Journal of science and medicine in sport · 2026
A longitudinal investigation of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) composite scores and associated factors among rugby union players.
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Zynda Aaron J, Purtill Helen, Mulvihill John, Power Laura, Bitzer Hannah, Kenny Ian C, Comyns Tom, van Dyk Nicol, Liston Mairead, Yeomans Caithriona, McLoughlin Rod, Collins Michael W, Kontos Anthony P
Аннотация
OBJECTIVES: To examine changes in Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) composite scores in elite rugby players over at least three years of Rugby Union participation. A secondary objective was to identify any factors associated with significant changes in ImPACT cognitive performance.
DESIGN: Retrospective repeated measures study.
METHODS: Baseline ImPACT scores from Irish Rugby Football Union (IRFU) players were collected between 2007 and 2022. Participants were included if they were ≥18 years old and completed baseline ImPACTs at three separate time points over at least three years. Linear mixed models examined changes in ImPACT composite scores over time while adjusting for relevant covariates.
RESULTS: A total of 384 male and 10 female rugby players were included. Overall, ImPACT memory, processing speed, and reaction time composite scores remained constant or improved over time. Among male players, length of follow-up (years) was associated with higher verbal memory (β = 0.70, 95% CI: 0.57-0.82), visual memory (β = 0.69, 95% CI: 0.54-0.85) and visual motor scores (β = 0.32, 95% CI: 0.26-0.38) but slower reaction times (β = 0.0021, 95% CI: 0.001-0.003). Controlling for length of follow-up, initial baseline and age at initial baseline, the number of previous concussions was associated with higher verbal (β = 0.6, 95% CI: 0.14-1.07) and visual memory scores (β = 0.78, 95% CI: 0.22-1.35) and the number of completed post-injury ImPACT assessments was associated with higher verbal memory (β = 0.41, 95% CI: 0.19-0.64) and visual motor (β = 0.25, 95% CI: 0.13-0.36) scores.
CONCLUSIONS: Elite male rugby players did not exhibit declines in ImPACT cognitive composite scores over at least three years of playing competitive rugby. More years of follow-up, post-injury ImPACT assessments, and previous concussions were associated with improvements in ImPACT cognitive scores over time. However, these improvements may not be clinically meaningful, as the effects were small and may reflect practice effects or test-to-test variability. These findings should be considered when interpreting acute and long-term changes in cognitive performance assessed via ImPACT among rugby players. Overall, these findings can inform player education about concerns associated with participating in rugby.
DESIGN: Retrospective repeated measures study.
METHODS: Baseline ImPACT scores from Irish Rugby Football Union (IRFU) players were collected between 2007 and 2022. Participants were included if they were ≥18 years old and completed baseline ImPACTs at three separate time points over at least three years. Linear mixed models examined changes in ImPACT composite scores over time while adjusting for relevant covariates.
RESULTS: A total of 384 male and 10 female rugby players were included. Overall, ImPACT memory, processing speed, and reaction time composite scores remained constant or improved over time. Among male players, length of follow-up (years) was associated with higher verbal memory (β = 0.70, 95% CI: 0.57-0.82), visual memory (β = 0.69, 95% CI: 0.54-0.85) and visual motor scores (β = 0.32, 95% CI: 0.26-0.38) but slower reaction times (β = 0.0021, 95% CI: 0.001-0.003). Controlling for length of follow-up, initial baseline and age at initial baseline, the number of previous concussions was associated with higher verbal (β = 0.6, 95% CI: 0.14-1.07) and visual memory scores (β = 0.78, 95% CI: 0.22-1.35) and the number of completed post-injury ImPACT assessments was associated with higher verbal memory (β = 0.41, 95% CI: 0.19-0.64) and visual motor (β = 0.25, 95% CI: 0.13-0.36) scores.
CONCLUSIONS: Elite male rugby players did not exhibit declines in ImPACT cognitive composite scores over at least three years of playing competitive rugby. More years of follow-up, post-injury ImPACT assessments, and previous concussions were associated with improvements in ImPACT cognitive scores over time. However, these improvements may not be clinically meaningful, as the effects were small and may reflect practice effects or test-to-test variability. These findings should be considered when interpreting acute and long-term changes in cognitive performance assessed via ImPACT among rugby players. Overall, these findings can inform player education about concerns associated with participating in rugby.