A majority of area schools use imPACT as their diagnostic concussion test of choice.
That doesn’t mean all of them employ the computer program — a cognitive quiz that tests the user’s memory and reaction time, among other things — in the same way. There even is one local public school that doesn’t use imPACT, which stands for Immediate Post-Concussion Assessment and Cognitive Testing.
An athlete’s initial test provides a baseline score so there is a foundation for comparison when the athlete experiences concussion symptoms.
Evanston requires of all its athletes to take the imPACT test before they can try out for a sport.
“We want to maximize our ability to keep our kids safe,” said Chris Livatino, Evanston’s athletic director. “They key is to make sure they don’t get a second concussion before the first one is healed.”
New Trier goes a step farther and tests all of its students.
Loyola only administers the imPACT test to athletes who play the following contact sports. Right now, the Ramblers test athletes who compete in basketball, field hockey, football, lacrosse and soccer. But Loyola athletic director Pat Mahoney has been urging the school to test all of its athletes.
“I think it’s cleaner that way,” Mahoney said. “You never know when you might get one. You could be walking down the hallway, trip and fall.”
Every athletic director and athletic trainer interviewed for this story agreed that imPACT is only one measure used to detect and monitor concussion symptoms.
“I find that it is a valuable tool,” said Dale Grooms, New Trier’s athletic trainer. “It’s not the end-all, be-all.”
The test is divided into six sections and requires a high level of concentration.
The first part shows test takers a series of simple words that they have to remember a short time later. Those same words then appear at the end of the test, which lasts about 30 minutes, for the user to remember. Another section shows pictures of squiggly lines and irregular shapes that must be recalled later. Yet another part flashes a red circle and blue square. The test taker must press a corresponding letter on the keyboard each time one of the shapes shows up.
“It’s a way to measure your cognitive reaction time,” Grooms said.
While Evanston and New Trier are two schools that require all of their athletes to have a baseline imPACT score on file, they each use the test differently once an athlete is concussed.
After putting the athlete through a series of physical examinations immediately following a possible head injury, Evanston will administer an imPACT test within 48 hours. Lucy Lipton, one of two athletic trainers at the school, said she wants to start a progress report as soon as possible.
“We like to have an idea of where we are starting post-concussion,” Lipton said. “We find that it’s a good objective tool to show something has changed.”
If an athlete doesn’t reach his or her baseline the first time, Evanston doesn’t retest again until no symptoms, such as headaches or nausea, are present.
New Trier waits until its athletes are free of symptoms until using imPACT at all. Grooms said he wouldn’t have an athlete run on a broken leg, so he doesn’t subscribe to testing an athlete’s brain while it potentially is concussed.
“If the brain is injured, we do not want to stress it,” said Grooms, who’s been the school’s trainer since 2000 and has used imPACT for nearly a decade.
“We don’t want them to take the test while they are still hurting. We want them to be successful.”
Ridgewood used the imPACT test in the past, but it doesn’t anymore, according to Rob St. John, the school’s athletic director. Instead, the school follows a concussion protocol set forth by Athletico Physical Therapy, which Ridgewood employs on a contractual basis.
“Athletico has a system in place that we follow, and we are happy with the results,” said St. John, who is also the Rebels’ boys soccer coach. “They are trained in evaluating concussions, asking the right questions. Most importantly, they are trained in knowing the right answers to those questions.”
Mike Palm, Athletico’s manager of concussion services, said his company uses a battery of tests that exam balance and cognition and study symptomatology. He said Athletico’s trainers will ask athletes to count back from 100 by sevens or recite the months of the year in reverse order.
“We want to ask them simple things that make them concentrate,” said Palm, who is based in Oak Brook. “It’s about the quality of how they are answering the questions.”
The IHSA doesn’t mandate that its member schools conduct imPACT or any other cognitive testing. Kurt Gibson, the organization’s associate executive director in charge of sports medicine, said the biggest reasons are cost and access.
“It may be cheap to one school, but not to another,” he said. “There also are some schools in pretty remote places in Illinois, so finding someone who is trained to interpret the data could be challenging.”