Two-year test-retest reliability in high school athletes using the four- and two-factor ImPACT composite structures: The effects of learning disorders and headache/migraine treatment history

Arch Clin Neuropsychol. 2017 Feb;


Brett, B. L., Solomon, G. S., Hill, J. and Schatz, P..



Objective: This study examined the test-retest reliability of the four- and two-factor structures (i.e., Memory and Speed) of ImPACT over a 2-year interval across multiple groups with premorbid conditions, including those with a history of special education or learning disorders (LD; n = 114), treatment history for headache/migraine (n = 81), and a control group (n = 792). Methods: Nine hundred and eighty seven high school athletes completed baseline testing using online ImPACT across a 2-year interval. Paired-samples t-tests documented improvement from initial to follow-up assessments. Test stability was examined using Regression-based measures (RBM) and Reliable change indices (RCI). Reliability was examined using intraclass correlation coefficients (ICC). Results: Significant improvement on all four composites were observed for the control group over a 2-year interval; whereas significant differences were observed only on Visual Motor Speed for the LD and headache/migraine treatment history groups. ICCs ranges were similar across groups and greater or comparable reliability was observed for the two-factor structure on Memory (0.67-0.73) and Speed (0.76-0.78) composites. RCIs and RBMs demonstrated stability for the four- and two-factor structures, with few cases falling outside the range of expected change within a healthy sample at the 90% and 95% CIs. Conclusion: Typical practices of obtaining new baselines every 2 years in the high school population can be applied to athletes with a history of special education or LD and headache/migraine treatment. The two-factor structure has potential to increase test-retest reliability. Further research regarding clinical utility is needed. KEYWORDS: Assessment; Childhood brain insult; Developmental and learning disabilities; Norms/normative studies; Practice effects/reliable change; Sports concussion PMID: 28666316 DOI: 10.1093/arclin/acx059

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