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Measuring Dynamic Symptom Response in Concussion: Children’s Exertional Effects Rating Scale (ChEERS)
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2019 Mar/Apr
Source: J Head Trauma Rehabil. 34(2):E35-E44
[PDF-588.88 KB]
Details:
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Alternative Title:J Head Trauma Rehabil
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Personal Author:
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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.
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Subject:
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Pubmed ID:30169434
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Pubmed Central ID:PMC6395581
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