TBI Blog: Sports teams turn to ImPACT for concussion diagnosis & management

Jack Sisson's TBI Blog

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In the United States, the annual incidence of sports-related concussion is estimated at 300,000. Estimates regarding the likelihood of an athlete in a contact sport experiencing a concussion may be as high as 19% per season. Although the majority of athletes who experience a concussion are likely to recover, an as yet unknown number of these individuals may experience chronic cognitive and neurobehavioral difficulties related to recurrent injury. Such symptoms may include chronic headaches, fatigue, sleep difficulties, personality change (e.g. increased irritability, emotionality), sensitivity to light/noise, dizziness when standing quickly, and deficits in short-term memory, problem solving and general academic functioning. This constellation of symptoms is referred to "Post-Concussion Syndrome" and can be quite disabling for an athlete. In some cases, such difficulties can be permanent and disabling. In addition to Post-Concussion Syndrome, suffering a second blow to the head while recovering from an initial concussion can have catastrophic consequences as in the case of "Second Impact Syndrome," which has led to approximately 30-40 deaths over the past decade.

In summary, athletes that are not fully recovered from an initial concussion are significantly vulnerable for recurrent, cumulative, and even catastrophic consequences of a second concussive injury. Such difficulties are prevented if the athlete is allowed time to recover from concussion and return to play decisions are carefully made. No athlete should return to sport or other at-risk participation when symptoms of concussion are present and recovery is ongoing. In summary, the best way to prevent difficulties with concussion is to manage the injury properly when it does occur.

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ImPACT 2005 is a user-friendly, Windows-based computer program that can be administered by a team coach, athletic trainer or physician with minimal training. Reaction time is reliably measured to one hundredth of a second across individual test modules (10 modules total) and allows for an assessment of processing speed as the player fatigues. The test battery consists of a near infinite number of alternate forms by randomly varying the stimulus array for each administration. This feature was built in to the program to minimize the "practice effects" that have limited the usefulness of more traditional neurocognitive tests. ImPACT takes approximately 20 minutes to complete. The program measures multiple aspects of cognitive functioning in athletes, including:

Test Section 1: Subject Profile and Health History Questionnaire
Test Section 2: Current Symptoms and Conditions
Test Section 3: Neuropsychological Tests (Baseline and Post-Concussion)
Module 1 (Word Discrimination)
Module 2 (Design Memory)
Module 3 (X's and O's)
Module 4x (Visual Attention Span)
ImPACT 1.0 only-This module has been removed for version 2.0.
Module 4 (Symbol Matching)
Module 5 (Color Match)
Module 6 (Three letters)
IV. Injury Description
V. Graphic Display of Data
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For more information on this exciting diagnostic tool, visit ImPACT's comprehensive Web site.