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. CLINICAL RELEVANCE Exercise appears to affect symptom burden and physical abilities, such as balance and tandem gait, more so than the cognitive components of the SCAT3.