Concussion Test for Athletes - Uses and Results

Introduction

The sports medicine clinician faces many challenges in providing care for young athletes, but perhaps none is more complex than the diagnosis and management of concussion. Detecting concussion is relatively clear-cut when the subject is rendered unconscious and disoriented, but more than ninety percent of sport-related head injuries result in no observable loss of consciousness (amnesia) and only slight disorientation. Milder deficits in memory and concentration are more common after an athlete experiences a concussion. The effects of concussion on mental status are usually more subtle, often making them difficult to identify on routine clinical examination.

What Is a Concussion?

A concussion is an injury to the brain that results in loss of brain function, which is usually temporary. Medically, it is described by immediate and transient loss of brain function due to trauma.

What Are the Causes?

• Direct trauma to the head- getting hit, falling, and having an accident.

• Rapid acceleration or deceleration injury to the head.

What Are the Symptoms?

• Amnesia (loss of memory).

• Lack of judgment, reflexes, speech, balance, and muscle coordination.

• Confusion.

• Headache.

• Vision disturbances.

• Dizziness or imbalance.

• Nausea or vomiting.

• Difficulty in concentrating.

• Ringing ears.

• Sensitivity to light.

What Is Concussion Testing?

• The standardized assessment of concussion was developed to provide healthcare professionals with a more objective for assessing an injured athlete's mental status during sports within a minute of sustaining a concussion.

• This includes neuropsychological evaluation and postural stability testing.

• It is not meant to measure the severity of the injury or athletes' readiness to participate after a concussion.

What Are the Uses of Concussion Tests?

• Concussion tests help to assess brain function after an injury.

• Useful in checking memory, alertness, focus, and thinking ability.

• Useful in checking balance and coordination.

• One of the tools to diagnose a concussion.

What Are the Tests to Detect Concussion?

Standardized Assessment of Concussion Test:

• This test is used on the sports sidelines and at the emergency room to assess the immediate mental status of the athletes.
• This test is used to check orientation, immediate memory, concentration, and delayed memory.
• This test usually takes five minutes.

Test questions are:

1. The athlete is questioned about the date, time, month, and year.

2. The athlete is asked to memorize a list of words and recall them.

3. Asked to repeat the sequence of numbers backward.

4. Asked to say the months in reverse order.

Sports Concussion Assessment Tool 5:

• This test is used for people thirteen years and older.

• This test is also used to evaluate concussion for ages six to twelve.

• This test includes neck evaluation, balance assessment, yes or no symptoms checklist, and other information on injury associated with concussion.

• This test takes about fifteen to twenty minutes.

Military Acute Concussion Evaluation: This test collects information based on the event, concussion signs, and symptoms.

King-Devick Test:

• The athlete is asked to read numbers on three index cards by the trainer.

• These index cards have a series of numbers spaced unequally apart across eight lines.

• This test is done before the athletic session.

• In case the athlete has a head blow, the athlete will go to the sideline and repeat the test.

• If the athlete takes an extra five minutes than the test before, then the athlete has a concussion.

• This test is called a one-minute or two-minute test.

Balance Error Scoring System:

• This test is used to measure the balance.

• This test usually consists of six stances- Three stances on a firm surface and three on an unstable surface like medium-density foam.

• During this test, the eyes are closed, and the hands are on the hips.

• The stance is achieved with the help of feet shoulder-width apart, which includes one foot in front of the other and a single leg standing on the non-dominant leg.

• This test usually takes twenty seconds.

Acute Concussion Evaluation Tool:

• This test questions the present concussion characteristics.

• This includes a checklist of twenty-two concussion symptoms and risk factors.

• These include- cause of concussion, early signs, memory issues, loss of consciousness, history of concussion, history of headache, learning disabilities, attention deficit hyperactivity disorder, anxiety, sleep disorder, depression, seizures, worsening headaches, slurred speech, weakness, numbness, diagnosis, and follow-up plan.

Post-concussion Symptom Scale:

• It is a self-reported test.

• It includes twenty-one ranks based on the severity of symptoms from none to severe at baseline and at various times.

• Symptoms include physical, emotional, sleep, and thinking.

Immediate Post-Concussion Assessment and Cognitive Test: This test is usually for athletes of twelve years and above. It usually has three sections.

• Section 1: The athletes fill in their history, which includes sports participation, drug and alcohol use, learning disabilities, other neurological disorders, and previous concussion.

• Section 2: The athletes complete a checklist of twenty-two symptoms.

• Section 3: The athletes do a visual and verbal memory test, reaction time, number sequencing ability, ability to learn, and brain's visual processing speed.

What Are the Uses of Results Obtained From Concussion Tests?

• The results obtained from the concussion tests help the healthcare provider to discuss the recovery plan.

• The recovery plan includes- Taking enough rest (too much mental rest will lengthen the recovery period).

• Able to know the triggers that worsen the concussion symptoms.

• Helps to add activities once the symptom improves.

• Helps to develop a return to work plan.

What Are the Warning Signs of Doing a Concussion Test?

• Concussion assessment tests are not to be used as a substitute for medical evaluation.

• No young athletes should return to the sport on the same day after a suspected concussion.

• They should be removed from the sports until a medical professional feels it is safe to return to their activity.

• It is against state law for an athlete to return to the game without being assessed by a medical professional for clearance.

Conclusion

The use of standardized methods can improve the accuracy of concussion assessment during sports. Screening instruments are valuable tools to assist the sports medicine physician in the assessment and management of concussion but should not be used as a replacement for medical evaluation of an injured athlete's readiness to return to play after a concussion.