One-Year Test-Retest Reliability of the Online Version of ImPACT in High School Athletes

2011 ◽  
Vol 39 (11) ◽  
pp. 2319-2324 ◽  
Author(s):  
R.J. Elbin ◽  
Philip Schatz ◽  
Tracey Covassin
Keyword(s):  
High School ◽  
Verbal Memory ◽  
Visual Memory ◽  
Online Version ◽  
Neurocognitive Performance ◽  
High School Athletes ◽  
Stable Measure ◽  
Motor Processing ◽  
Test Retest Reliability ◽  
The Impact

Background: The ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) neurocognitive testing battery is a popular assessment tool used for concussion management. The stability of the baseline neurocognitive assessment is important for accurate comparisons between postconcussion and baseline neurocognitive performance. Psychometric properties of the recently released online version of ImPACT have yet to be established; therefore, research evaluating the reliability of this measure is warranted. Purpose: The authors investigated the 1-year test-retest reliability of the ImPACT online version in a sample of high school athletes. Study Design: Case series; Level of evidence, 4 Methods: A total of 369 varsity high school athletes completed 2 mandatory preseason baseline cognitive assessments approximately 1 year apart as required by their respective athletics program. No diagnosed concussion occurred between assessments. Results: Intraclass correlation coefficients (ICCs) for ImPACT online indicated that motor processing speed (.85) was the most stable composite score, followed by reaction time (.76), visual memory (.70), and verbal memory (.62). Unbiased estimates of reliability were consistent with ICCs: motor processing speed (.85), reaction time (.76), visual memory (.71), and verbal memory (.62). Conclusion: The online ImPACT baseline is a stable measure of neurocognitive performance across a 1-year time period for high school athletes. These reliability data for online ImPACT are higher than the 2-year ICCs previously reported from the desktop version. Clinical Relevance: It is recommended that the ImPACT baseline assessment (both desktop and online) continue to be updated every 2 years. The online version of ImPACT appears to be a stable measure of neurocognitive performance over a 1-year period, and systematic evaluation of its stability over a 2-year period is warranted.

The Effect of Test Setting Upon Test-Retest Reliability of ImPACT Baseline Tests in High School Athletes

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S23.2-S23
Author(s):  
Mark Thomas William Roberts ◽  
Jonathan Danield Lichtenstein
Keyword(s):  
High School ◽  
Reaction Time ◽  
Verbal Memory ◽  
Visual Memory ◽  
Motor Speed ◽  
High School Athletes ◽  
Retest Reliability ◽  
Concussion Management ◽  
Visual Motor ◽  
Test Retest Reliability

ObjectiveTo determine the test-retest reliability of ImPACT baseline tests across different schools within the same larger concussion management program.BackgroundImPACT is the most widely used concussion management cognitive testing tool. Baseline testing is often required for high school sports participation. Typically, testing occurs every 2 years based on test-retest reliability statistics in previous studies. Demographic and environmental factors, such as age, sex, number of participants, and supervision, all impact baseline performance. Studies to date have not examined test-retest differences across testing sites, such as between school differences.Design/MethodsCross-sectional retrospective design. Valid baseline tests from high school athletes over a 2-year interval were included. Participants who experienced concussions prior to or between tests were excluded. A total of 979 student athletes from 5 schools were included. The Intra-class correlations were determined over a 2-year period for each ImPACT composite score and school.ResultsICC estimates averaged between schools reflected good reliability for visual-motor speed (0.833), visual memory (0.673) and reaction time (0.615) over the two-year period. Verbal memory (0.586) and impulse control (0.556) were less reliable. Between schools a greater range of composite reliability was observed for reaction time (0.484–0.730) and impulse control (0.461–0.655) compared to verbal memory (0.534–0.637), visual memory (0.61–0.719), and visual-motor speed (0.769–914).ConclusionsAs previously established, reliability of ImPACT baselines vary by composite. This study revealed that reliability also varies by setting, as different schools yielded different ICCs. Consistent with the literature, the most reliable measure was visual-motor speed. The greatest difference in reliability between schools was for reaction time. These results suggest that test setting and environment affect reliability of ImPACT baseline scores, with varying effects per composite. Attention must be paid to environmental setting to improve reliability of baseline cognitive test performance to maximize athlete safety.

scholarly journals SPORT TYPE AND BASELINE NEUROCOGNITIVE SCORES AMONG HEALTHY HIGH SCHOOL ATHLETES

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0012
Author(s):  
Jessie R. Oldham ◽  
David R. Howell ◽  
Corey J. Lanois ◽  
Paul D. Berkner ◽  
Rebekah C. Mannix ◽  
...  
Keyword(s):  
High School ◽  
Verbal Memory ◽  
Visual Memory ◽  
Symptom Burden ◽  
Reliable Change Index ◽  
Neurocognitive Performance ◽  
Head Impacts ◽  
Repetitive Head Impacts ◽  
Sport Type ◽  
Composite Scores

