Test-retest reliability of the SCAT6 tandem gait and cognitive components among professional hockey players

Objectives To examine test-retest reliability and reliable change of the Sport Concussion Assessment Tool-6 (SCAT6) cognitive and tandem gait components in a large sample of culturally diverse professional ice hockey players. Methods National Hockey League (NHL) and American Hockey League (AHL) players undergoing medical evaluations prior to the 2023/2024 (time 1) and 2024/2025 (time 2) seasons completed pre-season NHL Modified SCAT6 evaluations (referred to as SCAT6), including Total Cognitive Score and Tandem Gait components (n=1388). Data were extracted from an existing clinical database. Test-retest reliability was examined in English and English as a second language/non-English language preference speakers (ESL), using the Pearson coefficient (r) and intraclass correlation coefficient, and reliable change indices were developed. Results Players were re-assessed on average 353.69±46.01 days following their baseline. A regression-based reliable change model incorporating baseline scores and word list form number explained 40% of the variance in time 2 SCAT6 Total Cognitive Score performance. Test-retest reliability for Concentration components for English speakers ranged from r=0.54–0.61 and for ESL speakers from r = 0.56–0.60. A 2-point decline represented a reliable change in performance for both language groups. Test-retest reliabilities for Tandem Gait with skates ranged from r = 0.69–0.72 compared with r = 0.44–0.51 without skates. Conclusions Results showed adequate reliability for Tandem Gait in skates and marginal reliability for the Total Cognitive Score. Though cognitive components were still somewhat below commonly accepted clinical thresholds for adequate test-retest reliability, the study provides initial evidence that the test-retest reliability of SCAT6 components is appropriate for both English and ESL speakers in baseline/retest models.