Interpreting Change in Sport Concussion Assessment Tool-5th Edition (SCAT5) Scores in National Rugby League Women’s Premiership Players

Abstract Background The Sport Concussion Assessment Tool (SCAT) is a multimodal, evidence-based tool designed for repeat administration at baseline, pre-season and/ or for post-injury assessments, following a sport related concussion. Repeat administration of concussion assessment tools requires cli...

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Main Authors: Shreya McLeod, Douglas P. Terry, Andrew J. Gardner, Grant L. Iverson
Format: Article
Language:English
Published: SpringerOpen 2025-08-01
Series:Sports Medicine - Open
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Online Access:https://doi.org/10.1186/s40798-025-00896-9
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author Shreya McLeod
Douglas P. Terry
Andrew J. Gardner
Grant L. Iverson
author_facet Shreya McLeod
Douglas P. Terry
Andrew J. Gardner
Grant L. Iverson
author_sort Shreya McLeod
collection DOAJ
description Abstract Background The Sport Concussion Assessment Tool (SCAT) is a multimodal, evidence-based tool designed for repeat administration at baseline, pre-season and/ or for post-injury assessments, following a sport related concussion. Repeat administration of concussion assessment tools requires clinicians to understand the instrument’s stability and test-retest reliability. Typically, clinicians compare post-injury scores with baseline test results in order to determine whether a clinically significant change has occurred. The National Rugby League Women’s (NRLW) Premiership was created in 2018, with a concussion management process requiring annual pre-season baseline medical assessments of players using the Sport Concussion Assessment Concussion Tool-5th Edition (SCAT5). Although baseline normative data have been published for the SCAT5, reliability data are limited in women. The purpose of this study was to examine the one-year test-retest reliability of the SCAT5 component scores, and to develop reliable change indices, for the women’s league. Results Participants were 63 NRLW players (mean age = 26.9 years, SD = 5.5) from the 2018–2019 and 2019–2020 seasons. Team medical staff conducted the baseline SCAT5 assessments each year. Test-retest reliability estimates for each of the SCAT5 components were low to moderate (ICCs = 0.28–0.57). The following change scores, reflecting worsening, occurred in 20% or fewer of the sample: +3 symptom number, + 4 symptom severity, and − 2 on the Standardized Assessment of Concussion total score. A change of + 2 total modified Balance Error Scoring System errors occurred in fewer than 10% of the NRLW players between the test and retest. Conclusion SCAT5 scores had low to moderate test-retest reliability across a one-year period. Reliable change scores for the SCAT5 were developed in this study for use with professional women rugby league players. When evaluating post-injury SCAT5 scores, it can be helpful to consider both what the score means compared to normative reference values and compared to the athlete’s individual baseline scores.
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spelling doaj-art-2817cbdcb58b43e4b604528fa90ceb8d2025-08-20T03:05:29ZengSpringerOpenSports Medicine - Open2198-97612025-08-0111111110.1186/s40798-025-00896-9Interpreting Change in Sport Concussion Assessment Tool-5th Edition (SCAT5) Scores in National Rugby League Women’s Premiership PlayersShreya McLeod0Douglas P. Terry1Andrew J. Gardner2Grant L. Iverson3School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of NewcastleVanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University School of MedicineSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of NewcastleDepartment of Physical Medicine and Rehabilitation, Harvard Medical SchoolAbstract Background The Sport Concussion Assessment Tool (SCAT) is a multimodal, evidence-based tool designed for repeat administration at baseline, pre-season and/ or for post-injury assessments, following a sport related concussion. Repeat administration of concussion assessment tools requires clinicians to understand the instrument’s stability and test-retest reliability. Typically, clinicians compare post-injury scores with baseline test results in order to determine whether a clinically significant change has occurred. The National Rugby League Women’s (NRLW) Premiership was created in 2018, with a concussion management process requiring annual pre-season baseline medical assessments of players using the Sport Concussion Assessment Concussion Tool-5th Edition (SCAT5). Although baseline normative data have been published for the SCAT5, reliability data are limited in women. The purpose of this study was to examine the one-year test-retest reliability of the SCAT5 component scores, and to develop reliable change indices, for the women’s league. Results Participants were 63 NRLW players (mean age = 26.9 years, SD = 5.5) from the 2018–2019 and 2019–2020 seasons. Team medical staff conducted the baseline SCAT5 assessments each year. Test-retest reliability estimates for each of the SCAT5 components were low to moderate (ICCs = 0.28–0.57). The following change scores, reflecting worsening, occurred in 20% or fewer of the sample: +3 symptom number, + 4 symptom severity, and − 2 on the Standardized Assessment of Concussion total score. A change of + 2 total modified Balance Error Scoring System errors occurred in fewer than 10% of the NRLW players between the test and retest. Conclusion SCAT5 scores had low to moderate test-retest reliability across a one-year period. Reliable change scores for the SCAT5 were developed in this study for use with professional women rugby league players. When evaluating post-injury SCAT5 scores, it can be helpful to consider both what the score means compared to normative reference values and compared to the athlete’s individual baseline scores.https://doi.org/10.1186/s40798-025-00896-9Brain concussionReliabilityBaselineWomenRugby leagueHead injuries
spellingShingle Shreya McLeod
Douglas P. Terry
Andrew J. Gardner
Grant L. Iverson
Interpreting Change in Sport Concussion Assessment Tool-5th Edition (SCAT5) Scores in National Rugby League Women’s Premiership Players
Sports Medicine - Open
Brain concussion
Reliability
Baseline
Women
Rugby league
Head injuries
title Interpreting Change in Sport Concussion Assessment Tool-5th Edition (SCAT5) Scores in National Rugby League Women’s Premiership Players
title_full Interpreting Change in Sport Concussion Assessment Tool-5th Edition (SCAT5) Scores in National Rugby League Women’s Premiership Players
title_fullStr Interpreting Change in Sport Concussion Assessment Tool-5th Edition (SCAT5) Scores in National Rugby League Women’s Premiership Players
title_full_unstemmed Interpreting Change in Sport Concussion Assessment Tool-5th Edition (SCAT5) Scores in National Rugby League Women’s Premiership Players
title_short Interpreting Change in Sport Concussion Assessment Tool-5th Edition (SCAT5) Scores in National Rugby League Women’s Premiership Players
title_sort interpreting change in sport concussion assessment tool 5th edition scat5 scores in national rugby league women s premiership players
topic Brain concussion
Reliability
Baseline
Women
Rugby league
Head injuries
url https://doi.org/10.1186/s40798-025-00896-9
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