Examining Practice and Learning Effects With Serial Administration of the Clinical Reaction Time Test in Healthy Young Athletes

in Journal of Sport Rehabilitation
Restricted access

Purchase article

USD  $24.95

Student 1 year subscription

USD  $74.00

1 year subscription

USD  $99.00

Student 2 year subscription

USD  $141.00

2 year subscription

USD  $185.00

Context: The clinical reaction time (RTclin) test has been recommended as a valid test for assessing concussion and determining recovery of reaction time function following concussion. However, it is unknown whether repeat assessment, as is used in postconcussion testing, is affected by learning or practice phenomena. Objective: To determine if a practice or learning effect is present with serial administration of the RTclin test. Design: Randomized control trial. Setting: University athletic training clinics. Participants: A total of 112 healthy collegiate athletes (age = 19.46 [1.34] y). Interventions: The control group completed the RTclin test on days 1 and 60. The experimental group completed the RTclin test on days 1, 2, 3, 7, and 60. Main Outcome Measure: Reaction time as measured with the RTclin test. Results: The difference in RTclin test performance from day 1 to day 60 was not significant (mean change = −2.77 [14.46] ms, P = .42, 95% confidence intervals, −6.40 to 0.862) between groups. The experimental group experienced significant improvement (λ = 0.784, F4,49 = 3.365, P = .02, η2 = .216, power = 0.81) with acute repeat testing. However, post hoc analysis did not reveal a significant difference between scores during the 5 test periods. Conclusions: The results suggest serial administration of the RTclin test does not produce a practice or learning effect. Clinicians, however, should be cautious as the results do provide evidence patients may demonstrate improved scores when testing occurs on repetitive days after initial exposure to the test.

The authors are with the University of Idaho, Moscow, ID.

Baker (russellb@uidaho.edu) is corresponding author.
  • 1.

    National Council of Youth Sports Report on Trends and Participation in Organized Youth Sports. ncys.org. 2008. http://www.ncys.org/pdfs/2008/2008-ncys-market-research-report.pdf. Accessed May 16, 2017.

    • Search Google Scholar
    • Export Citation
  • 2.

    Daneshvar DH, Nowinski CJ, McKee AC, Cantu RC. The epidemiology of sport-related concussion. Clin Sports Med. 2011;30(1):1–17. doi:10.1016/j.csm.2010.08.006

  • 3.

    Giza CC, Hovda DA. The neurometabolic cascade of concussion. J Athl Train. 2001;36(3):228–235.

  • 4.

    Giza CC, Hovda DA. The new neurometabolic cascade of concussion. Neurosurgery. 2014;75(4):24–33. doi:10.1227/NEU.0000000000000505

  • 5.

    Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States: emergency department visits, hospitalizations and deaths 2002–2006. 2010. http://www.cdc.gov/traumaticbraininjury/pdf/blue_book.pdf. Accessed December 17, 2014.

    • Search Google Scholar
    • Export Citation
  • 6.

    McCrea M, Guskiewicz K, Marshall S, et al. Acute effects and recovery time following concussion in collegiate football players: the NCAA Concussion Study. JAMA. 2003;290(19):2556–2563. doi:10.1001/jama.290.19.2556

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Rabadi M, Jordan B. The cumulative effect of repetitive concussion in sports. Clin J Sport Med. 2001;11(3):194–198. PubMed ID: 11495325 doi:10.1097/00042752-200107000-00011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    McCrory P, Meeuwisse W, Johnston K, et al. Consensus statement on concussion in sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Br J Sports Med. 2009;43(1):76–90. doi:10.1136/bjsm.2009.058248

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    McKee AC, Cantu RC, Nowinski CJ, et al. Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J Neuropathol Exp Neurol. 2009;68(7):709–735. PubMed ID: 19535999 doi:10.1097/NEN.0b013e3181a9d503

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Cobb S, Battin B. Second-impact syndrome. J Sch Nurs. 2004;20(5):262–267. PubMed ID: 15469376 doi:10.1177/10598405040200050401

  • 11.

