ImPACT™ Baseline Pre-Concussion Testing
Also known as: ImPACT™ test.
What is ImPACT™ baseline pre-concussion testing?
ImPACT™ testing is a computer-based neurocognitive test that assesses memory, processing speed and reaction time. The rationale for this test is that if an athlete has a valid baseline for comparison to their post-concussion test, then that athlete’s concussion can be managed better.
What does the test involve?
ImPACT™ testing takes about 30 minutes to complete. The athlete fills out a number of questions related to personal characteristics and medical history, assigns a severity grade to 22 symptoms of concussion, then completes the timed neurocognitive testing. The software then processes the athlete’s answers into performance raw scores and percentiles that compare the athlete’s scores to approximately 5,000 healthy, non-concussed age-matched controls.
Is any special preparation needed?
No special preparation is needed for this test. Baseline tests are likely to be invalid or inaccurate if the athlete does not get at least 8 hours of sleep the preceding night, if the test is given at the end of a grueling physical work out, if they have ADD, ADHD, autism or dyslexia, if they are still recovering from a previous concussion, or if they are even slightly distracted during the test, e.g., by cell phones or other noise or commotion during the test.
What are the risk factors?
There are no risks associated with this test. There are, however, significant risks associated with returning to play too soon based on misinterpretation of ImPACT results. For this reason, ImPACT states that no athlete should ever be given clearance to return to play based solely on the results of ImPACT testing.
Are there any controversies about the ImPACT test?
Yes, absolutely. Many experts in concussion have significant concerns about the validity and reliability of ImPACT testing and have published negative findings about this test in the medical literature. Baseline test results are commonly affected negatively by the above-mentioned factors as well as by “sandbagging,” which is when the athlete purposefully marks wrong answers to get a low score so that when they have a concussion their post-concussion scores reach or exceed baseline faster thereby allowing them to return to play sooner. Baseline test results are rarely looked by anyone unless the athlete has a concussion, at which time it is too late to repeat it if the baseline test was invalid or questionable. Many concussion centers opt for other ways of assessing cognitive function after injury, particularly in cases where prolonged recovery occurs.
Reviewed by: John Kuluz, MD
This page was last updated on: 10/8/2018 2:22:00 PM
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Dr. John Ragheb, Director of the Division of Neurosurgery at Nicklaus Children’s Hospital, is among a group of renowned physicians who developed the first evidence-based guideline in the U.S. on mild traumatic brain injury (mTBI) and concussions among children, published by the CDC in September.
Dr. Aaron Berger is a pediatriac hand surgeon at Nicklaus Children's Hospital. For more information about the Brachial Plexus and Peripheral Nerve Disorders Program, please visit nicklauschildrens.org/BrachialPlexus