Guest Post by:
Stephanie Davey, ATC
Certified Athletic Trainer
MUSC Sports Medicine
In the past few years, concussions in sports have been a hot topic. The debate has ranged from how to prevent concussions to how to safely return an athlete to play after a concussion. As it is nearly impossible to prevent head injuries in sports, the focus on returning athletes to play after a concussion is high. We have multiple tools to do this, including cognitive assessment testing.
Cognitive testing evaluates the mental abilities of the brain. After a head injury, an athlete’s cognitive function can be diminished. Functions including but not limited to attention, memory, working memory and processing speed can all be affected by a concussion. In order to properly assess after injury cognitive function, a baseline cognitive assessment should be done on all contact sport and high-risk athletes. The most common way to attain a cognitive baseline assessment is through a computerized test. There are multiple computerized cognitive assessment tests on the market and they all have slightly different methods. However, all the tests should analyze learning and memory skills, ability to pay attention or concentrate, and how quickly the athlete is able to process and solve problems. Ideally, a baseline test should be done every year and prior to practice starting. The environment should be controlled and quiet so the athlete is able to focus while taking the test. Athletes should be well rested, hydrated, and not hungry prior to taking the test. Test results should be kept by the athletic trainer or the doctor administering the test.
There are some concerns with baseline cognitive testing. The most efficient way to test large teams is in a computer lab with multiple athletes testing at the same time. It can be difficult for some athletes to focus in a mass setting, which can lead to a skewed baseline. After injury tests are usually done one athlete at a time and in an office or clinic setting. The change in settings can lead to unreliable results. Athletes also have been known to purposely not try on the baseline, so that their scores will be lower. Lower scores make it easier to pass an after injury tests. Also, computerized baseline testing can be prohibitively expensive for some schools and organizations.
It is important to note that cognitive testing is just one part of the process to safely returning athletes to play. It should not be used as the only criteria to returning an athlete. When used correctly, computerized cognitive assessments are useful tool and should be part the return to play protocol.