    Collins MW, Lovell MR, Iverson GL, Cantu RC, Maroon JC, Field M. Cumulative effects of concussion in high school athletes. Neurosurgery. 2002;51(5):1175–1181. PubMed ID: 12383362 doi:10.1097/00006123-200211000-00011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Barr WB, McCrea M. Sensitivity and specificity of standardized neurocognitive testing immediately following sports concussion. J Int Neuropsychol Soc. 2001;7(6):693–702. doi:10.1017/S1355617701766052

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Valovich McLeod TC, Perrin DH, Guskiewicz KM, Shultz SJ, Diamond R, Gansneder BM. Serial administration of clinical concussion assessments and learning effects in healthy young athletes. Clin J Sport Med. 2004;14(5):287–295. PubMed ID: 15377968 doi:10.1097/00042752-200409000-00007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Eckner J, Kutcher J, Richardson J. Pilot evaluation of a novel clinical test of reaction time in National Collegiate Athletic Association Division I football players. J Athl Train. 2010;45(4):327–332. doi:10.4085/1062-6050-45.4.327

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Galetta KM, Brandes LE, Maki K, et al. The King-Devick test and sports-related concussion: study of a rapid visual screening tool in a collegiate cohort. J Neurol Sci. 2011;309(1):34–39. doi:10.1016/j.jns.2011.07.039

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Eckner JT, Kutcher JS, Broglio SP, Richardson JK. Effect of sport-related concussion on clinically measured simple reaction time. Br J Sports Med. 2014;48(2):112–118. doi:10.1136/bjsports-2012-091579

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Eckner J, Richardson J, Kim H, Lipps DB, Ashton-Miller JA. A novel clinical test of recognition reaction time in healthy adults. Psychol Assess. 2012;24(1):249–254. doi:10.1037/a0025042

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Erlanger D, Saliba E, Barth J, Almquist J, Webright W, Freeman J. Monitoring resolution of postconcussion symptoms in athletes: preliminary results of a web-based neuropsychological test protocol. J Athl Train. 2001;36(3):280–287. PubMed ID: 12937497

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Collie A, Makdissi M, Maruff P, Bennell K, McCrory P. Cognition in the days following concussion: comparison of symptomatic versus asymptomatic athletes. J Neurol Neurosurg Psychiatry. 2006;77(2):241–245. PubMed ID: 16421129 doi:10.1136/jnnp.2005.073155

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Broglio SP, Macciocchi SN, Ferrara MS. Neurocognitive performance of concussed athletes when symptom free. J Athl Train. 2007;42(4):504–508. PubMed ID: 18174938

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Eckner JT, Lipps DB, Kim H, Richardson JK, Ashton-Miller JA. Can a clinical test of reaction time predict a functional head-protective response? Med Sci Sports Exerc. 2011;43(3):382–387. doi:10.1249/MSS.0b013e3181f1cc51

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Eckner JT, Kutcher JS, Richardson JK. Between-seasons test–retest reliability of clinically measured reaction time in National Collegiate Athletic Association Division I athletes. J Athl Train. 2011;46(4):409–414. doi:10.4085/1062-6050-46.4.409

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Eckner JT, Chandran S, Richardson JK. Investigating the role of feedback and motivation in clinical reaction time assessment. PM R. 2011;3(12):1092–1097. doi:10.1016/j.pmrj.2011.04.022

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Eckner JT, Whitacre RD, Kirsch NL, Richardson JK. Evaluating a clinical measure of reaction time: an observational study. Percept Mot Skills. 2009;108(3):717–720. PubMed ID: 19725308 doi:10.2466/pms.108.3.717-720

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Macciocchi S. “Practice makes perfect:” retest effects in college athletes. J Clin Psychol. 1990;46(5):628–631. PubMed ID: 2246371 doi:10.1002/1097-4679(199009)46:5<628::AID-JCLP2270460514>3.0.CO;2-V

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Del Rossi G, Malaguti A, Del Rossi S. Practice effects associated with repeated assessment of a clinical test of reaction time. J Athl Train. 2014;49(3):356–359. doi:10.4085/1062-6059-49.2.04

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Thomas JR, Nelson JK, Silverman SJ. Research Methods in Physical Activity. 6th ed. Champaign, IL: Human Kinetics; 2010.

All Time Past Year Past 30 Days
Abstract Views 118 118 10
Full Text Views 10 10 1
PDF Downloads 6 6 0