Background: Athletes who participate in collision sports may experience more repetitive head impacts than other sport types. These repetitive head impacts have been theorized as a potential catalyst for cognitive problems later in life. It is unknown, however, if sport type influences neurocognitive performance. Hypothesis/Purpose: Our purpose was to investigate the association between sport type and baseline neurocognitive scores in a high school athletic population. We hypothesized that athletes participating in collision sports would demonstrate worse scores on baseline neurocognitive tests compared to those in contact or non-contact sports. Methods: We conducted a cross-sectional, observational study using baseline computerized neurocognitive scores of 186,117 high school student-athletes (age: 15.47±2.28 years, height: 168.53±10.77 cm, weight: 63.02±14.83 kg, 45% female) in the state of Massachusetts. The dependent variables were five composite scores (verbal memory, visual memory, visual motor, reaction time, and impulse control) and total symptom score. The independent variables included sport type (collision, contact, non-contact), age, sex, and concussion history. We used univariable one-way ANOVAS to compare composite scores between sport type. We conducted a series of multivariable regression models, controlling for age, sex, and number of previous concussions, to examine the independent association between sport type and composite scores. Results: There was a minimal but statistically significant association between sport type and composite scores, with collision sport athletes performing slightly worse than other athletes on most composite scores. Collision sport athletes had a slightly lower symptom burden. (Tables 1 and 2) Conclusion: While statistically significant, the differences in neurocognitive function and symptom burden between sport type are of questionable clinical significance. In fact, all of them fall within the reliable change index values of each respective score. As participants were in high school at the time of the study, we cannot determine the potential for associations later in life. Tables/Figures: [Table: see text][Table: see text]

scholarly journals An Examination of Adolescent Athletes and Nonathletes on Baseline Neuropsychological Test Scores

2018 ◽  
Vol 53 (4) ◽  
pp. 404-409 ◽  
Author(s):  
Christopher P. Tomczyk ◽  
Megan Mormile ◽  
Megan S. Wittenberg; ◽  
Jody L. Langdon ◽  
Tamerah N. Hunt
Keyword(s):  
High School ◽  
High School Students ◽  
High Schools ◽  
Reaction Time ◽  
Verbal Memory ◽  
Visual Memory ◽  
Neuropsychological Test ◽  
Test Battery ◽  
Cognitive Test ◽  
High School Athletes

Context:  An estimated 15.3 million adolescent students are enrolled in US high schools, with approximately 7.8 million participating in athletics. Researchers have examined various demographics in high school athletes; however, athletic participation may play a larger role in test performance than previously thought. Currently, investigations of concussion assessment may rely on uninjured athletes as controls. However, due to the intense nature of athletics, this may not be an appropriate practice. Objective:  To examine differences between athletes and nonathletes using a common computerized neuropsychological test. Design:  Retrospective cross-sectional study. Setting:  High schools from a school district in Columbus, Ohio. Patients or Other Participants:  A total of 662 adolescent high school students (athletes: n = 383, female n = 18; nonathletes: n = 279, female n = 193). Main Outcome Measure(s):  Participants were administered a computerized neuropsychological test battery (Immediate Post-Concussion Assessment and Cognitive Test [ImPACT]) during baseline concussion assessment. Differences between groups were established for output composite scores. Results:  Differences were found between athletes and nonathletes in composite reaction time (F1,522 = 14.855, P < .001) and total symptom score (F1,427 = 33.770, P < .001). Nonathletes reported more symptoms, whereas athletes had faster reaction times. No differences were present in composite verbal memory, composite visual memory, composite visual motor speed, or composite impulse control (P > .05). Conclusions:  Symptom reporting and reaction time differed between high school athletes and nonathletes. Participation in extracurricular activities may lead to cognitive differences in adolescents that can influence performance on the Immediate Post-Concussion Assessment and Cognitive Test battery. Researchers should account for these differences in baseline performance when making concussion diagnostic and management decisions.

scholarly journals How Do ImPACT Quick Test Scores Compare with ImPACT Online Scores in Non-Concussed Adolescent Athletes?

