Long-term Stability and Reliability of Baseline Cognitive Assessments in High School Athletes Using ImPACT at 1-, 2-, and 3-year Test–Retest Intervals

Brett, Benjamin L.; Smyk, Nathan; Solomon, Gary S.; Baughman, Brandon; Schatz, Philip

doi:10.1093/arclin/acw055

Cited by 21 publications

(14 citation statements)

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“…As mentioned above, the reliability of the KINARM tasks utilized here was similar to other assessment tools currently being used to assess SRC-related deficits, such as ImPACT neurocognitive testing [ 9 , 33 – 35 ], SOT posturography [ 38 ], and symptom reporting [ 39 ]. Given that SRC is a diffuse injury with many potential overlapping pathologies, it is not always clear what to look for (e.g., many different signs/symptoms, cognitive impairment, sensorimotor deficits, balance impairment, vestibular features, oculomotor deficits, cervicogenic features, autonomic nervous system dysfunction).…”

Section: Discussionmentioning

confidence: 75%

“…The test-retest reliability of the subset of KINARM Standard Tests studied presently appears comparable to other assessment tools currently being used to evaluate SRC in clinical and research settings. For example, investigation of test-retest reliability of computerized neurocognitive tests, such as the ImPACT, in athletes has yielded results suggesting a range from very poor to very good reliability [ 9 , 33 – 35 ]. A study of young healthy individuals completing the Sensory Organization Test of Computerized Dynamic Posturography (SOT), a test commonly used to evaluate postural stability in SRC research [ 36 , 37 ], determined an ICC of 0.64 for its composite score and ICCs ranging from 0.43 to 0.79 for the scores derived for each of the six SOT conditions [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…Developing assessments with good test-retest reliability poses another challenge to the field that is critical to overcome if such assessments are to be used to establish baseline levels of function and/or track individuals’ recovery post-SRC. For example, a large study of the Immediate Post-concussion Assessment Tool and Cognitive Test (ImPACT), one of the most commonly used SRC assessment tools in clinical and research settings [ 8 ], recently reported lower test-retest reliability than was previously thought (intraclass correlation coefficients [ICCs] for the four composite scores ranging from 0.36 to 0.90 across 1-, 2- and 3-year time intervals) [ 9 ]. Thus, there remains a need to develop valid clinical tools that are able to objectively, efficiently and reliably assess functional impairment across multiple domains.…”

Section: Introductionmentioning

confidence: 99%

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Test-retest reliability of the KINARM end-point robot for assessment of sensory, motor and neurocognitive function in young adult athletes

Mang

Whitten

Cosh³

et al. 2018

PLoS ONE

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BackgroundCurrent assessment tools for sport-related concussion are limited by a reliance on subjective interpretation and patient symptom reporting. Robotic assessments may provide more objective and precise measures of neurological function than traditional clinical tests.ObjectiveTo determine the reliability of assessments of sensory, motor and cognitive function conducted with the KINARM end-point robotic device in young adult elite athletes.MethodsSixty-four randomly selected healthy, young adult elite athletes participated. Twenty-five individuals (25 M, mean age±SD, 20.2±2.1 years) participated in a within-season study, where three assessments were conducted within a single season (assessments labeled by session: S1, S2, S3). An additional 39 individuals (28M; 22.8±6.0 years) participated in a year-to-year study, where annual pre-season assessments were conducted for three consecutive seasons (assessments labeled by year: Y1, Y2, Y3). Forty-four parameters from five robotic tasks (Visually Guided Reaching, Position Matching, Object Hit, Object Hit and Avoid, and Trail Making B) and overall Task Scores describing performance on each task were quantified.ResultsTest-retest reliability was determined by intra-class correlation coefficients (ICCs) between the first and second, and second and third assessments. In the within-season study, ICCs were ≥0.50 for 68% of parameters between S1 and S2, 80% of parameters between S2 and S3, and for three of the five Task Scores both between S1 and S2, and S2 and S3. In the year-to-year study, ICCs were ≥0.50 for 64% of parameters between Y1 and Y2, 82% of parameters between Y2 and Y3, and for four of the five Task Scores both between Y1 and Y2, and Y2 and Y3.ConclusionsOverall, the results suggest moderate-to-good test-retest reliability for the majority of parameters measured by the KINARM robot in healthy young adult elite athletes. Future work will consider the potential use of this information for clinical assessment of concussion-related neurological deficits.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Test-retest reliability of the KINARM end-point robot for assessment of sensory, motor and neurocognitive function in young adult athletes

