In the competitive athletics industry, concussions are a serious, yet nonetheless common injury, often with long-lasting effects. According to the Centers for Disease Control and Prevention (CDC), up to 3.8 million sports-related concussions occur in the US each year, meaning that 5 to 10% of all athletes will experience a concussion in any given sports season.
A UW Medicine study published June 11 revealed a critical issue in concussion assessment: nearly half of athletes who scored within normal ranges on the Standardized Assessment of Concussion (SAC) were actually concussed.
The SAC, a component of the Sport Concussion Assessment Tool-5 (SCAT5), specifically addresses the cognitive aspects of concussion, assessing orientation, immediate memory, concentration, and delayed recall. It is a tool used internationally by medical professionals to diagnose concussions and make return-to-play decisions.
This study sampled 184 Division I athletes, 92 athletes with concussions, and 92 matched control athletes from various sports at four universities over two and a half years. Researchers collected baseline SCAT5 data and then repeated the tests when an athlete presented a suspected concussion.
From the collected data, the study found that reported symptoms were the most accurate indicator of concussion, while the SAC’s tests of immediate memory and delayed recall showed limited sensitivity. 45% of athletes with concussions had SAC scores that were within normal limits, matching or exceeding their baseline scores.
Dr. Kimberly G. Harmon, professor of sports medicine and head football physician at UW, led the study, drawing from her firsthand experience with athletes and diagnosing concussions. She emphasized the significance of understanding the limitations of the SAC in concussion diagnosis.
“The takeaway is if you get hit in the head and you have a headache, you’re dizzy, and you don’t feel right — that’s a concussion even if you do normally on the [SAC],” Harmon said. “You have to look at the big picture.”
Although reported symptoms were found to be most useful in diagnosing concussions, challenges can be associated with identifying subjective symptoms, such as headache and dizziness. It is also apparent that players can be incentivized to underreport or minimize symptoms. Overall, the study demonstrated that improved diagnostic tools are necessary to ensure the safety and health of athletes.
“We keep looking for more objective diagnosis tools but until we find one, you need to look at all the pieces of the puzzle: balance, cognition, and especially symptoms,” Harmon said.
Reach reporter Sophie Dorey at news@dailyuw.com Twitter: @soap_avi
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