Detection of Persisting Concussion Effects on Neuromechanical Responsiveness

PURPOSEAssessment of various indices of neuromechanical responsiveness for association with concussion history. METHODSAn observational cohort study included 48 elite athletes (34 males23.8 ± 4.4 yr; 14 females25.4 ± 4.5 yr) who performed visuomotor reaction time (VMRT) tests involving rapid manual contact with illuminated target buttons that included two dual-task conditions1) simultaneous oral recitation of scrolling text (VMRT+ST) and 2) simultaneous verbal responses to identify the right or left direction indicated by the center arrow of the Eriksen flanker test (VMRT+FT). A whole-body reactive agility (WBRA) test requiring side-shuffle movements in response to visual targets was used to assess reaction time, speed, acceleration, and deceleration. RESULTSConcussion occurrence at 2.0 ± 2.3 yr before testing was reported by 21 athletes. Strong univariable associations were found for VMRT+FT left minus right difference ≥15 ms (odds ratio [OR], 7.14), VMRT+ST outer two-ring to inner three-ring ratio ≥1.28 (OR, 4.58), and WBRA speed asymmetry ≥7.7% (OR, 4.67). A large VMRT+FT by VMRT+ST interaction effect was identified (OR, 25.00). Recursive partitioning identified a three-way VMRT+FT by VMRT+ST by WBRA interaction that had 100% positive predictive value for identification of athletes with concussion history, whereas negative status on all three factors had 90% negative predictive value. CONCLUSIONSPerformance on dual-task VMRT tests and the WBRA test identified neuromechanical responsiveness deficiencies among elite athletes who reported a history of concussion.