The following position on baseline testing is consistent with the Parachute Canada position statement on baseline testing.
Youth and Recreational Adult Athletes
Baseline testing of youth and adult recreational athletes using any tool or combination of tools is not required to provide post-injury care of those who sustain a suspected or diagnosed concussion. Baseline testing is not recommended in youth athletes regardless of the sport or level of play.
Current evidence does not support a significant added benefit of baseline testing in youth athletes or adult recreational athletes with the Child SCAT5, SCAT5 or computerized neurocognitive tests. Therefore, baseline testing of youth athletes or adult recreational athletes to assist in the medical management of those with a diagnosed concussion is not necessary and is not recommended. Because medical doctors and nurse practitioners are the only healthcare professionals that are licensed in Canada to provide a medical assessment of athletes with a suspected concussion and medical clearance of athletes with a suspected or diagnosed concussion, obtaining baseline testing from allied health professionals using any tool or test is not recommended.
High Performance Program and Elite Provincial Athletes
Baseline testing is often used for adult national team affiliated athletes where teams have access to licensed healthcare professionals who provide care to these athletes on a regular basis. If baseline testing using certain tests is considered for selected adult athletes, it is recommended that the medical teams caring for these athletes have access to the licensed healthcare professionals who are optimally trained and licensed to administer and interpret these tests.
The Canadian Guideline on Concussion in Sport states that licensed healthcare professionals (an experienced athletic therapist, physiotherapist or medical doctor) may use the SCAT5 to evaluate national team affiliated adult athletes with a suspected concussion and make sideline decisions regarding Return-to-Sport (Parachute, 2017). Only those licensed healthcare professionals that have experience administering and interpreting the results of sideline assessment tools should consider use of these tools for baseline and post injury testing in national team affiliated adult athletes.
If other baseline tests are considered to aid in the in-office medical management of selected national team affiliated adult athletes (for example, computer-based or non-computer-based neurocognitive or neuropsychological tests), it is recommended that licensed healthcare professionals that are optimally trained to use these tests (for example, neuropsychologists) be available to interpret the results (McCrory et al, 2017). All licensed healthcare professionals that consider baseline testing of selected adult athletes should be aware of the potential limitations of the tests they use and take this into clinical consideration when providing multimodal medical assessment and medical clearance of athletes with a suspected or diagnosed concussion.
