A - 52 Process Improvement in Sport-Related Concussion Management: Neuropsychological Testing and Active Recovery

Abstract Purpose The management of sport-related concussion has moved away from passive strategies and towards active recovery models. How the accelerated presence of activity impacts the role of neuropsychological testing is not well understood. The current study examines outcomes for two distinct collegiate concussion management programs, each using differing approaches towards activity and testing. Method Data between August 2022 and December 2023 was reviewed retrospectively. One program used an active recovery protocol (AR = active recovery; n = 120; 47.5% female) and one did not (TU = treatment as usual; n = 50; 48% female). Both used ImPACT for neuropsychological testing. We examined frequencies and descriptive statistics, as well as chi-square tests to determine the relationship between outcome variables (e.g., repeat concussions, tests used) by group. Results 120 concussions occurred in the AR group; 103 (90.8%) PI-1 tests were completed after physical exertion (median days to first test = 11.0). In the TU group, 50 concussions occurred in the study period (median days to first test = 7.6), and all PI-1 tests were at-rest. While chi-square tests yielded no significant differences for repeat concussions (p = 0.609; 3 in AR, 2 in TU), there was a significant relationship between group and number of tests used; AR used significantly fewer post-injury tests (p < 0.00001). Conclusions These preliminary findings suggest that administering post-injury neuropsychological tests after physical exertion early in the recovery progression does not increase the risk of repeat concussions. Beginning with post-exertion tests may reduce the number of overall tests utilized, which could yield cost savings for athletic departments. Additional prospective studies are required for validation.