It is a common scene on athletic fields throughout the United States. A player takes a big hit and falls to the ground only to stumble to their feet and walk off more than just a little wobbly.

While it is estimated that about 300,000 people suffer a sports-related concussion each year, it is not always hard to tell when something is wrong with an athlete. But it can be difficult to tell when they are ready to resume athletic activity.

Now, athletic trainers and doctors in South Dakota have another tool at their disposal that may help solve some of the mystery surrounding concussions.

ImPACT is a computerized test which evaluates and documents multiple aspects of brain function that has proven to be a useful tool in measuring the severity and effects of concussion. It helps determine when it is safe for athletes to return to sports. Concussion symptoms can include amnesia, disorientation, fogginess, headache, fatigue and loss of consciousness among others with concussions being more prevalent among women than men when comparing the same sport.

"This is an enormous leap in the management of concussions and it provides us with much better data then what we used to be able to get," said Verle Valentine, MD, Sanford Clinic Orthopedics & Sports Medicine and Medical Director for Sports.

In the past medical professionals had to rely on the athlete to give them honest answers to determine if they were still suffering the effects of a concussion. The ImPACT test checks among other things verbal and visual memory, attention span, processing speed and reaction time. While it is not the complete answer, it gives medical professionals solid information to base future decisions on.

"It is an advantage to have this type of system than the normal questions like what day it is or the month," said South Dakota Mines head athletic trainer Scott Baird. "Getting objective data rather than subjective benefits us and the coaches when we make decisions."

The ImPACT system has been used in Sioux Falls for about nine months, but it was developed about eight years ago at the University of Pittsburgh and is used in several professional sports leagues, including the National Football League.

One of the biggest keys to ImPACT's success is to have athletes establish a baseline within the system. This is usually done during the preseason where the athlete takes the computerized test - which lasts between 20 and 30 minutes - which doctors can keep on file and compare the results if an athlete has to take the test again after suffering a concussion. When the results of the test post-concussion match that of the baseline, the athlete is more ready to return to the physical activity.

"You can compare data to some normative data if you don't have a baseline established, but you get so much better information if you do have that baseline," Valentine said. "But this doesn't replace the other things we do when we ask them questions about symptoms like trouble concentrating, headaches, and difficulty with balance or sleeping."

Valentine said an athlete may have to take the test just once after suffering a concussion or multiple times depending if the symptoms persist.

"One of the troubles we face is whether symptoms are being reported accurately," said Tryg Odney, an athletic trainer and Sports Medicine Outreach Manger as Sanford USD Medical Center. "(ImPACT) doesn't completely allow them to mask or hide the severity of what they are going through.

"The test is not designed to keep people out longer. It promotes a safer, quicker return to activity rather than just automatically saying you are out for three weeks or something if you have a concussion."

At this point, much of the work Valentine is conducting with ImPACT is focused at the college level, but he said that it is just as important for high school-aged athletes.

Baird agrees saying that a computerized system like ImPACT can be helpful at any level of contact sports.

Augustana College, the University of Sioux Falls and the University of South Dakota are all working with Valentine and Odney to use ImPACT for their athletic programs to varying degrees. The cost for the test is about $10 for an individual, but Odney said packages are available to schools that lessen the cost.

"We work with colleges because you really have a captive audience and it allows you to see what you need when you are setting up these tests," Odney said. "But it is just as important for high school athletes because concussions are more prevalent at that level and their brains are still maturing."

Baird, who has been at Mines for two years, said the school is not currently using a system like ImPACT, but it is a goal of his to bring something like that to Mines. Black Hills State athletic trainer Tony Silva has the same goal for the Yellow Jackets.

"I have utilized ImPACT and the University of Wyoming and one of my goals through the summer is to get some form of computerized testing here at Mines," Baird said. "I would start with the high-impact sports first at Mines like football and basketball."

Baird said concussions are a big enough issue at Mines - he estimated about two a season for the high-contact sports - that it would benefit from having a system like ImPACT.

Silva said if BHSU were to begin using ImPACT it would be his goal to have every Yellow Jacket athlete complete a baseline test. Since most college athletes play just one sport, it would be easier to test them at the beginning of their season, and get a base established.

While no system can guarantee an athlete who has suffered a concussion that all of the symptoms and risks are gone, ImPACT is clearing some of the uncertainty that comes with concussions.