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ImPact test-retest reliability: reliably unreliable?

Abstract：

CONTEXT:Computerized neuropsychological testing is commonly used in the assessment and management of sport-related concussion. Even though computerized testing is widespread, psychometric evidence for test-retest reliability is somewhat limited. Additional evidence for test-retest reliability is needed to optimize clinical decision making after concussion. OBJECTIVE:To document test-retest reliability for a commercially available computerized neuropsychological test battery (ImPACT) using 2 different clinically relevant time intervals. DESIGN:Cross-sectional study. SETTING:Two research laboratories. PATIENTS OR OTHER PARTICIPANTS:Group 1 (n = 46) consisted of 25 men and 21 women (age = 22.4 ± 1.89 years). Group 2 (n = 45) consisted of 17 men and 28 women (age = 20.9 ± 1.72 years). INTERVENTION(S):Both groups completed ImPACT forms 1, 2, and 3, which were delivered sequentially either at 1-week intervals (group 1) or at baseline, day 45, and day 50 (group 2). Group 2 also completed the Green Word Memory Test (WMT) as a measure of effort. MAIN OUTCOME MEASURES:Intraclass correlation coefficients (ICCs) were calculated for the composite scores of ImPACT between time points. Repeated-measures analysis of variance was used to evaluate changes in ImPACT and WMT results over time. RESULTS:The ICC values for group 1 ranged from 0.26 to 0.88 for the 4 ImPACT composite scores. The ICC values for group 2 ranged from 0.37 to 0.76. In group 1, ImPACT classified 37.0% and 46.0% of healthy participants as impaired at time points 2 and 3, respectively. In group 2, ImPACT classified 22.2% and 28.9% of healthy participants as impaired at time points 2 and 3, respectively. CONCLUSIONS:We found variable test-retest reliability for ImPACT metrics. Visual motor speed and reaction time demonstrated greater reliability than verbal and visual memory. Our current data support a multifaceted approach to concussion assessment using clinical examinations, symptom reports, cognitive testing, and balance assessment.

journal_name

J Athl Train

journal_title

Journal of athletic training

authors

Resch J,Driscoll A,McCaffrey N,Brown C,Ferrara MS,Macciocchi S,Baumgartner T,Walpert K

doi

10.4085/1062-6050-48.3.09

subject

Has Abstract

pub_date

2013-07-01 00:00:00

pages

506-11

issue

4

eissn

1062-6050

issn

1938-162X

journal_volume

48

pub_type

杂志文章

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