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Related Experiment Video

Updated: Apr 24, 2026

A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

Published on: December 8, 2014

Comparing post-concussive neurocognitive test data to normative data presents risks for under-classifying "above

Philip Schatz¹, Stacey Robertshaw²

¹Department of Psychology, Saint Joseph's University, Philadelphia, PA, USA pschatz@sju.edu.

Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists

|September 3, 2014

Summary

Reliable change indices (RCIs) and regression-based measures (RBz) are more effective than normative comparisons for identifying concussion impairment in athletes. These methods consistently detect impairment regardless of an athlete's baseline performance level.

Keywords:

Baseline assessment Concussion Neuropsychological assessment mTBI

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Last Updated: Apr 24, 2026

A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

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Area of Science:

Neuroscience
Sports Medicine
Clinical Psychology

Background:

Concussion assessment in athletes relies on comparing post-injury test data to baseline or normative data.
Accurate classification of concussion impairment is crucial for safe return to play.
Previous methods may not adequately account for individual baseline performance levels.

Purpose of the Study:

To compare the classification accuracy of post-concussion test data using reliable change indices (RCIs) and regression-based measures (RBz) against normative data.
To evaluate the impact of baseline performance levels on concussion classification.
To determine the most effective method for identifying concussed athletes.

Main Methods:

Athletes (N = 250) completed baseline and post-concussion ImPACT assessments within 7 days of injury.
Baseline performance was categorized as 'below average,' 'average,' or 'above average.'
Change from baseline was calculated using RCIs and RBz; comparisons to normative data used z-scores.

Main Results:

Normative comparisons identified fewer symptomatic athletes than RCIs and RBz.
RCIs and RBz consistently identified impairment at 1 and 1.5 standard deviations (SD) irrespective of baseline performance.
Normative comparisons underestimated the number of athletes performing 'above average' at baseline, particularly with higher SD cut-offs.

Conclusions:

RCIs and RBz are more sensitive in detecting concussion-related impairment compared to normative data, especially in athletes with varying baseline scores.
Reliance on normative data may lead to under-classification of concussion in athletes who do not fall within the 'average' baseline range.
Accurate concussion assessment requires methods that account for individual baseline performance, such as RCIs and RBz.