Use of the Sport Concussion Assessment Tool 5 (SCAT5) in professional hockey, part 2: which components differentiate concussed and non-concussed players?

Abstract

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.

Concussion in cricket: Clinical findings using Sport Concussion Assessment Tool and recovery timeframes

“…A significantly higher number of symptoms and symptom severity has been reported in concussed professional hockey players compared to non-concussed players following a possible concussive incident, yet with median scores of 0 for both groups. 12 Commonly reported symptoms of headache, pressure in head, neck pain, and fatigue or low energy in concussed athletes were reported by both concussed and non-concussed athletes and therefore had lower diagnostic value. This finding is supported by other studies which have also found symptoms such as headache to be sensitive for concussion, however not specific if used in isolation without the assistance of other concussion assessment tools.…”

“…Current literature is predominantly focused on male collision sports with less research performed on female athletes and non-contact sports. [10][11][12][13] The aim of this study is to retrospectively review SCAT data from concussed and non-concussed elite cricket athletes following a head impact to describe which clinical features on the day of injury are associated with concussion diagnosis. A secondary aim is to describe the typical recovery time of concussed athletes including symptom resolution and RTP.…”

Ten-Word List Performance in Healthy Athletes and Athletes at 3-to-5 Days Following Concussion

“…7 In view of this, a recent study in professional hockey players examining the diagnostic utility of the SCAT-5 within the first 24 hours of injury found a significant decline in performance of both immediate and delayed recall 10-word list tests. 13 However, other studies that have evaluated the 10-word list test in athletes have been limited to healthy samples. [14][15][16] Thus, it is still unknown whether there is utility in the 10-word list test for discriminating concussed from healthy athletes beyond professional hockey and whether differences exist between male and female athletes.…”

Accuracy of Components of the SCAT5 and ChildSCAT5 to Identify Children with Concussion

“…Concussion diagnosis is complex in that it requires synthesis of multifactorial, non-specific clinical information [7]. The diagnostic decision making in standard clinical practice is complicated by factors such as varying symptom assessment tools; unclear thresholds for diagnosis; heterogeneous and non-specific symptom presentations that may also be observed among patients with other injuries, chronic pain, or psychiatric conditions; and an absence of definitive diagnostic biomarkers [8][9][10]. The SCAT tools provide an evidence-based, uniform and standardized assessment of concussion, to assist health professionals with the clinical diagnosis of concussion.…”