Related Experiment Video
Updated: Jun 21, 2026
10:31
A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
13.4K
The Sport Concussion Assessment Tool: A multidimensional symptom model for detecting elevated post-concussion
Eric O Ingram1, Justin E Karr1
1Department of Psychology, University of Kentucky, Lexington, Kentucky, USA.
The Clinical Neuropsychologist
|February 18, 2024
Summary
A four-factor model effectively identifies persistent post-concussion symptoms in student-athletes, even when total scores appear normal. This approach aids in targeted assessment and personalized rehabilitation plans for athletes experiencing cognitive, physical, affective, or sleep issues.
Area of Science:
- Sports Medicine
- Neuroscience
- Psychology
Background:
- Concussion assessment in student-athletes often relies on total symptom scores, potentially missing nuanced or persistent issues.
- A multidimensional approach to post-concussion symptoms may offer a more comprehensive understanding of an athlete's recovery.
- Previous models may not adequately capture the distinct symptom clusters following a sport-related concussion.
Purpose of the Study:
- To evaluate the utility of a four-factor model (cognitive, physical, affective, sleep-arousal) for identifying persistent post-concussion symptoms in collegiate student-athletes.
- To determine if this model can detect symptom elevations not apparent in a total symptom score.
- To compare the fit of a four-factor model against a single-factor model for post-concussion symptoms.
Main Methods:
- Confirmatory factor analysis was employed to compare one-factor and four-factor models of post-concussion symptoms.
- Data from 32,066 collegiate student-athletes were analyzed from the Concussion Assessment Research and Education consortium.
- Symptom Evaluation data were collected at baseline, return-to-play (RTP), and 6-month follow-up using the Sport Concussion Assessment Tool, 3rd edition.
Main Results:
- The four-factor model demonstrated a good fit for post-concussion symptoms both pre- and post-injury.
- Student-athletes with higher symptom severity were more likely to be female or have pre-existing conditions.
- A significant percentage of athletes (11.8% at RTP, 8.3% at 6 months) showed subscale elevations without a high total symptom score, particularly in the physical domain (head and neck pain).
Conclusions:
- A four-factor model provides a valuable framework for assessing persistent symptoms after sport-related concussions in collegiate athletes.
- This model can help clinicians identify specific symptom domains requiring further evaluation and tailored interventions.
- Domain-specific symptom elevations may indicate the need for personalized rehabilitation strategies beyond standard concussion protocols.
