Andrew J Gardner1, Magdalena Wojtowicz2, Douglas P Terry3,4, Christopher R Levi5, Ross Zafonte6, Grant L Iverson7. 1. a Hunter New England Sports Concussion Program, John Hunter Hospital; Centre for Stroke and Brain Injury, School of Medicine and Public Health , University of Newcastle , Callaghan , NSW , Australia. 2. b Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital , MassGeneral Hospital for Children™ Sport Concussion Program, & Home Base, A Red Sox Foundation and Massachusetts General Hospital Program , Boston , Massachusetts , USA. 3. c Center for Health and Rehabilitation Research, Spaulding Rehabilitation Network , MassGeneral Hospital for Children™ Sports Concussion Program Boston, USA. 4. d Department of Physical Medicine & Rehabilitation , Harvard Medical School , Boston , Massachusetts , USA. 5. e Hunter New England Sports Concussion Program, John Hunter Hospital; Centre for Stroke and Brain Injury, School of Medicine and Public Health , University of Newcastle , Callaghan , NSW , Australia. 6. f Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, Harvard Medical School, and Home Base , A Red Sox Foundation and Massachusetts General Hospital Program , Boston , Massachusetts , USA. 7. g Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital , MassGeneral Hospital for Children™ Sports Concussion Program, & Home Base, A Red Sox Foundation and Massachusetts General Hospital Program , Boston , Massachusetts , USA.
Abstract
PRIMARY OBJECTIVE: This study reviewed the available sideline Sport Concussion Assessment Tool-Third Edition (SCAT3) performance of players who were removed from play using the 'concussion interchange rule' (CIR), the available video footage of these incidences, and associated return to play and concussion diagnosis decisions. RESEARCH DESIGN: Descriptive, observational case series. METHODS AND PROCEDURES: Data were collected from all NRL players who used the CIR during the 2014 season. MAIN OUTCOMES AND RESULTS: Complete SCAT3 and video analysis data were available for 38 (23%) of 167 uses of the concussion interchange rule, of which 20 (52.6%) players were medically diagnosed with concussion. Those with video evidence of unresponsiveness performed more poorly on the modified Balance Error Scoring System (M-BESS; p = .04; Cohen's d = .69) and reported greater symptoms (p = .03; d = .51). Similarly, players with a vacant stare reported greater symptoms (p = .05; d = .78). Those who demonstrated three signs (unresponsiveness, vacant stare and gait ataxia) performed more poorly on the M-BESS (p = .03; d = 1.4) and reported greater symptoms than those with no observable signs (p = .03; d = 1.4). CONCLUSIONS: The SCAT3 is sensitive to the acute effects of concussion in professional athletes; however, a minority of injured athletes might go undetected by this test.
PRIMARY OBJECTIVE: This study reviewed the available sideline Sport Concussion Assessment Tool-Third Edition (SCAT3) performance of players who were removed from play using the 'concussion interchange rule' (CIR), the available video footage of these incidences, and associated return to play and concussion diagnosis decisions. RESEARCH DESIGN: Descriptive, observational case series. METHODS AND PROCEDURES: Data were collected from all NRL players who used the CIR during the 2014 season. MAIN OUTCOMES AND RESULTS: Complete SCAT3 and video analysis data were available for 38 (23%) of 167 uses of the concussion interchange rule, of which 20 (52.6%) players were medically diagnosed with concussion. Those with video evidence of unresponsiveness performed more poorly on the modified Balance Error Scoring System (M-BESS; p = .04; Cohen's d = .69) and reported greater symptoms (p = .03; d = .51). Similarly, players with a vacant stare reported greater symptoms (p = .05; d = .78). Those who demonstrated three signs (unresponsiveness, vacant stare and gait ataxia) performed more poorly on the M-BESS (p = .03; d = 1.4) and reported greater symptoms than those with no observable signs (p = .03; d = 1.4). CONCLUSIONS: The SCAT3 is sensitive to the acute effects of concussion in professional athletes; however, a minority of injured athletes might go undetected by this test.
Entities:
Keywords:
Concussion; SCAT3; sideline assessment; video analysis