Baseline Concussion Symptom Scores Vary by Method of Collection

in International Journal of Athletic Therapy and Training
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The vast majority of athletic trainers administer preseason computerized inventories to document the presence of baseline symptoms; however, immediately following a concussion, athletic trainers frequently assess an athlete verbally or using a paper-based concussion symptom scale. The verbal or paper-based results are then compared with the preseason computer results. Little research is available regarding whether the methodology in which these symptoms are collected has an impact on the report given by the athlete.


To determine if baseline self-reported concussion symptom scores varied among collection methods.


Crossover study design.


University research laboratory.


Fifty-two healthy subjects (36 males, 16 females; age 20.27 ± 1.36 years; mass 72.68 ± 14.88 kg; height 175.05 ± 8.50 cm).


All subjects completed, as part of routine preseason baseline testing, the postconcussion scale revised symptom inventory scale in three ways: (1) using a computer, (2) verbally, and (3) on paper.

Main Outcome Measures:

Descriptive statistics were calculated. One-way ANOVAs were conducted to determine the difference in overall symptom score between the inventory methods and sexes as well. Alpha level was set a priori at .05.


Overall, participants reported a significantly higher number of symptoms on computer-based symptom inventories compared with either verbal- (t51 = 3.014, P = .004, 95% confidence interval [CI], 0.668 to 3.32) or paper-based inventories (t51 = 3.004, P = .004, 95% CI 0.765 to 3.850). No signifcant differences were found between verbal- and paper-based inventories (t51 = 1.129, P = .264, 95% CI –0.240 to 0.855).


Computer-based symptom inventories were significantly different than verbal- or paper-based symptom inventories. Participants may report a higher number of symptoms at baseline when reporting electronically compared with verbal- or paper-based reporting methods. The method in which symptom inventory is obtained may alter the postconcussion diagnosis and warrants further investigation.

Andrea E. Cripps serves as an assistant professor and clinical coordinator for the athletic training program at New Mexico State University, Las Cruces, NM. Dr. Cripps serves as the director of the NMSU concussion assessment research laboratory.

Mikaela D. Boham serves as an assistant professor and program director for the athletic training program at Texas A&M University—Corpus Christi, Corpus Christi, TX.