Concussion Test: Purpose, Test Details & Results

Concussions are a common type of traumatic brain injury, especially in sports and physical activities. Accurate and timely concussion testing is essential not only for diagnosis but also for guiding treatment and safe return to activity. In this article, we’ll explore the purpose behind concussion tests, examine the most widely used testing protocols and tools, and break down how results are interpreted and what happens next. Whether you’re an athlete, parent, coach, or healthcare provider, understanding these tests can empower you to make informed decisions about concussion care.

Purpose of Concussion Test

Concussion testing serves as the critical first step in identifying and managing brain injuries. These tests are designed to detect subtle changes in cognitive, physical, and visual function that may not be immediately obvious after a head injury. The ultimate goal is to protect individuals from further harm by ensuring accurate diagnosis and appropriate follow-up.

Identifying Concussion and Preventing Further Injury

The primary purpose of concussion tests is to identify whether a concussion has occurred, especially when outward symptoms are mild or ambiguous. Early detection is crucial because a second head injury before full recovery can result in more severe, sometimes permanent, damage 1, 2.

Assessing Symptom Severity and Functional Impact

Concussion tests help determine the severity and breadth of symptoms. They assess:

• Cognitive abilities (memory, attention, processing speed)
• Balance and coordination
• Visual functions (eye movements, tracking)
• Self-reported symptoms such as headache, dizziness, or confusion 1, 2, 4, 7

This assessment guides healthcare professionals in tailoring management plans and deciding on activity restrictions.

Monitoring Recovery and Guiding Return-to-Play

Recovery from a concussion isn't always straightforward. Concussion tests are used repeatedly to monitor symptoms and cognitive function over time. This ensures that athletes or patients only return to activity when it’s safe, reducing the risk of secondary injury 8, 11.

Concussion Test Details

Concussion testing encompasses a variety of tools and methods that evaluate brain function from multiple angles. No single test can diagnose a concussion; instead, a combination of assessments is used for a comprehensive evaluation.

Screening Tests

Screening tests are often used on the sidelines or in the immediate aftermath of a potential head injury. They are designed for quick administration and can be performed by non-medical personnel.

• Standardized Assessment of Concussion (SAC): Evaluates orientation, immediate memory, concentration, and delayed recall. A decline of just one point can strongly indicate concussion, with high sensitivity and specificity 1, 7.
• Balance Error Scoring System (BESS): Assesses postural stability and balance errors, which are commonly affected by concussion 1, 2.
• King-Devick (K-D) Test: A rapid visual test requiring reading numbers from cards as quickly and accurately as possible. Sensitive to eye movement and attention deficits, the K-D test is easy to use and effective for sideline screening 1, 3, 4, 5.

Confirmatory and Comprehensive Assessments

If a concussion is suspected, more detailed tests are administered:

• Sport Concussion Assessment Tool (SCAT): Integrates symptom checklists, cognitive testing, and balance evaluation. It is widely used in sports settings 1, 4.
• Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT): A computerized tool that measures memory, reaction time, and processing speed. ImPACT is sensitive in detecting neurocognitive deficits and tracking recovery 1, 2, 6, 9, 11.
• Vestibular Oculomotor Screening (VOMS): Evaluates visual tracking, eye movements, and vestibular symptoms such as dizziness 1, 4.

Objective Examinations

For complex or persistent cases, objective exams may be used:

• Brain Imaging (fMRI, DTI): Detects subtle changes in brain structure or function, especially when symptoms linger after clinical recovery 1, 10.
• Physiologic Markers: Research is ongoing into blood biomarkers and electrophysiological studies to add objective data to concussion assessment 1.

Test Administration and Reliability

• Baseline Testing: Many athletes undergo preseason baseline testing to allow direct comparison post-injury 2, 3, 5.
• Multifaceted Approach: Relying on a battery of tests increases sensitivity and reduces the risk of missing a concussion 2, 7.
• Learning Effects: Some tests, like the K-D, show improved scores with repeated practice, so baseline and post-injury comparisons are essential 3, 5.

Concussion Test Results & Follow-Up

The results of concussion testing not only confirm the diagnosis but also guide the management plan, including rest, monitoring, and return-to-play decisions.

Interpreting Test Results

• Immediate Changes: A significant worsening in test scores (e.g., slower K-D times, lower SAC scores) after injury indicates a probable concussion and mandates removal from play or activity 3, 5, 7.
• Symptom Inventories: Self-reported symptoms are compared to pre-injury baseline or normative values. Higher symptom counts or severity guide the need for further intervention 2, 11.

Tracking Recovery

• Serial Testing: Repeating tests over days or weeks tracks symptom improvement and cognitive recovery. Persistent deficits may indicate a need for specialized care or further evaluation 8, 9, 10, 11.
• Objective Monitoring: Tools like ImPACT and web-based protocols objectively measure when cognitive function returns to baseline, supporting safe return-to-play decisions 8, 9, 11.

Prognosis and Return-to-Play

• Severity Index (SI): Higher SI scores on the ImPACT test predict longer recovery and more extensive symptoms. This helps clinicians and patients anticipate recovery timelines 11.
• Residual Effects: Advanced imaging and oculomotor studies show that even when symptoms resolve, subtle differences may linger, underlining the need for a cautious, evidence-based approach to resuming activity 10.

Special Considerations

• Undetected Concussions: Routine use of tests like the K-D post-match can reveal unwitnessed or asymptomatic concussions, highlighting their value in preventing missed diagnoses 5.
• Test Limitations: Some computerized tests may be less reliable than others; combining multiple tools remains the best practice 2, 6.
• Pediatric and Adolescent Populations: Special versions of tests (child SCAT3, child ImPACT) are available and validated for younger athletes 1.

Conclusion

Concussion testing is a cornerstone of modern brain injury management. These tools help ensure that concussions are detected early, managed safely, and monitored effectively throughout recovery.

Key Takeaways:

• Purpose: Concussion tests aim to detect injury, assess severity, and monitor recovery to prevent further harm 1, 2, 4.
• Diverse Tools: A range of screening, confirmatory, and objective tests are used for a comprehensive assessment 1, 2, 4, 7.
• Evidence-Based: Using multiple tools increases diagnostic accuracy and guides individualized management 2, 7.
• Results Matter: Test outcomes inform both immediate care (removal from play) and long-term decisions (return-to-play) 3, 5, 7, 11.
• Ongoing Research: New objective markers and advanced imaging are enhancing our ability to detect and manage concussion 1, 10.

Understanding and utilizing concussion tests appropriately is essential for safeguarding brain health—on the field, in the clinic, and beyond.