Immediate Post-Concussion Assessment and Cognitive Testing (IMPACT) Practices of Sports Medicine Professionals (Report‪)‬

The assessment and management of sport-related concussions should be a multifaceted approach that consists of a clinical examination, completion of a self-reported symptom checklist, postural assessment, and neurocognitive testing. (1) Computerized neurocognitive testing has been deemed (2-5) a more objective measure for determining the subtle cognitive changes associated with concussion. Recently, numerous concussion consensus statements and position papers (1,6-9) have supported and emphasized the use of baseline preinjury and serial postinjury follow-up neurocognitive testing protocols. Because of the difficulty in detecting the signs and symptoms that often accompany concussion, baseline neurocognitive testing has resulted in increased detection of postconcussion neurocognitive impairments. (2,5,10,11) Moreover, baseline neurocognitive testing provides the most accurate representation of an athlete's preinjury cognitive status. The need for individual baseline examinations arises from individual differences in cognitive performance in the areas of attention, memory, concentration, information processing, and reaction time. Without this information, it is difficult to ascertain if a concussed athlete's postconcussion neurocognitive scores are the result of concussion or individual variability. In addition, baseline neurocognitive tests may be used as a tool to determine concussion resolution for return-to-play decisions. (7) Although normative data may be valuable in clinical cases when baseline scores are not available for each athlete, collecting preconcussion and postconcussion neurocognitive data allows sports medicine professionals to track the cognitive recovery of each concussed athlete, rather than using a universal or "one-size-fits-all" approach to managing concussion. (2,12,13) However, no authors have investigated the compliance or practice trends of sports medicine professionals using baseline neurocognitive testing at the high school and collegiate levels.