Concussion testing during COVID

Recommendations for Sports Concussion Baseline and Post-injury Testing

posted Summer 2020

During COVID-19 Pandemic*

*assuming resumption of contact sports

  1. As close in time as possible to the assessment, all athletes should be tested for the presence of COVID-19 (not the antibody test).  While this does not prevent someone from getting the virus, it will help to assure that there is no active virus at the start.

a) screening of viral symptoms should also take place prior to testing.

  • General guidelines should follow the State recommendations.  Inter-Organizational Practice Committee for testing suggests the following for face to face ( one-to-one) testing:
  • Update policies and procedures for COVID era (e.g., hand-washing etc)
  • Make arrangements for appropriate level of PPE/ensure clean rooms and equipment
  • Create appropriate signage for hallways and treatment rooms
  • Pre-appointment screening for COVID-19, and repeat on day of contact

Activities Prior to Student Arrival

  • Stagger check-in times, not re-using rooms until the next day, separate waiting rooms for parents or ask to wait in car.
  • Have clear space markers in any waiting area

Initial Entry and Forms

  • Consider shortened forms to be sent electronically to minimize exposure time
  • The priority for baseline testing should be for the most sensitive tool: the SCAT3/5. Computerized neuropsychological testing is not sensitive to injury, so its relative value is lessened. However, SCAT requires individual administration. To lower the burden, we recommend only testing those without a previous baseline.  Individual testing should be done with a plexiglass screen between test administrator and student, and masks should be worn. Waiting areas should be outside or in a well-ventilated area with appropriate physical distancing.
  • Group testing: For those schools that have the space and resources to maintain normal computerized neuropsychological test (CNT) baseline procedures while still following restrictions and infection control guidelines, the only changes are related to infection control guidelines.
  • For those schools where #4 is not feasible, complete computerized baselines on those who have not had a valid baseline in the past, either in a small group (10 or less) with infection control guidelines, or with individual administration as in #2.  In effect, suspend the two-year repeat testing.  If a student had a CNT in the 8th grade, they do not need to take it as a freshman if we can have access to the 8th grade test (will need their passport ID # if using ImPACT).
  • For CNT baseline testing in schools where neither of options 4 or 5 is feasible, we recommend no CNT baselines in 2020 and continued post-injury testing.  If staff are not comfortable with individualized administration, it should be discontinued for this year.
  • Any post injury testing should follow the guideline above for individual testing (#2), except for extremity testing.  Gloves should be worn in addition to masks to check strength, motor nerves and neck.

Note: baseline testing at home is not appropriate and will not be accepted. Allowing baseline testing at home is a violation of testing ethics and clinical best practice.

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