scholarly journals Use of the Sport Concussion Assessment Tool 5 (SCAT5) in professional hockey, part 1: cross-cultural normative data

2020 ◽  
pp. bjsports-2020-102071
Author(s):  
Ruben J Echemendia ◽  
Joanie Thelen ◽  
Willem Meeuwisse ◽  
Michael G Hutchison ◽  
Paul Comper ◽  
...  

ObjectivesThis paper provides comprehensive normative data stratified by language preference and age on the components of the National Hockey League (NHL) Sport Concussion Assessment Tool 5 (SCAT5) in a multilingual sample of professional ice hockey players and compares the findings from a paper form of the NHL SCAT5 with an electronic (App) version of the tool.MethodsA total of 1924 male NHL and American Hockey League (AHL) players (ages 17–41) were assessed during preseason medical evaluations (baseline); 1881 were assessed with the NHL SCAT5 App via tablet and 43 received the paper version of the NHL Modified SCAT5.ResultsNo significant differences between the App and paper modes of administration emerged in a subsample of English preference players. Significant SCAT5 differences among language preference groups emerged on measures of cognitive functioning (Immediate Memory,Concentration). No language preference differences emerged on the Delayed Recall component. Using age as a continuous variable, older participants outperformed younger players on Immediate Memory, Delayed Recall and Concentration. Players wearing skates demonstrated significantly more modified Balance Error Scoring System (mBESS) total errors than barefoot players. Normative data tables for language preference groups are presented.ConclusionsSignificant differences were found between English and non-English language preference groups on the components of SCAT5, which suggest that language-specific normative data, rather than aggregated normative data, are preferable when interpreting test scores. Similarly, age-specific normative data tables may provide greater precision in data interpretation. Due to clear ceiling effects on the mBESS single leg and tandem stances, players should not be tested while wearing skates.

2021 ◽  
Vol 3 ◽  
Author(s):  
Grant L. Iverson ◽  
David R. Howell ◽  
Ryan Van Patten ◽  
Paul Bloomfield ◽  
Andrew J. Gardner

Objective: To establish normative reference values for the Sport Concussion Assessment Tool-5th Edition (SCAT5) for the new National Rugby League Women's Premiership.Methods: Preseason SCAT5 baseline testing was administered individually to all National Rugby League Women's Premiership players (N = 117). Testing was completed by the medical staff. Normative reference values were calculated for the components of the SCAT5, including the Standardized Assessment of Concussion, modified Balance Error Scoring System, and the Symptom Scale. A small case series of players who sustained concussions were included to illustrate the use of the new normative data.Results: The median Standardized Assessment of Concussion total score was 27.0 (M = 26.9, SD = 2.1). The median modified Balance Error Scoring System score was 2.0 (M = 2.4, SD = 2.2). The median number of symptoms score was 1.0 (M = 3.2, SD = 4.7) and the median symptom severity score was 2.0 (M = 5.4, SD = 8.2). The most common baseline symptom was fatigue or low energy (33%), followed by trouble sleeping (24%), headache (23%), neck pain (22%), and difficulty remembering (21%). In the total sample, 41% reported no symptoms. The clinical interpretation of these new normative data to a case series of women with concussions is provided.Conclusions: Normative reference values are provided for the SCAT5 for women who are professional rugby league players. Using these normative data will improve clinical interpretation of SCAT5 scores following a concussion.


2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0000
Author(s):  
Amanda M. Black ◽  
Lauren N. Miutz ◽  
Paul H. Eliason ◽  
Kathryn Schneider ◽  
Keith O. Yeates ◽  
...  

