What Is Concussion Baseline Testing?

At Butterfly Paediatric Therapy, we believe that baseline concussion testing is a vital aspect of pre-season preparation for any athlete competing in sport. You may be asking, what is baseline testing? In short, baseline testing is a series of physical and cognitive tests that are used to measure HEALTHY brain function in an athlete BEFORE a season starts. Should a concussion occur, baseline testing provides healthcare practitioners with valuable information on brain recovery to aid in decision making when it comes to return to learn and play decisions.

Recently, discussions regarding concussion management have increased in Ontario with the implementation of Rowan’s Law in 2018. Despite this, the number of athletes seeking baseline concussion testing DOES NOT match the  number of athletes competing in sport.

At Butterfly Paediatric Therapy, we wonder…

 Is this due to a lack of knowledge relating to the value of concussion baseline testing?

 Are families aware of the different types of baseline testing available?

 Is the difference between multimodal baseline testing versus computerized testing well known?

To help answer some of these questions we would like to share and summarise an article posted by Complete Concussion Management Inc (CCMI), a research-based concussion care network, highlighting the 5 Misconceptions of Concussion Baseline Testing.

Misconception #1: “There’s no research to support baseline testing”
The most recent International Consensus Statement on Concussion
in Sport suggests that pre-season baseline testing can support healthcare practitioners to interpret the scores of post-injury tests. Further, baseline neuropsychological assessments may provide additional information to the overall interpretation of these tests, and allows for additional educational opportunities for healthcare providers to discuss the severity of concussions with athletes and athletic support staff. Although not required for all athletes, the Ontario Psychological Association, Ontario Neurotrauma Foundation, and the Center for Disease Control support the use of baseline testing in high-risk
athletes to help inform treatment and return to activity steps.

Misconception #2: “I completed an online test, I’m good to go”
While computerized neurocognitive testing can be a valuable tool as part of a comprehensive, multimodal baseline test, research shows these tests offer low-to-moderate test-retest reliability, and may be ineffective on their own.  CCMI’s comprehensive baseline test evaluates many parts of concussion injuries including memory, concentration, visual processing, reaction time, visual movements, balance, motor strength and neurocognitive testing.  Emerging research shows that using a variety of  tests can improve the testretest reliability, and provide much better accuracy in diagnosing and making return to play decisions for concussions.  In fact, NCAA best-practice guidelines also support the use of multimodal
baseline assessments for all high-risk contact sport athletes.

Misconception #3: “I did baseline testing last year, I don’t need another
one” As young brains are growing and developing, it’s recommended that those youth athletes who have had a baseline test should have one every year to ensure a valid and up-to-date comparison.

Misconception #4: “I had a concussion, why do I need a baseline test now?”  Healthcare practitioners can still diagnose and treat concussion symptoms without a baseline test; however, Return to Play decisions should be made with caution. If a patient plans to continue to be active in high risk or physical sports, then they should schedule a baseline test in preparation for the upcoming season.

Misconception #5: “Can’t medical scans diagnose?”  Concussions are a functional injury, not structural. Therefore, thedamage affects how areas of the  brain work and communicate with each other. Brain scans (CT scans) or MRIs look for more severe, structural injuries or brain bleeds, not functional issues.  The functional impairments of concussion are therefore best assessed with functional tests. To summarize the article shared above, 5 key points to take away from this information include:

 Research does in fact support the use of baseline testing to aid in treatment and return to sport decisions should concussion occur.

 Computerized baseline tests may not be effective when used alone to make
adequate return to play decisions. Baseline testing should instead assess multiple components of brain function using a series of cognitive and physical

 Baseline testing should be completed once a year.

 Baseline testing should still be completed even if an athlete has sustained a previous concussion.

 Medical testing such as MRIs or CT scans cannot diagnose concussion.

Still have questions? From initial pre-season baseline testing to concussion treatment and rehabilitation, all recognized CCMI practitioners are trained to effectively manage concussions. As a CCMI recognized clinic, should you be interested in more information, or to book a comprehensive mulit-nodal baseline assessment please contact Butterfly Paediatric Therapy at 905-206-0300.