CONCUSSIONS AND BASELINE TESTING
Written by Ismail Chbihi & Jovana Smoljanić
FAQs
What is Baseline Testing?
A baseline test is a neuro-cognitive and physical exam that includes a combination of objective measurements. It is usually done before the beginning of an athlete’s season to assess their brain function (such as memory, reaction time, balance…etc.)
Does Baseline Testing Help Avoid Concussions?
Absolutely not. Whether you take a baseline concussion test or not, will have zero impact on your likelihood of sustaining a concussion or on its severity.
Why do a Baseline Test?
The idea is that in the event of a suspected concussion, having a baseline test allows health care professionals to compare an individual to their own baseline and can help guide return to activity decisions.
How Reliable are Concussion Baseline Tests?
It depends. There are many different assessment tools that can be included in a concussion baseline test or in an assessment post-concussion. Some are more standardized and more widely used than others, while others are newer and their reliability has not yet been verified.
Furthermore, some assessment results may vary for the same individual depending on the time of day, hours of sleep, external and internal stressors, skill level of the tester, athlete’s willingness to fully disclose information, setting where the test is conducted, etc… Also, when in comes to youth athletes, their brains are still developing and as their brain develops their baseline test results will change. That is another factor that can influence the test’s reliability and needs to be considered. All to say, baseline testing has its limitations and should be used as one part of a comprehensive concussion management strategy.
Will a Baseline Test Accelerate an Athlete’s Recovery?
Absolutely not. Concussion baseline tests or post-concussion tests have no way of directly accelerating your recovery from a concussion. Furthermore, you don’t NEED a concussion baseline test to recover from a concussion and return to play. However, the results from these tests can be used by healthcare professionals to properly track symptoms and recovery, to plan rehabilitation and to inform a safe return to play. Baseline tests are one piece of the concussion-management puzzle.
So What’s All the Controversy About?
The reliability of concussion tests has been put into question recently due to varying research findings. And, as mentioned above, there are many factors that can impact the reliability and validity of these tests. For those reasons and others, many are opposing the widespread use of the testing for young athletes – especially within organizations that mandate it for all members. In addition, baseline tests can be quite costly, and some allied health professionals have made big business out of it.
What do WE think?
We believe that the most important tool when it comes to concussions and young athletes is comprehensive education for the players, parents, and staff regarding concussions and protocols if one is suspected. Personally, we have found that Concussion Baseline tests can be useful if administered properly and used in conjunction with other concussion management strategies. The more standardized the tools used in the Baseline Test the easier it is for the information to be shared and for re assessed by allied health professionals – especially the family physician. It is highly encouraged to share the results of the baseline test with all of the health care professionals that the athlete sees (if the athlete consents). It should be the players’ and parents’ decision whether they would like to have baseline testing done pre season or not. Furthermore, we believe that these tests should be accessible to all athletes, and not only the ones that are ready to pay hefty amounts of money for initial testing and retests.
What are WE doing about it?
In keeping with our philosophy, we have been working very hard to make our Concussion Program even more up to date and comprehensive while keeping it accessible to as many athletes in our community as possible. The goal is to have a comprehensive program with testing that is as reliable and valid as possible while using more standardized tools so that individual athlete scores can easily be accessed, understood, and reproduced by other health professionals – especially physicians.
Additional Resources:
Parachute Canada’s latest statement regarding Concussion Baseline Tests:
http://www.parachutecanada.org/downloads/injurytopics/BaselineTestingStatement-Parachute.pdf
Canadian Association of Sports Medicine’s response to that position:
http://casem-acmse.org/wp-content/uploads/2013/07/CASEM-response.pdf
Consensus Statement on Concussions in Sport:
http://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097699.full.pdf
Ottawa-Orleans MPP Marie-France Lalonde: Ontario bringing legislation for Concussion Safety following report from Rowan’s Law Advisory Committee:
http://mariefrancelalonde.onmpp.ca/News/14381?rc=l&l=EN
Yours Truly,
Ismail Chbihi & Jovana Smoljanić
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