The Effectiveness of Neurological Soft Sign Examinations in Diagnosing a Concussion

Overview

Current sports concussion exams are largely founded on either expert consensus (e.g., SCAT6) or the examiner's discretion. A mTBI results in subtle damage to a diffuse network of neuronal connections involving the cortex, brainstem, cervical cord, and/or autonomic nervous system. This often leads to a cluster of abnormalities that cannot be localized to a specific lesion. Therefore, it was hypothesized that soft sign examinations may be a better way to assess these patients. In this study, we used the Spokane mTBI Examination (SME), a soft sign exam originally developed for high -velocity mTBIs, to determine the average number of soft signs in a healthy, never concussed, athletic female population and compared their results to those from their peers who had previously been concussed but had ‘recovered’. The SME includes several visual, motor, balance, autonomic, and reflex tests that can be conducted at the bedside or sideline. We have studied 52 female athletes between the ages of 14 and 18 who attend Hellgat e High School in Missoula, MT. The average number of soft signs observed in the healthy population was 1.5, with a range of 0-4 and a standard deviation of 1. Individuals scoring 4 or more soft signs were more than two standard deviations beyond the mean. In our mTBI population, the average soft sign score was 9.8, with a range of 5-15. The SME shows promise to serve as a standardized tool for assessing all mTBI patients, improve diagnostic accuracy, and guide treatment interventions. Kentucky

Competition history

• JSHS 2025 Category not listed

Resources

• National JSHS abstract book ↗

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