What is the Scat-6 (Sport Concussion Assessment Tool, 6th edition)?

From the Guidelines

The SCAT-6 is not explicitly mentioned in the provided evidence, however, the SCAT2 is discussed in the context of concussion assessment and management, and it is recommended to rely on the SAC score until prospective studies are conducted on the SCAT2 1. The SCAT2 incorporates both the BESS and the SAC, and it is used to evaluate cognitive function, particularly in individuals who have experienced a concussion or traumatic brain injury. To administer the SCAT2, a healthcare professional will assess the patient's orientation, immediate and delayed memory, concentration, and neurological signs. The test typically takes 15-20 minutes to complete and should be performed by trained medical personnel such as athletic trainers, physicians, or neuropsychologists. Results from the SCAT2 help determine the severity of a concussion, guide return-to-play or return-to-learn decisions, and monitor recovery progress over time. Some key points to consider when using the SCAT2 include:

• The BESS is an assessment of postural stability that is performed with the subject in 3 positions, first on a firm surface and then on a 10-cm-thick piece of foam 1.
• The SAC has been shown to have little to no practice effect, and baseline assessments with an SAC test can be helpful in interpreting postinjury results 1.
• If a concussion is identified, the athlete should be removed from the remainder of the practice or game(s) on that day, and continue to be monitored for several hours after the injury to evaluate for any deterioration of his or her condition 1. The return to play protocol after a concussion follows a stepwise process, including:
• No activity, complete rest
• Light aerobic exercise
• Sport specific training
• Non-contact training drills
• Full contact training after medical clearance
• Game play 1. It is essential to prioritize the athlete's safety and well-being, and to follow a gradual return-to-play protocol to prevent complications like prolonged symptoms or second impact syndrome 1.

From the Research

SCAT-6 Overview

• The Sport Concussion Assessment Tool (SCAT) is a widely used tool for assessing sport-related concussion (SRC) 2.
• The SCAT has undergone several revisions, with the most recent version being the SCAT6, which was developed based on a systematic review of the literature and expert consensus 3.
• The SCAT6 is designed to assess various aspects of concussion, including symptoms, cognitive function, and balance 4, 5.

SCAT-6 Components

• The SCAT6 includes several components, such as symptom endorsement and severity, neurocognitive function, and balance function 4.
• The tool is designed to be used in the acute phase of injury, with maximal utility within the first 72 hours and diminishing utility up to 7 days post-injury 5.
• The SCAT6 has been shown to discriminate between concussed and non-concussed athletes within 72 hours of injury, but has limited utility as a return-to-play tool beyond 7 days 5.

SCAT-6 Limitations

• The SCAT6 has several limitations, including ceiling effects on certain subtests and limited temporal stability 5.
• There is a need for more research on the use of the SCAT6 in diverse populations, including children, women, and para-athletes 5, 3.
• The SCAT6 should be used in conjunction with other assessment tools and clinical judgment to ensure accurate diagnosis and management of concussion 3.

SCAT-6 Development and Validation

• The SCAT6 was developed based on a systematic review of the literature and expert consensus 3.
• The tool has been validated in several studies, including a systematic review of 612 articles on acute evaluation of sport-related concussion 5.
• The SCAT6 has been shown to be a reliable and sensitive tool for assessing concussion, but further research is needed to fully validate its use in various populations 5, 3.