2020 ◽  
Vol 35 (3) ◽  
pp. 326-331 ◽  
Author(s):  
R J Elbin ◽  
Nathan R D’Amico ◽  
Matthew McCarthy ◽  
Melissa N Womble ◽  
Sydne O’Connor ◽  
...  
Keyword(s):  
High School ◽  
Test Scores ◽  
Cognitive Testing ◽  
Online Version ◽  
High School Athletes ◽  
Post Injury ◽  
Quick Test ◽  
Significant Relationships ◽  
The Impact ◽  
D 72

Abstract Objective To compare neurocognitive scores between the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) Quick Test (QT) and Online Versions in non-concussed high school athletes. Methods A sample of 47 high school athletes completed the ImPACT Online Version pre-season and the ImPACT QT approximately 3 months later. Paired sample t-tests and Pearson’s correlations examined differences and relationships between the ImPACT batteries. Results The ImPACT QT scores were significantly higher for performance on the Three Letters: Average Counted (p < .001, d = .88), Three Letters: Average Counted Correctly (p < .001, d = .80), and Symbol Match: Correct RT Visible (p < .001, d = .72), and Symbol Match: Correct RT Hidden (p = .002, d = .50) subtests. There were significant relationships for Three Letters: Average Counted (r = .85, p < .001), Three Letters: Average Counted Correctly (r = .82, p < .001), and Symbol Match: Total Correct Hidden (r = .40, p = .006) subtests. Conclusions Post-injury evaluation data using ImPACT QT should be compared to normative referenced data, and not to pre-season data from the ImPACT Online Version.

scholarly journals Self-Reported History of Seizure, Baseline Neurocognitive Performance, and Symptoms Reported in High School Athletes

2019 ◽  
Vol 34 (5) ◽  
pp. 777-777
Author(s):  
A Datoc ◽  
L Lashley
Keyword(s):  
High School ◽  
Visual Memory ◽  
Cognitive Testing ◽  
Group Differences ◽  
Motor Speed ◽  
Neurocognitive Performance ◽  
High School Athletes ◽  
History Of ◽  
Visual Motor ◽  
Literature Highlight

Abstract Purpose To examine whether a self-reported history of seizure is associated with differences in baseline neurocognitive performance and total reported symptoms. Methods Data was derived from a de-identified Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) database of high school athletes in Florida. After inclusion and exclusion criteria were applied, athletes were separated into groups dependent on self-reported history of seizure. 260 athletes (Mage=15.49, SD=1.26; 57.1% male) reported a history of seizure, and 260 athletes were randomly selected from those with no such history (Mage=15.64, SD=1.22; 61.1% male). Results ANOVA (alpha=.05) revealed significant differences between groups on the visual memory composite (F[1,559]=4.915, p=.027) and total symptom score (F[1,559]=28.596, p<.001) at baseline. Athletes with a self-reported history of seizure performed significantly worse than athletes without on visual memory and reported significantly higher total symptom scores. No significant between-group differences were found on the other composites of ImPACT. Conclusion The association between seizure history and decreased neurocognitive performance has been documented in the neuropsychological literature, and may be explained by differences at a microstructural level such as differences in white matter integrity (Yassine et al., 2018). While these microstructural differences have implications on cognitive functioning and symptomatology, the present study surprisingly found comparable scores between athletes with a history of seizure and those without. Previous researchers published similar findings; however, differences were observed on the visual-motor speed composite of ImPACT (Zalneraitis et al., 2017). The inconsistencies and small effect sizes in the present literature highlight the need for investigators to determine the clinical significance of these results in concussion evaluations.

Disparities on Baseline Performance Using Neurocognitive and Oculomotor Clinical Measures of Concussion

2020 ◽  
Vol 48 (11) ◽  
pp. 2774-2782 ◽  
Author(s):  
Jessica Wallace ◽  
Ryan Moran ◽  
Erica Beidler ◽  
Jamie McAllister Deitrick ◽  
James Shina ◽  
...  
Keyword(s):  
High School ◽  
African American ◽  
Reaction Time ◽  
Title I ◽  
Verbal Memory ◽  
Visual Memory ◽  
Title I Schools ◽  
Black African ◽  
Motor Processing ◽  
Baseline Performance

