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A mobile application neurocognitive assessment has been used in place of equipment-intensive computerized neurocognitive-assessment protocols. A previous study showed high to very high test-retest reliability of neurocognitive assessment using the mobile application in healthy adults, but no researchers have explored test-retest reliability, reliable change indices (RCIs), and sex effects in middle school and high school populations when conducted 1 year apart. To examine the test-retest reliability and RCIs of baseline data collected at 2 time points approximately 1 year apart using a mobile application neurocognitive test in middle school and high school athletes. The secondary purpose was to investigate sex differences in neurocognitive measures. Cross-sectional study. Institution. A total of 172 middle school and high school healthy student-athletes (mean age = 13.78 ± 1.59 years). Mobile application neurocognitive test scores (reaction time, impulse control, inspection, and memory). Neurocognitive measures had low test-retest reliability across a 1-year time period in the middle and high school settings. Upon retesting, reaction time and inspection time improved in both middle and high school athletes, and impulse control improved in middle school athletes. More athletes in middle school showed RCI improvements compared with high school athletes. Although both males and females demonstrated improvements in neurocognitive measures throughout adolescence, males outperformed females in reaction time and impulse control. A mobile application neurocognitive test displayed unacceptably low test-retest reliability, most likely due to the cognitive development occurring throughout adolescence. Additionally, significant RCIs were noted. These naturally occurring improvements due to cognitive development could mask postconcussion deficits. Age and sex warrant consideration with respect to the neurocognitive performance of middle and high school athletes. [ABSTRACT FROM AUTHOR]

Objective: The comparison of baseline neuropsychological test results with post-concussion neuropsychological test results is a common practice to assess the aftermath of a sport-related concussion. The effectiveness of this approach is compromised when invalid baseline test performances occur. The present study was designed to assess the prevalence of invalid baseline test results of high school athletes, using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Method: A large sample of 8938 high school athletes' baseline test data were examined, including the four ImPACT Composite scores and three sets of embedded invalid indices: five ImPACT Invalidity Indicators, four ImPACT sandbagging red flags, and two ImPACT sandbagging subtest flags. Results: There were 8394 (93.91%) Valid scorers, who failed no Invalidity Indicators; 544 (6.09%) Invalid scorers, who failed at least one Invalidity Indicator, 2718 (30.41%) Red Flag scorers, who had at least one Red Flag score; and 4154 (46.47%) Subtest Flag scorers, who had at least one Subtest Flag score. Of the entire sample, 4485 (54.65%) failed at least one of the invalid indices. Conclusions: As in prior studies of high school athletes, the Invalidity Indicators identified a low portion (6.09%) of the athletes with invalid baseline test results, while other invalidity measures found 30.41% to 46.48% of the athletes producing questionable test results. The high rate of invalid test findings suggested in this research calls for greater efforts to improve the accuracy of baseline test results. [ABSTRACT FROM AUTHOR]

Objective This study was designed to determine concussion incidence, risk, and relative risk among middle and high school athletes participating in various sports. Method Data were retrospectively obtained from 10,334 athletes of 12 different sports in Hawaii. In addition to determining the overall concussion incidence, comparisons of incidence, risk, and relative risk were made according to age, sex, concussion history, sport, and football position. Results The overall incidence of concussion among youth athletes was 1,250 (12.1%). The relative risk for a concussion was almost two times greater in 18-year olds than in 13-year-old athletes. In comparable sports, girls had a 1.5 times higher concussion risk than boys. Athletes with a prior concussion had 3–5 times greater risk to sustain a concussion than those with no history of a concussion. Among varied sports, wrestling and martial arts had the highest relative risk of a concussion, followed by cheerleading, football, and track and field. No differences in concussion risks were found among the football players in different positions. Conclusions Older youths, females, those with a history of concussion, and those participating in high contact sports were found to have higher risks of sustaining a concussion. The findings increase awareness of concussion patterns in young athletes and raise concerns regarding protective strategies and concussion management in youth sports. [ABSTRACT FROM AUTHOR]