922 MEP049 – Using robotics to assess motor learning impairments after concussion at time of physician clearance

AbstractThere remains a lack of gold standard tools available to physicians to inform clearance criteria from concussion; a heavy reliance is placed on self-reported symptom scales which have inherent limitations of reliability. Further, growing evidence is showing that the neurophysiological underpinnings of concussion can persist past clinical recovery. As such, with this study, we aimed to provide objective, sensitive measures of neurological function of youth athletes who have sustained a concussion at the time of physician clearance to return to sport (RTP). As a sub-study of the National Football League-funded pan-Canadian study SHRed Concussions, we recruited (n=99) youth athletes who suffered a clinician-diagnosed sport-related concussion, and performed robotic testing on the day of RTP. We hypothesized that motor learning impairments, as assessed by a visuomotor rotation task, would be present at time of RTP, as compared to healthy age, sex, and sport-matched controls (n=89). The RTP group showed significantly reduced final adaptation to the visuomotor rotation task as compared to the control group, suggesting motor learning impairments are persisting and present at time of physician clearance. Results suggest that clinical recovery may not be sufficient in capturing the neurophysiological recovery of concussion, and objective robotic tools may provide a basis for informing clinician decision making to prevent premature clearance to return to sport, reducing risk of reinjury after concussion.