NEUROCOGNITIVE PERFORMANCE AT RETURN TO PLAY IN ELITE YOUTH HOCKEY PLAYERS WITH SPORT-RELATED CONCUSSION
Bibliographic record
Abstract
Background Neurocognitive recovery following sport-related concussion is important for re-injury risk reduction. In elite youth hockey, it is unknown if neurocognitive function returns to baseline values at the time of medical clearance to return to play (RTP). Objective To determine if ImPACT composite scores have returned to baseline values at the time of medical clearance to RTP. Design Prospective case series. Setting Sport Medicine Clinics (Alberta, Canada). Participants Concussed elite male and female youth (13–17 years) ice hockey players (n=68) and healthy controls (n=22) completed ImPACT and SCAT2 testing at baseline and RTP following concussion. Main outcome measurements Team therapists/trainers referred concussed players to the study sport medicine physician. The physician determined RTP via symptom resolution and SCAT2 score normalization. Physicians were blinded to ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) composite scores (verbal memory, visual memory, reaction time and visual motor), which were used to evaluate neurocognitive performance. Results Comparisons between baseline and RTP ImPACT scores were based on reliable change (RC) scores derived from a sample of healthy players tested twice at baseline within 2 weeks (RC scores with 90% CI: verbal memory +/−14; visual memory, +/−15; reaction time, +/−0.1; and visual motor, +/−8). All four ImPACT composite scores were normalized at RTP in 73.5% (95C% CI: 61.5–82.8) of concussed participants and all but one [95.5%; 95% CI:70.39–99.46) controls. In the concussed players, 25.0% (95% CI: 16.0–36.9) had 1 composite score not return to baseline at RTP. One player had three composite scores not return to baseline at RTP. Conclusions Elite hockey players are often cleared for RTP without the benefit of knowing neurocognitive performance on ImPACT. In this cohort, 25% of concussed players who were cleared to return to hockey had 1 composite score that had not yet returned to baseline. These results may have implications for tertiary prevention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".