Background: Given the high participation of Black/African American individuals in high school sports, especially high-risk sports for concussion, it is important to note if racial and socioeconomic status (SES) differences exist in baseline performance on clinical measures of concussion. Purpose: To explore the association between race and SES on baseline concussion assessments of neurocognitive performance and oculomotor function in adolescent athletes. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: A total of 564 high school athletes (mean ± SD age, 15.33 ± 1.1 years) completed the baseline Immediate Post-Concussion Assessment and Cognitive Test and King-Devick (KD) battery before the start of their competitive season. Race was defined as either White/non-Hispanic or Black/African American. SES status was determined by whether the individual’s participating high school was a Title I or non–Title I school. A series of multivariable linear regression analyses were conducted to evaluate the association of computerized neurocognitive test scores (verbal memory, visual memory, motor processing speed, and reaction time), symptom severity scores, and KD scores by race and SES. Results: White/non-Hispanic individuals performed significantly better than Black/African American individuals on verbal memory ( P < .01), visual memory ( P < .01), visual motor processing speed ( P < .01), and reaction time ( P < .01) and had a lower symptom score ( P < .01). Regarding SES, individuals from non–Title I schools performed better on visual memory ( P = .05) and reaction time ( P = .02) than individuals from Title I schools. Examination of cumulative KD test reading time revealed that there was no association between race on baseline reading times ( P = .12). There was a significant association between cumulative reading time and SES ( P = .02). Individuals from non–Title I schools performed significantly faster than individuals from Title I schools on KD test time. Conclusion: Overall, race and SES influence neurocognitive and oculomotor concussion baseline performance in high school athletes. These findings add to the growing literature on the influence of race and SES on neurocognitive and oculomotor function baseline concussion assessments; they highlight the necessity for individualized concussion baseline measurements or race-specific normative reference values.

scholarly journals Do Sideline Concussion Assessments Predict Subsequent Neurocognitive Impairment After Sport-Related Concussion?

2017 ◽  
Vol 52 (7) ◽  
pp. 676-681 ◽  
Author(s):  
Alicia Sufrinko ◽  
Jamie McAllister-Deitrick ◽  
Melissa Womble ◽  
Anthony Kontos
Keyword(s):  
High School ◽  
Verbal Memory ◽  
Visual Memory ◽  
Standard Of Care ◽  
Cognitive Testing ◽  
Assessment Tools ◽  
Motor Speed ◽  
Neurocognitive Testing ◽  
Symptom Scale ◽  
The Impact

Context:  Comprehensive, multidomain assessment is the standard of care after sport-related concussion. However, the relationship between performance on sideline concussion-assessment tools and in-office computerized neurocognitive testing has received little attention, and the prognostic utility of sideline measures is unknown. Objective:  To evaluate concurrent impairment on commonly used concussion measures 24 to 48 hours postinjury while also determining the predictive utility of sideline measures on computerized neurocognitive testing in the acute to subacute recovery periods postinjury. Design:  Case-control study. Setting:  High school and collegiate athletics. Patients or Other Participants:  A total of 125 high school and college-aged athletes (85 males, 40 females) 14 to 23 (16.8 ± 2.21) years old. Main Outcome Measure(s):  Participants were administered sideline concussion-assessment measures (ie, Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT], Standardized Assessment of Concussion [SAC], and Balance Error Scoring System [BESS]) 24 to 48 hours postinjury and completed ImPACT and the Post-Concussion Symptom Scale 5 to 7 and 10 to 14 days postinjury. Outcome measures were the ImPACT composite (verbal memory, visual memory, reaction time, visual-motor speed), SAC, and BESS scores and total symptom score on the Post-Concussion Symptom Scale. Results:  Participants demonstrated heterogeneous patterns of impairment on measures 24 to 48 hours postinjury, with the most common pattern being impairment on ImPACT and the SAC. Performance on the SAC and BESS at 24 to 48 hours after injury did not distinguish between those with and those without impairment on ImPACT at 5 to 7 days postinjury (χ2 = 5.076, P = .079) or 10 to 14 days postinjury (χ2 = 2.04, P = .361). Conclusions:  More than 90% of athletes were impaired on at least 1 sideline or neurocognitive measure 24 to 48 hours after sport-related concussion. Although sideline measures are useful for concussion diagnosis, they are not suitable for prognostication of impairment or the presence of symptoms 1 to 2 weeks postinjury.

scholarly journals The Impact of Competitive Markets on Recruiting: Lessons from Collegiate Athletics

2018 ◽  
Vol 79 (1) ◽  
pp. 25-35
Author(s):  
Cary A. Caro
Keyword(s):  
High School ◽  
Labour Market ◽  
College Athletics ◽  
College Football ◽  
Collegiate Athletics ◽  
High School Athletes ◽  
New Markets ◽  
Brand Recognition ◽  
Football Programs ◽  
The Impact

AbstractConference realignment in NCAA college athletics impacted traditional rivalries and affiliations as it took shape from 2010 to 2013. As schools traded conferences, their college football programs were left to compete against new foes, and in new markets for high school athletes. The impact of brand recognition, prestige, and new conference affiliation on recruiting are examined herein. The findings of the market competitive externalities are important for every labour market in which business opt to compete.

