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Computerized neurocognitive testing

Learn about ImPACT, a tool for assessing concussions developed by UPMC, measuring brain function and aiding in safe return-to-play decisions.

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Computerized neurocognitive testing

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  1. Computerized neurocognitive testing

  2. Scientific evaluation

  3. Other programs available • Headminder • Most research done more than 10yrs ago • Being used for dementia and other medical conditions- not specialized just for concussion • Cogstate Sport • Developed in Australia • Much fewer data elements • Markedly less research • Limited use compared to others

  4. ImPACT: A TOOL FOR EVALUATING CONCUSSION • (Immediate Post-Concussion Assessment and Cognitive Testing) • Computerized test developed by clinical researchers at the University of Pittsburgh Medical Center (UPMC) • Developed to allow for a more objective assessment of concussion and recovery • Accounts for individual differences in cognitive ability and symptom reporting through the use of baseline testing • Provides a common metric which allows for effective collaboration between athletic trainers, coaches, physicians, and neuropsychologists in concussion management • Utilized throughout professional and amateur sports across the country and internationally

  5. How does is help? • Quantify the injury with a highly sensitive measure of brain function • Protect the student athlete. •  Help determine safe return to play. •  Help prevent cumulative effects of multiple concussions •  Provides objective data to help determine athlete’s injury status •  Prevent lingering effects of concussion and potential catastrophic injury

  6. LATER SIGNS OF CONCUSSION: Post-Concussion Syndrome • Decreased Processing Speed • Short-Term Memory Impairment • Concentration Deficit • Irritability/Depression • Fatigue/Sleep Disturbance • General Feeling of “Fogginess” • Academic Difficulties

  7. WHAT DOES ImPACT MEASURE? • Demographic/Concussion History Questionnaire •  Concussion Symptom Scale • - 21 Item Likert scale (e.g. headache, dizziness, nausea, etc) •  Eight Neurocognitive Measures • - Measures domains of Memory, Working Memory, Attention, Reaction Time, Mental Speed, Verbal Memory, Visual Memory, Reaction Time, Processing Speed - Summary Scores •  Detailed Clinical Report • - Automatically computer scored • - Outlines demographic, symptom, neurocognitive data

  8. IS ImPACT SENSITIVE? (2003 ImPACT Data) Variables in Equation: ImPACT MEM, Processing, RT and Symptoms Composite and Concussion HX N=115 concussed N=49 controls CONCUSSEDCONTROL CONCUSSED 93% 7% (107) (8) CONTROL12% 88% (6) (43) F=25.2, p<.000 (Discriminant function analysis-classification)

  9. Clinical Studies 24-72 Hours Day 5-10 Concussion Baseline Testing (Normative data available for decision making when baseline data not available) Beyond (if necessary)

  10. CASE 1: KICK-OFF RETURNER DAY 3 6 10 13 14 Exertion

  11. ImPACT MEMORY COMPOSITEControl vs. Concussed Athletes Significant difference between groups out to at least 8 days post-injury N.S. p.<.00001 p.<.0001 p.<.03 N=410 . *Lower score indicates poorer performance Collins MW, Lovell MR, Maroon et al. Medicine and Science in Sports Exercise, 34:5;2002

  12. N.S. p.<.005 p.<.0004 N.S. ImPACT REACTION TIME COMPOSITEControl vs. Concussed Athletes Significant difference between groups out to 5 days post-injury N=410 . *Higher score indicates poorer performance Lovell MR, Collins MW, Maroon et al. Medicine and Science in Sports Exercise, 34:5;2002

  13. UNIQUE CONTRIBUTION OF ImPACT TO CONCUSSION MANAGEMENT N=115 MANOVA p<.000000 ImPACT reveals cognitive deficits in asymptomatic athletes within 4 days post-injury

  14. If Used Correctly, ImPACT will… • Help determine severity of concussion • Provide valuable information to the athlete, parents, athletic trainers, physicians • Provide information on academic deficits associated with concussion • Promote safe return to play • - Reduce liability for school districts

  15. ImPACT will NOT….. • Prevent a concussion from occurring • - Eliminate the risk of concussion

  16. Let’s take a test!!!

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