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Remote Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) subtest scores show minimal change between seasons. Evaluating these subtests alongside composite scores enhances clinical interpretation for athletes.

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Area of Science:

  • Sports Medicine
  • Neuroscience
  • Clinical Psychology

Background:

  • The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is widely used for concussion management in athletes.
  • Establishing the minimal detectable change (MDC) for ImPACT subtests is crucial for accurate interpretation of remote baseline data.
  • Understanding subtest variability is essential for reliable concussion assessment.

Purpose of the Study:

  • To determine the minimal detectable change (MDC) for individual subtests within the remotely administered ImPACT cognitive assessment.
  • To evaluate the stability of ImPACT subtest scores across consecutive athletic seasons.
  • To provide data supporting the clinical utility of ImPACT subtest scores in concussion management.

Main Methods:

  • Utilized remote ImPACT baseline data from 172 NCAA Division I student-athletes across two athletic seasons (2020-2021).
  • Calculated the MDC at 95%, 90%, and 80% confidence intervals for all subtests contributing to core and impulse control composite scores.
  • Employed statistical analyses including repeated measures MANOVA, ANOVAs, and Wilcoxon signed-ranks tests to assess score differences.

Main Results:

  • Identified specific MDC values for verbal memory, visual memory, visual motor speed, reaction time, and impulse control subtests at the 95% CI.
  • Demonstrated no statistically significant differences in subtest scores between the two remote ImPACT baseline administrations.
  • Reaction time subtests showed lower MDCs (e.g., 0.12 for XO average correct), indicating greater sensitivity.

Conclusions:

  • ImPACT subtest scores exhibit stability and do not significantly change between athletic seasons when administered remotely.
  • The findings support the use of individual ImPACT subtest scores as valuable metrics in clinical concussion assessment.
  • Integrating subtest-level analysis with composite scores offers a more comprehensive approach to interpreting cognitive function post-concussion.