Construção de uma escala de concussão: avaliação e acompanhamento em atletas de esportes de combate pós-concussão

Abstract

Combat sports athletes face a high risk of concussions, the effects of which go beyond immediate symptoms and compromise physical and motivational functions. This thesis proposed to construct and evaluate the measurement properties of a concussion scale, combined with a protocol adapted to the demands of combat sports. The methodological, applied and interdisciplinary research, with a qualitative and quantitative approach, was divided into three stages: construction and analysis of the measurement properties of the scale, neuropsychological evaluation and practical application of the protocol, involving 52 athletes from two leading MMA teams, distributed into Control and Sparring groups. The assessments were carried out by a qualified professional in the training environment. Statistical analyses included descriptive statistics, chi-squared tests, Student's t-test, Mann-Whitney test, ANCOVA test, Bonferroni post-hoc test, and Cohen's effect, d, using SPSS v.25 software and a significance level of p ≤ 0.05. The scale originated from 103 items, after systematic review and interviews with athletes, being reduced to 23 items distributed in two factors: Physical Symptoms (11items) and Motivational (12items), with high internal consistency (α = 0.92) and content validity (content validity index [CVI] = 0.90). The bifactor structure was confirmed by confirmatory factor analysis (CFA), with robust loadings (λ > 0.5) and satisfactory adjustment indices. It revealed cognitive decline in the group with a history of concussion, in processing speed, memory and inhibitory control, while the control group maintained stable performance. Increase in Neuroticism (p = 0.002) and reduction in Openness to Experience (p = 0.036). The sequential application of the scale revealed symptoms within 24 hours and up to 7 days, with an average daily decline of 2.02% (p = 0.001), stabilizing after 60 days. The third stage consolidated a longitudinal screening and monitoring protocol, integrating baseline measurements, acute responses and chronic assessments, with clinical potential for decisions on return to training, rehabilitation and risk prevention. The validation of the scale marks a milestone in sports neuropsychology by offering a specific, robust, and accessible tool for screening and longitudinal monitoring of physical and motivational symptoms. The results confirm persistent neurocognitive effects, even in subconcussive impacts, and highlight selective alterations in executive functions and personality traits. The research proposes an innovative model of biopsychosocial assessment, contributing to safer, more equitable and evidence-based clinical practices.