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The diagnostic utility of clinical tests for differentiating between cervicogenic and other causes of dizziness after a sports-related concussion: An international Delphi study.
J Sci Med Sport 2015; 18(4):366-72JS

Abstract

OBJECTIVES

Dizziness after a sports-related concussion is very common and is associated with prolonged recovery. The events in sports that cause concussion include strong mechanical forces exerted to the head and neck, potentially injuring the cervical region, the peripheral vestibular and central nervous system, all of which can contribute to a sensation of dizziness. The purpose of this study was to identify proper clinically administered tests and measures that are useful in differentiating between cervicogenic and other causes of dizziness after a sports-related concussion.

DESIGN

The Delphi method.

METHODS

The workgroup identified the initial list of suggested clinical tests and the initial list of content experts on dizziness and/or concussion through a search of peer-reviewed and grey literature. The respondent group included all invited experts who opted to participate. A sequential three-round process was used for elicitation of consensus opinions from the targeted content experts.

RESULTS

The respondent group included 25 members from several medical disciplines who were experts in concussion and dizziness. At the conclusion of the study, ten clinical tests achieved the designation of strong clinical utility, six were determined to have weak clinical utility and seven achieved no consensus among the experts.

CONCLUSIONS

The majority of clinical tests identified as having strong clinical utility are tests used to identify dizziness originating from the vestibular or central nervous system. No clinical tests specific for the cervical region achieved consensus. Expert opinion from different medical professions and even within professions was widely divergent regarding the utility of clinical tests to assess cervical dysfunction.

Authors+Show Affiliations

Division of Physical Therapy, Walsh University, North Canton, OH, USA; Community Based Outpatient Therapy, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Akron, OH, USA. Electronic address: JReneker@Walsh.edu.Community Based Outpatient Therapy, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Akron, OH, USA.Division of Physical Therapy, Walsh University, North Canton, OH, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24933505

Citation

Reneker, Jennifer C., et al. "The Diagnostic Utility of Clinical Tests for Differentiating Between Cervicogenic and Other Causes of Dizziness After a Sports-related Concussion: an International Delphi Study." Journal of Science and Medicine in Sport, vol. 18, no. 4, 2015, pp. 366-72.
Reneker JC, Clay Moughiman M, Cook CE. The diagnostic utility of clinical tests for differentiating between cervicogenic and other causes of dizziness after a sports-related concussion: An international Delphi study. J Sci Med Sport. 2015;18(4):366-72.
Reneker, J. C., Clay Moughiman, M., & Cook, C. E. (2015). The diagnostic utility of clinical tests for differentiating between cervicogenic and other causes of dizziness after a sports-related concussion: An international Delphi study. Journal of Science and Medicine in Sport, 18(4), pp. 366-72. doi:10.1016/j.jsams.2014.05.002.
Reneker JC, Clay Moughiman M, Cook CE. The Diagnostic Utility of Clinical Tests for Differentiating Between Cervicogenic and Other Causes of Dizziness After a Sports-related Concussion: an International Delphi Study. J Sci Med Sport. 2015;18(4):366-72. PubMed PMID: 24933505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The diagnostic utility of clinical tests for differentiating between cervicogenic and other causes of dizziness after a sports-related concussion: An international Delphi study. AU - Reneker,Jennifer C, AU - Clay Moughiman,M, AU - Cook,Chad E, Y1 - 2014/05/17/ PY - 2014/02/08/received PY - 2014/04/11/revised PY - 2014/05/02/accepted PY - 2014/6/17/entrez PY - 2014/6/17/pubmed PY - 2016/3/8/medline KW - Cervical dizziness differential diagnosis KW - Delphi method KW - Sports-related concussion SP - 366 EP - 72 JF - Journal of science and medicine in sport JO - J Sci Med Sport VL - 18 IS - 4 N2 - OBJECTIVES: Dizziness after a sports-related concussion is very common and is associated with prolonged recovery. The events in sports that cause concussion include strong mechanical forces exerted to the head and neck, potentially injuring the cervical region, the peripheral vestibular and central nervous system, all of which can contribute to a sensation of dizziness. The purpose of this study was to identify proper clinically administered tests and measures that are useful in differentiating between cervicogenic and other causes of dizziness after a sports-related concussion. DESIGN: The Delphi method. METHODS: The workgroup identified the initial list of suggested clinical tests and the initial list of content experts on dizziness and/or concussion through a search of peer-reviewed and grey literature. The respondent group included all invited experts who opted to participate. A sequential three-round process was used for elicitation of consensus opinions from the targeted content experts. RESULTS: The respondent group included 25 members from several medical disciplines who were experts in concussion and dizziness. At the conclusion of the study, ten clinical tests achieved the designation of strong clinical utility, six were determined to have weak clinical utility and seven achieved no consensus among the experts. CONCLUSIONS: The majority of clinical tests identified as having strong clinical utility are tests used to identify dizziness originating from the vestibular or central nervous system. No clinical tests specific for the cervical region achieved consensus. Expert opinion from different medical professions and even within professions was widely divergent regarding the utility of clinical tests to assess cervical dysfunction. SN - 1878-1861 UR - https://www.unboundmedicine.com/medline/citation/24933505/The_diagnostic_utility_of_clinical_tests_for_differentiating_between_cervicogenic_and_other_causes_of_dizziness_after_a_sports_related_concussion:_An_international_Delphi_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1440-2440(14)00085-1 DB - PRIME DP - Unbound Medicine ER -