Concussion Assessment and Return to Sport for a High School, Legally Blind, Female Swimmer
Bibliographic record
Abstract
Abstract Purpose Limited research exists on treatment of sport concussion in visually impaired individuals. Adaptation to athlete’s needs is vital for individualized sport specific return to play (RTP). Methods Fifteen year-old, visually impaired, female, swimmer presented to an interdisciplinary Sport Concussion Program for protracted recovery with complaints of disequilibrium, headaches, cognitive fatigue, and exacerbation of premorbid resting nystagmus after being kicked in the head during practice. Patient is legally blind due to Peter’s Anomaly and right retinal detachment, with history of migraine, carsickness, and glaucoma. Patient completed two visits with clinical sports neuropsychologist and three vestibular therapy (VT) appointments, assessed via Post-Concussion Symptom Scale (PCSS), Montreal Cognitive Assessment (MoCA-BLIND), Modified Balance Error Scoring System (mBESS), Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence scale (ABC), Buffalo Concussion Treadmill Test (BCTT), and Children's Memory Scales (CMS). Differential Diagnosis: Concussion, Post-Concussion Syndrome, Post-Traumatic Headache, Vestibular Dysfunction. Results Initial consult revealed PCSS of 35 and normal MoCA-BLIND (18/22). Patient’s mBESS improved from 7 to 3 errors with VT, DHI mildly elevated (36%), ABC moderately elevated (43%). VT consisted of: neuromuscular re-education, balance training, positional changes, cognitive activity, sport specific RTP progressions (dry land modifications, transitions into water, communication to team athletic trainer). BCTT passed on third VT visit. Patient cleared for RTP with PCSS at 7 and (CMS) Stories, Word Lists, Numbers, and Sequences subtests within expectations (average to high average ranges). Conclusion This case study illustrates an interdisciplinary approach to concussion treatment with modification of established tools and proposal of sport specific RTP guidelines for visually impaired athletes.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".