A - 10 Post-Concussive Changes in Functional Status and Associations between Concussion Symptoms and Domain-Specific Impairment

Purpose To investigate post-concussive changes in functional status and the relationships between concussion symptoms and domain-specific impairment. Method 25 collegiate athletes (11 males, 14 females, ages 17–23) were administered the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7th Edition (GAD-7), Vertigo Symptom Scale-Short Form (VSS-SF), and Sport Concussion Assessment Tool-5th Edition (SCAT-5) at baseline and post-injury evaluations. Athletes were diagnosed with concussion at post-injury. WHODAS 2.0 dimension-level scores in “cognition”, “mobility”, “self-care”, “getting along with others”, “life activities”, and “participation in society”were calculated via the second-order model approach. Disparity scores (d-scores) were calculating by subtracting baseline scores from post-injury scores. Results Dimension-level paired t-tests revealed significant increases in WHODAS 2.0 “cognition”(baseline: M = 2.36, SD = 0.70; post-injury: M = 2.96, SD = 1.65) and “participation in society”(baseline: M = 2.16, SD = 0.47; post-injury: M = 2.72, SD = 1.28) scores from baseline to post-injury [t(24) = 1.84, p = 0.039; t(24) = 2.59, p = 0.008], but not for other functional domains. SCAT-5 Symptom Severity d-scores were positively correlated with “getting along”d-scores (r = 0.42, p = 0.037). VSS-SF d-scores were positively correlated with “cognition”and “mobility”d-scores (r = 0.45, p = 0.025; r = 0.51, p = 0.009). GAD-7 and PHQ-9 d-scores were not significantly correlated with any functional domain d-scores. Conclusions Results suggest that concussed athletes report greater declines in cognitive functioning and participation in society, as compared to other WHODAS 2.0 functional dimensions. Additionally, increased post-concussive symptom severity and vertigo/imbalance difficulties appear to be associated with increased disability in certain functional dimensions. Dimension-specific compensatory strategies may be beneficial in improving the functional status of concussed athletes with similar symptom profiles.