The Standardized Assessment of Concussion (SAC) is a battery of tests developed to evaluate football (American) players who have suffered a concussion. It tests the player for orientation and probes for deficits in attention, concentration and memory. It was designed to comply with the Colorado and American Academy of Neurology (AAN) guidelines for concussion. The authors are from Northwestern University and the Rehabilitation Institute in Chicago.


Components of the sideline examination:

(1) orientation (5 points)

(2) immediate memory (15 points)

(3) concentration (5 points)

(4) delayed recall (5 points)


Components of the accompanying physical examination:

(5) neurological screening

(6) exertional maneuvers


Orientation subscore (0 to 5 points): 1 point each for ability to state:

(1) month

(2) today's date

(3) day of week

(4) year

(5) approximate time of day (within1 hour)


Immediate memory subscore (0 to 15 points): Ability to recall 5 words over 3 trials, with 1 point for each word recalled correctly.


Concentration subscore (0 to 5 points): For the string reversals, stop if unable to do both strings correctly.

(1) able to reverse 2 strings of 3 numbers: 1 point

(2) able to reverse 2 strings of 4 numbers: 1 point

(3) able to reverse 2 strings of 5 numbers: 1 point

(4) able to reverse 2 strings of 6 numbers: 1 point

(5) months of the year in reverse order: 1 point if able to state all 12 months correctly


Delayed recall subscore (0 to 5 points): Ability 5 minutes later to recall words used in the immediate memory subscore, with 1 point for each word recalled.


Physical examination (may be conducted while waiting for the delayed recall):

(1) recollection of injury

(2) symmetry of pupillary size

(3) evidence of uncoordination

(4) evidence of sensory abnormalities

(5) strength


Exertional maneuvers:

(1) 40 yard sprint (once)

(2) sit-ups (5)

(3) push-ups (5)

(4) knee bends (5)


total score for sideline examination =

= (points for orientation) + (points for immediate memory) + (points for concentration) + (points for delayed recall)



• minimum score: 0

• maximum score: 30

• The lower the score, the more seriously affected the player.

• Players with mild concussions may be detected on the immediate memory and delayed recall subscores.


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