Abstract

Objective: The negative effects of physical exertion on post-concussion symptoms have been well established, but there is a dearth of research on the effects of cognitive exertion. As neuropsychological assessment is a cognitively taxing process, it is possible that post-concussion assessments aimed at informing concussion recovery may exacerbate concussion symptoms and impact recovery. The present study aimed to evaluate changes in symptom reporting pre and post testing in athletes at baseline and post-concussion. Method: 155 athletes tested at baseline and 23 athletes tested post-concussion were included from a university-based sports concussion program. A self-report measure of post-concussion symptoms was administered pre and post testing during both the baseline and post-concussion testing sessions. Symptom difference scores were calculated by subtracting the pre-testing symptom score from the post-testing symptom score. A cutoff of 1 standard deviation from the mean difference of symptom scores at baseline (increase of 5 or more symptoms) was used to determine significant increase in symptoms. Results: Athletes tested post–concussion were significantly more likely to demonstrate an increase in symptoms post-testing than were athletes at baseline (30.4 % versus 11.6% respectively, p < .05, Fisher's exact test). Conclusion(s): Our findings suggest that the cognitive exertion involved in neuropsychological assessment may exacerbate concussion symptoms in a subset of athletes. Future work evaluating factors that may influence the likelihood of symptom exacerbation from cognitive exertion will be illuminating for determining cases in which neuropsychological assessment may do more harm than good.