Study raises questions about common concussion assessment tool

The tool used to diagnose concussions could overestimate the condition and misidentify symptoms like fatigue and neck pain caused by intense exercise and not brain injury, Rutgers researchers say.

This new research raises new questions about the Sport Concussion Assessment Tool (SCAT), a questionnaire widely used along with other methods to diagnose concussions sustained during sport. The results were presented at the annual meeting of the American Physiological Society on April 5.

“Our results underscore the importance of considering the effects of exercise and fatigue in the assessment of concussions in on-court athletes,” said study first author Stephanie Iring, candidate to the doctorate in the laboratory of Jorge Serrador, associate professor at the Rutgers School. health professions. “While players with head impact may report more symptoms in general, we must be careful in using all symptoms when evaluating, as some are common after intense exercise, even in the no impact to the head.”

A concussion is a traumatic brain injury usually caused by a blow to the head. Although generally not life threatening, the effects can be severe and long lasting. About 3.8 million sports-related concussions are reported each year in the United States.

The SCAT is a tool designed to be used by medical professionals to determine if a player has suffered a concussion. The assessment includes questions about “red flag” symptoms such as neck pain, headaches, muscle weakness and vision problems in addition to tests to assess memory loss and other symptoms.

In previous studies of the tool, researchers compared the symptoms of athletes who had received a blow to the head with people at rest. For the new study, the researchers compared the SCAT scores of rugby players who had suffered a blow to the head with teammates who had just played an intense game of rugby but had no impact to the head. They evaluated 209 players, 80 of whom had suffered a head impact and 129 who had not.

Compared to those with a head injury, those with a head injury had significantly more symptoms on the SCAT assessment, reporting 26 symptoms on average. Uninjured players reported around nine symptoms. However, many players without head injuries had symptoms similar to those reported by players with head injuries, including fatigue and neck pain.

“Our data show that exertion during a game increased the number and severity of self-reported symptoms in control players, even though they did not experience a head impact,” Iring said. “This could lead to difficulties in differentiating these players from those who suffered a head impact when using on-field ratings.”

Some symptoms, including headaches and “not feeling well,” were more closely associated with a head injury. This suggests that these symptoms could be a stronger indicator of concussion in players who have just finished intense play, the researchers said. In addition to headaches, other symptoms more common in people with traumatic brain injury included cognitive-sensory effects, emotional-affective symptoms, and hypersensitivity. The researchers suggested that further studies are needed to examine how these compounds can be used with current physiological measures to better assess concussion in athletes.

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Material provided by Rutgers University. Original written by Patti Verbanas. Note: Content may be edited for style and length.

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