AUTHORS: A. Edwards, V. Whitefield, S. Radloff
ABSTRACT: The recent development of computerized neurocognitive screening programmes has revolutionized medical management in the sports concussion arena where there is a need for mass testing of athletes, and repeat follow up testing of the concussed athlete to monitor recovery and facilitate safe return-to-play decisions. Automated programmes of this type have the facility for more accurate evaluation on timed tasks than paper-and-pencil testing, are time and cost effective in that group testing can be undertaken, and multiple randomized versions of the tasks reduce the problem of practice effects on repeated test occasions. In South Africa, the ImPACT test (Immediate Post Concussion Assessment and Cognitive Testing) that was developed within a research context at the University of Pittsburgh Medical Center, has been employed for clinical and research purposes since 2003, and is the only test of its type registered with the Health Professional Council of South Africa (HPCSA) for clinical use in this country. This chapter reviews research data derived using the ImPACT test in respect of players of contact sport from school through to the professional level that attests to the clinical sensitivity of this test in the identification of subtle neurocognitive deficit in association with participation in the contact sport of rugby. In addition, available South African normative indications in respect of the test are presented and discussed. Finally, the potential to use the ImPACT test to facilitate medical management and increase safety within other contexts is discussed, such as screening of aviation personnel (pilots and ground control employees) on a regular basis to identify the onset of intellectual dysfunction that might have sinister consequences.