Baseline concussion testing critical for later management

Note: This is another in a series of posts I am writing to highlight important studies from the 2011 Annual Meeting of the American Orthopaedic Society for Sports Medicine.

New research presented at the American Orthopaedic Society for Sports Medicine Annual Meeting in San Diego suggests that preseason baseline testing for athletes is critical to later management of concussions, should these injuries occur. The study, presented by Anikar Chhabra, MD, MS of Phoenix, Arizona, looks at variability of data among youth athletes and differences between males and female athletes.

The researchers studied 1,134 athletes at 15 different high schools in the Phoenix area. They administered a brief questionnaire to each athlete regarding prior concussions. The athletes also took the Sport Concussion Assessment Tool-2 (SCAT2). They found that female athletes scored better than males. Not surprisingly, athletes with prior concussions also scored lower than athletes who had never suffered a concussion. “Our results showed that otherwise healthy adolescent athletes do display some variability in results so establishing each player’s own baseline before the season starts and then comparing it to test results following a concussion leads to more accurate diagnosis and treatment,” Chhabra says.

Knowing the baseline neurologic function of an athlete is critical to properly diagnose and treat these injuries.

One of the most difficult aspects of treating athletes who had suffered a concussion is knowing if an athlete has recovered sufficiently. Asking an athlete who wants to play if he is having symptoms leads to the potential for the player to underreport symptoms such as headaches, dizziness, or feeling like he is in a daze. Physical examination and even neurologic testing might also be unremarkable. Without having baseline neurologic tests, it is difficult to truly know when an athlete is back to normal. These tests can give physicians a starting point for each athlete.

There is a long way to go and much more research needed with respect to concussion preseason screening and post-concussion testing. This study at least shows the variability by gender and among all athletes, demonstrating the need for baseline tests. Chhabra argues, “This data provides the first insight into how the SCAT2 scores can be used and interpreted as a sideline concussion tool and as an initial baseline analysis. With concussions accounting for approximately nine percent of all high school athletic injuries, accurately utilizing assessments like these to quickly determine an athlete’s return-to-play probability is critical to long term athletic and educational performance.”

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