Development and preliminary testing of the concussion assessment web app tool : a thesis submitted to the Graduate Faculty of Massey University in partial fulfilment of the requirements for the degree Master of Science (MSc) endorsement of Sport and Exercise Science at Massey University, Wellington, New Zealand

Abstract

Introduction: Identifying and monitoring the resolution of cognitive impairment following sport-related concussion and providing objective information for clinical return-to-play decisions is crucial, particularly for contact sports. Many concussion symptoms do not appear immediately, and the sports person would need to be monitored and re-tested over time, however most sport teams do not have the luxury of readily available medical staff. Therefore, this study presents the process of developing a novel web-based neuropsychological test battery App for concussion, and the subsequent determination of sensitivity, reliability, and repeatability as a first step in validity and reliability testing. Subjects and design: Neuropsychological baseline data was collected on 11 healthy male volunteers (mean age = 22 ± 2.5 years). Repeat data was collected pre- and post-fatiguing exercise for sensitivity, and further tests for diurnal variation included three daily repeat assessments (morning: 0700 ± 2 h; afternoon; 1400 ± 2 h; evening: 1900 ± 2 h) over a five-day period. Measurements: The administration of the Concussion Assessment Web-App tool (CAWA) included six tests as a part of a test battery. These included concussion red flag questions, a self-report inventory of neuropsychological symptoms; The Concussion Symptom Inventory (CSI), as well as a series of four cognitive sub-tests: Simple Reaction Time, Complex Reaction Time, Digit Span Backwards, and Auditory Reaction Time. Results: The results indicate that the CAWA battery is sensitive to the effects of treadmill-based maximal exercise, with no diurnal variation in asymptomatic participants. Conclusions: Prior to any field trials, the CAWA preliminary findings indicate that the individual elements are sensitive and are repeatable in an asymptomatic population. The CAWA is an easy, time-efficient, and cost-effective method for individuals to test and re-test multiple times to identify latent signs / symptoms and neurocognitive trauma following sports-related concussion.