Mang

Whitten

Cosh³

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…An evidence-based definition of recovery from concussion is important given the risk of more severe consequences should repeat injury occur before resolution of the first concussion 15 and increased awareness of possible long-term effects of concussion. 16 The test-retest reliability and internal consistency of Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), 17 the Buffalo Concussion Treadmill Test (BCTT), 18 and the Sport Concussion Assessment Tool (SCAT) 19 have been reported on but not for other measures. The international consensus meetings on concussion in sport 67 has stated that a single criterion may not be sufficient to define concussion recovery; hence, we included only research articles that used at least two measures to define recovery from sport-related concussion.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of criteria used to define recovery from sport-related concussion in youth athletes

et al. 2017

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All studies of sport-related concussion use symptom reports to define recovery. A minority of studies used multiple measures of outcome or had clearly defined recovery criteria, the most common being a combination of a self-reported symptom checklist and a computerised neurocognitive test. Future studies ideally should define recovery a priori using objective physiological measures in addition to symptom reports.

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“…Patients with no further testing after their initial baseline test were considered lost to follow-up. 5,6,42 In accordance with Centers for Disease Control and Prevention guidelines, participants lost to follow-up contributed 1 person-year. 8 To estimate the severity of each head trauma and/or concussion, we calculated the previously published SI.…”

Section: Concussion Composite Scores and Symptom Clustersmentioning

confidence: 99%

Sex-Related Differences in the Incidence, Severity, and Recovery of Concussion in Adolescent Student-Athletes Between 2009 and 2019

Hannah

Spiera

et al. 2021

Am J Sports Med

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Background: The sex of an athlete is thought to modulate concussion incidence; however, the effects of sex on concussion severity and recovery are less clear. Purpose: To evaluate sex differences in concussion severity and recovery using a large, heterogeneous sample of young student-athletes with the goal of understanding how sex affects concussion outcomes in young athletes. Study Design: Cohort study; Level of evidence, 3. Methods: The Immediate Post-Concussion Assessment and Cognitive Testing results of 11,563 baseline and 5216 postinjury tests were used to calculate the incidence of concussion of adolescent male and female student-athletes ages 12 to 22 years (median, 15 years). The postinjury tests of 3465 male and 1751 female student-athletes evaluated for concussion or head trauma were used to assess differences in the Severity Index (SI) and recovery. Chi-square tests and t tests were used to compare differences in demographic characteristics, incidence, and SI between the 2 cohorts. Multivariable linear, logistic, and Cox proportional hazards regressions were used to control for differences between cohorts in analyses of incidence, SI, and recovery. Results: When we controlled for demographic differences, female participants had higher odds of concussion (odds ratio, 1.62; 95% CI, 1.40-1.86; P < .0001) and higher SI after concussion (β = 0.67; 95% CI, 0.02-1.32; P = .04). This discrepancy in SI was a result of differences in Symptom (2.40 vs 2.94; P < .0001) and Processing Speed (0.91 vs 1.06; P = .01) composite scores between male and female participants, respectively. We found no effect of sex on time to recovery when controlling for initial concussion SI (hazard ratio, 0.94; 95% CI, 0.78-1.12; P = .48). Conclusion: Using large, multisport cohorts, this study provides evidence that female athletes are at higher risk for more concussions and these concussions are more severe, but male and female athletes have similar recovery times when the analysis controls for initial concussion SI.

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Long-term Stability and Reliability of Baseline Cognitive Assessments in High School Athletes Using ImPACT at 1-, 2-, and 3-year Test–Retest Intervals

Cited by 21 publications

References 58 publications

Test-retest reliability of the KINARM end-point robot for assessment of sensory, motor and neurocognitive function in young adult athletes

Test-retest reliability of the KINARM end-point robot for assessment of sensory, motor and neurocognitive function in young adult athletes

A systematic review of criteria used to define recovery from sport-related concussion in youth athletes

Sex-Related Differences in the Incidence, Severity, and Recovery of Concussion in Adolescent Student-Athletes Between 2009 and 2019

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