TY  - JOUR
PY  - 2023//
TI  - Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: a systematic review
JO  - British journal of sports medicine
A1  - Echemendia, Ruben J.
A1  - Burma, Joel S.
A1  - Bruce, Jared M.
A1  - Davis, Gavin A.
A1  - Giza, Christopher C.
A1  - Guskiewicz, Kevin M.
A1  - Naidu, Dhiren
A1  - Black, Amanda Marie
A1  - Broglio, Steven
A1  - Kemp, Simon
A1  - Patricios, Jon S.
A1  - Putukian, Margot
A1  - Zemek, Roger
A1  - Arango-Lasprilla, Juan Carlos
A1  - Bailey, Christopher M.
A1  - Brett, Benjamin L.
A1  - Didehbani, Nyaz
A1  - Gioia, Gerry
A1  - Herring, Stanley A.
A1  - Howell, David
A1  - Master, Christina L.
A1  - Valovich McLeod, Tamara C.
A1  - Meehan, William P. 3rd
A1  - Premji, Zahra
A1  - Salmon, Danielle
A1  - van Ierssel, Jacqueline
A1  - Bhathela, Neil
A1  - Makdissi, Michael
A1  - Walton, Samuel R.
A1  - Kissick, James
A1  - Pardini, Jamie
A1  - Schneider, Kathryn J.
SP  - 722
EP  - 735
VL  - 57
IS  - 11
N2  - OBJECTIVES: To systematically review the scientific literature regarding the acute assessment of sport-related concussion (SRC) and provide recommendations for improving the Sport Concussion Assessment Tool (SCAT6). DATA SOURCES: Systematic searches of seven databases from 2001 to 2022 using key words and controlled vocabulary relevant to concussion, sports, SCAT, and acute evaluation. ELIGIBILITY CRITERIA: (1) Original research articles, cohort studies, case-control studies, and case series with a sample of >10; (2) ≥80% SRC; and (3) studies using a screening tool/technology to assess SRC acutely (<7 days), and/or studies containing psychometric/normative data for common tools used to assess SRC. DATA EXTRACTION: Separate reviews were conducted involving six subdomains: Cognition, Balance/Postural Stability, Oculomotor/Cervical/Vestibular, Emerging Technologies, and Neurological Examination/Autonomic Dysfunction. Paediatric/Child studies were included in each subdomain. Risk of Bias and study quality were rated by coauthors using a modified SIGN (Scottish Intercollegiate Guidelines Network) tool. <br><br>RESULTS: Out of 12 192 articles screened, 612 were included (189 normative data and 423 SRC assessment studies). Of these, 183 focused on cognition, 126 balance/postural stability, 76 oculomotor/cervical/vestibular, 142 emerging technologies, 13 neurological examination/autonomic dysfunction, and 23 paediatric/child SCAT. The SCAT discriminates between concussed and non-concussed athletes within 72 hours of injury with diminishing utility up to 7 days post injury. Ceiling effects were apparent on the 5-word list learning and concentration subtests. More challenging tests, including the 10-word list, were recommended. Test-retest data revealed limitations in temporal stability. Studies primarily originated in North America with scant data on children. <br><br>CONCLUSION: Support exists for using the SCAT within the acute phase of injury. Maximal utility occurs within the first 72 hours and then diminishes up to 7 days after injury. The SCAT has limited utility as a return to play tool beyond 7 days. Empirical data are limited in pre-adolescents, women, sport type, geographical and culturally diverse populations and para athletes. PROSPERO REGISTRATION NUMBER: CRD42020154787.<p />  <p>Language: en</p>
LA  - en
SN  - 0306-3674
UR  - http://dx.doi.org/10.1136/bjsports-2022-106661
ID  - ref1
ER  -