Inversion position testing in concussed athletes

Abstract

Context No prior study has examined inversion position testing in individuals who have experienced sports related concussions. Objective To investigate whether the inversion position testing (IPT) would un-mask symptoms in asymptomatic concussed collegiate athletes during the return to play progression assessment. Design Case-Control Study. Setting Athletic Training Room. Participants One hundred and thirty-nine collegiate student athletes were randomly recruited from 12 different sports belonging to National Collegiate Athletic Association Division I Conference. Main outcome measure(s) A baseline concussion symptom questionnaire was administered. Of the 139, 122 participants without any of the suspicious symptoms related to concussions were examined using the Concussion Symptom Inventory (CSI) in connection with IPT. Also, the 18 concussed athletes underwent the IPT when any symptom subsided. Results Eighteen of the 122 (16.2%) non-concussed athletes showed some post-IPT symptoms, while 5 of 12 (41.7%) concussed athletes showed some post-IPT symptoms in the baseline test. For the latter, neither the interaction ( P = 0.08) nor difference in the total CSI score was observed either from pre- to post-IPT ( P = 0.14) or between the baseline and post-concussion ( P = 0.96). Conclusion This study demonstrated that symptoms could be exacerbated by the IPT in concussed athletes even when their original symptoms had subsided prior to the testing. The IPT exacerbated post-concussive symptoms may depend on a number of days required for post-concussive symptoms to subside. The innovative instrument of IPT may prove effective in clarifying the degree to which post-concussive symptoms have subsided. Key words Concussion, College athletes, Inversion position, Symptoms.