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Use of the Sport Concussion Assessment Tool 5 (SCAT5) in professional hockey, part 2: which components differentiate concussed and non-concussed players?
  1. Jared M Bruce1,
  2. Joanie Thelen2,3,
  3. Willem Meeuwisse4,
  4. Michael G Hutchison5,
  5. John Rizos6,
  6. Paul Comper7,
  7. Ruben J Echemendia8,9
  1. 1Department of Biomedical and Health Informatics, University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA
  2. 2National Hockey League, New York City, New York, USA
  3. 3University of Missouri Kansas City, Kansas City, Missouri, USA
  4. 4National Hockey League, Calgary, Alberta, Canada
  5. 5Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
  6. 6Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
  7. 7Department of Family and Community Medicine, University Health Network, Toronto, Ontario, Canada
  8. 8Concussion Care Clinic, University Orthopedics Center, State College, Pennsylvania, USA
  9. 9Department of Psychology, University of Missouri - Kansas City, Kansas City, Missouri, USA
  1. Correspondence to Dr Ruben J Echemendia, UOC Concussion Care Clinic, State College, Pennsylvania, USA; rechemendia{at}comcast.net

Abstract

Objectives To examine the utility of Sport Concussion Assessment Tool (SCAT5) subcomponents in differentiating physician diagnosed concussed players from controls.

Methods We evaluated 1924 professional hockey players at training camp using the National Hockey League (NHL) Modified SCAT5 prior to the 2018–2019 season. Over the course of the season, 314 English-speaking players received SCAT5 evaluations within 1 day of a suspected concussive event. Of these players, 140 (45%) were subsequently diagnosed with concussion by their team physicians.

Results Concussed players reported more symptoms (Concussed M=8.52, SD=4.78; Control M=3.32, SD=3.97), and recalled fewer words than Controls on both the Immediate Memory (Concussed M=19.34, SD=4.06; Control M=21.53, SD=2.94) and Delayed Recall (Concussed z=−0.91; Control z=−0.09) tasks during the acute evaluation. Concussed players also made more errors than Controls on the mBESS and were more likely to report double vision and exhibit clinician-observed balance problems than controls. There were no between-group differences on the Concentration component of the SCAT5. Stepwise regression revealed that symptom report and list learning tasks both accounted for independent variance in identifying players diagnosed with concussion.

Conclusions These findings provide support for use of the SCAT5 to assist in identifying concussed professional hockey players. When examining SCAT5 subtests, both symptom report and the 10-item word list accounted for independent variance in identifying concussion status in this sample of professional hockey players. The mBESS also differentiated Concussed players and Controls. The Concentration component of the SCAT5 did not significantly differentiate Concussed players and Controls.

  • concussion
  • diagnosis
  • ice hockey
  • evaluation
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Footnotes

  • Contributors RJE and JMB assumed full responsibility for all aspects of this study including design, data acquisition, analysis and interpretation of the data, drafting and editing the manuscript, approval of the final version and submission. JT, WM, MGH, JR and PC contributed to the design of the project, data interpretation, manuscript review and editing, and final approval/responsibility of the document.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests RJE is a paid consultant for the NHL and co-chair of the NHL/NHLPA Concussion Subcommittee. He is also a paid consultant for Major League Soccer and Princeton University Athletic Medicine. He has a financial interest in EyeGuide and is chair of their Scientific Advisory Board and is currently a co-PI for a grant funded by the NFL (NFL-Long) through Boston Children’s Hospital and occasionally provides expert testimony in matters related to MTBI and sports concussion. JT is a part-time employee of the NHL. WM is Medical Director for the NHL and an employee of the NHL. MGH is a member of the NHL/NHLPA Concussion Subcommittee and a consultant to the NHLPA, for which he receives remuneration. JR is a member of the NHL/NHLPA Concussion Subcommittee and a paid medical/physician consultant to the NHLPA. PC is co-chair of the NHL/NHLPA Concussion Subcommittee and a paid consultant to the NHLPA. JMB is a part-time employee of the NHL. He receives grant funding from Genzyme and is a consultant to Med-IQ and Sporting KC.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval All data were deidentified and analysed following approval from the University of Missouri-Kansas City Office of Research Compliance (FWA#00005427).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information. All aggregate data relevant to the study are included in the article or uploaded as online supplementary information. Individual player raw data are not publicly available.

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