Clinical reaction-time performance factors in healthy collegiate athletes

Abstract

Context: In the absence of baseline testing, normative data may be used to interpret postconcussion scores on the clinical reaction-time test (RTclin). However, to provide normative data, we must understand the performance factors associated with baseline testing. Objective: To explore performance factors associated with baseline RTclin from among candidate variables representing demographics, medical and concussion history, self-reported symptoms, sleep, and sport-related features. Design: Cross-sectional study. Setting: Clinical setting (eg, athletic training room). Patients or Other Participants: A total of 2584 National Collegiate Athletic Association student-athletes (n 1/4 1206 females [47%], 1377 males [53%], and 1 unreported (<0.1%); mass1/476.7 6 18.7 kg; height±176.7 6 11.3 cm; age±19.0 6 1.3 years) from 3 institutions participated in this study as part of the Concussion Assessment, Research and Education Consortium. Main Outcome Measure(s): Potential performance factors were sex; race; ethnicity; dominant hand; sport type; number of prior concussions; presence of anxiety, learning disability, attention-deficit disorder or attention-deficit/hyperactivity disorder, depression, or migraine headache; self-reported sleep the night before the test; mass; height; age; total number of symptoms; and total symptom burden at baseline. The primary study outcome measure was mean baseline RTclin. Results: The overall RTclin was 202.0 6 25.0 milliseconds. Female sex (parameter estimate [B] ± 8.6 milliseconds, P , .001, Cohen d ± 0.54 relative to male sex), black or African American race (B ± 5.3 milliseconds, P ± .001, Cohen d ± 0.08 relative to white race), and limited-contact (B±4.2 milliseconds, P , .001, Cohen d±0.30 relative to contact) or noncontact (B± 5.9 milliseconds, P , .001, Cohen d ± 0.38 relative to contact) sport participation were associated with slower RTclin. Being taller was associated with a faster RTclin, although this association was weak (B ±0.7 milliseconds, P