Understanding the various concussion tests (Part I)

Understand concussion tests

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Concussion tests have been revised a significant number of times over the past decade as more research was done on the issue by experts from different fields of work. For your ease of understanding, I shall categorize concussion tests based on the phases of injury that they are useful in and which specialists qualify to perform these tests.

Most concussion tests usually would help us rule in or rule out if the athlete has suffered a concussion. However, in my opinion, the testing I.e. assessment should not end here. If a concussion is suspected, further evaluation is critical and it should be done in a timely manner.

Baseline Testing1) BASELINE CONCUSSION TEST:

As per the US center for disease control (CDC), Baseline testing is a pre-season exam ie it is conducted on a healthy brain and always by a trained health care professional.

These include athletic trainers, coaches, on site medical personnel or a specialist like neurologist.  The concussion tests are used to assess an athlete’s balance and brain function (including learning and memory skills, ability to concentrate, attention span and problem-solving skills), in addition to presence of any concussion symptoms. Results from baseline tests (or pre-injury tests) are used and compared to a similar exam conducted by a health care professional during the season if an athlete has a suspected concussion.

Hence, baseline testing generally takes place during the pre-season most likely prior to the first practice. Since they mostly involve testing of neurocognitive elements, some baseline and concussion assessment tools are only suggested for use among athletes ages 10 years and older.

Baseline testing also provides an important opportunity to educate athletes and others about concussion and return to school and play protocols.

Every school and sports organization use a different baseline test. It could be in paper format or computerized. What is important is that it covers all components of testing the athlete as a whole.

Most common used tests are the Impact, Hit Check, SCAT5 etc. to name a few.

2) TESTS / ASSESSMENT AT THE EMERGENCY ROOM:

While the true first evaluation of concussion symptoms occurs on the street or playing field where the head injury occurred, the first doctors to see concussion patients are often those staffing the emergency department of their local hospital.

The most commonly used tool for emergency evaluation of concussion symptoms is called the SCAT5. This stands for “Sports Concussion Assessment Tool.” There are several versions of this test, including the “SCAT5 Child” a variation which is more accurate for detecting concussion in children under the age of 12 and the CRT5, or “Concussion Recognition Tool 5,” which is designed to help people who aren’t medical professionals recognize concussion on the field.

3) The King Devick Test:

The King-Devick Test is proven to be mostly useful in early concussion. It is a rapid reading and response time test in which players are asked to read aloud from a series of flash cards. This test takes just a few minutes to administer, and can reveal subtle cognitive and ocular symptoms of concussion. People with concussions have slower response times on this test.

However, for the King-Devick Test to give accurate results, athletes must have a “baseline” King-Devick Test on file. In other words, athletes must have taken the test in the past when their brains were healthy, in order to accurately determine whether their response times have changed. 

For this reason, some sports teams administer King-Devick Tests to athletes during training, and keep their response time results on file for easy comparison on the sidelines during competitions.

Read Part II of this article here..

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