A “baseline test” is a test that is done BEFORE a concussion happens.
The purpose of a baseline test is to measure multiple areas of brain function that are commonly affected following a concussion. This way, if an athlete does get a concussion, we can compare their post-injury state to their baseline parameters to help make an accurate diagnosis, as well as to establish a more objective determinant of recovery and readiness to return to their sport.
The Ontario Neurotrauma Foundation Paediatric Concussion Guidelines recommends that baseline testing be considered in athletes engaged in high-risk sports and the Centres for Disease Control and Prevention recommend that baseline tests be repeated annually to establish a valid comparison.
Many companies have been promoting online neurocognitive tests as “baseline concussion evaluations”, however when used as the only method of assessment, these tests have been shown to be extremely inadequate (see below), as they fall very short of testing all facets of concussion injuries. As part of a complete evaluation, these tests have been shown to lend a valuable insight into neurocognitive functioning. Our comprehensive baseline testing includes tests of all facets of concussion injuries, including but not limited to:
- Visual Processing/Visual Movements
- Reaction Time
- Balance and Proprioception
- Motor Strength
- Neurocognitive Testing
Truth about online-testing
Baseline testing should be repeated at least once per year and should involve more than just online/computer-based neurocognitive testing. Medical research has repeatedly demonstrated online or computer-based testing to be insufficient on their own. Several studies have shown, and several world-wide consensus statements have concluded, that by themselves, online testing may over-estimate recovery and send players back in to harms way (click here). It is important to off-set your online testing with a full protocol of physical and in-person baseline neurological testing.
Here are some quotes from recent research studies examining the usefulness of a concussion program that only uses online testing:
“Neuropsychological tests should only be used as a part of a comprehensive concussion management strategy and SHOULD NOT BE USED IN ISOLATION” — American Medical Society position statement on concussion in sport – Clinical Journal of Sports Medicine, 2013
“Computer-based concussion evaluations did not provide stable measures of cognitive functioning. Inconsistent performance on concussion assessments may lead clinicians to inaccurate determinations of cognitive function” — Broglio et al., 2007
“We conclude that the empirical evidence does not support the use of ImPACT testing (a popular computer-based concussion test) for determining the time of post-concussion return to play” — Mayers et al. Journal of Clinical and Experimental Neuropsychology, 2012
Although these tests have shown unreliability as a stand-alone test, they are currently recommended as an adjunct to a complete and comprehensive program. Our program has been designed to be completely research-based, which is why we include online testing as only one small component of our comprehensive protocol, as they were intended to be used.
This post is also available in French