Validation and reproducibility assessment of 10-word memory sets in the Russian version of SCAT-5: A cross-sectional single-center study

Introduction. Concussion, whose diagnosis is primarily based on clinical evaluation, is a pressing issue in modern sports. To improve diagnostic methods for concussion in high-performance sports, the Sport Concussion Assessment Tool (SCAT) protocol is used. However, as the original versions of this protocol are published in English, their application in other languages presents challenges in terms of cultural adaptation and linguistic nuances.

Objective. To evaluate the comparability and equivalence of the three proposed Russian-language 10-word lists for memory assessment in athletes within the SCAT-5 protocol.

Materials and methods. An examination of 446 athletes was conducted using the SCAT-5 protocol (373 males, 73 females; median age 37 [26; 43] years). Only athletes who showed no abnormalities during baseline (pre-competition) testing were included. The Russian-language version of the SCAT-5 protocol, featuring three different word lists for memory assessment, was prepared and adapted by specialists from the National Center of Sports Medicine of the Federal Medical and Biological Agency. Depending on the word list used to assess immediate memory, the athletes were divided into three groups. Evaluation metrics included the total number of symptoms, symptom severity score, immediate memory, and delayed recall. Statistical analysis was performed using IBM SPSS Statistics 23.0 software.

Results. Comparison of the integrated immediate memory scores across groups revealed no statistically significant differences (p > 0.05). Similarly, analysis of the integrated delayed recall scores showed no significant intergroup variations (p > 0.05). A positive correlation was found between the integrated immediate memory and delayed recall scores in each group (Group 1: r = 0.629, p < 0.001; Group 2: r = 0.663, p < 0.001; Group 3: r = 0.591, p < 0.001). No correlations were observed between immediate memory and the total number of symptoms (r = –0.011, p = 0.824) or symptom severity (r = –0.015, p = 0.747).

Conclusions. Each of the three proposed word lists demonstrated methodological validity comparable to the original English-language versions of SCAT protocols. These lists are interchangeable and are validated for use in the Russian-language versions of the SCAT-5, SCAT-6, and subsequent protocols where memory is assessed using 10-word sets. The implementation of this protocol enables more objective diagnosis and monitoring of athletes throughout various stages of post-concussion recovery.

1. Matias-Soto J, Infante-Cano M, García-Muñoz C, Pineda-Escobar S, Martinez-Calderon J. Concussion Incidence by Type of Sport: Differences by Sex, Age Groups, Type of Session, and Level of Play an Overview of Systematic Reviews with Meta-analysis. The Journal of Orthopaedic and Sports Physical Therapy. 2024;54(11):681–742. https://doi.org/10.2519/jospt.2024.12677

2. Putukian M, D’Alonzo BA, Campbell-McGovern CS, Wiebe DJ. The Ivy League-Big Ten Epidemiology of Concussion Study: A Report on Methods and First Findings. The American Journal of Sports Medicine. 2019;47(5):1236–47. https://doi.org/10.1177/0363546519830100

3. Van Pelt KL, Puetz T, Swallow J, Lapointe AP, Broglio SP. Data-Driven Risk Classification of Concussion Rates: A Systematic Review and Meta-Analysis. Sports Medicine. 2021;51:1227–44. https://doi.org/10.1007/s40279-021-01428-7

4. Pfister T, Pfister K, Hagel B, Ghali WA, Ronksley PE. The incidence of concussion in youth sports: a systematic review and meta-analysis. British Journal of Sports Medicine. 2016;50:292–7. https://doi.org/10.1136/bjsports-2015-094978

5. Schneider KJ, Patricios J, Echemendia RJ, Makdissi M, Davis GA, Ahmed OH, et al. Concussion in sport: the consensus process continues. British Journal of Sports Medicine. 2022;56(19):1–8. https://doi.org/10.1136/bjsports-2022-105673

6. Baioccato V, Bazo M, Leo I, Simonelli A, Ermolao A, Patricios JS, et al. Translation, cultural adaptation, and validation of the Concussion Recognition Tool 6 (CRT6™), Sport Concussion Assessment Tool 6 (SCAT6®) and Sport Concussion Office Assessment Tool 6 (SCOAT6™): the Italian process. Italian Journal of Pediatrics. 2025;51:109. https://doi.org/10.1186/s13052-025-01950-8

7. Liu J, Zhao R, Cai J, Wang Z, Zhu M, Wang X, et al. Translation, Cross-Cultural Adaptation, and Validation of the Simplified Chinese Version of Sport Concussion Assessment Tool 6. Clinical Journal of Sport Medicine. 2026;36(1):36–41. https://doi.org/10.1097/JSM.0000000000001346

