The effect of sport concussion on neurocognitive function, self-report symptoms and postural control - A meta-analysis

Sport concussion is commonly assessed using a battery of tests that evaluate neurocognitive functioning, postural control and self-report symptoms. The degree to which concussion affects each of these measures is unclear. Thus, the purpose of this meta-analysis is to systematically review and quantify the effect of sport concussion on each assessment measure when administered immediately post-injury and in the 2 weeks following injury. PubMed and PsychINFO databases were searched from January 1970 to June 2006, from which 39 were included for review. Studies were selected for review if they included concussed athletes who were evaluated using one of the three assessment measures. One post-morbid assessment must have been completed within 14 days of injury and compared with a baseline measure or control group. Study design, type of neurocognitive assessment, timing of assessment following injury and number of post-concussion assessments were extracted as potential moderators. Sport-related concussion had a large negative effect (mean Delta; 95% confidence interval) on neurocognitive functioning (-0.81; -1.01, -0.60), self-report symptoms (-3.31; -6.35, -0.27) and postural control (-2.56; -6.44, 1.32) in the initial assessment following injury. A reduced, but large effect, was also seen in the 14 days following the initial assessment for neurocognitive functioning (-0.26; -0.46, -0.06), self-report symptoms (-1.09; -2.07, -0.11) and postural control (-1.16; -2.59, 0.27). Our findings demonstrated large effects for each aspect of the assessment battery. These findings support the use of the multifaceted concussion evaluation.