ImPACT & Concussion Management

Sprague High School's Athletic Department and Training Room is proud to use cognitive testing program called ImPACT as an ally in our treatment of head injuries. This tool will be used to assist in determining when athletes are ready to return-to-play after sustaining a concussion. The following information will help educate you on this exciting opportunity for your student athletes!

What is a concussion?

A concussion is a brain injury in which trauma to the head results in a temporary disruption of normal brain function. The injury occurs when a person’s brain is violently rocked back and forth or twisted inside the skull as a result of a direct or indirect force. A concussion disturbs brain activity and should be handled as a serious injury. An individual does not have to lose consciousness (“knocked-out”) to suffer a concussion. Proper healing and recovery time following a concussion are crucial in preventing further injury.

Athletes who are not fully recovered from an initial concussion are significantly vulnerable for recurrent, cumulative, and even catastrophic consequences for a second concussive injury. Such difficulties are prevented if the athlete is allowed time to recover from concussions and return to play decisions are carefully made. No athlete should return-to-sport or other at-risk participation when symptoms of concussion are present and recover is ongoing. In summary, the best way to prevent difficulties with concussion is to manage the injury properly when it occurs.

What is ImPACT?

ImPACT is currently the most widely utilized computerized concussion management program in the world and has been implemented effectively for high school, collegiate, and professional athletes. This program was developed through research by neuropsychologists, neurologists and physicians at the University of Pittsburgh Medical Center (UPMC).

ImPACT stands for Immediate Post-concussion Assessment and Cognitive Test. It is a sophisticated software program developed to help sports-medicine clinicians evaluate recovery following concussion. ImPACT is a computer test that evaluates multiple aspects of neurocognitive functioning including memory, brain processing speed, reaction time and post-concussive symptoms.

Athletes, especially those who participate in contact sports, should take a “baseline” test prior to the start of their athletic season. The baseline test takes approximately 30 minutes and can be done through the Internet. Taking a baseline is like “giving your brain a physical” and establishes a normal level of performance.

After an athlete suffers a concussion, a medical evaluation followed by a “post-concussion” ImPACT test is performed. Post-concussion testing should be taken within 48 to 72 hours after the injury. Diagnostic testing may be ordered, such as a MRI or a CT scan, to rule out structure injury to the skull or brain. In spite of the fact that these tests are usually normal, a serious concussion may still have occurred.

If an athlete has not taken the baseline test, ImPACT Inc. has developed norms that can be used to evaluate the recovery process of a concussed athlete.

ImPACT assists in:

  • Protecting the student athlete

  • Determining safe return to sport

  • Preventing the cumulative effects or repeated concussions

  • Providing objective data to help assess an athletes’ recovery. IT IS NOT THE DETERMINING FACTOR FOR RETURN-TO-PLAY.

TEST FEATURES:

Baseline Test:

  • The baseline test is a pre-injury measurement of an athletes’ cognitive function. Should an athlete sustain a concussion, post-injury tests can be compared to a baseline data and provide valuable information that aids in the return to sport decision.

  • Baseline tests are recommended for any athlete ages 13 and up and especially for those who participate in contact sports.

Post-Concussion Tests:

  • If a concussion occurs a post-concussion test would be administered 48-72 hours after injury, and interpreted by medical clinicians.

  • These results are then compared with the baseline data to assist in determining the degree of recovery. Additional post-injury tests may be required until complete recovery has occurred.

Where can I find more information?

If you would like more information, please visit the ImPACT Website.

Why is it so important to utilize tools like ImPACT to gather more information about the concussion?

It is important to note that ImPACT is not designed to make all the decision about when an athlete has sustained a concussion or when they are ready to return. It is just another tool that can be utilized to gather more information about the injury. Click here to see a video and read an article about the diagnosis of concussions and the importance of preventing Second Impact Syndrome.

Who will be tested?

Any athlete who suffers a head injury will take a post-concussion test. Sprague is proud to promote the fact that ALL athletes will be baseline tested, regardless of their risk of a head injury.

What are the return-to-play guidelines after a concussion?

Any athlete who sustains a concussion will be required to complete the return-to-play guidelines jointly established between Hope Orthopedics of Oregon and the Salem-Keizer School District. Those guidelines are as follows:

  • The athlete must meet the requirements of each step of the RTP protocol, with no return of symptoms, in order to progress to the next step.

  • There must be a minimum of 24 hours elapsed for progress between steps. If symptoms return at any step, the athlete will return to step 1 until symptoms resolve, and repeat the progression.

  • Clearance from a licensed health care professional as defined per OAR 581-022-0421 (see below) must be given before the athlete moves past Step 1. Clearance can be given via communication with the school Athletic Trainer; office visits are not always mandated.

    • Step 1: NO ACTIVITY. The athlete has completed the following items:

A. Self-reported to be symptom free on the Symptom Monitoring Form

B. Has returned to school full time and normal academic performance

C. Satisfactory ImPACT score

D. Their Health Care Provider has cleared the athlete for return-to-play progression. Clearance can be provided via communication with the school Athletic Trainer; office visits are not always mandated.

    • Step 2: LIGHT EXERCISE. The athlete may engage in light, non-contact, low-impact aerobic activity such as walking, swimming, or riding an exercise bike with a goal of elevating heart rate (<70% of age-predicted maximum heart rate).

    • Step 3: SPORT-SPECIFIC ACTIVITIES. The athlete may engage in vigorous, non-contact, sport specific drills, with a goal of challenging concentration and increasing impact associated with elevated heart rate without the threat of contact from others. No helmet or other equipment should be utilized.

    • Step 4: NON-CONTACT TRAINING DRILLS IN FULL EQUIPMENT. The athlete may participate in non-contact practice, with a goal of simulating sport participation without opportunity for re-injury. Resistance training can begin or resume.

    • Step 5: FULL CONTACT PRACTICE or TRAINING. The athlete may participate in unrestricted training or practices.

    • Step 6: RETURN TO PLAY. The athlete is considered fully cleared for participation, including games.

* Based on the 2014 NATA Position Statement: Management of Sports Concussion Per OAR 581-022-0421 “Health Care Professional” means a Physician (MD), Physician Assistant (PA), Doctor of Osteopathic (DO) licensed by the Oregon State Board of Medicine, nurse practitioner licensed by the Oregon State Board of Nursing, or Psychologist licensed by the Oregon Board of Psychologist Examiners.