Background: The Sport Concussion Assessment Tool 5 (SCAT5) is a standardized instrument designed to assist with the clinical and sideline assessment of concussion. Following the 5th International Conference on Concussion in Sport in 2016, the SCAT5 was released. Compared to the previous version (SCAT3), the SCAT5 includes more detailed instructions regarding the symptom checklist and a 10-word list in the immediate memory section to diminish ceiling effects. This study aims to examine the association between having a previous history of concussion and SCAT5 scores in high school rugby players. A second objective is to provide reference values for healthy rugby players for the SCAT5, including typical scores on immediate memory using the 10-word list. Methods: High school rugby players (ages 15-18) from Calgary, Alberta participating in the 2018 high school rugby season (n=388, male=212, female=176) were recruited to a cohort study and asked to complete a baseline SCAT5 assessment administered by trained research assistants at the beginning of the playing season. Outcome measures included baseline symptom evaluation (/22 symptoms)], self-reported rating of percentage of normal (100% perfectly normal) felt at time of testing, immediate memory score using a 10-word list [/30)], digits backward (/4), delayed word memory (/10), and modified Balance Error Scoring System [BESS (/30)]. Players also completed a preseason demographic questionnaire, which assessed their history of concussion. Results: A total of 237/388 (61.08%) rugby players reported no history of concussion (NC) and 151/388 (38.92%) reported at least 1 previous concussion (PC). Ninety of the 212 males (42.45%) and 61 of the 176 females (34.66%) reported a history of previous concussion. Median SCAT5 symptom score was 6 (range; 0-21) for NC and 7 (0-22) for PC groups. At the time of baseline testing, only 30.51% of NC players and 21.85% of PC players reported feeling 100% of normal. Median total scores on the immediate memory score (/30) were 21 (range; 9-28) for NC and 21 (range; 9-29) for PC. Median total score on digits backward (/4) was 3 (range; 0-4) and the delayed memory score (/10) was 7 (range; 0-20), for both NC and PC groups. Median total errors made on the BESS were 4 (range; 0-20) for NC players and 5 (range; 0-17) for PC players. Conclusions: Players with and without a previous history of concussion obtained similar scores on all components of the SCAT5 at baseline. Many high school rugby players did not report feeling 100% of normal during typical baseline testing sessions. The addition of the 10-word list option in the immediate and delayed memory section reduces the likelihood of a ceiling effect. This study informs the use and interpretation of the SCAT5 in high school rugby players.


2018 ◽  
Vol 21 (8) ◽  
pp. 794-799 ◽  
Author(s):  
Timo Hänninen ◽  
Jari Parkkari ◽  
Markku Tuominen ◽  
Juha Öhman ◽  
David R. Howell ◽  
...  

2018 ◽  
Vol 4 (1) ◽  
pp. e000412 ◽  
Author(s):  
Nicole Norheim ◽  
Alicia Kissinger-Knox ◽  
Megan Cheatham ◽  
Frank Webbe

ObjectivesThe Sport Concussion Assessment Tool-5 (SCAT5) was published in 2017; however, normative performance within the college athlete population on the optional 10-item word list has not been described. This study reports normative values for immediate memory trials, total immediate memory score and delayed recall of the 10-item word list.MethodsThe SCAT5 was administered as part of the preparticipation medical testing to 514 collegiate student-athletes, aged 17–23 (M=19.65,SD=1.40; 64% male) prior to the 2017–2018 athletic season.ResultsOn the SCAT5’s optional 10-item word list, with a total possible immediate memory score of 30, participants recalled an average of 20.57 (SD=3.22) words over three learning trials, with an average for trial 3 of 8.13 (SD=1.32). The average delayed memory score was 6.59 (SD=1.85). Small but significant demographic comparisons were found. Women scored higher on both immediate and delayed recall, non-native speakers scored higher on delayed recall, and Black/African-American athletes scored lower than White athletes on immediate, and lower than White and Hispanic/Latino athletes on delayed recall.ConclusionThe 10-item word list on the SCAT5 eliminates the ceiling effect observed on the five-item word list of the SCAT3, therefore, increasing its clinical utility in the diagnosis of sports-related concussions. Significant demographic differences suggest use of category-specific norms for sex, native language and race/ethnicity.


2016 ◽  
Vol 19 (8) ◽  
pp. 636-641 ◽  
Author(s):  
Timo Hänninen ◽  
Markku Tuominen ◽  
Jari Parkkari ◽  
Matti Vartiainen ◽  
Juha Öhman ◽  
...  

2016 ◽  
Vol 40 (4) ◽  
pp. E6 ◽  
Author(s):  
Aaron M. Yengo-Kahn ◽  
Andrew T. Hale ◽  
Brian H. Zalneraitis ◽  
Scott L. Zuckerman ◽  
Allen K. Sills ◽  
...  

