Evaluation of a
Simple Test of Reaction Time for Baseline Concussion Testing in a Population of
High School Athletes

J., Wilson J., Young J., Duerson D., Swisher G., Collins C., Meehan W. The Clinical
Journal of Sports Medicine.2014; ahead of print.

Take Home Message:
The clinical reaction time test is a cost efficient, simple test to perform;
however, further validation of this clinical measure is warranted before
incorporation into the concussion protocol.

common sign following a concussion is impaired reaction time. It is not only
important to measure reaction time due to is prognostic importance, but also because
it has been found that reaction time decreases with multiple concussions as
well as it is may be unsafe for an athlete to return to play if they have impaired
reaction time. The simple reaction time test is validated within the collegiate
population, but not within the high school population. Therefore, the purpose
of this study was to assess the reliability and validly of the clinical reaction time test in a high school
population. Four hundred and forty-eight high school athletes (75% male; average
age 15.5 years) that competed in football or soccer during their 2011 to 2012 (222
athletes) or 2012 to 2013 (226 athletes) academic years were included in this
study. Athletes completed a baseline neurocognitive exam (i.e., AxonSports) and
clinical reaction time test. The authors assessed how related that clinical
reaction time was to computerized reaction time. To complete the clinical
reaction time test the authors asked an athlete to catch the device between his/her
thumb and fingers. After one unrecorded practice attempt the athlete completed
8 attempts. The test administer measured the distance the device fell before
being caught using the 0.5-cm incremental markings on the device. The total
distance the device fell before being caught was converted into the athlete’s
reaction time. Within the first year of the study, the computerized reaction and
the clinical reaction time were barely related. During the second year of the study,
there was no relationship between the tests. Among 176 athletes who completed
the test in both years the authors found that there was marginal reliability
for both the computer ( 2011: average 313.8 ms versus 2012: average 336.1 ms)
and clinical reaction time (2011: average 230. 0 ms versus 2012: average 218.8).

is an important study because validity and reliability are fundamental
characteristics that need to be established for any clinical test such as the
clinical reaction time test. The clinical reaction time test device produced a
“faster” measure of reaction time compared to the computer. However, the
clinical reaction time task was not as reliable as the computerized reaction
time test. Additionally, the relationship between the tests were low to
nonexistent. This could be due to the high school athletes taking the tests in
a group environment, where the computerized test may be sensitive to distractions.
Age may also play a factor, where younger athletes may still be developing hand
eye coordination. Further reliability and validity testing is necessary before
incorporating the clinical reaction time test into the concussion protocol for
high school athletes. This study is a nice reminder that a test validated in
one population (for example, college athletes) might not work in another
population (for example, high school athletes).

Questions for Discussion:
Have you used this test before? If so, what are your thoughts? Do you prefer
the computerized version to assess reaction time? If so, why do you prefer the
computerized version?

by: Jane McDevitt, PhD
by: Jeff Driban


Effectiveness of Computerized Neurocognitive Testing

Macdonald J, Wilson J, Young J, Duerson D, Swisher G, Collins CL, & Meehan WP 3rd (2014). Evaluation of a Simple Test of Reaction Time for Baseline Concussion Testing in a Population of High School Athletes. Clinical Journal of Sport Medicine PMID: 24727576