Evaluation of a simple test of reaction time for baseline concussion testing in a population of high school athletes.


A common sequela of concussions is impaired reaction time. Computerized neurocognitive tests commonly measure reaction time. A simple clinical test for reaction time has been studied previously in college athletes; whether this test is valid and reliable when assessing younger athletes remains unknown. Our study examines the reliability and validity of this test in a population of high school athletes.
Cross-sectional study.
Two American High Schools.
High school athletes (N = 448) participating in American football or soccer during the academic years 2011 to 2012 and 2012 to 2013.
All study participants completed a computerized baseline neurocognitive assessment that included a measure of reaction time (RT comp), in addition to a clinical measure of reaction time that assessed how far a standard measuring device would fall prior to the athlete catching it (RT clin).
Validity was assessed by determining the correlation between RT clin and RT comp. Reliability was assessed by measuring the intraclass correlation coefficients (ICCs) between the repeated measures of RT clin and RT comp taken 1 year apart.
In the first year of study, RT clin and RT comp were positively but weakly correlated (rs = 0.229, P < 0.001). In the second year, there was no significant correlation between RT clin and RT comp (rs = 0.084, P = 0.084). Both RT clin [ICC = 0.608; 95% confidence interval (CI), 0.434-0.728] and RT comp (ICC = 0.691; 95% CI, 0.554-0.786) had marginal reliability.
In a population of high school athletes, RT clin had poor validity when compared with RT comp as a standard. Both RT clin and RT comp had marginal test-retest reliability. Before considering the clinical use of RT clin in the assessment of sport-related concussions sustained by high school athletes, the factors affecting reliability and validity should be investigated further.
Reaction time impairment commonly results from concussion and is among the most clinically important measures of the condition. The device evaluated in this study has previously been investigated as a reaction time measure in college athletes. This study investigates the clinical generalizability of the device in a younger population.
A video abstract showing how the RT clin device is used in practice is available as Supplemental Digital Content 1, http://links.lww.com/JSM/A43.


  • Publisher Full Text
  • Authors

    MacDonald J

    *Department of Pediatrics, Division of Sports Medicine, Nationwide Children's Hospital, Columbus, Ohio; †Department of Orthopaedics, Children's Hospital Colorado, Aurora, Colorado; ‡Center for Injury Research Policy, Nationwide Children's Hospital, Columbus, Ohio; §The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts; and ¶Department of Orthopaedics, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts.

    Wilson J

    Young J

    Duerson D

    Swisher G

    Collins CL

    Meehan WP


    Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 25:1 2015 Jan pg 43-8

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't



    PubMed ID