Pilot evaluation of a novel clinical test of reaction time in national collegiate athletic association division I football players

Abstract

Context: Evidence suggests that concussion prolongs reaction time (RT). We have developed a simple, reliable clinical tool for measuring reaction time that may be of value in the assessment of concussion in athletes.

Objective: To compare baseline values of clinical RT (RT(clin)) obtained using the new clinical reaction time apparatus with computerized RT (RT(comp)) obtained using a validated computerized neuropsychological test battery.

Design: Cross-sectional study.

Setting: Data were collected during a National Collegiate Athletic Association Division I collegiate football team's preparticipation physical examination session.

Patients or other participants: Ninety-four Division I collegiate football players.

Main outcome measure(s): The RT(clin) was measured using a 1.3-m measuring stick embedded in a weighted rubber disk that was released and caught as quickly as possible. The RT(comp) was measured using the simple RT component of CogState Sport.

Results: For the 68 athletes whose CogState Sport tests passed the program's integrity check, RT(clin) and RT(comp) were correlated (r = 0.445, P < .001). Overall, mean RT(clin) was shorter and less variable than mean RT(comp) (203 +/- 20 milliseconds versus 268 +/- 44 milliseconds; P < .001). When RT(clin) and RT(comp) were compared between those athletes with (n = 68) and those without (n = 26) valid CogState Sport test sessions, mean RT(clin) was similar (202 +/- 19 milliseconds versus 207 +/- 23 milliseconds; P = .390), but mean RT(comp) was different (258 +/- 35 milliseconds versus 290 +/- 55 milliseconds; P = .009).

Conclusions: The RT(clin) was positively correlated with RT(comp) and yielded more consistent reaction time values during baseline testing. Given that RT(clin) is easy to measure using simple, inexpensive equipment, further prospective study is warranted to determine its clinical utility in the assessment of concussion in athletes.

Figures

Figure 1

The authors demonstrate the clinical reaction time (RTclin) testing procedure using the clinical reaction time apparatus. The examiner (standing) vertically suspends the apparatus, allowing the spacer portion of the device to rest inside the open hand of the test participant. When the examiner drops the apparatus, the test participant catches it as quickly as possible. The distance the apparatus falls is recorded and converted into a reaction time (in milliseconds) using the formula for a body falling under the influence of gravity.

Figure 2

Clinical reaction time (RTclin) by trial averaged across all 94 athletes. Error bars represent 95% confidence intervals.