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Study: Baseline Concussion Tests Critical for Accurate Diagnosis

Nearly 30 U.S. states now have laws regarding student-athlete concussion awareness and prevention, but none of those state laws requires schools to administer baseline concussion tests before the start of the season.

According to research recently presented at the annual meeting of the American Orthopaedic Society for Sports Medicine, that's a mistake. All student-athletes need individual concussion baselines before the start of a sport season for accurate diagnosis, according to the new study.

The study, titled "Sideline Management of Concussions in Adolescent Athletes: Can the Sport Concussion Assessment Tool 2 (SCAT2) Be Accurately Used to Determine Return to Play Status?," sought to examine the effectiveness of the SCAT2Requires Adobe Acrobat Reader, a baseline concussion test.

The purpose of baseline concussion tests in sports is to measure a student-athlete's typical brain-activity level (the baseline). When a student-athlete may have sustained a concussion, he/she would retake the concussion test, and medical professionals would compare the results of the two. The more a student-athlete diverges in the responses on the two tests, the more likely it is that he/she sustained a concussion.

But not all healthy athletes have the same baselines, as the researchers point out.

"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," said lead researcher Dr. Anikar Chhabra of the Orthopaedic Clinic Association in Phoenix, according to a press release.

The researchers studied a total of 1,134 student-athletes—872 males and 262 females—from 15 high schools around the Phoenix area. All participants answered a brief questionnaire about their personal concussion history, then were given a baseline score based on their SCAT2 results.

Females scored "significantly higher" than males on the SCAT2 scores, and athletes with no history of concussions also scored much higher than those student-athletes with a prior history of concussions. There's no benefit to scoring higher or lower on the baseline test; it's the variability of the baseline scores that speak to the need of using these tests, say the researchers.

"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 9 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," said Chhabra.

It's worth noting that the SCAT2 isn't the only baseline concussion test out there. Other companies such as ImPACT and Axon Sports are already working with schools to implement baseline tests for their student-athletes.

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