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Concussion Testing and Protocols: The Importance of Evaluation

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Concussion Testing and Protocols: The Importance of Evaluation

Concussion testing is a common topic of concern for parents with active children, especially those who play sports. Numerous testing measures exist, making it difficult to know which is most effective in concussion diagnosis. UnityPoint Health Sports Medicine provider, Shawn Spooner, M.D. explains what is involved in testing for concussion and the importance of taking those tests seriously.

Pre-season Concussion Tests

Proper concussion care for athletes begins before the sports season with pre-season evaluations. The American Medical Society for Sports Medicine (AMSSM) suggests athletes first have a conversation with their team health care professional or trainer, sharing the number of concussions they may have previously experienced and any lingering effects of those head injuries. The AMSSM also lists three common concussion tests used to evaluate everything from balance to memory and recall:

  • Baseline computerized neuropsychological (NP) testing
  • Sport Concussion Assessment Tool 3 [SCAT3]
  • NFL Sideline Concussion Assessment Tool

“Pre-season, baseline concussion testing should be performed, as it allows for something to compare to following an injury to help determine if an athlete has returned to baseline and is ready to return to play,” Dr. Spooner says.

According to Dr. Spooner, it is rare to find a school that does not perform some sort of pre-season testing or post-injury testing. Because studies have not clearly demonstrated computerized testing to be superior to less expensive, paper-based testing, Dr. Spooner believes, at this time, any type of pre-season and post-injury testing is encouraged and adequate.

“Parents of athletes in any size of school should inquire about the type of testing performed and should feel comfortable that any standardized test (computer or paper-based) is a valid and adequate method of testing for their athlete,” Dr. Spooner says.

According to the AMSSM, it is important to remember the effectiveness of concussion testing is only as accurate as the truthful information provided by the athlete. It’s important for parents to encourage their athletes to be fully transparent with providers about their injuries and experiences.

“At times, priorities of young athletes may not align with those of parents. Athletes want to play and not let down their team mates. For this reason, they are sometimes less likely to report any injury including concussion. But, failure to treat a concussion might lead to poor academic performance, permanent injury and other long-term life consequences. Parents, school and team leaders have the responsibility to stress safety,” Dr. Spooner says.

While higher levels of athletic competition can be more complicated, both the National College Athletic Association (NCAA) and the National Football League (NFL) have standardized concussion protocols in place, which generally focus on early recognition and diagnosis of concussion, treatment and standard return-to-play protocols. Dr. Spooner acknowledges the rate of self-reporting may be lower, especially at the professional level, but encourages parents and coaches to educate their athletes that health and safety are the first priority.

Returning to Play

Athletes and their parents should be educated regarding the symptoms of concussion and how to evaluate their athlete if they suspect a head injury. Dr. Spooner says parents can identify concerns simply by observation.

  • Trouble concentrating or remembering
  • More fatigued
  • Headache or light sensitivity
  • More difficult to stimulate
  • Struggling academically

“Parents can educate themselves regarding management of concussion. The Center for Disease Control and Prevention (CDC) has an excellent program called “Heads Up,” where, parents, athletes and coaches will find a significant amount of valuable material to help educate all-involved on the nature and treatment of concussion,” Dr. Spooner says.

If an athlete does suffer a concussion, it’s important to receive “return-to-play clearance.” Dr. Spooner stresses the importance of listening to medical advice after a concussion or head injury.

“When determining return-to-play clearance, the authority will be with the team physician, trainer and coaching staff. Just because an athlete obtains a letter from a physician, such as their primary care provider, the team physician, trainer and coach have authority to over-ride and hold out until they feel the athlete is clear to begin and has finished a return-to-play protocol. Many times, athletes will ‘shop around’ until they obtain a clearance letter. This type of practice places the athlete at risk of further injury,” Dr. Spooner says.

If you believe your child has experienced a head injury or concussion, contact your UnityPoint Health provider immediately.