Echemendia et al. (2023). Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: A systematic review. British Journal of Sports Medicine, 57(11), 722–735. https://doi.org/10.1136/bjsports-2022-106661

  • Conclusion: Support exists for using the SCAT within the acute phase of injury. Maximal utility occurs within the first 72 hours and then diminishes up to 7 days after injury. The SCAT has limited utility as a return to play tool beyond 7 days. Empirical data are limited in pre-adolescents, women, sport type, geographical and culturally diverse populations and para athletes.

Echemendia et al. (2023). Introducing the Sport Concussion Assessment Tool 6 (SCAT6). British Journal of Sports Medicine, 57, 619-621. https://doi.org/10.1136/bjsports-2023-106849

  • The original Sport Concussion Assessment Tool (SCAT) was published in 2005 and contained educational information, a concussion symptoms scale and information on management of concussion. In the years that followed several iterations of the SCAT have been published, informed by empirical data, systematic reviews and clinical experience. Each iteration of the SCAT evolved along with the scientific literature, with each version increasingly representing the complexity and multimodal nature of SRC assessment.

The SCAT6 (2023). British Journal of Sports Medicine, 57, 622-631. https://doi.org/10.1136/bjsports-2023-107036

Patricios et al. (2023). Beyond acute concussion assessment to office management: A systematic review informing the development of a Sport Concussion Office Assessment Tool (SCOAT6) for adults and children. British Journal of Sports Medicine, 57(11), 737–748. https://doi.org/10.1136/bjsports-2023-106897

  • Conclusion: Current SRC tools have limited utility beyond 72 hours. Incorporation of a multimodal clinical assessment in the subacute phase of SRC may include symptom evaluation, orthostatic hypotension screen, verbal neurocognitive tests, cervical spine evaluation, neurological screen, Modified Balance Error Scoring System, single/dual task tandem gait, modified VOMS and provocative exercise tests. Screens for sleep disturbance, anxiety and depression are recommended. Studies to evaluate the psychometric properties, clinical feasibility in different environments and time frames are needed.

Patricios et al. (2023). Introducing the Sport Concussion Office Assessment Tool 6 (SCOAT6). British Journal of Sports Medicine, 57(11), 648–650. https://doi.org/10.1136/bjsports-2023-106860

  • As part of the 6th International Consensus Conference on Concussion in Sport, the author group was tasked with developing a clinical tool better suited to evaluating and managing SRC in the days and weeks after the acute (first 72 hours) period postinjury. The Sport Concussion Office Assessment Tool 6 (SCOAT6), for use in athletes 13 years and older, is the product of the 6th International Consensus Conference on Concussion in Sport aimed at assisting Health Care Professionals (HCPs) in an office-based, multimodal assessment of SRC. A child version for use in children ages 8–12 years is described separately in this issue.5 Consistent with the principles of previous consensus conference outputs, the Sport Concussion Office Assessment Tool 6 (SCOAT6) will be freely available.

The SCOAT6 (2023). British Journal of Sports Medicine, 57(11), 651–667. https://doi.org/10.1136/bjsports-2023-106859

Davis et al. (2023). Introducing the Child Sport Concussion Assessment Tool 6 (Child SCAT6). British Journal of Sports Medicine, 57(11), 632–635. https://doi.org/10.1136/bjsports-2023-106853

  • During 6th International Conference on Concussion in Sport held in Amsterdam in 2022, the CISG reviewed the evidence to implement improvements to the Child SCAT5 and develop the Child SCAT6.

Child SCAT6. (2023). British Journal of Sports Medicine, 57(11), 636–647. https://doi.org/10.1136/bjsports-2023-106982

Davis et al. (2023). Introducing the Child Sport Concussion Office Assessment Tool 6 (Child SCOAT6). British Journal of Sports Medicine, 57(11), 668–671. https://doi.org/10.1136/bjsports-2023-106858

  • Based on feedback from clinicians, the CISG scientific committee determined that a tool for assessment and management of SRC in the subacute period (beyond 72 hours post-injury) would be useful, and established the process for development of the Sport Concussion Office Assessment Tool 6 (SCOAT6).5 Consistent with the approach for the SCAT and Child SCAT, the requirement for an age-appropriate version of the SCOAT6 for children aged 8–12 years led to the development of the Child SCOAT6.

