Diversifying sport-related concussion measures with baseline balance and ocular-motor scores in professional Zambian football athletes.

PURPOSE: Normative values of common sport-related concussion assessment tools may assist clinical diagnosis and management. However, current baseline normative values are not representative of athletic participants across international domains. This study develops healthy baseline norms on the Balance Error Scoring System (BESS), and King-Devick (K-D), providing baseline reference values for professional Zambian football athletes. METHODS: Of the 125 male participants (aged 24.48 ± 5.41 years) screened for this study, 9 (7.2%) reported a previous history of concussion, 98 (78.4%) completed the Balance Error Scoring System and 88 (70.4%) completed the King-Devick. Descriptive statistics calculated for the BESS and the K-D test included mean, standard deviation, median, interquartile range (IQR), and percentiles ranks. MAIN FINDINGS: Participants scored a mean ± standard deviation of 10.15 ± 5.6 and a median [IQR] of 9 [6-12.25] errors on the total BESS and completed the K-D test in a mean ± standard deviation 56.85 ± 10.55 seconds and a median [IQR] 55.28 [48.7-64.8] seconds. CONCLUSIONS: Cross-cultural awareness and management of sport-related concussion are continuously improving the safety and well-being of athletic participants around the world. The diverse representation in these data may aid in interpretation of post-injury performance during sport-related concussion management in Zambia. This study develops baseline reference values currently lacking within African cultures and demonstrates the feasibility and global clinical utility of two sport-related concussion assessment resources.

Cross-cultural exploration of baseline ImPACT Quick Test performance among football athletes in Zambia.

OBJECTIVE: Concussion is a global sport injury; however, this public health issue has yet to be studied across Africa. It is unknown if tests such as the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) Quick Test (QT) are culturally appropriate for implementation as part of a concussion screening protocol in Zambia or other African nations. Study objectives included: 1) establish that Zambian athletes are able to complete the iPad-based ImPACT QT with respect to language or cultural barriers that may exist, and 2) document baseline neurocognitive percentile ranks among Zambian football athletes on the ImPACT QT. METHODS: This study was completed with adult premiere league football athletes in Zambia (n = 125) aged 24.48 ± 5.41. Participants completed the ImPACT QT neurocognitive assessment prior to a preseason practice. Outcome measures were average performance on 3 factor scores: Motor Speed, Memory, and Attention Tracker, presented as percentile ranks using normative data built-into the ImPACT QT. RESULTS: Zambian athletes scored nearly two standard deviations below the mean on Motor Speed (7th percentile), using North American normative data. However, performance on Attention Tracker (44th percentile) and Memory (56th percentile) was within the average range. CONCLUSION: Results of the current study show that Zambian athletes are able to complete the ImPACT QT, despite any language or cultural differences that may exist. In addition, preliminary percentile ranks suggest Zambian football athletes have average scores on Attention and Memory and below average scores on Motor Speed. These data are the first to explore Zambian athletes' performance on a cognitive concussion measure.