Baseline Testing - is it worth it?

As a parent, coach or athlete have you been thinking about baseline testing?

 You might want to reconsider.

Just this month, the national injury prevention organization Parachute Canada released a Statement on Concussion Baseline Testing in Canada that makes pivotal statements on the use of baseline testing for Canadian Athletes.  Parachute is a highly respected group that makes recommendations that influence practice across the whole country.  

The key messages from the statement were:

  1. Baseline testing is not recommended for youth sports in general.
  2. Baseline testing is not required to provide good quality care after a concussion.
  3. Rather than using resources to pay for an organize baseline testing, sports organizations should develop guidelines to recognize concussions and when to remove athletes from play.
  4. Return to play should be guided by a licensed medical provider and based on a comprehensive assessment, not any one test.
  5. In adults, baseline testing should only be done if there are qualified healthcare practitioners available to administer testing and follow up after injury.

There are plenty of reasons why these things are being suggested.  For one, evidence has not shown that baseline tests are always reliable and useful.  Quality care and decision making can still be provided based on tests done after injury - just like with most other health conditions or injuries.  A truly comprehensive baseline assessment is difficult and expensive to administer and takes a lot of time - so it is rarely ever done.  Most of the time baseline tests are of a single type (like the ImPACT test) and only assess a small number of issues.  Concussion is a complex injury that has a wide variety of potential symptoms and issues, so unless we test absolutely everything we will be missing key information.

Quality care and decision making can still be provided based on tests done after injury - just like with most other health conditions or injuries.

Parachute recommends that time and money be better spent on developing better policies and procedures for how concussion is recognized and dealt with on the field.  We don’t need expensive, time consuming tests to decide when to pull athletes out of play.  We just need to better recognize the situations where concussions can occur, assume and injury has happened and pull players out of the game or practice quickly.

Through the last few years, baseline testing has been aggressively marketed to sports teams all over North America.  While the intentions are overall good (baseline testing seems logical and helpful) the research just hasn’t panned out to say that it’s a necessity or that it significantly helps us make better decisions for children and youth especially.  There can be a conflict of interest when these baseline test platforms become multi million dollar businesses rather than clinically oriented assessments.

 

Side notes:

If your team or sports organization wants to put together better policies around concussion management, reach out to us.  We’re keen on consulting with groups to best manage concussion in the community.  If you are still interested in exploring baseline assessment even in light of these recommendations, you can seek out free services from the University of Victoria’s Brain Lab.