Concussion Management Defined

Test/ Retest Reliability for ImPACT Pediatric Post One to Two Years in Five to Eleven Year Olds

Journal of Athletic Training. 2018 Nov;


Cornell, N. A., Moore, M. T., Wujcik, N. A., Hamachek, J. and Lovell, M. R..


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Context: There is a scarcity of information regarding the pediatric population and sports-related concussions in the age range 5-11. Furthermore, there is no test on the market that assesses neurocognition in this age group. Objective: To assess the test retest reliability of a new Pediatric ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) within a one to two year span. The ImPACT test was designed to test neurocognition in the pediatric population ages 5-11.

Design: Cohort Setting: Quiet environment Patients or Other Participants: There were 39 students (6 females, 33 males) ages 5-11. Students were recruited from local sports (hockey and soccer) in a rural location to participate in this research. Mean BMI was 17.408 ± 3.685 and mean age 7.172 ± 1.535. The student’s baselines were 15.859 ± 5.572 months apart for test/retest reliability. Interventions: Students were partnered with a trained Certified Athletic Trainer or athletic training student. The students worked one-on-one in a quiet environment. Each time the students participated they were rewarded with a small snack of their choice. The student’s height and weight were measured or recorded from subjective parental report.

Main Outcome Measures: Two-way mixed intraclass correlation coefficients (ICC) determined relationships between modules on the Pediatric ImPACT which are word list, design rotation, memory touch, stop and go and picture match. Pearson correlations examined if older children 7-11 were more reliable.

Results: Intraclass correlation coefficients were strongly significant for Picture Match number correct [ICC = .858, P < .001] and average number of taps [ICC = .791, P < .001]. This improved in older children, ages 7 + (N = 25) Pearson correlations were strong for Picture Match number correct (r = .858, P < .001) and improved withchildrenage9+(N=7)(r=.966,P< .001). Results were moderately correlated for Stop and Go average time [ICC = .805, P < .001], Design Rotation average time [ICC = .716, P < .001] and Memory Touch number of sequences correct [ICC = .497, P = .019]. Weak, but significant correlations for Word Recall number correct [ICC = .275, P = .043] were found.

Conclusions: This preliminary testing indicates that Pediatric ImPACT is consistent over time for several of the modules. The modules improve in consistency as a child’s cognitive development changes over time.

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