Efa supported a threefactor solution for postconcussive symptoms employing 18 of the original 19 scale items. We would like to know if you now suffer from any of the symptoms given below. After a head injury or accident some people experience symptoms which can cause worry or. If there is any loss of consciousness or alteration in mentation or neurological deficit, labeling the injury as traumatic brain injury would also be appropriate. A rating of 0 means that you have not experienced this symptom today. Jan 2014 fac tsheet postconcussion syndrome is a description given to a cluster of physical and cognitive symptoms that sometimes occurs after minor head injury or concussion. Pdf clinical assessment of cerebral concussion relies on the presence and duration of post concussive symptoms pcs.
The athletes were instructed to identify and rate only those symptoms they experienced at the time of the study. Some of the ways you can get a concussion are when you hit your head during a. Scat3 sport concussion assesment tool 3 page 3 20 concussion in sport group instructions words in italics throughout the scat3 are the instructions given to the athlete by the tester. The post concussion symptom scale report your current experience of symptoms. Postconcussion syndrome is a condition that is typically associated with a head injury. Post concussion syndrome pcs is a disorder in which these symptoms persist beyond the typical 1021 day recovery time. The majority of concussion symptoms will resolve within about two weeks, and with proper recovery almost all dissipate within a month. If symptoms are new and present, there is no lower limit symptom score. Anatomically, the cervical spine is closely linked to structures that can cause many of the same symptoms as concussion. Post concussion symptom scale brain injury guidelines.
The athlete should fill out the form, on his or her own, in order to give a subjective value for each symptom. A rating of 6 means you have experienced severe problems with this symptom. Post concussion syndrome information leaflet taken from. Treatment and management of prolonged symptoms and post. The rivermead postconcussion symptom questionnaire rpq is a selfreport scale to measure the severity of post concussive symptoms following a traumatic brain injury tbi. The head injury may be categorized as a concussion or a mild traumatic brain injury. The rivermead postconcussion symptoms questionnaire. Symptoms such as headache, or signs such as loss of consciousness, or memory problems any athlete with a suspecte d concussion shoul be monitored for deterioration i. Do symptoms worsen with thinkingcognitive activity. Clinical assessment of cerebral concussion relies on the presence and duration of post concussive symptoms pcs. Postconcussion syndrome diagnosis and treatment mayo.
The rivermead postconcussion symptoms questionnaire after a head injury or accident some people experience symptoms which can cause worry or nuisance. The pcss is a list of 22 common symptoms of a concussion and athletes are asked to rate each symptom on a 7point scale 0 no symptoms. A rating of 6 means that you have experienced severe problems with this symptom today. Pdf a revised factor structure for the postconcussion. The american academy of neurology scale is graded on a scale of 1 to 3, where grade 3 has any loss of consciousness. This form can be used with each encounter to track the athletes progress towards the resolution of symptoms. Adapted from oregon concussion awareness and management program ocamp. During the period when the patient denies symptoms but metabolic changes are still in effect, symptoms may be induced by rigorous exercise. Selfreport post concussion symptom scales have been used for many years as a key method of monitoring recovery from sportrelated concussion, to assist in medical management and returntoplay decisionmaking. Paper a validation of the post concussion symptom scale in. Please indicate how much each symptom has bothered you over the past 2 days.
The symptoms of post concussion syndrome often improve after the affected person learns that there is a cause for his or her symptoms and that they will likely improve with time. Validity of the impact postconcussion symptom scale pcss. A validation of the post concussion symptom scale in the. Establish baseline score prior to the start of the after a concussive injury, reassess the athlete for each symptom. Grade 2 is with any symptoms lasting more than 15 minutes. Concussion may or may not involve a loss of consciousness loc. Concussion symptom inventory is presented and recommended as a research and clinical tool for monitoring recovery from sportrelated concussion.
Reliability and normative data for the post concussion scale measurement of symptomslovell et al. Vanderbilt sports medicine concussion management guidelines. Postconcussion syndrome pcs, or post concussive syndrome, refers to the lingering symptoms following a concussion or a mild traumatic brain injury tbi this. Graded symptom scale checklist modified from various published symptom checklists27 30 evaluate all signs and symptoms, ranking each on a scale of 06. Symptom scale you should score yourself on the following symptoms, based on how you feel now. To evaluate the usefulness of selfreported pcs by means of cognitive tests and functional mri fmri. Select health of south carolina considers the use of immediate postconcussion assessment and cognitive testing impact when performed by medical professionals to be clinically proven and, therefore, medically necessary in the assessment of acute head trauma alsalaheen 2016, hope 2015, harmon 20, giza 20 limitations. The diagnosis of a concussion is a clinical judgment, made by a medical professional. Postconcussion syndrome and treatment guidelines 1 cervicogenic background cervical spine injury is well documented following a trauma. Postconcussion symptom scale acupuncture neurology. Concussion recovery pattern and pathway concussions ontario. Page 1 prepared by dr jon stone, consultant neurologist, university of edinburgh, uk. Immediate postconcussion assessment and cognitive testing. The rivermead post concussion symptoms questionnaire with modified scoring rpq3 and rpq is a selfreport scale to measure the severity of post concussive symptoms following a traumatic brain injury tbi.
