By Father Bob 
Baseline testing has become an important part of concussion management, particularly for athletes and individuals in high-risk professions. This type of testing provides valuable information that helps healthcare providers make more informed decisions if a concussion occurs. But what exactly does baseline testing involve, and what should you expect during the process?
What Is Baseline Testing?
Baseline testing is a pre-injury assessment used to measure an individual’s normal brain function. It typically includes a series of cognitive, balance, and neurological tests that record how your brain performs when you are healthy. If you suffer a head injury later on, these baseline results can be compared to post-injury scores to help diagnose a concussion and guide your recovery.
This testing is commonly recommended for:
-
Athletes in contact or collision sports (e.g. rugby, AFL, soccer)
-
Workers in industries with higher risk of head trauma
-
Children and adolescents, who may have longer recovery times after concussions
Components of a Baseline Test
A baseline test is non-invasive and usually takes about 20–45 minutes, depending on the methods used. It may include:
1. Cognitive Assessment
This involves tasks designed to assess memory, attention, processing speed, and problem-solving skills. Computer-based tools like the SCAT5 (Sport Concussion Assessment Tool) or ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) are often used.
2. Balance Testing
Concussions often affect balance, so this portion of the test assesses your stability while standing still, walking, or performing specific balance tasks. A common tool for this is the Balance Error Scoring System (BESS).
3. Symptom Evaluation
You’ll be asked about any symptoms you may be experiencing, such as headaches, dizziness, nausea, or difficulty concentrating. Though you might not have symptoms at the time, this helps establish a reliable baseline for comparison.
4. Neurological Screening
A healthcare professional may assess reflexes, eye movements, coordination, and other neurological functions to ensure everything is functioning as expected.
Who Performs the Testing?
Baseline concussion testing should be conducted by trained healthcare professionals such as:
-
Sports physicians
-
Physiotherapists
-
Neurologists
-
Specialised concussion clinics
These professionals are trained to interpret the results accurately and provide appropriate follow-up care if a concussion occurs.
Why Is Baseline Testing Important?
Concussions can be difficult to diagnose, especially when symptoms are mild or delayed. Baseline testing allows medical professionals to compare your post-injury condition with your pre-injury state, making it easier to:
-
Identify subtle changes in brain function
-
Decide when it’s safe to return to sport or work
-
Prevent further injury by ensuring full recovery before resuming activities
Without a baseline, decisions are made based on general population averages, which may not reflect your personal norm.
How Often Should It Be Done?
For most athletes and students, baseline testing is recommended every 1–2 years. However, this can vary depending on age, medical history, and level of activity. Children and teenagers may require more frequent testing due to rapid developmental changes.
What Happens After a Concussion?
If you experience a head injury, a post-injury assessment will be conducted and compared to your baseline test. Your healthcare provider will monitor symptoms, cognitive function, and physical performance to guide your recovery plan. In cases where persistent symptoms such as headaches occur, a headache clinic can offer specialised treatment to help manage and alleviate the discomfort. Return-to-play or return-to-learn protocols will be tailored to your condition and updated as you recover.
Final Thoughts
Baseline testing is a proactive step towards safer participation in sports and other high-risk activities. It empowers individuals, parents, and coaches with objective data to support recovery and reduce the risk of long-term complications. If you or your child participates in contact sports, consider speaking to a healthcare provider about getting a baseline concussion test.
