The first, and by far the most important step in properly managing concussions comes before the injury happens. Actually, before the season even starts! A “baseline test” is a test that is done BEFORE a concussion happens.
The purpose of a baseline test is to measure every area of brain function, which could become affected following a concussion. This way, if an athlete does get a concussion, we can compare their post-injury state to their baseline parameters to help make an accurate diagnosis, as well as to establish when they are fully healthy and are safe to return to their sport. Without these baseline parameters we have no way of determining when the brain has fully recovered.
The initial concussion is generally not a large concern, especially since our certified practitioners are highly trained to treat and manage these injuries. However, it is a second concussion, sustained prior to full recovery of the initial concussion, that is a cause for concern as this may result in long term brain damage or other larger consequences. Ensuring every athlete has a baseline test done before their season starts is the first step in decreasing the greater risk of concussions.
Professional sports organizations have been undergoing pre-season baseline testing for years, however, comprehensive testing of this magnitude has never been available to youth and amateur sports associations; partly because most healthcare practitioners are not sure where to start.
Comprehensive Baseline
Many companies have been promoting online neurocognitive tests as “baseline concussion evaluations”, however when used as the only method of assessment, these tests have been shown to be extremely inadequate (see below), as they fall very short of testing all facets of concussion injuries. As part of a complete evaluation, these tests have been shown to lend a valuable insight into neurocognitive functioning. Our comprehensive baseline testing includes tests of all facets of concussion injuries, including but not limited to:
- Memory
- Concentration
- Visual Processing/Visual Movements
- Reaction Time
- Balance and Proprioception
- Motor Strength
- Neurocognitive Testing
Truth about online-testing
Baseline testing should be repeated at least once per year and should involve more than just online/computer-based neurocognitive testing. Medical research has repeatedly demonstrated online or computer-based testing to be insufficient on their own. Several studies have shown, and several world-wide consensus statements have concluded, that by themselves, online testing may over-estimate recovery and send players back in to harms way. It is important to off-set your online testing with a full protocol of physical and in-person baseline neurological testing.
Here are some quotes from recent research studies examining the usefulness of a concussion program that only uses online testing:
“Neuropsychological tests should only be used as a part of a comprehensive concussion management strategy and SHOULD NOT BE USED IN ISOLATION” — American Medical Society position statement on concussion in sport – Clinical Journal of Sports Medicine, 2013
“Computer-based concussion evaluations did not provide stable measures of cognitive functioning. Inconsistent performance on concussion assessments may lead clinicians to inaccurate determinations of cognitive function” — Broglio et al., 2007
“We conclude that the empirical evidence does not support the use of ImPACT testing (a popular computer-based concussion test) for determining the time of post-concussion return to play” — Mayers et al. Journal of Clinical and Experimental Neuropsychology, 2012
Posted by Complete Concussion-Toronto, ON