Sensitivity and specificity of the ImPACT Test Battery for concussion in athletes

Schatz, Philip; Pardini, Jamie E.; Lovell, Mark R.; Collins, Michael W.; Podell, Kenneth

doi:10.1016/j.acn.2005.08.001

Cited by 485 publications

(291 citation statements)

References 26 publications

Supporting

Mentioning

285

Contrasting

Unclassified

Order By: Relevance

“…28 For the computerized neurocognitive assessment, we were powered to detect minimal clinically significant differences (a difference of 9% in Verbal Memory, 17% in Visual Memory, 15% in Reaction Time, and 14% in Processing Speed). 23 …”

Section: Calculation Of Sample Sizementioning

confidence: 99%

Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial

et al. 2015

View full text Add to dashboard Cite

OBJECTIVES: To determine if recommending strict rest improved concussion recovery and outcome after discharge from the pediatric emergency department (ED).METHODS: Patients aged 11 to 22 years presenting to a pediatric ED within 24 hours of concussion were recruited. Participants underwent neurocognitive, balance, and symptom assessment in the ED and were randomized to strict rest for 5 days versus usual care (1-2 days rest, followed by stepwise return to activity). Patients completed a diary used to record physical and mental activity level, calculate energy exertion, and record daily postconcussive symptoms. Neurocognitive and balance assessments were performed at 3 and 10 days postinjury. Sample size calculations were powered to detect clinically meaningful differences in postconcussive symptom, neurocognitive, and balance scores between treatment groups. Linear mixed modeling was used to detect contributions of group assignment to individual recovery trajectory.RESULTS: Ninety-nine patients were enrolled; 88 completed all study procedures (45 intervention, 43 control). Postdischarge, both groups reported a 20% decrease in energy exertion and physical activity levels. As expected, the intervention group reported less school and after-school attendance for days 2 to 5 postconcussion (3.8 vs 6.7 hours total, P , .05). There was no clinically significant difference in neurocognitive or balance outcomes. However, the intervention group reported more daily postconcussive symptoms (total symptom score over 10 days, 187.9 vs 131.9, P , .03) and slower symptom resolution.CONCLUSIONS: Recommending strict rest for adolescents immediately after concussion offered no added benefit over the usual care. Adolescents' symptom reporting was influenced by recommending strict rest. WHAT'S KNOWN ON THIS SUBJECT:Expert consensus recommends rest after concussion with stepwise return to activity. Animal and retrospective human data suggest that early mental and physical activity may worsen outcome. There are no pediatric studies testing the efficacy of recommending strict rest after concussion. WHAT THIS STUDY ADDS:Recommending strict rest postinjury did not improve outcome and may have contributed to increased symptom reporting. Usual care (rest for 1-2 days with stepwise return to activity) is currently the best discharge strategy for pediatric mild traumatic brain injury/concussion. Dr Thomas developed the study concept and design, obtained funding, supervised the study, acquired data, analyzed and interpreted data, and drafted and revised the manuscript; Dr Apps assisted with study concept and design, supervised the study, provided technical support, analyzed and interpreted data, and critically revised the manuscript; Dr Hoffmann assisted with study design, analyzed data, provided statistical expertise, and critically revised the manuscript; Dr McCrea assisted with study design, analyzed and interpreted data, provided technical support, and critically revised the manuscript; Dr Hammeke assisted with study concept and ...

show abstract

Section: Calculation Of Sample Sizementioning

confidence: 99%

Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial

et al. 2015

View full text Add to dashboard Cite

show abstract

“…11,24,25 The clinician must be aware of these potential misclassifications (either false-positives or false-negatives) when using the ImPACT battery. Specifically, a false-positive result would lead to more conservative management of a concussed athlete.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, higher ICCs (0.38 to 0.85) were reported for the ImPACT composite visual motor speed and composite reaction time scores and lower ICCs (0.23 to 0.64) for composite visual and verbal memory. 7,10,11 The highest ICC values were for the Web version of ImPACT (0.62 to 0.85), using a 1-year test-retest interval, in participants 13 to 18 years old. 10 The rationale for these discrepancies in ICC values may be varying methods among studies.…”

mentioning

confidence: 99%

ImPact Test-Retest Reliability: Reliably Unreliable?

