Concussions are a critical concern within the realm of sports, and utilizing reliable assessment tools to ensure athletes' safety is very important. The Sport Concussion Assessment Tool (SCAT), published by the Concussion in Sport Group (CISG) has been a cornerstone in this regard. In this article, we delve into the improvements introduced in the SCAT6 compared to the SCAT5. SCAT6 represents a substantial advancement in concussion assessment, introducing specific modifications and enhancements aimed at improving the evaluation process. HEADCHECK is pleased to extend this tool as part of our comprehensive platform. The SCAT6 is enabled by default for all of our free account users.
1- Improved Age Adaptation:
SCAT5: SCAT5 provided guidelines for assessing concussions but did not offer extensive age-specific recommendations.
SCAT6: SCAT6 offers improved age adaptation, tailoring assessments for different age groups. For instance, it provides age-appropriate questions and criteria for pediatric and elderly populations, recognizing that concussion presentation can vary across ages.
Cognitive Assessment Expansion:
SCAT5: SCAT5 had the option of both 5 and 10 word lists for immediate and delayed recall.
SCAT6: The SCAT6 has transitioned exclusively to the 10-word list, to better gauge athletes' cognitive function. This also provides better standardization between health care professionals when testing post-injury.
2- Updated Maddocks Questions:
SCAT5: The cognitive assessment in SCAT5 utilized the Maddocks Questions.
SCAT6: SCAT6 has updated the Maddocks Questions, making them more relevant and accurate. For example, questions have been modified to better gauge an athlete's orientation and memory recall. Moreover, there is an added option to modify questions to be sport-specific and to use appropriate terminology.
3- Expanded Symptom Checklist:
SCAT5: The symptom checklist in SCAT5 encompassed a relatively limited range of symptoms.
SCAT6: The Symptoms checklist remains the same, however, focusing on more specific instructions based on baseline or post-injury testing.
4- Timer for Months in Reverse Test:
SCAT5: SCAT5 did not include a timer during the Months in Reverse Test.
SCAT6: SCAT6 introduces the use of a timer during the Months in Reverse Test, a cognitive assessment. This timer ensures that healthcare professionals can measure an athlete's ability to recall months in reverse within a set time frame, providing a more objective evaluation of cognitive function.
5- Enhanced Balance Examination:
SCAT5: The balance examination component in SCAT5 was reliable but improvements were made to include more details.
SCAT6: SCAT 6 introduces improved balance assessments, including more detailed instructions and specific measurements. For example, additional tasks have been implemented for tandem gait, the introduction of a new test (dual task Gait); mBESS remains the same
Tandem Gait updates include:
- The instructions and text accompanying the section have been revised to enhance clarity
- The number of trials required has been reduced from four to three
- "Can the patient perform tandem gait normally?" has been removed from the assessment process; the focus is more-so on quantitative data
- SCAT6 introduces an additional "Average Time" field
- SCAT6 includes a question about whether any tandem gait trials could not be completed due to walking errors or other reasons; this helps identify challenges that may impact the accuracy of the assessment
Dual Task Gait:
- The Dual-Task cognitive task assesses whether athletes are able to walk heel-to-toe while simultaneously counting backwards out loud by a specific integer (typically 7)