Echemendia, who is chairing the conference session "Return to Play Following Mild Traumatic Brain Injury: Neuropsychology's Role," believes that RC scores can be used as a general guideline, but that there are some inherent problems in applying them routinely without evaluation. The tests measure cognition; attention and concentration; speed of information processing and memory, and learning. While anyone can administer the tests, it takes a competent neuropsychologist to interpret the test scores.
"Some tests have practice effects as well," says Echemendia. "Each time an athlete takes the test, they naturally become better at it, skewing any comparison to the baseline test."
One of the biggest problems is determining when post- injury scores have actually returned to the baseline. Determining the point beyond which scores are the same and not just appear to be the same through a chance variation is difficult. Determining the margin of error and the reliable significant difference is not trivial. Reliable Change scores also fall within a relatively wide band of what might be clinically significant rather than statistically significant.
"Because of the way statistics are, when using RC scores, there is an equal chance of putting someone in too early as too late," says Echemendia, a faculty member in the College of the Liberal Arts. "We don't want someone still at risk taking the chance on further injury or career- ending injury.
"People can be asymptomatic and still be cognitively deficient. They can still have problems with memory and processing of information."
Echemendia suggests that the athletes be looked at individually,
evaluating the entire pattern including initial physical symptoms, how long
symptoms lasted, the nature of the injury and the test data. Cli
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Contact: A'ndrea Elyse Messer
aem1@psu.edu
814-865-9481
Penn State
20-Aug-1999