Baseline Testing

5 misconceptions of concussion baseline testing

Baseline testing is a series of tests done before a sports season starts that can provide healthcare practitioners with important information on which to compare should an athlete get a concussion. Comprehensive baseline testing helps to measure many areas of brain function that can be impacted by a concussion. As symptoms often disappear before the brain fully recovers, baseline testing provides valuable information, which may help healthcare practitioners make safer Return to Learn, Work and Play decisions.

In this post, we look at five common misconceptions.

“There’s no research to support baseline testing”

The most recent International Consensus Statement on Concussion in Sport suggests that pre-season baseline testing can support healthcare practitioners to interpret the scores of post-injury tests. Further, baseline neuropsychological assessments may provide additional information to the overall interpretation of these tests, and allows for additional educational opportunities for healthcare providers to discuss the severity of concussions with athletes and athletic support staff.1

Although not required for all athletes, the Ontario Psychological Association, Ontario Neurotrauma Foundation, and the Center for Disease Control support the use of baseline testing in high-risk athletes to help inform treatment and return to activity steps.2,3,10

“I completed an online test, I’m good to go”

While computerized neurocognitive testing can be a valuable tool as part of a comprehensive, multimodal baseline test, research shows these tests offer low-to-moderate test-retest reliability, and may be ineffective on their own.4,5 CCMI’s comprehensive baseline test evaluates many parts of concussion injuries including memory, concentration, visual processing, reaction time, visual movements, balance, motor strength and neurocognitive testing. Emerging research shows that using a variety of tests can improve the test-retest reliability, and provide much better accuracy in diagnosing and making return to play decisions for concussions.6,7,8  In fact, NCAA best-practice guidelines also support the use of multimodal baseline assessments for all high-risk contact sport athletes.9

“I had a baseline test last year, I don’t need another one”

As young brains are growing and developing, it’s recommended that those youth athletes who have had a baseline test should have one every year to ensure a valid and up-to-date comparison.10,11

“I had a concussion, why do I need a baseline test now?”

Healthcare practitioners can still diagnose and treat concussion symptoms without a baseline test; however, Return to Play decisions should be made with caution. If a patient plans to continue to be active in high risk or physical sports, then they should schedule a baseline test in preparation for the upcoming season.

“Can’t medical scans diagnose?”

Concussions are a functional injury, not structural. Therefore, the damage affects how areas of the brain work and communicate with each other. Brain scans (CT scans) or MRIs look for more severe, structural injuries or brain bleeds, not functional issues. The functional impairments of concussion are therefore best assessed with functional tests.

From initial pre-season baseline testing to concussion treatment and rehabilitation, all recognized CCMI practitioners are trained to provide standardized healthcare solutions to effectively manage concussions, and help athletes safely Return to Learn, Work and Play. For more information find a clinic near you.

Sources:

1 McCrory P, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med 2017; 0:1–10.

2 OPA Guidelines for Best Practice in the Assessment of Concussion-Related Symptoms. Ontario Psychological Association. www.psych.on.ca/OPA/media/Public/OPA%20Guidelines%20and%20Reviews/OPAConcussionGuidelinesFINAL.pdf?ext=.pdf.

3 Guidelines for Mild Traumatic Brain Injury and Persistent Symptoms. Ontario Neurotrauma Foundation. onf.org/system/attachments/266/original/GUIDELINES_for_Diagnosing_and_Managing_Pediatric_Concussion_Recommendations_for_HCPs__v1.1.pdf.

4 Broglio SP, et al. Test-Retest Reliability of Computerized Concussion Assessment Programs. Journal of Athletic Training 2007;42(4):509–514. www.ncbi.nlm.nih.gov/pmc/articles/PMC2140077/pdf/i1062-6050-42-4-509.pdf.

5 Harmon KG, et al.American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med 2013;47:15–26. bjsm.bmj.com/content/bjsports/47/1/15.full.pdf.

6 Borges A, Raab S, Lininger M. A comprehensive instrument for evaluating mild traumatic brain injury (mTBI)/concussion in independent adults: A pilot study. IJSPT 2017;12(3):381-389. https://www.ncbi.nlm.nih.gov/pubmed/28593091

7 Resch JE, Brown CN, Schmidt J, Macciocchi SN, Blueitt D, Cullum CM, Ferrara MS. The sensitivity and specificity of clinical measures of sport concussion: three tests are better than one. BMJ Open Sport Exerc Med. 2016;2. http://bmjopensem.bmj.com/content/2/1/e000012.

8 Molloy JH, Murphy I, Gissane C.  The King-Devick (K-D) test and concussion diagnosis in semi-professional rugby union players. J Sci Med Sport 2017;20(8):708-711. https://www.ncbi.nlm.nih.gov/pubmed/28258820.

9 Baugh CM, Kroshus E, Stamm JM, Daneshvar DH, Pepin MJ, Meehan III WP. Clinical practices in collegiate concussion management. Am J Sports Med. 2016 https://www.ncbi.nlm.nih.gov/pubmed/27037282.

10 FAQs About Baseline Testing. Centers for Disease Control and Prevention. www.cdc.gov/headsup/basics/baseline_testing.html.

11 Rogers SD, Smith PJ, Stephenson AJ, Everhart ED. A retrospective cross-sectional and longitudinal study of the effects of age on CNS vital signs scores in high-school athletes. Sports Med 2017. https://www.ncbi.nlm.nih.gov/pubmed/28236259

 

0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *