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

Elbin RJ, Schatz P, Covassin T. Am J Sports Med. 2011; 39(11): 2319-2324

Computer neurocognitive assessment tools are being utilized more and more in athletic training rooms and physician offices. ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is one of those computer programs, which has been evaluated and supported by many medical personnel. An online version has just been released and though it is similar to the older desktop version they are not identical. The purpose of this study was to determine a 1-year test-retest reliability of the ImPACT online version in a sample of 369 varsity high school athletes. This was a within-subject design, where participants completed 2 mandatory preseason baseline cognitive assessments ~1.2 years apart. There were no diagnosed concussions between assessments within this population. Intraclass correlation coefficients (ICCs), a means of evaluating consistency between repeated tests, indicated that motor processing speed had the most stable score (.85), then reaction time (.76), visual memory (.70), and lastly verbal memory (.62). Additional analyses explored the stability of online ImPACT testing over time and found that there was little variation between baseline and follow up. There was some evidence that visual memory, reaction time, and symptom scores had some participants that changed over time.

The online version of ImPACT was produced to update the older desktop versions limitations (e.g., decrease number of invalid baseline scores). This study suggests that baseline scores from the online version were stable up to one year. When compared to previous desktop ImPACT data collected over 2 years (Schatz, 2010) the online version performed better.  This study also compared favorably to reliability data that was collected after just 7 days (Iverson et al., 2003).  While there were changes with the online version some scores improved and some scores decline. With this in mind, most athletic departments/teams perform a baseline test every 2 years. It would be beneficial to know if the online version ImPACT baseline would be stable over a 2-year period, not only in the high school population but in a collegiate population as well. Also, this study was done using high school athletes that did not sustain a concussion. Though, this study supports implementing the online version it will be helpful to see more data about how it performs over a longer follow-up time or after a concussion before adopting it in the clinics. It would also be beneficial to observe if an athlete’s baseline changes after sustaining a concussion. If you utilize ImPACT how often do you measure an athlete’s baseline? Did any of your athlete’s baseline change after sustaining a concussion?

Written by: Jane McDevitt MS, ATC, CSCS
Reviewed by: Jeffrey Driban

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Elbin RJ, Schatz P, & Covassin T (2011). One-Year Test-Retest Reliability of the Online Version of ImPACT in High School Athletes. The American Journal of Sports Medicine, 39 (11), 2319-24 PMID: 21841066