Concussion projectdefenseversion2
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STOP WATCH TESTINGAn analysis into the use of a new testing technique to identify and treat concussions
By Peter Eggleston ConnorData provided by
Southern Oregon OrthopedicsA Graduate Thesis from
Southern Oregon University
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TERMINOLOGY
Reaction TimeHealthy / Injured / Recovering
Days Since Injury (or: Recovery Time)
Symptom Score
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HISTORY
• Prior to 2001: Concussion detection had little empirical evidence supporting it.
• 2001-2012: American Academy of Neurology (AAN) creates guidelines for more globally accessing concussion risks in athletes.
• 2013: An update came out pointing towards evidence that having a concussion made future concussions more likely.
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OBJECTIVES
• Identify changes between healthy and injured reaction times
• Determine a concussion recovery rate based on reaction time
• Identify significant symptom scores over course of recovery
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DATA COLLECTION – HEALTHY AND INJURY FORM
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DATA COLLECTION – RECOVERING FORM
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DATA ORGANIZATION
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DESCRIPTIVE ANALYSIS
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DESCRIPTIVE ANALYSIS – RECOVERY TIME
n = 39
Mean:8.2 days
Standard Deviation:5.3 days
90th Percentile:~11 days
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DESCRIPTIVE ANALYSIS – HEALTHY REACTION TIME
Mean:0.18 sec
Standard Deviation:0.03 sec
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DESCRIPTIVE ANALYSIS – HEALTHY REACTION TIME IN CONCUSSED PLAYERSMean:
0.18 secStandard Deviation:
0.02 sec
Hypothesis Test All vs Concussed Healthy Reaction Timesp-value:
0.16Conclusions:
Accept Null
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DESCRIPTIVE ANALYSIS – INJURED REACTION TIME Mean:
0.27 secStandard Deviation:
0.10 sec
Hypothesis Test Healthy vs Injured Reaction Time in Concussed Athletes p-value:
~1Conclusion:
Reject Null
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DESCRIPTIVE ANALYSIS – REACTION TIME
DIFFERENCES
Mean:.088 sec
Standard Deviation:.098 sec
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DESCRIPTIVE ANALYSIS – REACTION TIME RATIOS
Mean:1.49
Standard Deviation:0.52
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COMPAREDAYS TO REACTION TIME
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EXPONENTIAL MODELING:DIFFERENCE 𝑦=(𝑐−h)𝑒𝛽𝑡+hy: The reaction time at t days since injury
c: The reaction time at the time of injury
h: The healthy reaction time
β: The rate of decay in the reaction time during recovery
t: The number of days since the concussion injury
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EXPONENTIAL MODELING
𝑦=(𝑐−h)𝑒𝛽𝑡+h
Purple:β = .01
Red:β = .2
Blue:β = 1
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EXPONENTIAL MODELING: DIFFERENCES
𝑦 𝑖=(𝑐 𝑖−h 𝑖¿𝑒−𝛽 𝑡+h𝑖
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EXPONENTIAL MODELING: DIFFERENCES
Where:i: Index for patient histories (1 to 39)ŷ: The predicted reaction time at t days since injury
Objective: Find the β that minimizes
∑𝑖
𝑛
∑𝑗
𝑚𝑖
( 𝑦 𝑖− ŷ𝑖 )2
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PREDICTIVE MODELUSINGDIFFERENCES
𝑦=(𝑐−h )𝑒−0.5441 𝑡+h
With β selected as 0.5441 is optimized at 0.62
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PREDICTIVE MODEL USING DIFFERENCES
Can be transformed into: 𝑡 𝑦 ,𝑖=¿¿Where 𝑘=𝑦−h𝑖
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PREDICTIVE MODEL USING DIFFERENCE BETWEEN HEALTHY AND INJURY
𝑡𝑦 ,𝑖=¿¿Optimal k:0.0014
Mean:6.97 Days
Standard Deviation:1.52 Days
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EXPONENTIAL MODELING: RATIO
𝑦 𝑖
h 𝑖=(
𝑐 𝑖
h𝑖−1)𝑒−𝛽 𝑡+1
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EXPONENTIAL MODELING: RATIO
Objective: Find the β that minimizes
∑𝑖
𝑛
∑𝑗
𝑚𝑖
( 𝑦 𝑖
h𝑖−^(𝑦 𝑖
h 𝑖))
2
Where: : Is the predicted ratio
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PREDICTIVE MODEL USING RATIOS
With β selected as 0.5696 is optimized at 0.43
𝑦 𝑖
h 𝑖=(
𝑐 𝑖
h𝑖−1)𝑒− 0.5696𝑡+1
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PREDICTIVE MODEL USING RATIOS
To predict days until RTP:
Where𝑝=
𝑦 𝑖
h𝑖−1
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PREDICTIVE MODEL USING RATIOS OF HEALTHY TO INJURY
Optimal p:0.008
Mean:6.97 Days
Standard Deviation:1.50 Days
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SYMPTOMS Blurry Vision Concentration Dizziness Fatigue Headache Heightened Feelings Light Sensitivity Loss of Balance Memory Loss Nausea Noise Sensitivity Sleeping Habits
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SYMPTOMS COMPARED TO DAYS SINCE INJURYHEADACHE EXAMPLE
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SYMPTOM LINEAR MODELING: SINGLE DESCRIPTIVE VARIABLE
Where:y: Represents the response variable, days since
injury x: Represents the predictor variable, a symptom: Is the value of y when x is zero: The amount y changes when x increases by 1
𝑦=𝑏0+𝑏1𝑥
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SYMPTOM LINEAR MODELING: MULTIPLE DESCRIPTIVE VARIABLES
Where:n: Is the number of predictor variables used in the
model: Is a predictor variable value, where are
symptoms: The amount y changes when increases by 1
𝑦=𝑏0+𝑏1𝑥1+𝑏2 𝑥2+...+𝑏𝑛𝑥𝑛
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SYMPTOMS COMPARED TO DAYS SINCE INJURY
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ANALYSIS OF VARIANCE(ANOVA)
• Identify Predictor Variables Independently in Multivariable Experiments
• Assess Explained and Residual Variation of Response Variable
• Determine Significance of Predictor Variables on Response Variable
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SYMPTOMS COMPARED TO DAYS SINCE INJURYANOVA
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SYMPTOMS COMPARED TO REACTION TIMEHEADACHE EXAMPLE
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SYMPTOMS COMPARED TO REACTION TIME
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SYMPTOMS COMPARED TO REACTION TIMEANOVA
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CONCLUSIONS:DETERMINING A CONCUSSION OFF OF STOP WATCH TESTINGThe reaction times taken after injury were significantly different from those of healthy times taken at the beginning of the season.
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CONCLUSIONS:RETURN TO PLAY
𝑡𝑦 ,𝑖=¿¿Best Calculator:
Roughly 97.5% of cases recover in 10 Days.
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CONCLUSIONS:CONCUSSION SYMPTOMS
Headache, dizziness, fatigue, heightened feelings, and feeling nauseas showed significance when looking at reaction time.
Headache showed significance when looking at days since injury.
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FURTHER RESEARCH
Unconscious Incidents
Multiple Concussions
Correlation Coefficients in Linear Analysis
Larger Data Set