8. Echemendia RJ, Burma JS, Bruce JM, Davis GA, Giza CC, Guskiewicz KM, et al. Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: a systematic review. British Journal of Sports Medicine. 2023;57:722–35. https://doi.org/10.1136/bjsports-2022-106661

9. Scollard P, Choi SE, Lee ML, Mukherjee S, Trittschuh EH, Sanders RE, et al. Ceiling effects and differential measurement precision across calibrated cognitive scores in the Framingham Study. Neuropsychology. 2023;37(4):383–97. https://doi.org/10.1037/neu0000828

10. Gaudet CE, Konin J, Faust D. Immediate Post-concussion and Cognitive Testing: Ceiling Effects, Reliability, and Implications for Interpretation. Archives of Clinical Neuropsychology. 2021;36(4):561–9. https://doi.org/10.1093/arclin/acaa074

11. Echemendia RJ, Meeuwisse W, McCrory P, Davis GA, Putukian M, Leddy J, et al. The Sport Concussion Assessment Tool 5th Edition (SCAT5): Background and rationale. British Journal of Sports Medicine. 2017;51:848–50. https://doi.org/10.1136/bjsports-2017-097506

12. Luriya AR. Higher human cortical functions and their disorders in local brain lesions. Moscow: Moscow university; 1962 (In Russ.).

13. Deakin ND, Cronin T, Trafford P, Olvey S, Roberts I, Mellor A, et al. Concussion in motor sport: a medical literature review and engineering perspective. Journal of Concussion. 2017;1. https://doi.org/10.1177/2059700217733916

14. Deakin ND, Suckling J, Hutchinson PJ. Research Evaluating Sports ConcUssion Events-Rapid Assessment of Concussion and Evidence for Return (RESCUE-RACER): a two-year longitudinal observational study of concussion in motorsport. BMJ Open Sport & Exercise Medicine. 2021;7(1):e000879. https://doi.org/10.1136/bmjsem-2020-000879

15. Petit KM, Savage JL, Bretzin AC, Anderson M, Covassin T. The Sport Concussion Assessment Tool-5 (SCAT5): Baseline Assessments in NCAA Division I Collegiate Student-Athletes. International Journal of Exercise Science. 2020;13(3):1143–55. https://doi.org/10.70252/SUJD2658

16. Bailey C, Meyer J, Soden D, Tangen C, Deane R, Briskin S, et al. SCAT5 Sex Differences: Normative Data, Clinical Thresholds, and Relevance for Identification of Concussion. Archives of Clinical Neuropsychology. 2022;37(7):1536–44. https://doi.org/10.1093/arclin/acac007

17. Sarkis GA, Zhu T, Yang Z, Li X, Shi Y, Rubenstein R, et al. Characterization and standardization of multiassay platforms for four commonly studied traumatic brain injury protein biomarkers: a TBI Endpoints Development Study. Biomarkers in Medicine. 2021;15(18):1721–32. https://doi.org/10.2217/bmm-2021-0284

18. Beran KM, Scafide KN. Factors Related to Concussion Knowledge, Attitudes, and Reporting Behaviors in US High School Athletes: A Systematic Review. The Journal of School Health. 2022;92(4):406–17. https://doi.org/10.1111/josh.13140

19. Baugh CM, Meehan WP, Kroshus E, McGuire TG, Hatfield LA. College Football Players Less Likely to Report Concussions and Other Injuries with Increased Injury Accumulation. Journal of Neurotrauma. 2019;36(13):2065–72. https://doi.org/10.1089/neu.2018.6161

20. Makdissi M, Davis G, McCrory P. Clinical challenges in the diagnosis and assessment of sports-related concussion. Neurology. Clinical Practice. 2015;5(1):2–5. https://doi.org/10.1212/CPJ.0000000000000061

21. Bhandari S, Mak SYG, Heron N, Rogers J. Tools for Diagnosing and Managing Sport-Related Concussion in UK Primary Care: A Scoping Review. Sports. 2025;13(7):201. https://doi.org/10.3390/sports13070201

22. Ahn SY, Prock M, Seo J, Han S, O’Sullivan DM, Song W. Mapping the acute trajectory of sport-related concussion outcomes across symptoms, cognition, and blood biomarkers. Sports Medicine and Health Science. 2025;8(2):119–27. https://doi.org/10.1016/j.smhs.2025.07.003

23. Owusu Otoo K, Chou B, Chou N, Stanley R, Quaynor S. A Review of Sideline Assessment Measurements for Identifying Sports-Related Concussions and Their Appropriate Management Techniques. Cureus. 2025;17(11):e97710. https://doi.org/10.7759/cureus.97710

24. Wingerson MJ, Wilson JC, Seehusen CN, Walker GA, Howell DR. Patient Characteristics Predictive of Immediate and Delayed Word Recall Performance Following Adolescent Concussion. International Journal of Sports Medicine. 2023;44(1):72–7. https://doi.org/10.1055/a-1941-5673