Resch

Driscoll

McCaffrey

et al. 2013

Journal of Athletic Training

117

View full text Add to dashboard Cite

Context: Computerized neuropsychological testing is commonly used in the assessment and management of sport-related concussion. Even though computerized testing is widespread, psychometric evidence for test-retest reliability is somewhat limited. Additional evidence for test-retest reliability is needed to optimize clinical decision making after concussion.Objective: To document test-retest reliability for a commercially available computerized neuropsychological test battery (ImPACT) using 2 different clinically relevant time intervals.Design: Cross-sectional study. Setting: Two research laboratories.Patients or Other Participants: Group 1 (n ¼ 46) consisted of 25 men and 21 women (age ¼ 22.4 6 1.89 years). Group 2 (n ¼ 45) consisted of 17 men and 28 women (age ¼ 20.9 6 1.72 years).Intervention(s): Both groups completed ImPACT forms 1, 2, and 3, which were delivered sequentially either at 1-week intervals (group 1) or at baseline, day 45, and day 50 (group 2). Group 2 also completed the Green Word Memory Test (WMT) as a measure of effort.Main Outcome Measures: Intraclass correlation coefficients (ICCs) were calculated for the composite scores of ImPACT between time points. Repeated-measures analysis of variance was used to evaluate changes in ImPACT and WMT results over time.Results: The ICC values for group 1 ranged from 0.26 to 0.88 for the 4 ImPACT composite scores. The ICC values for group 2 ranged from 0.37 to 0.76. In group 1, ImPACT classified 37.0% and 46.0% of healthy participants as impaired at time points 2 and 3, respectively. In group 2, ImPACT classified 22.2% and 28.9% of healthy participants as impaired at time points 2 and 3, respectively.Conclusions: We found variable test-retest reliability for ImPACT metrics. Visual motor speed and reaction time demonstrated greater reliability than verbal and visual memory. Our current data support a multifaceted approach to concussion assessment using clinical examinations, symptom reports, cognitive testing, and balance assessment.Key Words: intraclass correlation, concussions, mild traumatic brain injuries, neuropsychological testing, athletes Key PointsImPACT had strong to weak test-retest reliability over time, consistent with the results of previous studies. Reliability was greater for the visual motor speed and reaction time subscores than for the verbal and visual memory subscores. Computerized neuropsychological testing is only 1 component of a multifaceted concussion-management program that uses all appropriate tools in clinical decision making.

show abstract

“…The ImPACT test battery, however, uses object discrimination and reaction time tests to evaluate brain function. 13 The tasks of concentration and object discrimination are also known to suffer during concussion, but how these tasks relate to balance changes associated with concussion is not well understood to date. Further investigation into the possible relationship between balance and concentration/object discrimination is required to fully understand if any correlation between OptoGait and ImPACT items is anything more than a spurious interaction.…”

mentioning

confidence: 99%

Validation of the OptoGait System for Monitoring Treatment and Recovery of Post-Concussion Athletes

Engelson

Bruns²,

Nightingale

et al. 2017

Journal of Chiropractic Medicine

View full text Add to dashboard Cite

Objective: This study sought to investigate correlations between OptoGait motion analysis technology and 2 commonly used concussion assessment instruments, the Balance Evaluation Scoring System (BESS) and the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) computerized neurocognitive assessment software, to see if OptoGait might be a valid concussion assessment tool. Methods: Twenty Division-1 college women varsity soccer players completed trials of 8 different conditions of the OptoGait test battery. Then participants completed the BESS and ImPACT tests. One hundred twenty-eight total spatiotemporal variables were recorded for each trial of OptoGait. Pearson's r correlations among these variables and BESS and ImPACT results were calculated, and pattern analysis was completed to evaluate for emergent patterns in the data. Results: Correlations for the 8 OptoGait mean-score subtests were related to the balance double-leg foam test (BESS). Correlations for the 8 OptoGait mean-score subtests were related to the balance double-leg foam test (BESS), and correlations between OptoGait standard deviation measures and the balance tandem hard surface test (BESS) both indicated potentially significant patterns. No consistent patterns of correlation existed between the OptoGait variables and the ImPACT results. Conclusion: OptoGait conditions correlate at higher than predicted rates with subtests of the BESS instruments but not the ImPACT measures. (J Chiropr Med 2017;16:163-169)

show abstract

Sensitivity and specificity of the ImPACT Test Battery for concussion in athletes

Cited by 485 publications

References 26 publications

Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial

Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial

ImPact Test-Retest Reliability: Reliably Unreliable?

Validation of the OptoGait System for Monitoring Treatment and Recovery of Post-Concussion Athletes

Contact Info

Product

Resources

About