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. 2018 Mar 1;33(2):216-226. doi: 10.1093/arclin/acx059.

Abstract

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.

MeSH terms

  • Adolescent
  • Age Factors
  • Athletic Injuries / complications
  • Brain Concussion / complications*
  • Brain Concussion / etiology
  • Female
  • Humans
  • Learning Disabilities / diagnosis
  • Learning Disabilities / etiology*
  • Longitudinal Studies
  • Male
  • Memory Disorders / etiology
  • Migraine Disorders / diagnosis
  • Migraine Disorders / etiology*
  • Neuropsychological Tests*
  • Reaction Time / physiology
  • Reproducibility of Results
  • Schools
  • Verbal Learning