Tracking neuropsychological recovery following concussion in sport

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.