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New Test Could Have Great ImPACT on Concussions
By Lois Thomson

One reason why young people enjoy playing sports is because they welcome the competition. But a different type of competition, one related to concussions, is something that could have a greater impact on their lives. Or perhaps that should be "ImPACT."



Danielle Violette said concussion evaluation is like piecing together a puzzle. "Concussions are unique from other injuries. If you break your arm you can get an X-ray, see the fracture, know it's broken, and know how to treat it. But a concussion doesn't show up on an MRI or a CT scan." Violette, Sports Medicine Coordinator at The Washington Hospital, said, "That's why it's important that these kids be seen by an experienced sports medicine physician, because they'll know the different facets of a concussion to evaluate for. We check for headache, dizziness, blurry vision, balance problems, memory, reaction time, concentration. Any one of those independently may not seem like a big deal, but someone who's trained can piece it all together, and may be able to evaluate that patient differently. It's common for two athletes to sustain a very similar hit, and the one only has memory problems and the other only has dizziness. Concussions are an individualized injury and should not be compared with anyone else's."


ImPACT—Immediate Post-Concussion Assessment and Cognitive Testing—is a test given to athletes who have suffered a concussion or head injury. Danielle Violette, Sports Medicine Coordinator at The Washington Hospital, administers the 20-minute test that is taken at a computer.

"It's set up to be like playing a video game or something on the computer," she said. "It's very task-oriented and challenging. Some of the tests will show you pictures of things, or they'll show you a list of the words, and you'll have to recall them later. Some of the tests (focus) more on concentration, like recognizing colors and words and putting them together. You use a mouse to click through the whole thing, so it challenges your concentration and focus ability, and your reaction time. The goal is to be as fast and as accurate as you can—that's how they get the scores, based on how many right answers you get and how quickly you get them."

Ideally, young athletes should take the test before any type of injury occurs. "Usually what we recommend to athletes, especially if you play a collision sport like football, hockey, lacrosse, or basketball, is that you do a baseline test when you're healthy and uninjured. Most of the athletes really do enjoy that, they find it challenging and their competitive spirit comes out. They really want to perform well on it." Having a baseline test is important because if the athletes do get injured, they can be re-tested and the scores can be compared with the original. However, Violette said that if a baseline isn't available, "We can just use normal age-matched data that we have from studies to compare their test results."

Violette works closely with Dr. Mary Lamb at the new Lakeside Primary Care Center at Waterdam Plaza, and Dr. Todd Franco at Medical Rehabilitation, Inc., located in the Wilfred R. Cameron Wellness Center; both physicians follow up with athletes. "Any athletes who have experienced a concussion need to be out of play until they're well evaluated by a sports medicine trained physician, so that they can be completely evaluated and cleared to return to play."

The Washington Hospital started offering ImPACT testing just last year and the testing is now accessible at three locations: The Washington Hospital Outpatient Rehabilitation, along with the Urgent Care Center and Lakeside Primary Care, both in McMurray. Violette wants people to know about the program's availability in the area. "A lot of people drive all the way into Pittsburgh to get it, so we really want to get the word out that the test is available here, closer to home."

For more information or to schedule an appointment, call The Washington Hospital Outpatient Rehabilitation at (724) 250-6280; the Urgent Care Center at (724) 969-4321; or Lakeside Primary Care at (724) 969-1001.

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