The Clinical Utility of Recaptured Baselines after Return-to-Play
Kissinger-Knox, Alicia Miran
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Objective: The present study was designed to investigate the clinical utility of recaptured baselines or “rebaselines” in collegiate athletes after return -to-play. Several concussion management teams endorse the use of baseline neurocognitive assessments at the beginning of an athlete’s sports season to use as a measure of comparison in the instance of concussion or head injury. Once physical and cognitive symptoms are resolved, an athlete is requested to reestablish their baseline for the rest of the season. It has been questioned whether this “rebaselining” is necessary and warranted. Method: Forty-one Division II collegiate athletes at Florida Institute of Technology who sustained a concussion during the respective sport season were studied across four testing sessions; baseline, post-trauma, follow-up, and rebaseline. The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) was used to examine four composite scores; verbal memory, visual memory, visual motor, and reaction time across the four testing sessions to assess for significant change over time. Results: As predicted, there were no significant differences found between the follow-up assessments and rebaselines. Significant differences were found in all composite scores between post-trauma evaluations versus follow-up and rebaseline assessments. Significant interactions were additionally noted for sex, sport, and first exposure to the ImPACT measure. No significant interactions were found between a prior history of concussion and the length of recovery across the testing sessions. Conclusions: The current study found no empirical validity (and hence no clinical utility) for the procedure of rebaselining. Therefore, it is recommended that concussion management programs discontinue to use of rebaselines and use the follow-up assessment as an athlete’s new baseline for the remainder of the sport season.