A new study by researchers at Indiana University-Purdue University Columbus and Pace University is critical of the widespread use of computerized neuropsychological tests (CNT) in decisions regarding when athletes can return to play after suffering a concussion.
"Our knowledge of the effects of concussions continues to evolve," said Thomas Redick, assistant professor of psychology at IUPUC. "We should continue to ask ourselves what the best practices are when dealing with a brain injury, which is what a concussion is."
The use of computer tests to measure an athlete's thinking ability before and after concussion has become commonplace at all levels of contact sport, typically beginning in high school, and the post-trauma test result is one part in determining when an athlete can get back in the game. The dangers of returning to play prematurely can be grave -- including the rare cases that lead to a degeneration of brain tissue (chronic traumatic encephalopathy) and even death. Yet the ability to determine the severity of a head trauma and stage of recovery is very difficult.
"We should note that no 'gold standard' exists for concussion diagnosis and management," the researchers wrote. "Sports medicine practitioners still lack simple, reliable and affordable techniques to confidently address these issues. Although experienced first responders can accomplish a clinical diagnosis in most instances of suspected concussion, concerns related to return of play and whether or not to continue specific sport participation are not resolved by current CNT."
The study, published online in the Journal of Clinical and Experimental Neuropsychology, reviewed previously published research articles involving Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), one of several CNT in use today and considered the most scientifically validated computerized concussion evaluation system. The researchers cautioned against over-reliance on CNT in return-to-play decisions for the following reasons: