Effects of neurocognitive reactive activities on upper extremity closed kinetic chain functional performance testing.

Abstract

Existing UE return-to-sport (RTS) decision-making criteria do not assess neurocognitive (NC) deficits, increasing the risk of reinjury. This study aimed to establish the test-retest reliability of two NC reactive (NCR) variations of an upper extremity (UE) functional performance test (FPT). Forty-two healthy adults completed two trials each of the Closed Kinetic Chain (CKC) UE Stability Test and two NCR variations, the UE Reactive CKC Test-Single Light (UERCKCT-SL) and UE Reactive CKC Test-Multi-Light (UERCKCT-ML), on two separate days. The average number of touches and reaction time were recorded. Reliability was assessed using systematic bias, total error, intraclass correlation coefficients (ICC), and 90% minimal detectable change. ICC results for each test ranged from .669 to .816 for females and .676 to .872 for males. A significant difference in the average number of touches performed between the test variations was observed for both females (<i>F</i> _2,38 = 7.6, <i>p</i> = .002, <math xmlns="http://www.w3.org/1998/Math/MathML"><msubsup><mi>η</mi> <mi>p</mi> <mn>2</mn></msubsup> </math>  = .29) and males (<i>F</i> _2,42 = 13.5, <i>p</i> < .001, <math xmlns="http://www.w3.org/1998/Math/MathML"><msubsup><mi>η</mi> <mi>p</mi> <mn>2</mn></msubsup> </math>  = .39). Test reaction time differences between the UERCKCT-SL and UERCKCT-ML were not significant for females (<i>t</i> ₁₉ = 1.20, <i>d</i> = 0.21, <i>P</i> = .245, CI_diff = -56.78 to 15.43) and males (<i>t</i> ₂₁ = 0.40, <i>d</i> = 0.05, <i>p</i> = .692, CI_diff = -59.65 to 40.33). Adding NCR multitask UE testing may improve RTS decision-making guidelines by better mimicking sporting demands. However, further research is needed to identify clinically suitable and ecologically valid NCR UE CKC FPT.