OBJECTIVE Over the last 2 decades, sport-related concussion (SRC) has garnered significant attention. Even with increased awareness and athlete education, sideline recognition and real-time diagnosis remain crucial. The need for an objective and standardized assessment of concussion led to the eventual development of the Sport Concussion Assessment Tool (SCAT) during the Second International Conference on Concussion in Sport in 2004, which is now in its third iteration (SCAT3). In an effort to update our understanding of the most well-known sideline concussion assessment, the authors conducted a systematic review of the SCAT and the evidence supporting its use to date. METHODS English-language titles and abstracts published between 1995 and October 2015 were searched systematically across 4 electronic databases and a review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines adapted for the review of a heterogeneous collection of study designs. Peer-reviewed journal articles were included if they reported quantitative data on any iteration of the SCAT, Standardized Assessment of Concussion (SAC), or modified Balance Error Scoring System (mBESS) data at baseline or following concussion in an exclusively athlete population with any portion older than 13 years of age. Studies that included nonathletes, only children less than 13 years old, exclusively BESS data, exclusively symptom scale data, or a non–SCAT-related assessment were excluded. RESULTS The database search process yielded 549 abstracts, and 105 full-text articles were reviewed with 36 meeting criteria for inclusion. Nineteen studies were associated with the SAC, 1 was associated with the mBESS exclusively, and 16 studies were associated with a full iteration of the SCAT. The majority of these studies (56%) were prospective cohort studies. Male football players were the most common athletes studied. An analysis of the studies focused on baseline differences associated with age, sex, concussion history, and the ability to detect an SRC. CONCLUSIONS Looking toward the upcoming Concussion in Sport Group meeting in fall 2016, one may expect further revision to the SCAT3. However, based on this systematic review, the authors propose further, in-depth study of an already comprehensive concussion test, with acute, diagnostic, as well as long-term use.


Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S31.2-S32
Author(s):  
Nicole Wong ◽  
Jamie Bogle ◽  
David Dodick ◽  
Jennifer Wethe ◽  
Michael Cebette ◽  
...  

ObjectiveThe goal of the present research was to provide updated normative TTG data for younger athletes and increase understanding of the reliability of the TTG.BackgroundImbalance is a hallmark sign of concussion. The Sport Concussion Assessment Tool (SCAT-3) suggests using the Modified Balance Error Scoring System (mBESS) or Timed Tandem Gait (TTG) to evaluate balance function. TTG instructions indicate that times >14 seconds are abnormal as established in individuals between 16-37 years of age (Schneiders et al., 2010). Currently, there is a lack of normative data for the pediatric population.Design/MethodsPre-season TTG data were collected from 363 male and 20 female athletes with no active concussion complaints. The best TTG time out of 4 trials without errors was recorded. In addition, post-season data were collected for 107 male athletes.ResultsResults demonstrated a significant decrease in TTG time with age. Given this improvement, separate expected values were constructed: 7–8 years (21.4 +/− 7 s), 9–10 years (18.56 +/− 6 s), 11–12 years (18 +/− 5 s), 13–14 years (15.8 +/− 4 s), and 15–16 years (14.0 +/− 3 s). Analysis showed a significant improvement in TTG time over the season. Preliminary analysis shows no difference between baseline and post-concussion scores.ConclusionsThese results suggest that TTG time should be established annually. Future research will need to explore the expected amount of change in individuals with post-concussion imbalance.


2020 ◽  
pp. bjsports-2020-102072
Author(s):  
Jared M Bruce ◽  
Joanie Thelen ◽  
Willem Meeuwisse ◽  
Michael G Hutchison ◽  
John Rizos ◽  
...  

ObjectivesTo examine the utility of Sport Concussion Assessment Tool (SCAT5) subcomponents in differentiating physician diagnosed concussed players from controls.MethodsWe evaluated 1924 professional hockey players at training camp using the National Hockey League (NHL) Modified SCAT5 prior to the 2018–2019 season. Over the course of the season, 314 English-speaking players received SCAT5 evaluations within 1 day of a suspected concussive event. Of these players, 140 (45%) were subsequently diagnosed with concussion by their team physicians.ResultsConcussed players reported more symptoms (Concussed M=8.52, SD=4.78; Control M=3.32, SD=3.97), and recalled fewer words than Controls on both the Immediate Memory (Concussed M=19.34, SD=4.06; Control M=21.53, SD=2.94) and Delayed Recall (Concussed z=−0.91; Control z=−0.09) tasks during the acute evaluation. Concussed players also made more errors than Controls on the mBESS and were more likely to report double vision and exhibit clinician-observed balance problems than controls. There were no between-group differences on the Concentration component of the SCAT5. Stepwise regression revealed that symptom report and list learning tasks both accounted for independent variance in identifying players diagnosed with concussion.ConclusionsThese findings provide support for use of the SCAT5 to assist in identifying concussed professional hockey players. When examining SCAT5 subtests, both symptom report and the 10-item word list accounted for independent variance in identifying concussion status in this sample of professional hockey players. The mBESS also differentiated Concussed players and Controls. The Concentration component of the SCAT5 did not significantly differentiate Concussed players and Controls.


