Sport Concussion Assessment Tool: baseline and clinical reference limits for concussion diagnosis and management in elite Rugby Union

Abstract

Three of the authors (RT, EF, MH) are full-time and part-time employed by World Rugby in roles of research and medicine. JP and GF have served as independent advisors on a working group on concussion administered by World Rugby, for which expenses are covered. Ethics approval and consent to participateThe research plan for this study was approved by the World Rugby Institutional Ethics committee (REF 19007). Players had provided written informed consent for all data gathered as part of the World Rugby Concussion management programme to be used for research in a de-identified manner Availability of data and materialOriginal participant data belongs to the players and the clubs/unions that generate such data. This may be provided upon request to third parties. World Rugby (the corresponding author) may facilitate the provision of that data, in terms of permissions and contacts, though there is not a single point of contact, since the data are generated globally from multiple teams and Unions. Author' contributions and declarationMR conceived the study. MR, RT and EF designed the study. RT and MH performed the analyses. All authors made substantial contributions to the study design, data processing and interpretation. RT drafted the article and all other authors revised it critically for important intellectual content. RT is the guarantor. All authors had full access to all of the data in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. The manuscript has not been published elsewhere and is not being considered for publication elsewhere.

Sport Concussion Assessment Tool-5th Edition (SCAT5): Normative Reference Values for the National Rugby League Women's Premiership

“…These results are consistent with prior literature in that fatigue is typically the most frequent or second most frequent symptom reported during baseline SCAT evaluations across a variety of age groups, geographic regions, and sports (Schneider et al, 2010;Jinguji et al, 2012;Hänninen et al, 2016;Petit et al, 2020;Tucker et al, 2020b), and difficulty sleeping is also common (Schneider et al, 2010;Jinguji et al, 2012;Hänninen et al, 2016;Tucker et al, 2020b), reflecting that these symptoms occur frequently in daily life (Yengo-Kahn et al, 2016). Scores on the SAC and mBESS were high but imperfect and were broadly consistent with prior normative studies (Jinguji et al, 2012;Valovich McLeod et al, 2012;Snyder et al, 2014;Hänninen et al, 2016;Snedden et al, 2017;Tucker et al, 2020b). Small proportions of the current sample earned perfect scores on SAC delayed recall (8%) and digits backwards (38%), while most of the sample (85%) correctly named the months in reverse.…”

“…In our study, the most common symptoms were fatigue or low energy (33%), trouble sleeping (24%), headache (23%), neck pain (22%), and difficulty remembering (21%). These results are consistent with prior literature in that fatigue is typically the most frequent or second most frequent symptom reported during baseline SCAT evaluations across a variety of age groups, geographic regions, and sports (Schneider et al, 2010 ; Jinguji et al, 2012 ; Hänninen et al, 2016 ; Fuller et al, 2018 ; Petit et al, 2020 ; Tucker et al, 2020b ), and difficulty sleeping is also common (Schneider et al, 2010 ; Jinguji et al, 2012 ; Hänninen et al, 2016 ; Fuller et al, 2018 ; Tucker et al, 2020b ), reflecting that these symptoms occur frequently in daily life (Yengo-Kahn et al, 2016 ).…”

“…Scores on the SAC and mBESS were high but imperfect and were broadly consistent with prior normative studies (Jinguji et al, 2012 ; Valovich McLeod et al, 2012 ; Snyder et al, 2014 ; Hänninen et al, 2016 ; Snedden et al, 2017 ; Fuller et al, 2018 ; Tucker et al, 2020b ). Small proportions of the current sample earned perfect scores on SAC delayed recall (8%) and digits backwards (38%), while most of the sample (85%) correctly named the months in reverse.…”

“…The majority of the sample (59%) endorsed at least one baseline symptom, and approximately one in three women (32%) endorsed four or more symptoms at baseline ( Table 5 ). The women in this sample endorsed more preseason symptoms than are endorsed during the preseason by elite male Rugby Union players (Fuller et al, 2018 ; Tucker et al, 2020b ). In our study, the most common symptoms were fatigue or low energy (33%), trouble sleeping (24%), headache (23%), neck pain (22%), and difficulty remembering (21%).…”

Use of the Sport Concussion Assessment Tool 5 (SCAT5) in professional hockey, part 1: cross-cultural normative data

“…30 A large sample of rugby union athletes achieved an average of 21.5 (SD=3.7; median=21) on Immediate Memory and 7.1 (SD=1.9; median=7) on Delayed Recall. 31 All of these studies determined that the ten-word list largely eliminated the ceiling effects found on the five-word lists. Although NHL players had similar scores on the Immediate Memory and Delayed Recall scores, the form differences across the word lists in our sample as well as the differences by language preference preclude the use of an omnibus mean across the entire sample.…”