Tucker, R., Falvey, E.C., Fuller, G.W. orcid.org/0000-0001-8532-3500 et al. (3 more authors) (2021) Sport Concussion Assessment Tool : baseline and clinical reference limits for concussion diagnosis and management in elite Rugby Union. Journal of Science and Medicine in Sport, 24 (2). pp. 122-128. ISSN 1440-2440
Abstract
Objectives
Rugby Union has adapted the Sports Concussion Assessment Tool (SCAT) into an abridged off-field concussion screen and the complete SCAT is used during diagnostic screens performed after head impact events. No firm guidelines exist as to what should be considered “abnormal” and warrant further evaluation. This study evaluates SCAT performances in 13,479 baseline SCAT assessments, and proposes clear reference limits for each sub-component of the SCAT5. Baseline reference limits are proposed to guide management of baseline testing by identifying abnormal sub-tests, enhancing the clinical validity of baseline screens, while clinical reference limits are identified to support concussion diagnosis when no baseline is available.
Design
Cross sectional census sample.
Methods
13,479 baseline SCATs from 7565 elite male rugby players were evaluated. Baseline reference limits were identified for each sub-test as the sub-test result achieved by approximately 5% of the population, while clinical references limits corresponded to the sub-test score achieved by as close as possible to 50% of the cohort.
Results
Players reported symptoms 35% (95% CI 1.29–1.42) more frequently during SCAT5 than SCAT3 baseline assessments (mean 1.4 ± 2.7 vs 1.0 ± 2.4). Ceiling effects were identified for many cognitive sub-tests within the SCAT. Baseline and Clinical reference limits corresponding to the worst performing 5th percentile and 50th percentile were described.
Conclusions
Targeted baseline re-testing should be repeated when abnormal sub-tests are identified according to proposed baseline reference limits, while a more conservative clinical reference limit supports concussion diagnosis during screens in diagnostic settings.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 Sports Medicine Australia (SMA). This is an author produced version of a paper subsequently published in Journal of Science and Medicine in Sport. Uploaded in accordance with the publisher's self-archiving policy. Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Concussion; SCAT; Rugby Union; Neurological screening; Concussion management; Injury |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 02 Sep 2020 09:49 |
Last Modified: | 21 Jan 2022 14:26 |
Status: | Published |
Publisher: | Elsevier |
Refereed: | Yes |
Identification Number: | 10.1016/j.jsams.2020.07.006 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:165047 |
Download
Filename: 200313 J Sci Med Sport submission Combined SCAT Baseline resting final.pdf
Licence: CC-BY-NC-ND 4.0