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Table 1 Clinical examination tests utilized at initial evaluation

From: Clinical examination factors that predict delayed recovery in individuals with concussion

System Assessment Method Abnormal Findings Reference
Cognitive Standardized Assessment of Concussion (SAC) Score < 26, mean score 26.6 (1996 McCrea) McCrea M, Kelly J, Randolph C. Standardized Assessment of Concussion (SAC): Manual for Administration, Scoring and Interpretation. Waukesha, WI: CNS Inc.; 1996.
Cervical Active ROM
Palpation of spinous processes and musculature
Pain
Decreased ROM
 
Visual King-Devick (KD) Symptom provocation during test Galetta KM, Barrett J, Allen M, et al. The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters. Neurology. 2011;76 (17):1456–1462. doi:https://0-doi-org.brum.beds.ac.uk/10.1212/WNL.0b013e31821184c9.
Balance Balance Error Scoring System (BESS) Score > 19, normal scores 12.03 ± 7.34 Guskiewicz KM. Postural stability assessment following concussion: One piece of the puzzle. Clin J of Sport Med. 2001;11 (3):182–189.
Vestibular Vestibular Oculomotor Screen (VOMS):
(1) smooth pursuit, (2) horizontal and vertical saccades*, (3) near point of convergence (NPC) distance, (4) horizontal vestibular ocular reflex (VOR)*, and (5) visual motion sensitivity (VMS)
*Performed for 10 s
Symptom provocation with any of the tests Mucha A, Collins MW, Elbin RJ, et al. A Brief Vestibular/Ocular Motor Screening (VOMS) Assessment to Evaluate Concussions: Preliminary Findings. Am J Sports Med. 2014;42:2479–2486.