A Retrospective Cohort Study of the Temporal Stability of ImPACT Scores Among NCAA Division I Collegiate Athletes

Date of Award


Document Type

Doctoral Research Paper

Degree Name



Graduate School of Professional Psychology

First Advisor

Kim A. Gorgens, Ph.D., ABPP

Second Committee Member

Bradley Davidson, Ph.D.

Third Committee Member

Laura Meyer, Ph.D.

Fourth Committee Member

Marybeth Lehto, Ph.D.


Concussion, Division I, NCAA, ImPACT, Psychometrics, Temporal stability, Test-retest reliability

Publication Statement

Copyright held by the author. Permanently suppressed.


Objective: This study examined the temporal stability of the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) within NCAA Division I athletes across various timepoints.

Method: Within a retrospective cohort design, 48 athletes completed repeated baseline ImPACT assessments at various timepoints. Intraclass correlation coefficients (ICC) were calculated using a two-way mixed effects model with absolute agreement. Additional facets of temporal stability were explored via Limits of Agreement (LOA), Bland-Altman Plots, Minimal Detectable Change (MDC), and Reliable Change Indices (RCI).

Results: Four ImPACT composite scores (Verbal Memory, Visual Memory, Visual Motor Speed, and Reaction Time) demonstrated moderate reliability (ICC = 0.51-0.66) across the span of a typical Division I athlete’s career. No evidence of fixed bias was detected within Verbal Memory, Visual Motor Speed, or Reaction Time composite scores, and MDC values exceeded the limits of agreement.

Conclusions: ImPACT psychometrics support the NCAA’s recommendation to obtain a single pre-participation cognitive baseline for use in sports-related concussion management throughout an athlete’s career. Clinical interpretation guidelines are provided.


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