Measuring Dynamic Symptom Response in Concussion: Children’s Exertional Effects Rating Scale (ChEERS)

Details

• Alternative Title:
  J Head Trauma Rehabil
• Personal Author:
  Sady, Maegan D. ; Vaughan, Christopher G. ; Gioia, Gerard A.
• Description:
  Objective
  
  To introduce and evaluate a measure of momentary symptom response to cognitive activity, a core feature of concussion.
  
  Setting
  
  Concussion clinic at a large regional children’s hospital
  
  Participants
  
  Individuals ages 5–18 years, comprising three clinical groups: Uninjured (n=590), recently concussed but clinically recovered (n=160), and recently concussed but not yet recovered (n=570).
  
  Design
  
  Participants completed pre-test symptom ratings, underwent neurocognitive assessment and completion of questionnaires, then completed post-test ratings. An exertional effects index (EEI) was computed by subtracting pre-test from post-test ratings.
  
  Main Measures
  
  Children’s Exertional Effects Rating Scale (ChEERS), which includes four symptoms (Headache, Fatigue, Concentration Problems, and Irritability) rated pre- and post-activity.
  
  Results
  
  The ChEERS was found to have adequate reliability and validity. There were negligible differences in ratings (pre-test and exertional effects) between the Uninjured and Recovered groups, while individuals who were Not-Recovered rated higher levels of pre-test and exertional effects. Base rates showed that an EEI of 4 or more points is rare in individuals who do not have a current concussion.
  
  Conclusion
  
  The ChEERS is a psychometrically sound scale for evaluating momentary symptom increase in response to cognitive activity. Clinicians can use this scale as part of a multi-modal battery for concussion assessment and treatment.
  
  
• Subjects:
  Article Cognitive Exertion Concussion Momentary Symptom Assessment MTBI Pediatric Psychometrics Traumatic Brain Injury
• Source:
  J Head Trauma Rehabil. 34(2):E35-E44
• Pubmed ID:
  30169434
• Pubmed Central ID:
  PMC6395581
• Document Type:
  Journal Article
• Funding:
  M01 RR020359/RR/NCRR NIH HHS/United States ; U17 CE323352/CE/NCIPC CDC HHS/United States
• Volume:
  34
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:0c815768bb23e117943ca713b28fdee256db492154c5202e027c228ace9a3049
• Download URL:
  https://stacks.cdc.gov/view/cdc/76278/cdc_76278_DS1.pdf
• File Type:
  [PDF - 588.88 KB ]