903 MEP043 – Using the functional test for concussion as a final medical clearance check: can we prevent athletes from returning to sport prematurely?
Bibliographic record
Abstract
Background Exertional tests have become informative in assisting with concussion management and are commonly used for medical clearance (MC) decisions, however, the majority are resource intensive and require expertise. We developed an economical and easy to implement four-stage Functional Test for Concussion (FTC) using physical movement tasks that incorporate cardiovascular responses, head acceleration, coordination, and multi-tasks. Objective To evaluate whether FTC performance aligns with MC to return-to-play. Hypothesis Time to successful completion of the FTC will align or exceed time to achieve clinical MC. Design Prospective, observational cohort study. Setting Sport medicine clinic and research institution (University of Toronto, Canada). Participants Twenty-four interuniversity athletes with a physician diagnosed sport-related concussion (females=15, males=9) and thirty healthy interuniversity athletes (females=14, males=16). Interventions A four-stage Functional Test for Concussion at 1-, 2-, 3-, 4-, 6-, and 8-weeks post-concussion and at baseline for healthy athletes. Independent variables: 1) binary indicator for the group membership (concussion vs. healthy), and 2) binary indicator of pass/fail for each stage of the FTC. Main Outcome Measurements FTC parameters including change in symptoms following each FTC task compared to initial score, performance metrics (time duration and errors), and heart rate. Results 50%, 33.3%, 14.3%, and 11.1% of athletes failed the FTC at 1-, 2-, 3-, and 4-weeks post-concussion, respectively. Two athletes failed the FTC on the week they were scheduled for MC while thirteen athletes passed. During weeks 1–4, athletes with concussion exhibited greater symptom change during the FTC compared to normative data. By week 6, all athletes with concussion successfully completed the FTC. During all weeks, heart rates aligned between athletes with concussion who successfully completed the FTC and normative data. Conclusions The FTC may be able to elicit ongoing functional deficits beyond clinical recovery. Additional research is underway to determine if the FTC can offer clinical utility.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".