Study Design: A case series of NCAA Division I Football Championship Subdivision football players who suffered a concussion during the 2008 football season.

Background: Neuropsychological testing after a concussion has been shown to be effective in assessing functioning following a concussion but has not been used to corroborate return to play criteria. The purpose of this case series is to describe the use of a computerized neuropsychological test and corroborate a return to play concussion criteria following a concussion.

Case Description: Baseline data was obtained at the beginning of the season for all 78 players who were cleared to compete in the 2008 season. Five subjects who suffered a concussion during the season were retested using ImPACT™ immediately after the concussion and at intervals during recovery while being progressed through a return to play protocol. The results of these subjects are described in the case discussion.

Outcomes: Four of the five subjects were able to return to the baseline values and met physical return to play criteria with no issues. The fifth individual returned to baseline levels on ImPACT™ but had a reoccurrence of symptoms during the return to play progression. 

Discussion: After suffering a concussion, the brain has to heal both physically and mentally.  Neuropsychological testing tests the brain’s mental functions and physical activity reveals if the brain is healing properly physically. Neuropsychological testing alone cannot judge whether an individual is ready to return to play after a concussion due to the design of the program. Current technology does not allow for neuropsychological testing to be performed during events of physical stress, where a recurrence of symptoms may happen. It is suggested that neuropsychological testing and asymptomatic physical activity progression are both used in a return to play decision.