Child SCOAT6. (2023). British Journal of Sports Medicine, 57(11), 672–688. https://doi.org/10.1136/bjsports-2023-106984

Echemendia et al. (2023). Introducing the Concussion Recognition Tool 6 (CRT6). British Journal of Sports Medicine, 57, 689-691. https://doi.org/10.1136/bjsports-2023-106851

  • The SCAT has been revised several times, including the most recent SCAT6. The SCAT6 and its predecessors were designed for use by healthcare professionals (HCPs). However, HCPs are rarely present at many, if not most, sporting and recreational activities, particularly at the community level involving children and adolescents. Understanding this void in concussion care, the CISG designed the Pocket SCAT2 in 2009 following the 3rd International Consensus Conference in Zurich3 as a tool to assist the layperson recognise the signs and symptoms of suspected SRC at all ages. The tool was also designed to provide guidance for removing an athlete from activity and seeking further medical assessment. The Pocket SCAT2 was revised by the CISG in 20124 and renamed the Pocket Concussion Recognition Tool (CRT) and subsequently the CRT 5 (CRT5).5 This paper introduces the most recent version, the CRT6.

The CRT6 (2023). British Journal of Sports Medicine, 57(11), 692-694. https://doi.org/10.1136/bjsports-2023-107021

Hohmann et al. (2023). Return to sports following sports-related concussion in collision sports: An expert consensus statement using the modified Delphi technique. Arthroscopy, 0(2),460-469. https://doi.org/10.1016/j.arthro.2023.06.027

  • Conclusion: Consensus was achieved for 10 of the 25 return to sport (RTS) criteria: early RTS can be considered earlier than 48 to 72 hours if athletes are completely symptom-free with no headaches, a normal clinical, ocular and balance examination. A graduated RTS should be used but should be individualized. Only 2 of the 9 assessment tools were considered to be useful: Sports Concussion Assessment Tool 5 and vestibular and ocular motor screening. RTS is mainly a clinical decision. Only 31% of the baseline assessment items achieved consensus: baseline assessments should be performed at collegiate and professional levels using a combination of neurocognitive and clinical tests. The panel disagreed on the number of recurrent concussions that should be season- or career-ending.

Yeates et al. (2023). What tests and measures accurately diagnose persisting post-concussive symptoms in children, adolescents and adults following sport-related concussion? A systematic review. British Journal of Sports Medicine, 57, 780-788. https://doi.org/10.1136/bjsports-2022-106657

  • Conclusion: The diagnosis of persisting post-concussive symptoms continues to rely on symptom report, preferably using standardised symptom rating scales. The existing research does not indicate that any other specific tool or measure has satisfactory accuracy for clinical diagnosis. Future research drawing on prospective, longitudinal cohort studies could help inform clinical practice.

Mito et al. (2022). White matter abnormalities characterize the acute stage of sports-related mild traumatic brain injury. Brain Communications, 4(4), fcac208. https://doi.org/10.1093/braincomms/fcac208

  • Conclusion: Overall, this study demonstrates that acute mild traumatic brain injury is characterized by specific white matter abnormalities, which are compatible with tract-specific cytotoxic oedema. These potential oedematous changes were absent in our subacute mild traumatic brain injury participants, suggesting that they may normalize within 12 days after injury, although subtle abnormalities may persist in the subacute stage. Future longitudinal studies are needed to elucidate individualized recovery after brain injury.

Pedersen et al. (2020). Quantitative MRI as an imaging marker of concussion: Evidence from studying repeated events. European Journal of Neurology, 27(10). https://doi.org/10.1111/ene.14377