title: Baseline Neurocognitive Performance and Clearance for Athletes to Return to Contact.
abstract: BACKGROUND
  Computerized neurocognitive assessments are commonly used to manage sport-related concussion. Variations in baseline performance may influence neurocognitive performance after injury as well as the amount of time needed for an athlete to be cleared for return to sport participation.
  
  
  OBJECTIVE
  To investigate the relationship between mean baseline Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) scores and postconcussion reliable decline as well as the association between postconcussion cognitive decline and days missed after injury.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  University concussion databank.
  
  
  METHODS
  A total of 84 collegiate athletes who sustained a concussion between 2008 and 2015 were studied. For each ImPACT composite score (verbal memory, visual memory, visual motor speed, reaction time), athletes were grouped based on the presence or absence of reliable decline and on the presence of reliable decline in 0, 1, 2, 3, or 4 cognitive domains.
  
  
  METHODS
  Outcome measures were baseline ImPACT composite scores and days missed due to concussion.
  
  
  RESULTS
  Athletes with a reliable decline in visual memory scored higher on baseline visual memory than did athletes with no decline or an improvement (t82= -2.348, P = .021, d = 0.65). When comparing athletes who displayed a reliable decline with those who showed no change or an improvement in any composite score, days missed did not differ. The number of composite scores with a reliable decline demonstrated no main effect on days missed (P = .530).
  
  
  CONCLUSIONS
  Athletes who exhibited cognitive decline in most or all of the composite scores did not miss more days after injury than athletes with a decline in fewer or none of the composite scores. Athletes should be educated regarding the lack of association between baseline neurocognitive scores and the presence or absence of a reliable decline after concussion, as well as the fact that, on average, individuals with a reliable decline across multiple domains did not miss more time after concussion.
authors.affiliation: Department of Clinical and Health Psychology, University of Florida, Gainesville.
authors.forename: Breton M
authors.initials: BM
authors.lastname: Asken
authors.affiliation: University Athletic Association and Department of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: James R
authors.initials: JR
authors.lastname: Clugston
authors.affiliation: Department of Clinical and Health Psychology, University of Florida, Gainesville.
authors.forename: Aliyah R
authors.initials: AR
authors.lastname: Snyder
authors.forename: Russell M
authors.initials: RM
authors.lastname: Bauer
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes / Q000523:psychology; D001265:Athletic Injuries / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D001924:Brain Concussion / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D003072:Cognition Disorders / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D011930:Reaction Time / Q000502:physiology; D012189:Retrospective Studies; D000068958:Return to Sport / Q000502:physiology / Q000523:psychology*; D013334:Students; D014495:Universities
keywords: ImPACT; brain injuries; collegiate athletes; computerized testing