CCSP Concussion Evaluation and Management 5 — Questions and Answers
Question 1: Which demographic group has the LONGEST average recovery time following sports-related concussion?
- Adult male athletes over 25
- Adolescent female athletes (Correct answer)
- Collegiate male athletes
- Masters-level athletes over 40
Correct answer: Adolescent female athletes
Adolescent female athletes consistently demonstrate the longest recovery times following concussion, likely due to hormonal factors, neck strength differences, and neurological development.
Question 2: What is the recommended initial management approach for an athlete with persistent dizziness and balance problems 2 weeks post-concussion?
- Extend complete rest until symptoms fully resolve
- Refer for vestibular physical therapy (Correct answer)
- Prescribe meclizine for symptomatic relief indefinitely
- Perform cervical manipulation immediately
Correct answer: Refer for vestibular physical therapy
Vestibular physical therapy is the evidence-based treatment for persistent dizziness and balance impairment following concussion, targeting the vestibular and oculomotor systems.
Question 3: During pre-participation concussion baseline testing, which factor most significantly reduces the validity and utility of computerized neurocognitive tests?
- Testing athletes early in the morning
- Poor athlete effort or intentional sandbagging (Correct answer)
- Testing within 48 hours of intense practice
- Using a group testing format
Correct answer: Poor athlete effort or intentional sandbagging
Poor effort or intentional sandbagging on baseline testing undermines the validity of post-injury comparisons, as an artificially low baseline makes concussion-related decline undetectable.
Question 4: An athlete with known anxiety disorder sustains a concussion. Why is this comorbidity clinically significant for concussion management?
- Anxiety disorders cause false-positive concussion symptom reporting
- Pre-existing anxiety is associated with prolonged recovery and symptom amplification (Correct answer)
- Anxious athletes cannot perform reliable baseline testing
- Anxiety medications accelerate neurometabolic recovery
Correct answer: Pre-existing anxiety is associated with prolonged recovery and symptom amplification
Pre-existing anxiety is a well-established risk modifier for prolonged concussion recovery, as psychological factors amplify somatic symptom reporting and complicate clinical decision-making.
Question 5: Which finding on the Sport Concussion Assessment Tool 5 (SCAT5) would most strongly support a diagnosis of concussion in a sideline evaluation?
- Total symptom score of 3 out of 132
- Maddocks score of 4 out of 5 correct
- BESS total errors significantly elevated above baseline (Correct answer)
- SAC total score of 28 out of 30
Correct answer: BESS total errors significantly elevated above baseline
A BESS score significantly elevated above the athlete's own baseline most strongly supports concussion diagnosis, as objective postural stability decline is a reliable concussion indicator.
Question 6: A chiropractic sports physician evaluating a wrestler finds cervical spine pain and limited range of motion along with concussion symptoms post-impact. What is the MOST appropriate initial management priority?
- Immediate cervical manipulation to restore joint mobility
- Rule out cervical spine injury before any concussion-specific management (Correct answer)
- Administer the SCAT5 immediately to quantify concussion severity
- Apply ice to the cervical spine and begin concussion protocol simultaneously
Correct answer: Rule out cervical spine injury before any concussion-specific management
Cervical spine injury must be ruled out before any manipulation or concussion-specific physical examination, as spinal cord compromise takes precedence over concussion management.
Question 7: Which statement best describes the current evidence on sub-symptom threshold aerobic exercise in early concussion management?
- Complete rest until asymptomatic is superior to early aerobic exercise
- Sub-threshold aerobic exercise initiated early promotes recovery and reduces prolonged symptoms (Correct answer)
- Aerobic exercise should be avoided for at least 2 weeks post-concussion
- High-intensity interval training accelerates neurometabolic recovery
Correct answer: Sub-threshold aerobic exercise initiated early promotes recovery and reduces prolonged symptoms
Current evidence supports initiating sub-symptom threshold aerobic exercise within the first few days post-concussion, as it promotes autonomic recovery and reduces risk of prolonged symptoms.
CCSP Concussion Evaluation and Management 5
Which demographic group has the LONGEST average recovery time following sports-related concussion?