Effects of neurocognitive reactive activities on upper extremity closed kinetic chain functional performance testing

Background Existing UE return-to-sport (RTS) decision-making criteria do not assess neurocognitive (NC) deficits, increasing the risk of reinjury. This study aimed to establish the test–retest reliability of two NC reactive (NCR) variations of an upper extremity (UE) functional performance test (FPT). Methods Forty-two healthy adults completed two trials each of the Closed Kinetic Chain (CKC) UE Stability Test and two NCR variations, the UE Reactive CKC Test—Single Light (UERCKCT-SL) and UE Reactive CKC Test—Multi-Light (UERCKCT-ML), on two separate days. The average number of touches and reaction time were recorded. Reliability was assessed using systematic bias, total error, intraclass correlation coefficients (ICC), and 90% minimal detectable change. Results ICC results for each test ranged from .669 to .816 for females and .676 to .872 for males. A significant difference in the average number of touches performed between the test variations was observed for both females ( F 2,38 = 7.6, p = .002, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:msubsup> <mml:mi>η</mml:mi> <mml:mi>p</mml:mi> <mml:mn>2</mml:mn> </mml:msubsup> </mml:math> = .29) and males ( F 2,42 = 13.5, p &lt; .001, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:msubsup> <mml:mi>η</mml:mi> <mml:mi>p</mml:mi> <mml:mn>2</mml:mn> </mml:msubsup> </mml:math> = .39). Test reaction time differences between the UERCKCT-SL and UERCKCT-ML were not significant for females ( t 19 = 1.20, d = 0.21, P = .245, CI diff = −56.78 to 15.43) and males ( t 21 = 0.40, d = 0.05, p = .692, CI diff = −59.65 to 40.33). Conclusion Adding NCR multitask UE testing may improve RTS decision-making guidelines by better mimicking sporting demands. However, further research is needed to identify clinically suitable and ecologically valid NCR UE CKC FPT.