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Published byChristian McLaughlin Modified over 9 years ago
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Computerized neurocognitive testing
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Scientific evaluation
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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
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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
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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
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Decreased Processing Speed Short-Term Memory Impairment Concentration Deficit Irritability/Depression Fatigue/Sleep Disturbance General Feeling of “Fogginess” Academic Difficulties LATER SIGNS OF CONCUSSION: Post-Concussion Syndrome
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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
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IS ImPACT SENSITIVE? (2003 ImPACT Data) CONCUSSED CONTROL CONCUSSED 93% 7% (107) (8) CONTROL 12% 88% (6) (43) F=25.2, p<.000 (Discriminant function analysis-classification) Variables in Equation: ImPACT MEM, Processing, RT and Symptoms Composite and Concussion HX N=115 concussed N=49 controls
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24-72 Hours y Day 5-10 Concussion Beyond (if necessary) Baseline Testing (Normative data available for decision making when baseline data not available) Clinical Studies
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CASE 1: KICK-OFF RETURNER Exertion DAY 3 6 10 13 14
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N=410. p.<. 00001 N.S. p.<.0001p.<.03 Significant difference between groups out to at least 8 days post-injury Collins MW, Lovell MR, Maroon et al. Medicine and Science in Sports Exercise, 34:5;2002 ImPACT MEMORY COMPOSITE Control vs. Concussed Athletes *Lower score indicates poorer performance
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ImPACT REACTION TIME COMPOSITE Control vs. Concussed Athletes Significant difference between groups out to 5 days post-injury N=410. p.<.005 N.S. p.<.0004N.S. Lovell MR, Collins MW, Maroon et al. Medicine and Science in Sports Exercise, 34:5;2002 *Higher score indicates poorer performance
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UNIQUE CONTRIBUTION OF ImPACT TO CONCUSSION MANAGEMENT N=115 MANOVA p<.000000 ImPACT reveals cognitive deficits in asymptomatic athletes within 4 days post-injury
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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
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ImPACT will NOT….. - Prevent a concussion from occurring - Eliminate the risk of concussion
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Let’s take a test!!!
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