Interpreting change on the SCAT3 in professional ice hockey players

Abstract

Objectives: To examine test-retest reliability of the SCAT3 for two consecutive seasons using a large sample of professional male ice hockey players, and to make recommendations for interpreting change on the test.

Design: A cross-sectional descriptive study.

Methods: Preseason baseline testing was administered in the beginning of the seasons 2013-2014 and 2014-2015 to 179 professional male hockey players in rink side settings.

Results: The test-retest reliabilities of the SCAT3 components were uniformly low. However, the majority of athletes remained grossly within their own individual performance range when two pre-season SCAT3 baseline scores were compared to published normative reference values. Being tested by the same person or a different person did not influence the results. It was uncommon for the Symptom score to worsen by ≥3 points, the Symptom Severity score to worsen by ≥5 points, SAC total score to worsen by ≥3 points, M-BESS total error points to increase by ≥3, or the time to complete Tandem Gait to increase by ≥4s; each occurred in less than 10% of the sample.

Conclusions: The SCAT3 has low test-retest reliability. Change scores should be interpreted with caution, and more research is needed to determine the clinical usefulness of the SCAT3 for diagnosing concussion and monitoring recovery. Careful examination of the natural distributions of difference scores provides clinicians with useful information on how to interpret change on the test.

Keywords: Baseline survey; Brain concussion; Head injuries; Ice hockey.