-related concussion. Whilst there are numerous assessments available for clinicians for diagnosis and during return to play following concussion, many may lack the ability to detect these subclinical changes in function. Currently, there is no consensus or collated sources on the reliability, validity and feasibility of these assessments, which makes it difficult for clinicians and practitioners to select the most appropriate assessment for their needs. Objectives This systematic review aims to (1) consolidate the reliability and validity of motor function assessments across the time course of concussion management and (2) summarise their feasibility for clinicians and other end-users. Methods A systematic search of five databases was conducted. Eligible studies were: (1) original research; (2) full-text English language; (3) peer-reviewed with level III evidence or higher; (4) assessed the validity of lower-limb motor assessments used to diagnose or determine readiness for athletes or military personnel who had sustained a concussion or; (5) assessed the test-retest reliability of lower-limb motor assessments used for concussion management amongst healthy athletes. Acceptable lower-limb motor assessments were dichotomised into instrumented and non-instrumented and then classified into static (stable around a fixed point), dynamic (movement around a fixed point), gait, and other categories. Each study was assessed using the COSMIN checklist to establish methodological and measurement quality. Results A total of 1270 records were identified, with 637 duplicates removed. Titles and abstracts of 633 records were analysed, with 158 being retained for full-text review. A total of 67 records were included in this review; 37 records assessed reliability, and 35 records assessed the validity of lower-limb motor assessments. There were 42 different assessments included in the review, with 43% being non-instrumented, subjective assessments. Consistent evidence supported the use of instrumented assessments over non-instrumented, with gait-based assessments demonstrating sufficient reliability and validity compared to static or dynamic assessments. Conclusion These findings suggest that instrumented, gait-based assessments should be prioritised over static or dynamic balance assessments. The use of laboratory equipment (i.e. 3D motion capture, pressure sensitive walkways) on average exhibited sufficient reliability and validity, yet demonstrate poor feasibility. Further high-quality studies evaluating the reliability and validity of more readily available devices (i.e. inertial measurement units) are needed to fill the gap in current concussion management protocols. Practitioners can use this resource to understand the accuracy and precision of the assessments they have at their disposal to make informed decisions regarding the management of concussion. Trail Registration: This systematic review was registered on PROSPERO (reg no. CRD42021256298). |
| first_indexed | 2024-03-09T15:09:45Z |
| format | Article |
| id | doaj.art-5d779d3acfb74a7a9da500a8310dd6a7 |
| institution | Directory Open Access Journal |
| issn | 2198-9761 |
| language | English |
| last_indexed | 2024-03-09T15:09:45Z |
| publishDate | 2023-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Sports Medicine - Open |
| spelling | doaj.art-5d779d3acfb74a7a9da500a8310dd6a72023-11-26T13:26:36ZengSpringerOpenSports Medicine - Open2198-97612023-08-019112510.1186/s40798-023-00625-0Validity and Reliability of Methods to Assess Movement Deficiencies Following Concussion: A COSMIN Systematic ReviewLaura A. M. Dunne0Michael H. Cole1Stuart J. Cormack2David R. Howell3Rich D. Johnston4School of Behavioural and Health Sciences, Australian Catholic UniversitySchool of Behavioural and Health Sciences, Australian Catholic UniversitySPRINT Research Centre, Faculty of Health Sciences, Australian Catholic UniversitySports Medicine Center, Children’s Hospital ColoradoSchool of Behavioural and Health Sciences, Australian Catholic UniversityAbstract Background There is an increased risk of subsequent concussion and musculoskeletal injury upon return to play following a sports-related concussion. Whilst there are numerous assessments available for clinicians for diagnosis and during return to play following concussion, many may lack the ability to detect these subclinical changes in function. Currently, there is no consensus or collated sources on the reliability, validity and feasibility of these assessments, which makes it difficult for clinicians and practitioners to select the most appropriate assessment for their needs. Objectives This systematic review aims to (1) consolidate the reliability and validity of motor function assessments across the time course of concussion management and (2) summarise their feasibility for clinicians and other end-users. Methods A systematic search of five databases was conducted. Eligible studies were: (1) original research; (2) full-text English language; (3) peer-reviewed with level III evidence or higher; (4) assessed the validity of lower-limb motor assessments used to diagnose or determine readiness for athletes or military personnel who had sustained a concussion or; (5) assessed the test-retest reliability of lower-limb motor assessments used for concussion management amongst healthy athletes. Acceptable lower-limb motor assessments were dichotomised into instrumented and non-instrumented and then classified into static (stable around a fixed point), dynamic (movement around a fixed point), gait, and other categories. Each study was assessed using the COSMIN checklist to establish methodological and measurement quality. Results A total of 1270 records were identified, with 637 duplicates removed. Titles and abstracts of 633 records were analysed, with 158 being retained for full-text review. A total of 67 records were included in this review; 37 records assessed reliability, and 35 records assessed the validity of lower-limb motor assessments. There were 42 different assessments included in the review, with 43% being non-instrumented, subjective assessments. Consistent evidence supported the use of instrumented assessments over non-instrumented, with gait-based assessments demonstrating sufficient reliability and validity compared to static or dynamic assessments. Conclusion These findings suggest that instrumented, gait-based assessments should be prioritised over static or dynamic balance assessments. The use of laboratory equipment (i.e. 3D motion capture, pressure sensitive walkways) on average exhibited sufficient reliability and validity, yet demonstrate poor feasibility. Further high-quality studies evaluating the reliability and validity of more readily available devices (i.e. inertial measurement units) are needed to fill the gap in current concussion management protocols. Practitioners can use this resource to understand the accuracy and precision of the assessments they have at their disposal to make informed decisions regarding the management of concussion. Trail Registration: This systematic review was registered on PROSPERO (reg no. CRD42021256298).https://doi.org/10.1186/s40798-023-00625-0Sports-related concussionMotorAssessmentValidityReliability |
| spellingShingle | Laura A. M. Dunne Michael H. Cole Stuart J. Cormack David R. Howell Rich D. Johnston Validity and Reliability of Methods to Assess Movement Deficiencies Following Concussion: A COSMIN Systematic Review Sports Medicine - Open Sports-related concussion Motor Assessment Validity Reliability |
| title | Validity and Reliability of Methods to Assess Movement Deficiencies Following Concussion: A COSMIN Systematic Review |
| title_full | Validity and Reliability of Methods to Assess Movement Deficiencies Following Concussion: A COSMIN Systematic Review |
| title_fullStr | Validity and Reliability of Methods to Assess Movement Deficiencies Following Concussion: A COSMIN Systematic Review |
| title_full_unstemmed | Validity and Reliability of Methods to Assess Movement Deficiencies Following Concussion: A COSMIN Systematic Review |
| title_short | Validity and Reliability of Methods to Assess Movement Deficiencies Following Concussion: A COSMIN Systematic Review |
| title_sort | validity and reliability of methods to assess movement deficiencies following concussion a cosmin systematic review |
| topic | Sports-related concussion Motor Assessment Validity Reliability |
| url | https://doi.org/10.1186/s40798-023-00625-0 |
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