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Updated: Dec 9, 2025
A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
The Effect of Age and Competition Level on Subtle Motor Performance in Adolescents Medically Cleared Postconcussion:
Jewel E Crasta1, Altamash E Raja, Brian S Caffo
1From the Kennedy Krieger Institute, Baltimore, Maryland (JEC, SJS); Division of Occupational Therapy, The Ohio State University, Columbus, Ohio (JEC); Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland (AER, CMH, SJS); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (BSC); and Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland (SJS).
Objective:
The aim of this study was to examine the effect of age and level of competition on subtle motor performance in adolescents who have recently been medically cleared postconcussion and never-injured controls.
Design:
Thirty adolescents who were recently medically cleared postconcussion (12-18 yrs) and 30 never-concussed, typically developing controls were examined using the Revised Physical and Neurological Examination of Subtle Signs (PANESS) and the Immediate Post-Concussion Assessment and Cognitive Testing.
Results:
Older age was associated with better Immediate Post-Concussion Assessment and Cognitive Testing scores in both groups, whereas only the control group showed improved motor performance on the PANESS with increasing age. Adolescents across both groups participating at a higher level of competition (school or travel level) had better motor performance on the PANESS than those participating at a lower level of competition (recreational level or no sports participation). Adolescents medically cleared postconcussion had greater motor deficits on the PANESS than controls did.
Conclusion:
After medical clearance, adolescents with a history of recent concussion demonstrate alterations in the relationship between motor function and age. The PANESS merits further exploration as a measure that is sensitive to factors affecting motor performance, such as age and level of athletic competition, as well as to persistent subtle motor deficits in adolescents medically cleared postconcussion.
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