In recent decades, the development of computerised neurocognitive screening has revolutionised medical management in the sports concussion arena by making possible preseason (baseline) testing of large numbers of athletes, and repeat follow-up testing of the concussed athlete, to monitor recovery and facilitate safe return-to-play decisions (Moser et al., 2007). The aim of this chapter is to introduce the most widely employed instrument of this genre, the ImPACT (Immediate Postconcussion Assessment and Cognitive Testing) test (Iverson, Lovell & Collins, 2002), and to review the available South African normative research data in respect of the instrument to date. While the test has potential for wide application beyond the sports concussion arena (as discussed in the concluding section of this chapter), its development within the sports injury context calls for background detail in this regard.

Mild traumatic brain injury (concussion) in sport

Mild traumatic brain injury (MTBI), typically referred to as ‘concussion’ in the sports arena, is a common feature amongst both amateur and professional sports alike (Cassidy, Carroll, Peloso, Borg & Von Holst, 2004). While once considered to be a ‘routine risk’ associated with participation in the game, the impact of these injuries has gained significant international interest and concern amongst sports and health professionals in the past three decades (Barth et al., 1989; Collins, Lovell & McKeag, 1999; Shuttleworth-Edwards, Border, Reid & Radloff, 2004), and is currently considered by the Centers for Disease Control and Prevention (CDC, 1997) to be of epidemic proportions. The incidence of the concussive injury varies widely depending on the sport, such that in one comparative high school study US football accounted for 63 per cent of all cases, wrestling for 10.5 per cent, girls’ soccer for 6.2 per cent, boys’ soccer for 5.7 per cent, girls’ basketball for 5.2 per cent, boys’ basketball for 4.2 per cent, softball for 2.1 per cent, baseball for 1.2 per cent, field hockey for 1.1 per cent and volleyball for 0.5 per cent (Powell & Barber-Foss, 1999).