Getting Ahead of the Game: The Importance of Baseline Testing in Concussion Management

We plan ahead for a lot of things in life, but planning for injuries is generally not on the top of our “to do” list. Many people just hope that they don’t happen, and for most minor injuries, that’s probably ok. The story for concussions, however, is different.

We’ve shared prior posts on simple concussion facts, along with recognizing concussion symptoms. We need to flash back now to BEFORE the injury happens and talk about what can be done in the present moment, to help treat the concussion that hasn’t even occurred yet.

What is baseline testing? Baseline testing is typically a series of assessments that measure different components of an individual’s balance and brain function such as memory, reaction time and problem solving. These tests serve as a marker, so to speak, of the current state of affairs of the brain. Results from these pre-injury tests are compared to similar tests completed post-injury when a concussion is suspected or traumatic impact to the head has occurred.

Why is it important to have baseline testing prior to having a concussion? As you can probably imagine, there is a great deal of variability in the performance of normal healthy individuals on tests involving areas such as memory, concentration, and problem solving. Because of this, best practice in concussion management is to have individualized performance on such measures well documented prior to a concussion. Without it, the best that can be done after a suspected concussion is to compare post-injury test performance to standardized norms, which could be drastically different than an individual’s baseline performance. This can subsequently impact decisions on return to school, work or play.

Who should get baseline tested? The Centers for Disease Control recommends all youth athletes 10 years and up get baseline tested. Adult athletes or adults in jobs with risk of trauma or blow to the head should also consider testing. Bottom line is the most commonly used standardized concussion assessments are intended for individuals 10-59 years old and anyone in that age range can get tested.

When and how often should testing occur? Baseline testing should occur prior to the season or prior to the start of the at-risk activity for those in the age range mentioned above. Most recommendations suggest that young athletes be tested every two years from the age of 10 through senior year of high school. In college and at professional levels, athletes should be baseline tested once prior to the start of playing at those levels.

Who should provide baseline testing?  Testing should be provided by healthcare professionals trained specifically in the use of the testing tools.

Who should provide post-injury assessment?  While baseline testing can be provided by a variety of professionals trained in the use of the testing tools, post injury assessments should be analyzed by a physician, neuropsychologist, or other credentialed health care provider. Many states have specific guidelines about who may clear a school-age athlete for return-to-play. Concussions which are improving within in typical time frame likely can be managed by an individual physician or neuropsychologist; however, a concussion with prolonged symptoms and/or post-concussion syndrome should be managed by an experienced team that may include a Physician, Neuropsychologist, Physical Therapist, and Vision and Vestibular specialists.

To schedule your baseline test, or for more information about concussions, contact the Philadelphia Concussion Center at Magee at 855-587-BRAIN (855-587-2724).

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