The utility of individual baseline versus normative reference values for the scat3 following concussion in professional ice hockey players

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Abstract

Objective

To characterise whether individual SCAT3 baseline scores are more useful than normative reference values following acute concussion.

Design

Prospective cohort.

Setting

Finnish professional male ice hockey league.

Participants

SCAT3 baseline testing has been mandatory in the league since 2013. The league recommends day of injury testing for all players with suspected concussion. Of the reported day of injury SCAT3s, between seasons 2013–2016, a total of 29 concussions were confirmed by the teams’ medical staff.

Outcome measures

Measures included: the individual baseline and day of concussion scores of the injured players; The league’s normative reference values [based on 2013–2014 preseason baselines (n=304)]; and the limits of normal variation on SCAT3 [based on league’s preseason baselines 2013–2014 and 2014–2015 (n=179)]. The post-injury performance was ruled as abnormal if (i) the player scored within the worst 10th percentile of the normative reference values or (ii) the score differed from the player’s own baseline more than the cut offs for 90% normal variation.

Main results

The percentages of the players who performed abnormally on post-concussion testing (scores compared to individual baseline vs. normative reference values) were as follows: Symptoms: 96% vs. 100%; SAC: 31% vs. 22%; M-BESS: 50% vs. 50%; Tandem gait: 18% vs. 29%; Coordination: 7% vs. 7%.

Conclusions

Post-concussion testing conducted with individual baseline seems to be as sensitive as assessment compared to normative reference values in acute concussion recognition. Symptoms were the most sensitive SCAT3 component.

Competing interests

Timo Hnninen, Markku Tuominen, Jari Parkkari, Matti Vartiainen, Juha hman, Teemu M. Luoto: None.

Competing interests

Grant L. Iverson has been reimbursed by the government, professional scientific bodies, and commercial organisations for discussing or presenting research relating to mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums. He has a clinical and consulting practice in forensic neuropsychology involving individuals who have sustained mild TBIs (including professional athletes). He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He has not received research support from a test publishing company in the past 5 years.

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