Upper-Extremity Perceptual-Motor Training Improves Whole-Body Reactive Agility Among Elite Athletes With History of Sport-Related Concussion

Context : Sport-related concussion (SRC) elevates risk for subsequent injury, which may relate to impaired perceptual-motor processes that are potentially modifiable. Objective : To assess a possible upper-extremity (UE) training effect on whole-body (WB) reactive agility performance among elite athletes with history of SRC (HxSRC) and without such history of SRC. Design : Cohort study. Setting : Residential training center. Participants : Elite athletes (12 males and 8 females), including 10 HxSRC and 10 without such history of SRC. Intervention : One-minute training sessions completed 2 to 3 times per week over a 3-week period involved verbal identification of center arrow direction for 10 incongruent and 10 congruent flanker test trials with simultaneous reaching responses to deactivate illuminated buttons. Main Outcome Measures : Pretraining and posttraining assessments of UE and WB reactive responses included flanker test conflict effect (incongruent minus congruent reaction time) and WB lateral average asymmetry derived from reaction time, speed, acceleration, and deceleration in opposite directions. Discrimination was assessed by receiver operating characteristic analysis, and training effect was assessed by repeated-measures analysis of variance. Results : Pretraining discrimination between HxSRC and without such history of SRC was greatest for conflict effect ≥80 milliseconds and WB lateral average asymmetry ≥18%. Each athlete completed 6 training sessions, which improved UE mean reaction time from 767 to 646 milliseconds ( P < .001) and reduced mean conflict effect from 96 to 53 milliseconds ( P = .039). A significant group × trial interaction was evident for WB lateral average asymmetry ( P = .004), which was reduced from 24.3% to 12.5% among those with HxSRC. Conclusions : Suboptimal perceptual-motor performance may represent a subtle long-term effect of concussion that is modifiable through UE training, which appears to improve WB reactive capabilities.