25. Shaffer A, Anderson AT, Goldberg Z, Tarr A, Flannell J, Huesmann G, et al. SCAT5 baseline values, test-retest reliability, and reliable change metrics in high school athletes. Neurosurgical Focus. 2024;57(1):E5. https://doi.org/10.3171/2024.4.FOCUS24112

26. Cameron B, Burma JS, Jasinovic T, Lun V, van Rassel CR, Sutter B, et al. One-year stability of preseason Sport Concussion Assessment Tool 5 (SCAT5) values in university level collision and combative sport athletes. The Physician and Sports Medicine. 2022;50(6):478–85. https://doi.org/10.1080/00913847.2021.1955225

27. Hänninen T, Parkkari J, Howell DR, Palola V, Seppänen A, Tuominen M, et al. Reliability of the Sport Concussion Assessment Tool 5 baseline testing: A 2-week test-retest study. Journal of Science and Medicine in Sport. 2020;24:129–34. https://doi.org/10.1016/j.jsams.2020.07.014

28. McLeod S, Terry DP, Gardner AJ, Iverson GL. Interpreting Change in Sport Concussion Assessment Tool-5th Edition (SCAT5) Scores in National Rugby League Women’s Premiership Players. Sports Medicine — Open. 2025;11:89. https://doi.org/10.1186/s40798-025-00896-9

29. Bruce JM, Thelen J, Meeuwisse W, Hutchison MG, Rizos J, Comper P, et al. Use of the Sport Concussion Assessment Tool 5 (SCAT5) in professional hockey, part 2: which components differentiate concussed and non-concussed players? British Journal of Sports Medicine. 2021;55:557–65. https://doi.org/10.1136/bjsports-2020-102072

30. Zhou J, Gong L, Huang X, Mu C, Mi Y. The synaptic correlates of serial position effects in sequential working memory. Frontiers in Computational Neuroscience. 2024;18:1430244. https://doi.org/10.3389/fncom.2024.1430244

31. Weitzner DS, Calamia M. Serial position effects on list learning tasks in mild cognitive impairment and Alzheimer’s disease. Neuropsychology. 2020;34(4):467–78. https://doi.org/10.1037/neu0000620

32. Carlson C, Cela AM, Garcia NA, Ontiveros-Olivas A, Puente AE. B — 136 Examining the Effects of Word-Level Characteristics on Short Term Recall in an Adapted US-English Verbal Memory Task. Archives of Clinical Neuropsychology. 2025;40(S2):ii295. https://doi.org/10.1093/arclin/acaf084.286

33. Subon F, Al-Saggaf MA. Serial position effect: a case study among primary school students. Quantum. Journal of Social Sciences and Humanities. 2024;5(6):285–96. https://doi.org/10.55197/qjssh.v5i6.504

34. Franzen S, Watermeyer TJ, Pomati S, Papma JM, Nielsen TR, Narme P, et al. Cross-cultural neuropsychological assessment in Europe: Position statement of the European Consortium on Cross-Cultural Neuropsychology (ECCroN). The Clinical Neuropsychologist. 2022;36(3):546–57. https://doi.org/10.1080/13854046.2021.1981456

35. Holtzhausen LJ, Souissi S, Sayrafi OA, May A, Farooq A, Grant CC et al. Arabic translation and cross-cultural adaptation of the Sport Concussion Assessment Tool 5 (SCAT5). Biology of sport. 2021;38(1):129–44. https://doi.org/10.5114/biolsport.2020.97673

36. Halabchi F, Tavana MM, Khazaei R, Jalili M. Persian Translation of the Sport Concussion Assessment Tool 6 (SCAT6); a Cross-Cultural Adaptation and Validation Study. Archives of Academic Emergency Medicine. 2024;12(1):e42.

37. Shapiro JS, Hearps S, Rausa VC, Anderson V, Anderson N, Pugh R, et al. Validation of the SCAT5 and Child SCAT5 Word-List Memory Task. Journal of Neurotrauma. 2022;39(1–2):138–43. https://doi.org/10.1089/neu.2020.7414

38. Black AM, Miutz LN, Eliason PH, Schneider K, Yeates KO, Emery CA. The association of history of concussion with baseline scores on the sport concussion assessment tool (scat5) in high school rugby players. Orthopaedic Journal of Sports Medicine. 2019;7(3 Suppl):2325967119S00006. https://doi.org/10.1177/2325967119S00006

39. Iverson GL, Howell DR, Van Patten R, Bloomfield P, Gardner AJ. Sport Concussion Assessment Tool-5th Edition (SCAT5): Normative Reference Values for the National Rugby League Women’s Premiership. Frontiers in Sports and Active Living. 2021;3:653743. https://doi.org/10.3389/fspor.2021.653743