{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T21:25:01Z","timestamp":1783718701814,"version":"3.55.0"},"reference-count":155,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"11","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Synopsis<\/jats:title><jats:p> Concussion is an ongoing concern for health care providers. The incidence rates continue to be high and the rate of recovery is variable due to potential risk factors. With no valid biomarkers, diagnosis and assessment of concussion remain a clinical challenge. The heterogeneity in presentation following injury provides an additional level of complexity, requiring the screening and evaluation of diverse body systems, including oculomotor, vestibular, autonomic, psychiatric, cervical, and cognitive symptoms. While a few tools, such as the Vestibular\/Ocular Motor Screening and Balance Error Scoring System, have been developed specifically for concussion, the vast majority of tests are adapted from other conditions. Further complicating the process is the overlapping and interactive nature of the multiple domains of postconcussion presentation. This commentary illustrates how clinicians can conceptualize the multiple profiles that present following concussion and describes tools that are available to assist with screening and evaluation of each area. The multifaceted nature of concussion warrants broad clinical screening skills and an interdisciplinary approach to management. J Orthop Sports Phys Ther 2019;49(11):787\u2013798. doi:10.2519\/jospt.2019.8855 <\/jats:p><\/jats:sec>","DOI":"10.2519\/jospt.2019.8855","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T03:14:50Z","timestamp":1570677290000},"page":"787-798","update-policy":"https:\/\/doi.org\/10.2519\/jospt.crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Considerations for Diagnosis and Management of Concussion"],"prefix":"10.2519","volume":"49","author":[{"given":"Anne","family":"Mucha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Trbovich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1394","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12628"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2017.1346283"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516668624"},{"key":"bib4","first-page":"675","volume":"10","author":"Balke B","year":"1959","journal-title":"U S Armed Forces Med J."},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2016.01.003"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0925"},{"key":"bib7","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617701766052"},{"key":"bib8","first-page":"257","volume-title":"Mild Head Injury","author":"Barth JT","year":"1989"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2005.05.015"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816689660"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.3233\/VES-1998-8105"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.3109\/00016489.2014.906749"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1080\/23279095.2016.1248765"},{"key":"bib14","first-page":"994","volume":"56","author":"Boake C","year":"2005","journal-title":"Neurosurgery"},{"key":"bib15","doi-asserted-by":"publisher","DOI":"10.1177\/0333102416681571"},{"key":"bib16","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2014.12.005"},{"key":"bib17","first-page":"504","volume":"42","author":"Broglio SP","year":"2007","journal-title":"J Athl Train."},{"key":"bib18","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000426"},{"key":"bib19","doi-asserted-by":"publisher","DOI":"10.1111\/head.12139"},{"key":"bib20","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000260"},{"key":"bib21","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-12-00061"},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2013.08.295"},{"key":"bib23","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-8-8"},{"key":"bib24","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200535110-00002"},{"key":"bib25","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516648141"},{"key":"bib26","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-09-00258"},{"key":"bib27","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000001447"},{"key":"bib28","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1990.68.4.1458"},{"key":"bib29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2012.08.011"},{"key":"bib30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.08.034"},{"key":"bib31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2018.07.002"},{"key":"bib32","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2009.04.009"},{"key":"bib33","doi-asserted-by":"publisher","DOI":"10.3810\/psm.2010.12.1830"},{"key":"bib34","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci7090119"},{"key":"bib35","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000682"},{"key":"bib36","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2015.04.015"},{"key":"bib37","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00499.2016"},{"key":"bib38","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2018.1484166"},{"key":"bib39","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517705640"},{"key":"bib40","author":"Eddy R","journal-title":"Clin J Sport Med."