Concussion baseline testing gives Athletic Trainers and healthcare professionals a reference point for evaluating an athlete's balance and cognitive performance following a suspected concussion. But how often should those baselines be updated?
Healthy Roster recommends annual baseline testing, as well as re-baselining after an injury or event when appropriate.
There are two important reasons behind that recommendation: athletes change over time, and individual baseline results can help identify changes that might otherwise be missed.
These results establish a personal reference point that healthcare professionals can use alongside other clinical information when evaluating an athlete following a suspected concussion.
Baseline testing does not diagnose concussions or replace a comprehensive medical evaluation. Instead, it provides additional objective information that can support clinical assessment.
Healthy Roster recommends completing concussion baseline testing annually and considering re-baselining following an injury or event.
Why every year? Because an athlete's balance and cognitive abilities aren't necessarily the same from one season to the next.
This is especially important for younger athletes, whose abilities continue to develop throughout childhood and adolescence.
An updated baseline can provide a more current picture of an athlete's performance if a suspected concussion occurs later in the season.
An athlete's cognitive and balance performance can change with age.
Research referenced in Healthy Roster's baseline testing guide describes improvements during childhood and adolescence, relative stabilization in early adulthood, and declines associated with aging.
These age-related patterns have been observed across the five modules of the Sway Sports+ test battery.
That means an athlete's results from a previous year may not accurately reflect their current abilities.
For example, an athlete who completed baseline testing as a freshman may perform differently as a sophomore, even without experiencing an injury.
Annual testing helps provide a more current reference point for comparing post-injury results.
That's why comparing an athlete's post-injury results only against population averages may not always tell the whole story.
Consider an athlete who performs well above average during baseline testing.
After a suspected concussion, that athlete's performance might decline significantly but still fall within a typical range for their age.
Without an individual baseline, that change could be harder to recognize.
The Healthy Roster guide illustrates this with a reaction-time example:
In the example, the athlete's post-injury result does not cross the illustrated population-based abnormality threshold, but the change from their own baseline exceeds the example's change threshold.
This demonstrates why individual comparisons can provide useful additional information during concussion assessments.
Actual interpretation depends on the assessment, the athlete, and the applicable clinical criteria.
Baseline results can help Athletic Trainers and other qualified healthcare professionals better understand changes in an athlete's performance following a suspected concussion.
Individual results may provide additional context for evaluating balance, reaction time, and other cognitive measures.
However, baseline scores are only one part of concussion management. Clinical symptoms, medical history, physical examination findings, and professional judgment remain essential.
No single baseline or post-injury test should be used by itself to diagnose a concussion or make return-to-play decisions.
Coordinating baseline testing across multiple teams can take time, especially when Athletic Trainers are already managing practices, treatments, injuries, and documentation.
Healthy Roster Concussion, powered by Sway Sports+, provides mobile balance and cognitive assessments using compatible phones and tablets.
That flexibility can make it easier to incorporate baseline testing into preseason preparations without relying on dedicated computer labs.
And with annual testing, Athletic Trainers can maintain more current individual reference points to support future assessments.
Whether you're preparing for a new sports season or reviewing your concussion management process, it's worth understanding why annual baseline testing may be beneficial.
Healthy Roster created a one-page guide explaining the two key reasons behind its recommendation, including examples of how athlete performance changes over time.
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Healthy Roster recommends annual concussion baseline testing and re-baselining after an injury or event when appropriate. Annual testing provides a more current reference point because an athlete's balance and cognitive performance may change over time.
Balance and cognitive abilities develop throughout childhood and adolescence. An athlete's previous baseline may no longer reflect their current performance, making updated results useful for future concussion assessments.
Yes. Comparing post-injury performance with an athlete's individual baseline may reveal changes that are less apparent when using population averages alone. These results should be interpreted alongside other clinical findings.
No. Baseline testing does not diagnose concussions. It provides reference information that qualified healthcare professionals may use as part of a comprehensive concussion assessment.