Baseline Testing in Concussion
TD Forss, MA,CAT(C)
Martin Mrazik, PhD, R.P
There is a lot of talk these days about BASELINE TESTING for athletes. By now, many parents, coaches, and players are familiar with tests like Sport Concussion Assessment Tool (SCAT), ImPACT, King Devick, etc. These tests are routinely given to players BEFORE the start of their competitive season. If a player gets a concussion, these tools are used to establish a baseline level of functioning which can be later used to ensure a player is back to “normal” functioning before they are cleared.
In October 2016, the International Conference on Concussion (ICC) in sport was held in Berlin, Germany. The working group authored the 5th Consensus Statement on concussion in sport1 that was published online in the British Journal of Sport Medicine in April 2017. One of the key changes from the 2008 version was that baseline testing was recommended but not mandatory. The reasons being the costs of doing baseline testing, making sure a qualified person reviews the results and having good normative data.
With that in mind, baseline testing should be performed by a qualified professional and include:
Clinical History:
- the number of previous concussions, their duration and the symptoms related to them.
- a symptom checklist of current or recurrent symptoms that may be present prior to a concussive injury event (trouble sleeping, neck pain, anxiousness etc.)
- personal and family history of migraines, mood disorders, learning disabilities and the like.
- Personal and family history of migraines, mood disorders, learning disabilities, etc.
Physical and Neurological Evaluation;
- a physical exam that examines eye movement, muscle strength and neck evaluation
Measures of Motor Control
- including coordination and balance assessment
Measures of Neurocognitive Brain Function
- assessment of pre-injury brain cognitive function that includes delayed recall and reaction time
- assessment of current mental status such as memory, attention, orientation, the ability to concentrate
With this in mind, the ASM Concussion Program uses the SCAT 5 and King Devick tests to provide baseline data.
The SCAT 5 (Sport Concussion Assessment Tool – 5th Edition)
- A standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. SCAT 5 baseline testing is useful for interpreting post-injury test scores1.
The King Devick Concussion Screen
- A reading test based on the time to perform rapid number naming. It involves reading aloud a series of single-digit numbers from left to right as quickly and accurately as possible without making errors
- When used in combination with a qualified clinical evaluation, the SCAT 5 and King Devick assessment tools can help determine the presence of a concussion. And once a concussion is diagnosed, both tools can be used as aids to monitor the course of recovery.
Take home message
BASELINE TESTING is a good idea, but not mandatory. We recommend a low cost, simple baseline test that includes the SCAT 5 and King Devick tests administered by a qualified clinician.
HealthPointe Rehabilitation and Sport Injury Clinic is a multidisciplinary rehabilitation clinic consisting of Physiotherapists, Athletic Therapists, Kinesiologists, Physiatrists and Sport Med Physicians. They are leaders in Physiotherapy and Rehabilitation in the Edmonton area.
If you have any questions, don’t hesitate to contact Advantage Sport Medicine today!.
TD Forss, MA, CATA(C), CSCS is the Head Athletic Therapist of the Edmonton Oilers Hockey Club. His interests are contact sports, functional movement, personal development and family.
Martin Mrazik, PhD, is a specialist in Clinical Neuropsychology. He is an Associate Professor at the University of Alberta in the Department of Educational Psychology. He consults with the Edmonton Oilers Hockey Club, Edmonton Eskimos Football Club and the University of Alberta Golden Bears Football Team. His clinical interests include traumatic brain injury, concussion, and psychological functioning.
Reference:
- McCrory, P, Meeuwisse WH, Dvorak, et al 5th International Conference on Concussion in Sport (Berlin), October 2016. Br J of Sports Med; 2017; 51:837
- Enchemendia R. et al. The Sport Concussion Assessment Tool 5th Edition (SCAT5), Br J Sports Med. 2017, 51, 851-858
- Broglio S. et al. National Athletic Trainers’ Association Position Statement: Management of Sport Concussion, Journal of Athletic Training, 2014: 49(2); 245-265
Baseline Concussion Testing
At Advantage Sport Medicine we offer baseline concussion testing, which are tests routinely given to players and athletes before the start of their competitive season. These tools are used to establish a baseline level of functioning. If an athlete sustains a concussion, these tests can be later used to ensure a player is back to normal functioning before they are cleared to return to play.
After the International Conference on Concussion (ICC) in sport, which was held in Berlin, Germany in 2016, it was deemed that baseline concussion testing for athletes was recommended, with qualified personnel being able to administer testing. At Advantage Sport Medicine we have qualified staff consisting of physiotherapists, athletic therapists, kinesiologists, and sport medicine physicians to administer and interpret concussion testing. We utilize a combination of tests, such as the Sport Concussion Assessment Tool (SCAT5) and King Devick.
Throughout the testing we gather a thorough and relevant history, test motor control (coordination and balance), neck movement, neurological and neurocognitive function (memory, concentration, orientation, and reaction time). This provides us with information that is supported by sufficient research and data so we can best interpret the results and help with recovery and return to play if a concussion is sustained throughout the season.
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