},{"key":"bib41","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2009.0906"},{"key":"bib42","doi-asserted-by":"publisher","DOI":"10.3171\/2015.1.PEDS14524"},{"key":"bib43","doi-asserted-by":"publisher","DOI":"10.3109\/02699052.2014.965207"},{"key":"bib44","doi-asserted-by":"publisher","DOI":"10.3171\/2015.5.PEDS15220"},{"key":"bib45","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1041053"},{"key":"bib46","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci7080100"},{"key":"bib47","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0b013e3182407ace"},{"key":"bib48","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-2007-22307"},{"key":"bib49","volume-title":"FDA authorizes marketing of first blood test to aid in the evaluation of concussion in adults [press release]"},{"key":"bib50","first-page":"68","volume":"8","author":"French L","year":"2008","journal-title":"J Spec Oper Med."},{"key":"bib51","author":"Fuller GW","journal-title":"Br J Sports Med."},{"key":"bib52","volume-title":"Vestibular Disorders: A Case-Study Approach to Diagnosis and Treatment","author":"Furman JM","year":"2010","edition":"3"},{"key":"bib53","doi-asserted-by":"publisher","DOI":"10.3109\/02699052.2013.862740"},{"key":"bib54","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3306"},{"key":"bib55","first-page":"263","volume":"36","author":"Guskiewicz KM","year":"2001","journal-title":"J Athl Train."},{"key":"bib56","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000161"},{"key":"bib57","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2004.04.004"},{"key":"bib58","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1988.00520310043015"},{"key":"bib59","first-page":"207","volume":"18","author":"Harvey SA","year":"1997","journal-title":"Am J Otol."},{"key":"bib60","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200007133430204"},{"key":"bib61","doi-asserted-by":"publisher","DOI":"10.1177\/0333102413485658"},{"key":"bib62","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000183"},{"key":"bib63","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.03.014"},{"key":"bib64","doi-asserted-by":"publisher","DOI":"10.1177\/0333102415590240"},{"key":"bib65","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2017.02.003"},{"key":"bib66","doi-asserted-by":"publisher","DOI":"10.1076\/jcen.21.1.70.945"},{"key":"bib67","doi-asserted-by":"publisher","DOI":"10.1177\/0883073818789320"},{"key":"bib68","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.2374"},{"key":"bib69","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2007.01345.x"},{"key":"bib70","doi-asserted-by":"publisher","DOI":"10.1111\/head.12737"},{"key":"bib71","doi-asserted-by":"publisher","DOI":"10.1177\/0269215507082141"},{"key":"bib72","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617713001471"},{"key":"bib73","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2012.03.032"},{"key":"bib74","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513488751"},{"key":"bib75","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512455400"},{"key":"bib76","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516632754"},{"key":"bib77","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000000573"},{"key":"bib78","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-016-0571-y"},{"key":"bib79","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026119331193"},{"key":"bib80","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61558-0"},{"key":"bib81","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2016.00013"},{"key":"bib82","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511410655"},{"key":"bib83","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e3181fdc721"},{"key":"bib84","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000000008"},{"key":"bib85","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.01.012"},{"key":"bib86","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-0149-2"},{"key":"bib87","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00002-2"},{"key":"bib88","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1987.66.2.0234"},{"key":"bib89","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000506"},{"key":"bib90","doi-asserted-by":"publisher","DOI":"10.3109\/00016488709107283"},{"key":"bib91","doi-asserted-by":"publisher","DOI":"10.1177\/0333102413499645"},{"key":"bib92","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097791"},{"key":"bib93","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2004.04076.x"},{"key":"bib94","doi-asserted-by":"publisher","DOI":"10.1177\/0009922815594367"},{"key":"bib95","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617705050083"},{"key":"bib96","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-13-00349"},{"key":"bib97","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.19.2556"},{"key":"bib98","doi-asserted-by":"publisher","DOI":"10.1097\/00001199-199804000-00005"},{"key":"bib99","doi-asserted-by":"publisher","DOI":"10.1097\/01.jsm.0000159931.77191.29"},{"key":"bib100","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/bjsports-2017-097699","volume":"51","author":"McCrory P","year":"2017","journal-title":"Br J Sports Med."