Tracking neuropsychological recovery following concussion in sport

Abstract

PRIMARY OBJECTIVE: The purpose of this study was to illustrate the serial use of computerized neuropsychological screening with ImPACT to monitor recovery in a clinical case series of injured athletes. METHODS AND PROCEDURES: Amateur athletes with concussions (n= 30, average age= 16.1, SD= 2.1 years) underwent pre-season testing and three post-concussion evaluations within the following intervals: 1-2 days, 3-7 days (M= 5.2 days) and 1-3 weeks (M= 10.3 days). The study selection criteria increased the probability of including athletes with slow recovery. RESULTS: Repeated measures ANOVAs revealed significant main effects for all five composite scores (verbal memory, visual memory, reaction time, processing speed and total symptoms). In group analyses, performance decrements and symptoms relating to concussion appeared to largely resolve by 5 days post-injury and fully resolve by 10 days. Athletes' scores were examined individually using the reliable change methodology. At 1 day post-injury, 90% had two or more reliable declines in performance or increases in symptom reporting. At 10 days, 37% were still showing two or more reliable changes from pre-season levels. CONCLUSIONS: This study illustrates the importance of analysing individual athletes' test data because group analyses can obscure slow recovery in a substantial minority of athletes.