The "Immediate Post-Concussion Assessment and Cognitive Testing" battery (ImPACT) is a computer-based neurocognitive test that has proven useful in the management of concussions. It tests attention, working memory, and processing speed. It is often administered to athletes prior to participation in contact sports to establish a baseline score. When taken after a concussion, the score can either be compared to baseline (or historical controls) to guide treatment and return to play decisions.
The reference by Schatz showed that baseline scores in college athletes remained stable over a 2-year period, indicating that these athletes do not need to be re-tested every year in order to have an acceptable baseline should they sustain a concussion. This has not been the case in youth athletes. The author recommends that baseline assessments should be continued annually in high school and youth athletes.
Miller et al obtained SAC and ImPACT scores preseason, midseason, and postseason on collegiate football players who had no known concussion. They concluded that ImPACT and SAC neurocognitive test scores are not significantly altered by a season of repetitive contact in collegiate football athletes who have not sustained a concussion.
Answer 2. The Standardized Assessment of Concussion (SAC) was developed to establish a standardized evaluation tool for the immediate assessment of concussion in athletes. It is a “pencil and paper” test performed by the examiner on the sideline and includes measures of orientation, immediate memory, concentration and delayed recall. It does not measure reaction time, balance, coordination or include a neurologic exam.
Answer 3 & 4: The SCAT2 is a newer version of the SCAT that is designed for the use of medical and health professionals. It was designed as a “pencil and paper” test but a version has been created as computer application. Preseason baseline testing with the SCAT2 can be helpful for interpreting post-injury test scores. The SCAT2 includes elements from the Standardized Assessment of Concussion as well as coordination and balance examinations. It does not measure reaction time.
Answer 5: SCORE is a smart phone application which helps to direct parents and coaches in the diagnosis and treatment of athletes with head injuries.
Schatz P. Long-term test-retest reliability of baseline cognitive assessments using IMPACT. Am J Sports Med. 2010 Jan;38(1):47-53.
PMID:19789333 (Link to Abstract)
Miller JR, Adamson GJ, Pink MM, Sweet JC. Comparison of preseason, midseason, and postseason neurocognitive scores in uninjured collegiate football players. Am J Sports Med. 2007 Aug;35(8):1284-8.
PMID:17405886 (Link to Abstract)