Comparison of Pre-season, Mid-season and Post-season ImPACT and SAC Concussion Management Scores in Uninjured Collegiate Football Players

In Research

2004 AOSSM Annual Meeting

  1. Jennifer Miller MD, Congress Medical Associates Pasadena, CA
  2. John Sweet MA ATC, Occidental College Los Angeles, CA
  3. Selina Shah MD, Kaiser Permanente Los Angeles, CA
  4. Gregory Adamson , Congress Medical Associates Pasadena, CA


Concussions are frequent injuries in athletes participating in contact sports. Many different tests are used to evaluate players suspected of sustaining a concussion, and to help determine when they are safe to return to play. The SAC test is the most frequently used on-field assessment. A new computerized neuropsychological test battery, ImPACT, has been adopted by the NFL and many collegiate football teams. Validity and reliability studies have been performed for injured vs baseline scores. The purpose of our study was to determine if there is a difference in SAC and ImPACT scores when uninjured football players, who were involved in repetitive contact activity, are tested pre-season, mid-season, and post-season.


All 76 football players who participated in the 2003 football season at Occidental College underwent baseline SAC and ImPACT testing pre-season. During a bye week mid-season, and at the end of the season, the tests were repeated. Four players sustained concussions during the season and were excluded from the study. The remaining 72 players completed each test three times. The amount of contact activity each player was exposed to was determined from practice and game logs, and players were stratified into two groups. History of previous concussions was obtained.


No statistical differences were found in overall SAC scores or any of the subsets of the test (immediate recall, orientation, reverse digits, months backwards, delayed recall) when pre-season, mid-season and post-season scores were evaluated. Scores varied by up to 4 points on the 30 point scale, but the majority were within 1 point of their baseline score. No statistical differences were found in the ImPACT composite scores (verbal memory, visual memory, visual motor speed, reaction time, impulse control) when pre-season, mid-season and post-season scores were evaluated. Memory scores showed the most variability, but results did not attain statistical significance. The amount of contact had no effect on scores.


ImPACT and SAC concussion management scores are not significantly altered by repetitive contact activity in athletes who have not sustained a concussion. Therefore, changes in these scores in an injured athlete should not be dismissed as changes brought on by the effects of the season. This study validates the use of SAC and ImPACT tests in collegiate athletics.

  1. McCrea, M. Standardized Assesment of Concussions in Football Players. Neurology 1997; 48:586-588.
  1. Clinical Medicine
  2. Statistics/Assessment
  1. CLINICAL: Head