2020 ◽  
Vol 55 (2) ◽  
pp. 116-123
Author(s):  
Amanda M. Black ◽  
Lauren N. Miutz ◽  
Vineetha Warriyar KV ◽  
Kathryn J. Schneider ◽  
Keith Owen Yeates ◽  
...  

Context Version 5 of the Sport Concussion Assessment Tool (SCAT5) was released in 2017 with an additional 10-word list option in the memory section and additional instructions for completing the symptom scale. Objective To provide reference scores for high school rugby union players on the SCAT5, including immediate memory using the 10-word list, and examine how age, sex, and concussion history affected performance. Design Cross-sectional study. Setting Calgary, Alberta high schools. Patients or Other Participants High school rugby union players (ages 15–18 years) participating in a 2018 season cohort study (n = 380, males = 210, females = 170). Main Outcome Measure(s) Sport Concussion Assessment Tool 5 scores, including total number of symptoms (of 20), symptom severity (of 132), 10-word immediate memory (of 30), delayed memory (of 10), modified Standardized Assessment of Concussion (of 50), and balance examination (of 30). Results The median number of symptoms reported at baseline ranged from 5 to 8 across sex and age stratifications. Median symptom severity was lowest in males with no concussion history (7; range, 0–28) and highest in females with a concussion history (13, range = 0–45). Median total scores on immediate memory were 2–3 (range = 0–4) for males and 21 (range = 9–29) for females. Median total scores were 3 (range = 0–4) on digits backward and 7 (range = 0–20) on delayed memory (all groups). Based on simultaneous quantile (q) regression at 0.50 and 0.75, adjusted for age and concussion history, being female was associated with a higher total symptoms score (q0.75 βfemale = 2.85; 99% confidence interval [CI] = 0.33, 5.37), higher total symptom severity score (q0.75 βfemale = 8.00; 99% CI = 2.83, 13.17), and lower number of errors on the balance examination (q0.75 βfemale = −3.00; 99% CI = −4.85, −1.15). Age and concussion history were not associated with any summary measures. Conclusions The 10-word list option in the memory section reduced the likelihood of a ceiling effect. A player's sex may be an important consideration when interpreting the SCAT5 after concussion.


2019 ◽  
Vol 14 (2) ◽  
pp. 153-161 ◽  
Author(s):  
Sarah Hutchinson ◽  
Paul Ellison ◽  
Andrew Levy ◽  
David Marchant

Objective Concussion is a common injury in ice hockey, and previous research suggests some misconceptions and unsafe attitudes amongst players. The purpose of this study was to assess sport concussion knowledge, attitudes and the effect of sport concussion history in UK-based male ice hockey players across three levels of competition: professional, semi-professional and amateur. Methods Sixty-one participants across a number of UK ice hockey teams completed the Rosenbaum Concussion Knowledge and Attitudes Survey and reviewed a series of statements to assess knowledge (concussion knowledge index), attitudes (concussion attitude index) and misconceptions of concussion. Results Level of competition and concussion history had no significant effect on concussion knowledge index or concussion attitude index. A positive significant relationship exists between playing experience and concussion knowledge index and concussion attitude index. Statements identified common misconceptions and areas of accurate knowledge regarding concussion symptoms suggesting that male ice hockey players have a higher level knowledge compared to a sample of the UK general public. Playing experience was associated with increased knowledge and increasingly safe attitudes towards concussion. Conclusion Despite knowledge relating to loss of consciousness and correct management of symptoms being generally accurate, there are worryingly unsafe attitudes regarding aspects of concussion. Such attitudes may well pose significant threats to players’ safety and long-term health.


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