Youth Preseason Performance on the Sport Concussion Assessment Tool 5 Across Multiple Sports

Benjamin Leggett; Paul Eliason; Stacy Sick; Joel S Burma; Sophie K Wong; David Laperrière; Claude Goulet; Pierre Fremont; Kelly Russell; Kathryn J Schneider; Carolyn A Emery

doi:10.1097/JSM.0000000000001201

Youth Preseason Performance on the Sport Concussion Assessment Tool 5 Across Multiple Sports

Clin J Sport Med. 2023 Dec 27. doi: 10.1097/JSM.0000000000001201. Online ahead of print.

Authors

Benjamin Leggett^{1

2

3

4

5

6}, Paul Eliason^{1

3

4

5}, Stacy Sick^{1

3

4

5

7}, Joel S Burma^{1

2

3

4

5

6

8}, Sophie K Wong^{1

8}, David Laperrière^{9

10

11}, Claude Goulet¹¹, Pierre Fremont⁹, Kelly Russell^{10

12}, Kathryn J Schneider^{1

4

5

13

14}, Carolyn A Emery^{1

3

4

5

6

15

16}

Affiliations

¹ Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
² Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
³ O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
⁴ Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
⁵ Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
⁶ McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada.
⁷ Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.
⁸ Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
⁹ Pavillon de l'Éducation physique et des sports, Université Laval, Québec City, QC, Canada.
¹⁰ Pediatrics and Child Health, University of Manitoba, Winnipeg, MN, Canada.
¹¹ Department of Physical Education, Faculty of Education, Université Laval, Québec City, QC, Canada.
¹² Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
¹³ Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
¹⁴ Evidence Sport and Spine, Calgary, AB, Canada.
¹⁵ Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; and.
¹⁶ Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

PMID: 38149828
DOI: 10.1097/JSM.0000000000001201

Abstract

Objective: To examine preseason Sport Concussion Assessment Tool 5 (SCAT5) performance of adolescent sport participants by environment (in-person/virtual), sex, age, concussion history, collision/noncollision sport participation, and self-reported medical diagnoses.

Design: Cross-sectional.

Setting: Canadian community and high-school sport settings.

Participants: Three thousand eight hundred five adolescent (2493 male, 1275 female, and 37 did not disclose; 11- to 19-year-old) sport participants.

Assessment of risk factors: Sport Concussion Assessment Tool 5 administration method (in-person/virtual), sex (male/female/unreported), age (years), concussion history (0/1/2/3+), collision/noncollision sport participant, and self-reported medical diagnoses [attention deficit disorder or attention-deficit/hyperactivity disorder, headache/migraine, learning disability, and psychiatric disorder (ie, anxiety/depression/other)].

Outcome measures: Preseason SCAT5 outcomes including total number of symptoms (TNS; /22), symptom severity score (SSS; /132), Standardized Assessment of Concussion (SAC; /50), and modified Balance Error Scoring System (mBESS; /30).

Results: Multiple multilevel linear or Poisson regression complete case analyses adjusting for clustering and robust standard errors, with β-coefficients (95% CI) back-transformed to indicate an increase/decrease in SCAT5 subdomains when relevant for clinical interpretation. Virtual (V) performance was associated with fewer symptoms reported [TNSDifference V-IP = -1.53 (95% CI, -2.22 to -0.85)], lower SSS [-2.49 (95% CI, -4.41 to -0.58)], and fewer mBESS errors (IP) [-0.52 (95% CI, -0.77 to -0.27)] compared with in-person. For every one-year increase in age, more symptoms [TNS = 0.22 (95% CI, 0.01-0.44)], higher SSS [0.52 (95% CI, 0.01-1.06)], higher SAC [0.27 (95% CI, 0.15-0.38), and poorer balance [mBESS = -0.19 (-0.28 to -0.09)] were observed. Differences between males and females were also seen across all SCAT5 outcomes. Individuals reporting any medical diagnosis or 3+ concussion history also reported more symptoms (TNS) and higher SSS than those who did not.

Conclusions: Administration environment, sex, age, concussion history, and medical diagnoses were associated with SCAT5 subdomains and are important considerations when interpreting the SCAT5 results.