ImPACT Measures Five Cognitive Domains ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the most widely used computerized neurocognitive test for concussion assessment. Over 45 million tests have been administered since its development. ImPACT generates five composite scores that together provide a cognitive profile showing which brain functions are affected by concussion and how recovery progresses over time (Schatz et al., 2006). The test takes approximately 20-25 minutes and is administered on a computer or tablet. It includes six test modules that generate the five composite scores, plus a 22-item post-concussion symptom scale. ImPACT is used both for baseline testing (before injury) and post-injury assessment (after concussion), with the comparison between the two driving clinical decisions. ImPACT is a tool, not a diagnosis. Scores inform clinical decision-making but do not independently diagnose concussion, determine return-to-play readiness, or replace comprehensive clinical assessment. A trained clinician interprets ImPACT scores within the context of the full clinical picture. The Five Composite Scores Verbal Memory Composite. This score measures your ability to remember words and verbal information. The test presents word lists and you recall them after delays. Verbal memory deficits after concussion indicate impaired temporal lobe and hippocampal function. Low scores correlate with difficulty remembering instructions, conversations, and academic material. This is one of the most sensitive composites for detecting concussion-related impairment. Visual Memory Composite. This measures your ability to remember visual information including patterns, designs, and spatial arrangements. You view visual displays and identify them from memory after delays. Visual memory deficits indicate parietal and occipital lobe dysfunction. Low scores correlate with difficulty remembering faces, locations, and visual sequences. Visual memory often recovers on a different timeline than verbal memory. Visual Motor Speed Composite. This measures how quickly you process visual information and coordinate motor responses. Tasks require rapid matching, sequencing, and visual scanning with timed responses. Low scores indicate reduced information processing speed, one of the hallmark cognitive effects of concussion. Processing speed deficits produce the subjective feeling of "thinking through fog" and are often the last cognitive domain to normalize. Reaction Time Composite. This measures how quickly you respond to visual stimuli. Measured in milliseconds, reaction time increases (slows) after concussion. Slowed reaction time is one of the most consistent findings after concussion and has direct safety implications: slower reactions mean less time to avoid hazards in sport, driving, and daily activities. Reaction time is measured with higher precision than most self-reported symptoms. Impulse Control Composite. This measures response accuracy and inhibitory control. It tracks errors of commission (responding when you shouldn't) across the test battery. The impulse control composite also serves as a validity indicator: very high impulse control errors suggest the test-taker wasn't giving full effort, was randomly clicking, or didn't understand the instructions. This score helps clinicians identify invalid test sessions. How Scores Are Interpreted Baseline comparison. When baseline data exists, post-injury scores are compared to the individual's own pre-injury performance. Reliable Change Indices (RCIs) determine whether score differences exceed normal test-retest variation. A decline that exceeds the RCI threshold is considered a meaningful change attributable to concussion rather than normal score fluctuation. Normative comparison. Without baseline data, post-injury scores are compared to age- and sex-matched population averages. Percentile rankings show where the individual falls relative to peers. Scores below the 25th percentile in multiple domains raise concern. Scores below the 10th percentile are highly suggestive of impairment. Pattern analysis. The specific pattern of score changes provides clinical information. Concussion typically produces deficits across multiple domains. A single low score with all others normal is less likely concussion-related. The clinician evaluates which domains are affected and the magnitude of change relative to baseline or norms. Symptom score integration. ImPACT includes a 22-item symptom inventory scored on a 0-6 severity scale (total possible score: 132). Symptom scores are interpreted alongside cognitive scores. Some individuals show cognitive impairment with low symptom scores (underreporting or cognitive reserve masking symptoms). Others show high symptom scores with normal cognition (anxiety-driven symptom amplification or cervicogenic symptom contribution). Cervical Factors That Affect ImPACT Performance Cervical dysfunction produces headache, difficulty concentrating, and fatigue that affect test performance independently of brain injury: JME 14 Chin tucks address deep cervical flexor weakness producing tension headaches that impair concentration during ImPACT testing. JME 1 Cervical rotation mobility reduces neck stiffness that causes referred headache and difficulty sustaining attention on screen-based tasks. JME 6 Cervical flexion addresses anterior neck tension contributing to headache patterns that worsen with forward head posture during computer-based testing. JME 5 Cervical extension mobility reduces posterior neck tension that produces occipital headache aggravated by screen time. Start your 14-day free trial for cervical mobility programming that supports cognitive recovery after concussion. Supporting Recovery Through Mobility JME 3 Lateral flexion addresses unilateral cervical tension that produces one-sided headache affecting sustained concentration. JME 42 Shoulder mobility reduces upper quarter tension patterns that contribute to cervicogenic headache during desk work and testing. JME 150 Thoracic rotation maintains mid-back mobility that prevents compensatory cervical strain during seated activities like ImPACT testing. JME 164 Scapular mobility supports the upper body posture that minimizes cervical stress during prolonged computer-based assessment. What ImPACT Cannot Tell You ImPACT cannot diagnose concussion. No single test diagnoses concussion. ImPACT provides data points that contribute to clinical diagnosis when integrated with symptom assessment, physical examination, and injury history. ImPACT cannot determine concussion severity. Severity is determined by recovery trajectory, not initial test scores. An athlete with very low initial ImPACT scores who recovers in 10 days had a less clinically significant concussion than someone with modestly low scores who takes 3 months to recover. ImPACT scores returning to baseline does not automatically mean you're ready to return to play. Return-to-play readiness requires symptom-free status at rest and with exertion, successful completion of the graduated return protocol, normal clinical examination, and clinical judgment. ImPACT scores are one piece of the return-to-play picture. ImPACT has known limitations. Test-retest reliability varies across composite scores (reaction time is more reliable than memory composites). Practice effects from repeated testing inflate scores. Effort and motivation affect results. Environmental factors (noise, distraction, fatigue) influence scores. Trained clinicians account for these limitations in interpretation. Support your cognitive recovery with simplmobility's cervical and mobility programming. How often is ImPACT testing done after a concussion? Typically at 24-72 hours post-injury for initial assessment, then repeated every 5-7 days during recovery to track improvement. Testing frequency depends on clinical need and symptom progression. Repeated testing continues until scores return to baseline (or normative range) and the individual is symptom-free, at which point the graduated return-to-play protocol begins. What happens if my ImPACT scores don't return to baseline? Scores that remain below baseline for more than 4-6 weeks warrant further evaluation. Non-recovering ImPACT scores sometimes reflect ongoing concussion effects, but frequently result from cervical dysfunction, vestibular impairment, psychological factors (anxiety, depression), or sleep disruption. Identifying and treating these contributing factors often produces score improvement that brain-focused treatment alone does not achieve. Is ImPACT the only concussion test available? No. C3Logix, Cogstate, King-Devick, and SCAT5 are other validated assessment tools. ImPACT is the most widely used and has the most extensive normative database, but other tests provide comparable clinical utility. The specific tool matters less than having a trained clinician interpret results within the full clinical context. References Schatz, P., et al. (2006). Sensitivity and specificity of the ImPACT Test Battery for concussion in athletes. Archives of Clinical Neuropsychology, 21(1), 91-99. PubMed Broglio, S. P., et al. (2017). National Athletic Trainers' Association position statement: management of sport concussion. Journal of Athletic Training, 52(5), 442-462. PubMed