Baseline concussion testing is a proactive method for effectively managing sport-related concussions.
In this comprehensive guide, we will explain what baseline concussion testing is, why it matters, who should conduct it, and how to implement it successfully. We will also walk through the components of the SCAT6 assessment, offer practical advice, and review research supporting its use.
This information in this guide aligns with concussion protocols that are recognized and recommended by international organizations. (1-3)
What Is Baseline Concussion Testing?
Baseline concussion testing involves a series of assessments conducted before the sports season begins and when the athlete is healthy. These assessments evaluate an athlete’s medical history, symptom status, cognitive function, balance, and coordination.
The testing results serve as personalized reference points that can be used to detect changes in brain function following a suspected head injury.
Baseline Concussion Testing Checklist
To help with implementation of baseline concussion testing, HEADCHECK Health has developed a free, printable checklist that outlines the necessary and recommended steps.
Find and download the Baseline Concussion Testing Checklist HERE!
What Does the Research Say?
Baseline concussion testing is widely recognized as a valuable tool in sports medicine, offering several benefits supported by research.
Research supports the utility of baseline testing, particularly when combined with other tools and clinical judgment. Studies show that individualized comparisons are more reliable than population norms when evaluating post-injury symptoms and performance. (4,5) The position statement from the National Athletic Trainers’ Association suggests that all athletes be baseline tested, when feasible. (2) If resources are limited, those athletes with a history of concussion or those in contact sports should be prioritized to receive baseline testing.
The SCAT6 and Child SCAT6, while not standalone diagnostic tools, are widely endorsed by international sports medicine organizations for their comprehensive, standardized approach to concussion assessment. (1,2)
Baseline testing is especially valuable in youth athletes, who may underreport symptoms or lack the awareness to self-assess post-concussion changes without a known benchmark. (4,6)
Why Baseline Testing Matters for Athletes
The brain function of each and every person is unique. In sports settings, baseline testing helps healthcare professionals to:
- Enhance concussion diagnosis through objective evaluation
- Tailor recovery plans to the individual athlete
- Make more informed return-to-play decisions
- Reduce the risk of long-term complications
By comparing post-injury assessments to baseline data, healthcare professionals can more accurately determine the impact of a concussion and monitor recovery progress.
Who Should Conduct Baseline Testing?
Baseline testing should be conducted by healthcare professionals trained in sport-related concussion evaluation and management (for example, athletic trainers).
If your organization doesn’t have available staff or adequate time, HEADCHECK Health can send a representative to perform baseline testing for your athletes.
When Should Baseline Concussion Testing Occur?
Baseline concussion testing should occur before the sports season begins, ideally during pre-season assessments.
Factors to Consider When Conducting Baseline Concussion Testing
Create a quiet, controlled environment to minimize distractions during testing. Make sure that the athlete is in a healthy, normal state (no recent illnesses or fatigue). Ensure that the athlete is also able to comprehend the testing instructions. Remember that for children <13 years, the child version (Child SCAT6) of the SCAT6 is available.
Components of Baseline Concussion Testing
A comprehensive baseline concussion test typically includes the following components, many of which are outlined in the SCAT6:
Medical History
Athletes will report relevant medical history, including prior concussion history. It is important to also gather information on history of headaches/migraines, mental health disorders (i.e., depression), and learning disabilities (i.e., ADHD).
Symptom Evaluation
Athletes will complete a 22-item checklist, rating symptoms such as headache, dizziness, nausea, sensitivity to light/noise, and difficulty concentrating.
Cognitive Assessments
The tests of cognitive function measure memory (immediate and delayed recall), attention (e.g., counting digits backwards), and orientation (naming date, time, and location).
Balance and Coordination Tests
Evaluations such as the Balance Error Scoring System (BESS) are used to assess postural stability during standing and single-leg stances.
Neurological Screening
Assessments of neurological function include vision, hearing, coordination, reflexes, and motor function testing.
Implementation of Baseline Concussion Testing
For successful implementation of baseline testing, your sports team and organization can set up the following:
- Schedule team-wide pre-season testing before the sports season starts.
- Create a testing environment that is quiet, well-lit, and free from distractions.
- Use healthcare professionals familiar with SCAT6 and concussion protocols.
- Maintain secure records that can be easily accessed if a head injury occurs.
- Educate stakeholders. Baseline concussion testing is a great opportunity to inform athletes, parents, and coaches about its purpose and importance in concussion management. (7)
Use of Baseline Data Post-Injury
If a head injury occurs and a concussion is suspected, the results of the post-injury assessment will be compared to the baseline data to identify changes in symptoms, cognition, balance, etc. The results will first guide immediate on-field decisions, such as whether the athlete should be removed from play or referred for medical evaluation. The results will also be used to guide recovery, including return-to-learn and return-to-play protocols. Importantly, the athlete will need to return to baseline levels before resuming activities.
Annual Reassessment
Baseline testing should be repeated annually to account for developmental changes and ensure current data is available for comparison.
Conclusion
Baseline concussion testing is a vital component of an athlete’s health and safety. By establishing individualized benchmarks of brain function following a concussion, it enables more accurate diagnosis, improved management, and safer return-to-play decisions.
Checklists from HEADCHECK Health
For a practical tool to assist in implementing baseline testing, don’t forget to refer to:
For other checklists on concussion management from HEADCHECK Health, refer to:
References
- Concussion in Sport Group. https://www.concussioninsportgroup.com/.
- Broglio SP, Cantu RC, Gioia GA, Guskiewicz KM, Kutcher J, Palm M, Valovich McLeod TC. National Athletic Trainers’ Association Position Statement: Management of Sport Concussion. J Athl Train. 2014; 49 (2): 245–265.
- Sport Concussion Assessment Tool 6 (SCAT6). British Journal of Sports Medicine 2023;57:622-631. https://doi.org/10.1136/bjsports-2023-107036.
- Pandey HS, Lahijanian B, Schmidt JD, et al. Quantifying the Diagnostic Utility of Baseline Testing in Concussion Management: An Analysis of Collegiate Athletes From the NCAA-DoD CARE Consortium Dataset. The American Journal of Sports Medicine. 2025;53(1):181-191.
- Schmidt JD, Register-Mihalik JK, Mihalik JP, Kerr ZY, Guskiewicz KM. Identifying impairments after concussion: normative data versus individualized baselines. Med Sci Sports Exerc. 2012;44(9):1621–1628.
- Valovich-Mcleod TC, Bay RC, Lam KC, Chhabra A. Representative baseline values on the Sport Concussion Assessment Tool 2 (SCAT2) in adolescent athletes vary by gender, grade, and concussion history. Am J Sports Med. 2012;40(4):927–933.
- Salmon D, Badenhorst M, Clark B, Walters S, Sullivan SJ, Sole G. Unintended consequences – A qualitative exploration of baseline testing in community rugby concussion management. Journal of Science and Medicine in Sport. 2024;27(9):594-602.
About the Author
Dr. Jennifer Hunnicutt is a licensed athletic trainer with a PhD in Health and Rehabilitation Science, who has worked with all types of athletes, including professionals and Olympians. She has held prominent research positions at Emory Sports Medicine and the NBA Hawks Center in Atlanta, GA, as well as serving on the national network of healthcare providers for U.S. Figure Skating. Now the owner of Hunnicutt Writing and Consulting, LLC, Dr. Hunnicutt collaborates with global institutions, spearheading innovation and research among professionals and businesses in Sports Medicine and Orthopedics. Learn more at https://drhunnicutt.com.
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