Abstract
Sports-related concussion has emerged as a public health crisis due to increased diagnosis of the condition and increased participation in organized and recreational athletics worldwide. Under-recognition of concussions can lead to premature clearance for athletic participation, leaving athletes vulnerable to repeat injury and subsequent short- and long-term complications. There is overwhelming evidence that assessment and management of sports-related concussions should involve a multifaceted approach. A number of assessment criteria have been developed for this purpose. It is important to understand the available and emerging diagnostic testing modalities for sports-related concussions. The most commonly used tools for evaluating individuals with concussion are the Post-Concussion Symptom Scale (PCSS), Standard Assessment of Concussion (SAC), Standard Concussion Assessment Tool (SCAT3), and the most recognized computerized neurocognitive test, the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The strengths and limitations of each of these tools, and the Concussion Resolution Index (CRI), CogSport, and King-Devick tests were evaluated. Based on the data, it appears that the most sensitive and specific of these is the ImPACT test. Additionally, the King-Devick test is an effective adjunct due to its ability to test eye movements and brainstem function.
Highlights
An estimated 38 million children and adolescents participate in organized sports in the United States (US), and approximately 170 million adults participate in some form of athletic activity [1]
Many diagnostic modalities can be utilized for the diagnosis and evaluation of concussions
No single test has proven sufficient for stand-alone use in the diagnosis of sportsrelated concussions
Summary
An estimated 38 million children and adolescents participate in organized sports in the United States (US), and approximately 170 million adults participate in some form of athletic activity [1]. Up to 3.8 million traumatic brain injuries (TBI) occur in this country each year, and over 300,000 of these injuries occur due to sports and recreational activities [1]. These values are likely underestimated, as 50% of concussions may go unreported [2]. With approximately 5.3 million US residents living with TBI-related disabilities, including long-term cognitive and psychological deficits, the importance of effective prevention and management strategies is clear [3]. The most commonly used assessments for evaluating individuals with concussions are the Post-Concussion Symptom Scale (PCSS), Standard Assessment of Concussion (SAC), Standard Concussion Assessment Tool (SCAT3), and the Immediate PostConcussion Assessment and Cognitive Testing (ImPACT) [6]. To facilitate a comprehensive assessment of concussed athletes, several assessment batteries, such as SCAT3 and ImPACT, can be and rapidly administered over multiple testing sessions
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