Effects of exercise on Sport Concussion Assessment Tool-Third Edition performance in professional athletes

Background: The Sport Concussion Assessment Tool–Third Edition (SCAT3) is currently considered the standard sideline assessment for concussions. In-game exercise, however, may affect SCAT3 performance and the diagnosis of concussions. Purpose: To examine the influence of exercise on SCAT3 performance in professional male athletes. Study Design: Controlled laboratory study. Methods: We examined the SCAT3 performance of 82 professional male athletes under 2 conditions: at rest and after exercise. Results: Athletes reported significantly fewer total symptoms (mean, 1.0 ± 1.5 vs 1.6 ± 2.3 total symptoms, respectively; P = .008; Cohen d = 0.34), committed significantly fewer errors on the modified Balance Error Scoring System (mean, 3.5 ± 3.5 vs 4.6 ± 4.1 errors, respectively; P = .017; d = 0.31), and required significantly less time to complete the tandem gait test (mean, 9.5 ± 1.4 vs 9.9 ± 1.7 seconds, respectively; P = .02; d = 0.30) during the at-rest condition compared with the postexercise condition. Conclusion: The interpretation of in-game (sideline) SCAT3 results should consider the effects of postexercise fatigue levels on an athlete’s performance, particularly if preseason baseline data have been collected when the athlete was well rested.