A review of modifying factors affecting usage of diagnostic rating scales in concussion management

• Currently no test has demonstrated sufficient sensitivity for standalone use.
• Advantages and drawbacks of the evaluation method used should be considered.
• Important patient factors: age, gender, fitness, psychiatric and learning disorders.
• Baseline testing represents the principle paradigm for concussion management.
• Baseline testing can introduce additional complexity in test interpretation.

Sport-related concussion has gained increasing recognition as a result of recent legislation, public health initiatives and media coverage. Moreover, there have been substantial paradigm shifts in the management of concussion. This article will discuss the variables that affect the use of diagnostic rating scales such as ImPACT and SCAT in the current management of concussed individuals. Specifically, patient-specific modifying factors affecting test interpretation, including age, gender, fitness level, psychiatric conditions, learning disorders and other components of medical history will be addressed, as well as methodological concerns with baseline testing.