One year test-retest reliability of neurocognitive baseline scores in 10- to 12-year olds.

How often youth athletes 10-12 years of age should undergo neurocognitive baseline testing remains an unanswered question. We sought to examine the test-retest reliability of annual ImPACT data in a sample of middle school athletes. Participants were 30 youth athletes, ages 10-12 years (Mean = 11.6, SD = 0.6) selected from a larger database of 10-18 year old athletes, who completed two consecutive annual baseline evaluations using the online version of ImPACT. Athlete assent and parental consent were obtained for all participants. Assessments were conducted either individually or in small groups of 2 to 3 athletes, under the supervision of a neuropsychologist or post-doctoral fellow. Test-retest coefficients were as follows: Verbal Memory .71, Visual Memory .35, Visual Motor Speed .69, Reaction Time .34. Intra-class Correlation Coefficients (single/average) were as follows: Verbal Memory .70/.83, Visual Memory .35/.52, Visual Motor Speed .69/.82, Reaction Time .34/.50. Regression-based measures to correct for practice effects revealed that only a small percentage of cases fell outside 90 and 95% confidence intervals, reflecting stability across assessments. Findings indicate that test-retest reliability of Verbal Memory and Visual Motor Speed are generally stable in 10-12 year old athletes. Nevertheless, Visual Memory Index, Reaction Time Index, and Symptom Checklist scores appear to be less reliable over time, especially compared to published data on high school athletes, suggesting the utility of re-testing on an annual basis in this younger age group.

Examining prescribed rest as treatment for adolescents who are slow to recover from concussion.

OBJECTIVE: Rest is a widely recommended treatment for concussion, but its utility is unclear following the acute stage of recovery. This study examined the effects of 1-week of prescribed rest in concussed adolescent athletes. METHOD: Participants were 13 adolescent athletes with persistent symptoms following a concussion. More than three-quarters (77%) had self-reported ADHD, learning disability or two prior concussions. All completed ImPACT at another facility, but none completed a period of comprehensive rest prior to examination at a specialty practice. Three time points of test data were compared, to control for possible spontaneous recovery: Test 1 (external facility), Test 2 (before prescribed rest) and Test 3 (following prescribed rest). RESULTS: Repeated measures ANOVAs revealed a significant effect of prescribed rest on all ImPACT composite scores and the total symptom score. Post-hoc analyses revealed no significant differences between Time 1 and Time 2, whereas significant differences were present after prescribed rest. Following prescribed rest, having two or more reliably improved cognitive test scores or having improved symptoms was present in eight of the 13 patients (61.5%). CONCLUSIONS: A substantial percentage of adolescents with persistent symptoms following concussion showed improvement in symptoms and cognitive functioning following education, reassurance and 1-week of prescribed rest.