Evidence map›Paper›PMID 32514379›Full record

ArticleArchives of physiotherapy2020

Clinical examination factors that predict delayed recovery in individuals with concussion.

Corina Martinez, Zachary Christopherson, Ashley Lake, Heather Myers, Jeffrey R Bytomski, Robert J Butler, Chad E Cook

Open access · diamondAbstract read
In one paragraph

Article in Archives of physiotherapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Concussion: A Comprehensive Review of Current Evidence.Current reviews in musculoskeletal medicine · 2026
    Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Corina MartinezDepartment of Physical Therapy and Occupational Therapy, Duke University, DUMC 3965, Durham, NC 27705 USA.ORCID 0000-0002-4903-1241
Zachary ChristophersonDepartment of Physical Therapy and Occupational Therapy, Duke University, DUMC 3965, Durham, NC 27705 USA.
Ashley LakeDepartment of Physical Therapy and Occupational Therapy, Duke University, DUMC 3965, Durham, NC 27705 USA.
Heather MyersDepartment of Physical Therapy and Occupational Therapy, Duke University, DUMC 3965, Durham, NC 27705 USA.
Jeffrey R BytomskiDepartment of Orthopedics, Duke University, Durham, NC USA.
Robert J ButlerSt Louis Cardinals, St. Louis, MO USA.
Chad E CookDivision of Physical Therapy, Department of Orthopedics, Duke University, 2200 W. Main Street, Durham, NC 27708 USA.
Duke University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRisk factors for prolonged recovery after concussion have been well researched, but specific objective clinical examination findings have not. This study examined whether clinical examination results could predict delayed recovery (DR) in individuals with concussion diagnosis. A secondary aim explored the influence of early examination on individual prognosis.

methodsThe study was a retrospective, observational cohort design that included 163 individuals seen at a concussion clinic who were followed longitudinally until cleared for sports activity. Cognitive, visual, balance, vestibular, and cervical clinical testing and symptom assessment were performed at initial evaluation. DR was calculated by taking the median value associated with time to clearance for activity. Bivariate logistic regression analysis was calculated to determine odds ratios (and 95% confidence intervals) for the odds of DR with presence or absence of each clinical finding. Multivariate analyses were used to define the best predictors of DR.

results80 of 163 individuals were considered delayed in their clearance to activity. Cognitive impairments (OR = 2.72; 95%CI = 1.40, 5.28), visual exam findings (OR = 2.98; 95%CI = 1.31, 6.80), and vestibular exam findings (OR = 4.28; 95%CI = 2.18, 8.43) all increased the odds of a DR. Multivariate modeling retained cognitive symptoms and clinical examination-vestibular testing as predictors of delayed recovery. Time to examination after injury was a mediator for DR.

conclusionsThe clinical examination provides value in identifying individuals who are likely to exhibit a delayed clearance. In particular, vestibular impairments identified clinically at initial evaluation and cognitive symptoms were associated with increased odds of a DR to return to activity. Our data support that early implementation of a standardized clinical examination can help to identify individuals who may be more at risk of prolonged recovery from concussion.

Indexed as

ConcussionPost-concussion syndromeVestibular

Identifiers

PMID32514379
PMCPMC7251896
OpenAlexW3030494268

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.