One-year stability of preseason Sport Concussion Assessment Tool 5 (SCAT5) values in university level collision and combative sport athletes

ABSTRACT

Objectives

To determine the stability of the Sport Concussion Assessment Tool (SCAT) 5 between consecutive seasons in uninjured collision and combative varsity athletes.

Methods

Thirty-six athletes (19 females) were recruited to participate (wrestling [n = 12], rugby [n = 14], and hockey [n = 10]). The SCAT5 was administration at the start of the 2017 and 2018 seasons. Median baseline demographics for 2017 were as follows: age (19 years [range: 17–24 years]), height (174 cm [range: 149–195 cm]), and weight (76 kg [range: 57–118 kg]). Outcome metrics included subcomponents of the SCAT5: symptom reporting, standardized assessment of concussion (SAC), neurological screening, and balance performance measured with the modified balance error scoring system (mBESS). Wilcoxon signed-rank tests and Cronbach’s alpha (α) values were calculated to determine the stability between consecutive years for the SCAT5 variables in the same cohort of athletes. Bonferroni corrections were applied for Wilcoxon signed-rank tests, where alpha = 0.006 (0.05/9).

Results

Between the 2017 and 2018 seasons, no differences were noted in symptom reporting (p = 0.14), SAC (p = 0.32), neurological screening (p = 0.98), and balance performance on the mBESS (p = 0.01). The Cronbach’s alpha displayed unacceptable to questionable levels of within-subject stability (range: α = 0.34–0.70) for all subcomponents, except months in reverse order (α = 0.92).

Conclusions

While no statistical differences were present for all SCAT5 subcomponent metrics between 2017 and 2018 baselines, all but one displayed unacceptable to questionable stability (α ≤ 0.70) when retested one year later. Further research is needed to understand the appropriate time duration baseline SCAT5 values can reliably be utilized within longitudinal studies; as well as the normal variation of SCAT5 reporting/scoring.

KEYWORDS:

• Sport concussion assessment tool 5
• sport-related concussion
• sideline testing
• standardized assessment of concussion
• neurocognitive testing
• balance assessment

Acknowledgments

The authors would like to acknowledge the contributions of all athletes, coaches, and therapists, who assisted and made this investigation possible. The present investigation was funded through the Canadian Academy of Sport Medicine Research Fund. The Sport Injury Prevention Research Centre is one of the International Olympic Committee Research Centers for the Prevention of Injury and Protection of Athlete Health.

Declaration of interest

The authors have no conflicts of interest to declare.

Additional information

Funding

The authors received unrestricted financial support of this study from the Canadian Academy for Sport and Exercise Medicine.