Detection of Persisting Concussion Effects on Neuromechanical Responsiveness

Purpose Assessment of various indices of neuromechanical responsiveness for association with concussion history. Methods An observational cohort study included 48 elite athletes (34 males: 23.8 ±4.4 years; 14 females: 25.4 ±4.5 years) who performed visuomotor reaction time (VMRT) tests involving rapid manual contact with illuminated target buttons that included 2 dual-task conditions: 1) 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. Results Concussion occurrence at 2.0 ±2.3 years prior to testing was reported by 21 athletes. Strong univariable associations were found for VMRT+FT left minus right difference ≥15 ms (OR=7.14), VMRT+ST outer 2-ring to inner 3-ring ratio ≥1.28 (OR=4.58), and WBRA speed asymmetry ≥7.7% (OR=4.67). A large VMRT+FT X VMRT+ST interaction effect was identified (OR=25.00). Recursive partitioning identified a 3-way VMRT+FT X VMRT+ST X WBRA interaction that had 100% positive predictive value for identification of athletes with concussion history, whereas negative status on all 3 factors had 90% negative predictive value. Conclusion Performance on dual-task VMRT tests and the WBRA test identified neuromechanical responsiveness deficiencies among elite athletes who reported a history of concussion. Corresponding Author: Gary Wilkerson, University of Tennessee at Chattanooga, 615 McCallie Avenue, Dept. 6606, Chattanooga, TN 37403. Email: Gary-Wilkerson@utc.edu. Phone: 423-290-9160. Fax: 423-425-1734 The reported data were acquired from equipment loaned to the US Olympic Committee by Dynavision International and Traq Global, Ltd. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation, and statement that results of the present study do not constitute endorsement by ACSM. The research was conducted in facilities of the US Coalition for the Prevention of Illness and Injury in Sport, which is one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee (IOC). One of the authors (GBW) has previously received a speaking honorarium and travel expense reimbursement from Dynavision International, and he has previously provided consulting services to Traq Global, Ltd. Accepted for Publication: 14 April 2018 © 2018 American College of Sports Medicine

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