Analysis of the Consistency of Post Concussion Symptoms Over Time

Cerebral concussion is defined as a closed head injury that produces a typically transient alteration in normal consciousness and brain processes as a result of the traumatic insult to the brain (Aubry, et al., 2002; McCrory, et al., 2005). Individuals sustaining mTBI often report physical, cognitive, emotional, and behavioral symptoms. Loss of consciousness, amnesia, and impairment of reflexive activities may follow, as does confusion and disorientation (Webbe, 2006, as cited in Moser, 2007). Through their ongoing work on the pathophysiology of mTBI, Giza and Hovda (2001) have detailed the biological reactions that are likely occurring within the brain of athletes who suffer concussions. As a result of their experimental research, concussion is now understood to involve a complex interplay between axonal shearing and an accompanying neurometabolic cascade of events. Given that the metabolic aspects of mTBI have been clearly demonstrated by the work of Hovda and his associates, psychophysiological assessment devices could have clinical utility in the management of mTBI or sport-related concussion. However, research using biofeedback as an assessment and intervention tool for clients with brain injury is limited. The few research studies conducted in this area have focused on clinical management, showing positive 24 associations between biofeedback and brain injury rehabilitation. For example, Holland, Witty, Lawler, & Lanzisera (1999) found that biofeedback-assisted relaxation training had a positive effect on the rehabilitation of clients in acute stages of brain injury recovery. To date, no-one has examined whether the metabolic changes observed within the brain following injury are associated with concomitant alterations in the physiological functioning of the rest of the body. The purpose of the proposed research study is to bridge this gap in the empirical literature on sport-related concussion and to ascertain whether athletes who suffer brain injury demonstrate consistent and predictable alterations in their psychophysiological functioning as a result of their injuries. Participants included ~20 high school and collegiate athletes who sustained a concussion within 10 days prior to the study. Participants completed the Immediate Post-Concucssion Assessment and Cognitive Testing (ImPACT), a computeradministered, neuro-cognitive screening instrument that consists of 6 individual test modules measuring attention, memory, reaction time, and visual-motor processing speed. While completing the ImPACT, participants were monitored with biofeedback equipment assessing heart rate, muscle tension, peripheral temperature, respiration, and neurological responses. Athletes were repeatedly assessed each time they returned for post-concussion clinical care, producing both within and between-person change over time. The current study will use repeated measures MANOVA to evaluate changes in physiological responses based upon ImPACT scores and post-concussion symptom scores