J Head Trauma Rehabil

ObjectiveTo introduce and evaluate a measure of momentary symptom response to cognitive activity, a core feature of concussion.SettingConcussion clinic at a large regional children\u2019s hospitalParticipantsIndividuals ages 5\u201318 years, comprising three clinical groups: Uninjured (n=590), recently concussed but clinically recovered (n=160), and recently concussed but not yet recovered (n=570).DesignParticipants completed pre-test symptom ratings, underwent neurocognitive assessment and completion of questionnaires, then completed post-test ratings. An exertional effects index (EEI) was computed by subtracting pre-test from post-test ratings.Main MeasuresChildren\u2019s Exertional Effects Rating Scale (ChEERS), which includes four symptoms (Headache, Fatigue, Concentration Problems, and Irritability) rated pre- and post-activity.ResultsThe ChEERS was found to have adequate reliability and validity. There were negligible differences in ratings (pre-test and exertional effects) between the Uninjured and Recovered groups, while individuals who were Not-Recovered rated higher levels of pre-test and exertional effects. Base rates showed that an EEI of 4 or more points is rare in individuals who do not have a current concussion.ConclusionThe ChEERS is a psychometrically sound scale for evaluating momentary symptom increase in response to cognitive activity. Clinicians can use this scale as part of a multi-modal battery for concussion assessment and treatment.M01 RR020359/RR/NCRR NIH HHS/United StatesU17 CE323352/CE/NCIPC CDC HHS/United States2020-03-01T00:00:00Z30169434PMC63955817273vault:3158