scholarly journals Concussion History and Cognitive Function in a Large Cohort of Adolescent Athletes

2018 ◽  
Vol 46 (13) ◽  
pp. 3262-3270 ◽  
Author(s):  
Kathryn M. Taylor ◽  
Marianthi-Anna Kioumourtzoglou ◽  
Jim Clover ◽  
Brent A. Coull ◽  
Jack T. Dennerlein ◽  
...  
Keyword(s):  
High School ◽  
Cognitive Function ◽  
Verbal Memory ◽  
Impulse Control ◽  
Visual Memory ◽  
Test Battery ◽  
Cognitive Test ◽  
Effect Estimate ◽  
Cognitive Score ◽  
And Performance

Background: The incidence of reported concussions in the adolescent population is increasing, yet research on the effects of concussions in this population is minimal and inconclusive. Purpose: To assess the association between concussion and performance on a cognitive test battery. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Using multivariate models, the authors assessed the association between concussion and performance on a cognitive test battery among 5616 high school and junior high school athletes. The researchers utilized a global cognitive score and scores for 5 domains: verbal memory, visual memory, visual motor, reaction time, and impulse control. Each cognitive score was converted to a z score with the mean and SD of the nonconcussed population. Results from each model were then interpreted as change in the standardized unit score. In the models, concussion was evaluated as ever having a concussion, number of concussions, time since last concussion, and age at first concussion. Results: Ever having a concussion was associated with a mean decrease of 0.11 standardized units (95% CI, −0.20 to −0.01) on the global cognitive score and lower scores in all cognitive domains. Each additional concussion was associated with lower scores on global cognitive function (effect estimate, −0.06; 95% CI, −0.11 to −0.02), verbal memory, visual memory, and impulse control. Concussion in early childhood was associated with lower global cognition (effect estimate, −0.05; 95% CI, −0.08 to −0.01), visual memory, and motor visual scores as compared with concussions in later childhood. The associations between time since last concussion and cognitive test scores were nonlinear, and on all tests, lower scores were observed even ≥1 year after the concussion. Conclusion: On the basis of objective performance metrics for cognitive function, concussions had a more persistent effect on cognitive function than previously thought. The age at which an individual has his or her first concussion may be an important factor in determining long-lasting cognitive effects.

scholarly journals Neurocognitive dysfunctioning and the impact of comorbid depression and anxiety in patients with somatic symptom and related disorders: a cross-sectional clinical study

2017 ◽  
Vol 48 (11) ◽  
pp. 1803-1813 ◽  
Author(s):  
Lars de Vroege ◽  
Anique Timmermans ◽  
Willem J. Kop ◽  
Christina M. van der Feltz-Cornelis
Keyword(s):  
Visual Memory ◽  
Somatic Symptom ◽  
Depression And Anxiety ◽  
Neurocognitive Performance ◽  
Information Processing Speed ◽  
Comorbid Depression ◽  
Health Care Centre ◽  
Cross Sectional ◽  
Neurocognitive Dysfunction ◽  
The Impact

BackgroundThe prevalence and severity of neurocognitive dysfunctioning of patients with somatic symptom and related disorders (SSRD) is unknown. Furthermore, the influence of comorbid depression and anxiety has not been evaluated. This study examines neurocognitive dysfunctioning of patients with SSRD and explores if comorbid depression and anxiety is associated with specific neurocognitive dysfunctioning.MethodsCross-sectional study with consecutive patients suffering from SSRD visiting an outpatient specialty mental health care Centre of Excellence for SSRD. Extensive neuropsychological assessment and assessment of depression and anxiety symptom levels using the Patient-Health-Questionnaire-9 and General Anxiety Disorder questionnaire-7 were performed at intake. Multivariate analysis was performed.ResultsThe study sample consisted of 201 SSRD patients, with a mean age of 43 years (Standard deviation = 13) years; 37.8% were male. Neurocognitive dysfunction in the domains information processing speed, sustained and divided attention, working memory, verbal and visual memory were reported, compared with normative data. Comorbid depression and anxiety occurred frequently within the sample (75.1% and 65.7%, respectively). Neurocognitive dysfunctioning was worse in patients suffering from comorbid depression [multivariateF(7,161) = 2.839,p= 0.008] but not in patients with comorbid anxiety.ConclusionsPoor neurocognitive performance of patients with SSRD is common and worsens in case of comorbid depression. This may explain treatment dropout of patients with SSRD from neurocognitive behavioral therapy. Research on novel interventions is needed targeting neurocognitive functioning of patients with SSRD, particularly those with comorbid depression.

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