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After a thorough literature search and through experience at adaptive sports events, we identified a lack of established guidelines for Sport-related concussion (SRC) evaluation and management in wheelchair athletes. Wheelchair athletes are a unique population, and certain conventional methods of evaluating SRC in able-bodied sports cannot be used. For example, wheelchair athletes' underlying disabilities restrict the use of standard balance testing protocols. In addition, some wheelchair athletes have concurrent traumatic brain injuries and may have baseline cognitive deficits associated with their disability that mimic the symptoms of a concussion. This research focused on discussing current concussion management guidelines in Adaptive Sports and formulating a new Concussion Management Protocol (CMP). We developed a CMP that incorporated the Wheelchair Error Scoring System (WESS), a seated balance test based on the Balance Error Scoring System to evaluate ataxia. We collected baseline data on wheelchair athletes that included a concussion history, symptoms, Standardized Assessment of Concussion and WESS. Baseline data was collected at 39th National Veterans Wheelchair Games (NVWG) where 81 athletes were asked to complete all aspects of the baseline exam. Out of the 76 patients who tried the WESS, only 28 could complete the full test. Those who were unable to perform the WESS had limitations with the wheelie balance task which led to the adaptation to an alternative test, the King-Devick. We also discovered that 43% of the athletes reported a history of a concussion.

Symposium Date

Fall 12-1-2012


brain--concussion, wheelchairs, WESS



Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Wheelchair Athlete Concussion Baseline Data: A Pilot Retrospective Analysis

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