What your School or Club can Learn from Professional Sport

As a doctor working in the NRL, I take concussion management very seriously. The physical nature of rugby league means head injuries will occur, so our responsibility is to ensure that players are assessed carefully and only return to play when it is safe to do so. The NRL has a range of processes to help identify and manage concussion, and one of the most useful tools we use is Baseline Cognitive Testing.

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Baseline Testing Starts Before The Season

Before each season begins, every player completes a short computer-based cognitive assessment called a Cognigram. This test is also widely used in professional rugby and by athletes at High Performance Sport New Zealand. The test takes about 10 - 15 minutes and feels a bit like an old-fashioned computer game. Players respond to shapes and symbols on the screen while the system measure's reaction time, attention, and processing speed. The results create a personal cognitive baseline for each player, that clearly measures their brain function. These scores are stored securely so that if a player sustains a concussion during the season we have a clear reference point for comparison. This baseline testing is embedded within the concussion protocol of the NRL and forms an important part of the medical decision-making process around return-to-play.

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Recovery is Not Always as Clear as it Seems

Because concussion recovery is not always straightforward. A player may feel well, have no symptoms, and pass their clinical assessment, yet still have subtle cognitive impairment. Research suggests that up to around 30% of players who appear to have clinically recovered, continue to show measurable impairment on cognitive testing. This is important and a player's reaction time, attention, and processing speed all influence how players move and respond on the field. If these systems have not fully recovered, the player may be slower to react, misjudge situations, or make poorer decisions during play. That places them at increased risk of further injury. This may include another concussion, but it can also mean a higher risk of other injuries, for example an anterior cruciate ligament injury, because reactions or coordination are not fully back to normal. Baseline cognitive testing helps us detect this phase of recovery and reduce the risk of players returning too soon.

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How Baseline Testing Guides Return-To-Play?

This is where baseline testing adds real value. When a player at the New Zealand Warriors sustains a concussion, we manage them through the usual clinical pathway with symptom monitoring and a graduated return to exercise. Once the player appears to have clinically recovered, we repeat the Cognigram test and compare the results with their preseason baseline. If their cognitive performance has returned to their normal level, we can progress them through the final stages of return-to-play with greater confidence. If they are not yet at their baseline, we continue to limit contact training and re-test.

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Baseline testing does not replace good clinical judgement and is not a test that can be used to diagnose concussion, but it provides an additional objective measure to guide decisions.

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Why This Matters for School and Clubs

While this approach is standard practice in professional sport, the same principles apply at school and community level. Young players are still developing neurologically and deserve the same careful approach to concussion management that elite players receive. Concussion Baseline Testing provides a record of a player's normal brain function before the season begin. If an injury occurs, doctors have a much clearer understanding of what "recovered" looks like for that individual. That information can make return-to-play decisions safer and more confident for clinicians, coaches and parents.

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What Axis Can Offer

At Axis, we offer Concussion Baseline Testing for schools and clubs using the same tools used in professional sport. The test is quick, simple, and can be completed on a laptop or tablet in around 10 - 15 minutes. Players that complete baseline testing with us also receive priority access to our concussion team if an injury occurs during the season. That means rapid assessment, expert management, and a structures pathway back to school and sport.

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Concussion care starts well before the injury happens. Establishing a baseline is a small step that can make a significant difference when it matters most.