C - 02Cultural Differences in Baseline ImPACT Composite Scores

Objective: To determine cultural differences in pre-concussion baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) composite scores between individuals from the USA, Haiti, Jamaica, Colombia, and Venezuela. Method: Athletes with no history of concussion (n = 469) with complete data were selected from an archival database of baseline ImPACT composite scores for high-school athletes. Participants were grouped based on their home country: USA (n = 98), Haiti (n = 89), Jamaica (n = 87), Colombia (n = 96), and Venezuela (n = 99). Results: Initial analyses indicated that groups differed significantly by gender (F(4,465) = 2.815, p = .025) and age (F(4,465) = 3.538, p = .007), but not by education (F(4,465) = 1.545, p = .188). Results of ANCOVA analyses using age and gender as covariates revealed significant differences between groups in visual-motor speed composite scores (F(4, 465) = 10.499, p < .001, partial η2 = .083), and reaction time composite scores (F(4, 465) = 14.908, p < .001, partial η2 = .114). Pairwise comparisons with a Bonferroni adjustment revealed the following significant differences in visual motor-speed composite scores: USA higher than Haiti (MD = 6.398, p < .001) and Jamaica (MD = 3.250, p = .019); and Haiti lower than Colombia (MD = −4.902, p < .001), Venezuela (MD = −4.345, p < .001), and Jamaica (MD = −3.148, p = .032). Results from reaction time composite score pairwise comparisons revealed that Haitian athletes scored lower than athletes from the USA (MD = 0.106, p < .001), Jamaica (MD = 0.062, p = .005), Colombia (MD = 0.109, p < .001), and Venezuela (MD = 0.111, p < .001). Conclusions: Results revealed significant differences in visual-motor speed and reaction time composite scores across groups at baseline ImPACT assessment. Results indicate that visual-motor speed and reaction time composite scores were significantly different based on the home country of athletes. As such, clinicians should carefully consider home countries when interpreting composite scores in ImPACT assessment.