Does Vestibular-Ocular-Motor (VOM) Impairment Affect Time to Return to Play, Symptom Severity, Neurocognition and Academic Ability in Student-Athletes following acute Concussion?

ABSTRACT

Introduction: Research indicates Sports-Related Concussion (SRC) impairs Vestibular-Ocular-Motor (VOM) function. The aim was to explore if VOM impairment correlates with longer Return To Play (RTP), symptom burden, neurocognitive performance and academic capability.

Participants: 40 (61.4% male) Loughborough University, UK, rugby union student-athletes who sustained 42 SRCs.

Methods: Student-athletes completed an assessment battery during pre-season (baseline), 2, 4, 8 and 14 days post-SRC and prior to RTP and were managed according to the rugby Football Union’ community pathway.

Outcome measures: Vestibular Ocular-Motor Screening (VOMS), Immediate Post-Concussion Assessment and Cognitive Test, Post-Concussion Symptom Scale, Perceived Academic Impairment Tool questionnaire and percentage of academic activities specifically missed due to SRC.

Results: VOMS scores were significantly (p < 0.005) greater than baseline at all time points except RTP. Presence of VOM dysfunction at 14 days post-SRC significantly correlated with a longer RTP, greater symptom burden and increased odds ratio at 2, 4 and 8 days and academic time loss at 2, 4 and 8 days post-SRC.

Conclusion: VOM impairment is associated with an increased symptom burden and impaired academic capability, and a longer time to RTP when present at 14 days post-SRC.

KEYWORDS:

• Sports-Related Concussion
• Vestibular-Ocular-Motor Screening
• neurocognition
• academic capability

Acknowledgments

The authors would like to thank the Musculoskeletal Association of Chartered Physiotherapists and Association of Chartered Physiotherapist in Sports and Exercise Medicine for their kind research grants, which have supported the undertaking of this research.

Declaration of interest statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the Musculoskeletal Association of Chartered Physiotherapists [Level 3 Award]; Association of chartered physiotherapists in sports and exercise medicine [ACPSEM Research Grant].

Notes on contributors

K. Glendon

K. Glendon is a PhD candidate and works as a sports physiotherapist for Loughborough University. She has completed a masters degree in Musculoskeletal Physiotherapy.

G. Blenkinsop

Dr.G. Blenkinsop is an editor of the Journal of Applied Biomechanics, he researches mechanics and neurological control of human movement and balance and has published papers in this field. He is a lecturer in motor control and biomechanics of sport.

A. Belli

Professor A. Belli is on the editorial board for several neurology journals and advisor to NICE and the Care Quality Commission. He is the Director of the NIHR SRMRC, leading on 23 projects, some of which are international, with an extensive publication list.

M. Pain

Dr. M. Pain has published over 60 peer-reviewed academic journal papers, over 100 peer-reviewed abstracts and delivered many conference presentations. He consults with sports on a wide range of projects and is an expert witness in major criminal cases regarding biomedical of injury causation and human movement.