},{"key":"bib101","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2013.2984"},{"key":"bib102","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e318291d3b3"},{"key":"bib103","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513487982"},{"key":"bib104","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2017.02.002"},{"key":"bib105","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2017.10.039"},{"key":"bib106","doi-asserted-by":"publisher","DOI":"10.1111\/sms.13286"},{"key":"bib107","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518756979"},{"key":"bib108","doi-asserted-by":"publisher","DOI":"10.3171\/2014.10.PEDS14356"},{"key":"bib109","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514543775"},{"key":"bib110","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000177886.94134.92"},{"key":"bib111","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-49.3.32"},{"key":"bib112","first-page":"378","volume":"31","author":"Nacci A","year":"2011","journal-title":"Acta Otorhinolaryngol Ital."},{"key":"bib113","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2017.5490"},{"key":"bib114","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-52.2.12"},{"key":"bib115","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-198606000-00005"},{"key":"bib116","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2007.12.006"},{"key":"bib117","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515606430"},{"key":"bib118","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-172298"},{"key":"bib119","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.12.035"},{"key":"bib120","doi-asserted-by":"publisher","DOI":"10.4103\/0976-9668.198350"},{"key":"bib121","doi-asserted-by":"publisher","DOI":"10.1186\/s40945-017-0040-x"},{"key":"bib122","first-page":"288","volume":"72","author":"Revel M","year":"1991","journal-title":"Arch Phys Med Rehabil."},{"key":"bib123","first-page":"19","volume":"35","author":"Riemann BL","year":"2000","journal-title":"J Athl Train."},{"key":"bib124","doi-asserted-by":"publisher","DOI":"10.1037\/spy0000098"},{"key":"bib125","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516677246"},{"key":"bib126","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.2003.00552.x"},{"key":"bib127","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512466038"},{"key":"bib128","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.3.422"},{"key":"bib129","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2700.160700"},{"key":"bib130","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-012-9167-2"},{"key":"bib131","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(03)00078-2"},{"key":"bib132","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.1999.019002107.x"},{"key":"bib133","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04561-X"},{"key":"bib134","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.15.1841"},{"key":"bib135","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2012.07.009"},{"key":"bib136","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000315"},{"key":"bib137","first-page":"157","volume-title":"Neurotrauma: A Comprehensive Textbook on Traumatic Brain Injury and Spinal Cord Injury","author":"Tator CH","year":"2019"},{"key":"bib138","first-page":"76","volume":"19","author":"Tjell C","year":"1998","journal-title":"Am J Otol."},{"key":"bib139","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2017.7052"},{"key":"bib140","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2007.11.002"},{"key":"bib141","doi-asserted-by":"publisher","DOI":"10.1080\/16501970306109"},{"key":"bib142","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30117-5"},{"key":"bib143","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506288677"},{"key":"bib144","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-52.1.07"},{"key":"bib145","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2015.4392"},{"key":"bib146","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518768750"},{"key":"bib147","doi-asserted-by":"publisher","DOI":"10.1016\/j.acn.2007.03.004"},{"key":"bib148","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20140598"},{"key":"bib149","doi-asserted-by":"publisher","DOI":"10.1177\/1941738116678411"},{"key":"bib150","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1203"},{"key":"bib151","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.10.067"},{"key":"bib152","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.1327"},{"key":"bib153","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2005.04.007"},{"key":"bib154","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000900"},{"key":"bib155","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.1997.3701006.x"}],"container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jospt.org\/doi\/pdf\/10.2519\/jospt.2019.8855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T13:56:19Z","timestamp":1724680579000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jospt.org\/doi\/10.2519\/jospt.2019.8855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":155,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.2519\/jospt.2019.8855"],"URL":"https:\/\/doi.org\/10.2519\/jospt.2019.8855","relation":{},"ISSN":["0190-6011","1938-1344"],"issn-type":[{"value":"0190-6011","type":"print"},{"value":"1938-1344","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]},"assertion":[{"value":"2019-10-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}