All athletes returned to sport without recurrent symptoms during. As many of these symptoms occur normally, we would like you to compare yourself now with before the accident. A concussion is a traumatic brain injury that alters your brain function. Commonly used clinical tools in pcs assessment include the minimental status examination mmse, immediate post concussion assessment and cognitive testing impact, sport concussion.
Post concussion symptom scale or graded symptom checklist symptom checklists. Pcs affects two out of 10 people who sustain a concussion. Ocamp oregon concussion awareness and management program symptoms none mild moderate severe headache 0 1 2 3 4 5 6. Management of concussion and postconcussion syndrome willer and leddy 417 that their symptoms are gone 34 days post concussion before they demonstrate physical and cognitive homeostasis. Zero 0 means you have never experienced the symptom, 1 means you experienced. No part of this publication may be reproduced in whole or in part or transmitted in any form.
To date, however, item selection and scaling metrics for these instruments have been based solely upon. After reading each symptom, please circle the number that best describes the way you have been feeling today please answer sleep rated questions for last night. Postconcussion program physical therapy specialists. Symptoms of acute concussion are believed to be secondary to a global cerebral energy crisis characterized by alterations in cell membrane permeability, ion transport regulation, neurotransmitter release, cellular metabolism and cerebral blood flow cbf 3. Describe the pathophysiology of concussion list the various components of concussion assessment incorporate appropriate examination techniques when examining individuals post concussion.
Despite being deemed ready to return to sport, 54% of athletes had 1 or more range 16 anam subtests below average 9th percentile or below and 22% had 1 or more range 14 anam subtests clearly below average 2nd percentile or below. Management of concussion and postconcussion syndrome. A revised factor structure for the post concussion symptom scale baseline and postconcussion factors article pdf available in the american journal of. Selfadministered questionnaire or completed by interview inperson or telephonically. In cases where symptoms last longer than one or two months, doctors may diagnose post concussion syndrome. It is caused by a bump, blow, or jolt to the head or body that causes the head and brain to move quickly back and forth.
Symptoms may last from several minutes to days, weeks, months or even longer in some cases. Education about the disorder can ease a persons fears and help provide peace of mind. Concussion results in a constellation of physical, cognitive, emotional, and sleeprelated symptoms. Pdf a validation of the post concussion symptom scale in the. Postconcussion syndrome symptoms and causes mayo clinic. Evaluation and management of concussion in athletes. The scat5 should not be used by itself to make, or exclude, the diagnosis of concussion. Aside from their duration, the symptoms experienced by individuals with prolonged recovery or pcs are the same as those experienced in the acute phase of the injury e. High score on the post concussion symptom scale pcss 40 4, 25, or on the rivermead post concussion questionnaire 15 previous concussion history 5, 12, 19, 27 persistent post traumatic headache and migraine 19, 32. A concussion is a type of traumatic brain injury tbi. Scale introduction the medical management of sportrelated concussion has suffered from a dearth of empirical data from prospective controlled outcome studies. Sum total number of symptoms present per area, and sum all four areas into total symptom score score range 022. Anova and regression analysis were used to examine associations between factor scores and sex, previous history of concussion, mood disorder, anxiety disorder or attentiondeficit disorder, and length of time since injury. Measurement of symptoms following sportsrelated concussion.
Given that these pcs are subjective reports and not always specific to concussion, their usefulness remains to be validated. After reading each symptom, please circle the number that best describes the way you have been feeling today. Pcs in children and adolescents is a concern because their brains are developing new skills daily. Post concussion symptoms ask the athlete to score themselves based on how they feel now. The rivermead post concussion symptoms questionnaire journal of. It is common to experience physical symptoms like headaches, dizziness, fatigue, cognitive symptoms like difficulty concentratingfocusing, memory deficits, emotional symptoms and sleep disturbances. The athlete should be given the symptom form and asked to read this instruction paragraph out loud then complete the symptom scale.
Concussion management guidelines rev 201507 page 7 of 34 appendix b post concussion symptom scale pcss address each symptom based on how you have felt on an average 24 hour period during the last 7 days. After reading each symptom, please circle the number that best describes. Symptom mild moderate severe headaches irritation nausea vomiting balance problems dizziness fatigue trouble falling asleep sleeping longer sleeping less drowsiness intolerance to light intolerance to noise difficulty concentrating difficulty remembering visual problems total symptom score sadness nervousness stronger emotions. For the baseline assessment, the athlete should rate hisher symptoms based on how heshe typically feels and for the post injury assessment the athlete should rate their symptoms at this point in time. Concussion signs and symptoms evolve over time and it is important to consider repeat evaluation in the assessment of concussion. The rivermead post concussion symptoms questionnaire.