Sway vs. ImPACT Concussion Testing: What a Study of 403 High School Athletes Found

How Does Sway Compare to ImPACT for Concussion Assessment?

For Athletic Trainers evaluating concussion testing options, one question comes up frequently: How does Sway compare to ImPACT?

A study published in Archives of Clinical Neuropsychology provides preliminary evidence to help answer that question.

Researchers compared Sway and ImPACT testing in 403 high school athletes, examining how the two systems' results related at baseline and following concussion.

The findings suggest that although Sway and ImPACT may measure different aspects of cognitive performance, they demonstrated similar overall utility in the acute post-concussion setting studied.

Importantly, the researchers emphasized that additional research is needed.

See how Sway Concussion can fit into your Athletic Training program!

Three Key Findings From the Sway vs. ImPACT Study

1. Sway and ImPACT May Measure Different Cognitive Abilities

Researchers found generally small correlations between most Sway and ImPACT measures.

This suggests the two systems may assess different neurocognitive constructs rather than measuring identical abilities in different ways.

For Athletic Trainers, that's an important distinction. Similar clinical utility does not necessarily mean two assessment tools provide the same information.

2. Both Systems Produced the Same Overall Post-Injury Decisions in the Studied Sample

Among athletes who completed baseline testing and had acute post-injury data available, researchers reported the same overall post-injury decisions using either Sway or ImPACT.

However, this comparison involved only 10 athletes.

That small post-injury sample is an important limitation and means the findings should be considered preliminary.

3. Researchers Found Similar Preliminary Utility Following Concussion

The researchers concluded that Sway demonstrated overall similar utility to ImPACT in the acute post-concussion setting examined.

This finding adds to the evidence Athletic Trainers can consider when evaluating mobile concussion assessment options.

It does not establish that the two systems are interchangeable or that either assessment should be used independently to diagnose a concussion.

What Does This Research Mean for Athletic Trainers?

Concussion assessment involves more than a single test score. As we've explored in our research on why concussion assessment shouldn't rely on symptoms alone, Athletic Trainers consider multiple sources of information when evaluating an athlete. 

Athletic Trainers consider symptoms, injury history, clinical examination, balance, cognitive performance, baseline results, and other relevant clinical findings when evaluating an athlete.

Understanding the difference between individual baselines and normative data is another important part of concussion assessment. Learn more in our article, Baseline vs. Normative Concussion Testing: What New Research Shows. 

The Sway vs. ImPACT study offers preliminary evidence that mobile concussion assessment may provide useful information as part of that broader process.

It also highlights an important consideration: Different assessment systems may provide different types of information, even when their overall post-injury classifications agree in a small sample.

Sway vs. ImPACT: How Does Baseline Testing Work in Practice?

Research is important, but so is the day-to-day reality of managing concussion testing for dozens or even hundreds of athletes.

Traditional computer-based testing workflows may require Athletic Trainers to coordinate computer access, testing locations, and schedules.

Sway takes a mobile approach.

With compatible iOS and Android devices, Athletic Trainers can conduct baseline testing in locations such as Athletic Training facilities, classrooms, and gymnasiums. Multiple athletes can complete testing simultaneously, allowing programs to organize testing around their schedules.

For programs managing large numbers of athletes, that flexibility can make a meaningful difference.

What Can Mobile Baseline Testing Look Like?

Healthy Roster customers have shared examples of how Sway fits into their preseason workflows.

One customer reported completing approximately 400–500 baseline tests across multiple teams in just a few hours.

At Bettendorf High School, one Athletic Trainer reported completing and verifying baseline tests for 30 basketball players in 30 minutes.

These are individual customer experiences, not results from the Sway vs. ImPACT research study. They illustrate how mobile testing can help Athletic Trainers manage the practical demands of preseason assessments.

What Are the Limitations of the Sway vs. ImPACT Study?

Although the baseline comparison included 403 high school athletes, only 10 had both baseline and acute post-injury data available for the direct post-concussion comparison.

The researchers specifically called for additional studies with larger post-injury samples.

These findings should therefore be viewed as preliminary rather than definitive evidence that the two systems perform equivalently.

Continued research will help clarify how mobile concussion assessment tools compare with established computerized testing approaches across different populations and clinical situations.

Interested in Seeing How Sway Concussion Works?

Healthy Roster Concussion, powered by Sway Sports+, brings mobile balance and cognitive testing together to support concussion assessment and management.

For Athletic Trainers looking to simplify baseline testing while incorporating objective information into their concussion assessment workflow, Sway offers an option worth exploring.

See how Sway Concussion can fit into your Athletic Training program!

Frequently Asked Questions About Sway vs. ImPACT

Is Sway comparable to ImPACT for concussion assessment?

A study of 403 high school athletes found that Sway demonstrated similar preliminary utility to ImPACT in the acute post-concussion setting. However, only 10 athletes had both baseline and post-injury data available for the direct comparison. Researchers emphasized that larger studies are needed to confirm these findings.

Can Sway be used for baseline concussion testing?

Yes. Sway allows Athletic Trainers to conduct baseline balance and cognitive testing using compatible iOS and Android devices. Multiple athletes can complete testing simultaneously, making it easier to organize preseason baseline testing without relying on a dedicated computer lab.

Does Sway diagnose concussions?

No. Sway Sports+ is an FDA-cleared assessment aid, not a standalone diagnostic tool. Athletic Trainers and other qualified healthcare professionals use its results alongside symptoms, clinical examinations, injury history, and other relevant information to support concussion assessment and management.

Do Sway and ImPACT measure the same cognitive abilities?

Not necessarily. Researchers found generally small correlations between most Sway and ImPACT measures, suggesting the systems may assess different neurocognitive constructs. This means similar overall clinical utility does not necessarily indicate that the two systems measure identical abilities.

What is the biggest limitation of the Sway vs. ImPACT study?

Although 403 athletes completed baseline testing with both systems, only 10 had the baseline and acute post-injury data needed for the direct post-concussion comparison. The researchers specifically recommended additional studies with larger post-injury samples.

Research Reference

Hautmann, A., et al. (2026). Preliminary Comparison of Sway and ImPACT as a Concussion Assessment Tool. Archives of Clinical Neuropsychology, 41(Supplement 1), i13.

Research findings are preliminary. Sway Sports+ is an FDA-cleared assessment aid for use by qualified healthcare professionals within its cleared indications. It does not diagnose concussion or replace a comprehensive clinical evaluation. Talk to Healthy Roster about details on how to use.