Pilot Evaluation of a Novel Test of Reaction Time in Division I College Football Players

Abstract

Computerized neuropsychological test batteries are a popular tool for the assessment and management of concussion in athletes. However, some have challenged their use due to cost, limited accessibility, and variability in motivational status during baseline testing. One subset of computerized test batteries that has been shown to be affected by concussion is reaction time (RT). We developed a novel clinical measure of RT that proved to be reliable and valid during pilot testing in a general population of healthy adults. A simple, inexpensive clinical measure of RT may have a place in the assessment of concussion, especially in young athletes who have limited access to formal computerized neuropsychological testing. PURPOSE: To compare clinical RT (RTclin) obtained using the new clinical reaction time apparatus (CRTA) to computerized RT (RTcomp) obtained using a validated computerized neuropsychological test battery. METHODS: Ninety-five Division I college football players underwent simple RT testing using the CRTA and the CogState-Sport program during pre-season physical exams. The CRTA is a meter-long measuring stick, coated in high-friction tape and embedded in a weighted rubber disk. The examiner releases the CMRT and the subject catches it as quickly as possible after it begins to fall. The fall distance is converted into a reaction time in ms using the formula for a body falling under the influence of gravity. RESULTS: In the 68 subjects whose CogState-Sport tests passed the program's integrity check, there was a significant positive correlation between RTclin and RTcomp (r = 0.462, p < 0.001). Mean RTclin was significantly shorter and less variable than mean RTcomp (202 + 19 ms vs. 248 + 28 ms, p < 0.001). When RTclin and RTcomp were compared between those athletes with (n = 68) and those without (n = 27) valid CogState-Sport test sessions, there was no group difference in mean RTclin (202 + 19 ms vs. 206 + 23 ms, p = 0.400), but there was a significant group difference in mean RTcomp (248 + 28 ms vs. 272 + 24 ms, p = 0.002). CONCLUSIONS: RTclin is positively correlated with RTcomp and appears to yield more consistent RT's during baseline testing. Given that RTclin is easy to measure using simple, inexpensive equipment further study is warranted to determine its utility in the assessment of concussion in athletes.