Preseason Assessment as a Predictor of Post-Concussion Performance of Athletes on the Immediate Post-Concussion Assessment and Cognitive Test

Kelly Lambeth, University of Texas at El Paso


Ideally, athletes are assessed pre-season to establish their cognitive-communicative status for comparison purposes if the athlete suffers a concussion during their season. Post-concussion (PC) assessment comparison with the baseline (BL) assessment will provide clinical information for treatment of the athlete's concussion. The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test was used for assessment of pre-and post-concussion. Because the literature indicates that some athlete's attempt to actively perform poorly on the preseason assessment to misrepresent their performance post-concussion it would be interesting to determine if there is a score on the ImPACT pre-season test that would predict their post-concussion test performance. This information may help in the management of sports-related concussions by identifying athletes at preseason assessment who are potentially underperforming. The current study examined the Cognitive Efficiency Score (CEI) because the CEI score measures accuracy and speed of the Symbol Match subtest which is a reliable indicator to determine the extent to which the athlete tried to work fast on the symbol match (decreasing accuracy) or attempted to improve their accuracy by taking a more deliberate and slow approach (jeopardizing speed). In this study, 52 participants underwent a preseason evaluation and then were reevaluated within 0–7 days after they sustained their injury. Results showed there were statistically significant difference between the baseline CEI and the post-season scores, which permitted the evaluation to determine if the baseline CEI could predict how athletes would perform on their post-concussion assessment. The participants were organized into three groups based on the results of their preseason CEI score (Group 1=.00-.20, N=11), (Group 2=.21-.40, N=26), and (Group 3=.41-.60, N=15)) to determine if performance on baseline CEI predicted their performance on the PC test. When separated into the three groups, the results were more specific. The results from this study suggest that the preseason CEI score for only Group 1 is a significant predictor for how athletes will perform on the PC ImPACT test. This study supports the potential use of the CEI score as an important clinical variable for assessing the compliance of an athlete's efforts to perform to their maximum abilities. Additionally, total symptom scores for BL CEI and PC CEI were both considered significant so it is important to continue to identify a measure(s) that could potentially be predictive factors of BL performance to PC performance which could provide clinicians with appropriate prognosis and return-to-play decisions for our athletes.

Subject Area

Speech therapy

Recommended Citation

Lambeth, Kelly, "Preseason Assessment as a Predictor of Post-Concussion Performance of Athletes on the Immediate Post-Concussion Assessment and Cognitive Test" (2018). ETD Collection for University of Texas, El Paso. AAI10813573.