A Sport Concussion Assessment Tool (SCAT2) for Use in Snowsports: Can the Balance Component of the Tool Be Improved?

Background: Currently, there are no recommended assessment protocols for monitoring possible effects of head injury in snowsports athletes who are in competition and training. Objective: This project evaluated the Sport Concussion Assessment Tool 2 (SCAT2) for concussion assessment in a snowsport athlete group. In addition, the project determined the effectiveness of enhancing the SCAT2 protocol by using accelerometer smartphone technology in the balance assessment component of the test battery, with a view to an enhanced protocol for assessment of changes in human motor performance post-concussion injury. Methods: The research team recruited 22 athletes from the New South Wales Institute of Sport and the Olympic Winter Institute Australia snowsport athlete squads who were undertaking baseline sport science testing during the Australian 2012 and 2013 winter seasons. Results: Overall correlation between the SCAT 2 over two separate occasions was moderate/strong (Pearson’s r = 0.58, p = 0.006). Examination of the subcategories within the SCAT2 indicated that the overall correlation was being mediated by the strong correlation of the subset “Symptom Score.” The subset “Balance Score” did not correlate across test occasions (r = 0.42, p = 0.054). There were no other significant correlations across the two occasions of testing. Those who had reported a major head impact history, signified by damage to their helmet during the impact, were significantly older (21.5, SD 4.6 years) than the group not reporting a major head impact (17.5, SD 2.6 years). Two of the instrumented balance test measures, one in the double-leg stance and one in the single-leg stance protocol, showed a significant difference between the “major helmet impact” and “no helmet impact” groups warranting further investigation in a larger sample.