CONCUSSION DECEPTION
Athletes can skew results
A University of Windsor study involving nearly 8,000 young athletes found they could be putting themselves at risk by returning prematurely to competition after a concussion because of invalid baseline test results.
Chris Abeare, an associate professor of psychology, found 55.7 per cent of the 7,897 athletes he studied between the ages of 10 to 21 failed at least one of the four validity indicator tests.
The failed tests are a warning that results are out of line with what should be normally expected in an age group and could render the baseline results meaningless — especially if some athletes distort the results.
“These scores are used as comparatives for when the athlete does get injured to know what his normal state of function is,” Abeare said. “By comparing before and after, it helps us tell if the brain is fully healed.
“If the baseline score to start is inaccurate, it can lead to serious consequences. It would allow an athlete to return prematurely and greatly increases the risk of getting another concussion.” According to Health Canada, 64 per cent of all emergency room visits by those aged 10 to 18 are related to sports, physical and recreational activity. Of that group, 63 per cent are diagnosed with a concussion or possible concussion.
In a Health Canada study covering 2012 to 2014, nearly 8,000 concussions were reported among boys five to 19 with 4,059 of those coming in the group aged 10 to 14, There were just under 3,000 concussions among girls with 1,231 being recorded between ages 10 and 14. The Canadian Hospital Injury Reporting Prevention Program, which documents injuries at 16 ER sites across Canada, found the rate at which concussions in football, soccer and hockey have been reported has risen more than 40 per cent in each sport since 2004. Hockey for boys and soccer for girls produced the most concussions.
Abeare studied the test results of 7,897 young athletes from southeastern Michigan compiled by Bradley Merker, who heads Detroit’s Henry Ford Hospital Concussion Clinic.
Nearly 56 per cent of the athletes failed at least one of the validity tests.
Nearly 84 per cent of 10-yearold athletes failed and nearly 30 per of the oldest group (21) also failed one or more validity indicator tests.
“The 56 per cent surprised me because I thought, based on some smaller studies, it would be around 40 per cent,” Abeare said. He speculated that a good portion of the failure rate among 10-year-olds is due to not being engaged with the test and failing to understand the significance of the testing.
However, the failure rate among older athletes was more troubling. “I think we could be seeing some deliberate sandbagging on the test in the older ages,” Abeare said. “That’s really concerning.” By having a lower baseline to start, athletes will lower threshold at which they would be declared fit to return to play when they actually are not fully healed. Abeare plans to do more testing with more sophisticated validity indicators to further clarify the study ’s findings. “We wanted to raise the issue that clinicians should take baseline testing with a grain of salt,” Abeare said.
“They should take a more conservative approach, use the normal group data we have.” Abeare said there should be a push for more accurate testing by educating athletes and parents about the importance of getting realistic baseline test results. He also suggested testing in smaller groups using more technology in more controlled environments to lessen distractions. “Baseline testing can be useful, but we see there can be pitfalls,” Abeare said. “An invalid baseline performance renders it useless and it actually can be harmful.” Also part of the study were University of Windsor assistant psychology professor Laszlo Erdodi and neuropsychology graduate students Isabelle Mess and Brandon Zuccato.