A Novel Approach to Assessment of Perceptual-Motor Efficiency and Training-Induced Improvement in the Performance Capabilities of Elite Athletes

Abstract

Standard clinical assessments of mild traumatic brain injury are inadequate to detect subtle abnormalities that can be revealed by sophisticated diagnostic technology. An association has been observed between sport-related concussion (SRC) and subsequent musculoskeletal injury, but the underlying neurophysiological mechanism is not currently understood. A cohort of 16 elite athletes (10 male, 6 female), which included nine individuals who reported a history of SRC (5 male, 4 female) that occurred between 4 months and 8 years earlier, volunteered to participate in a 12-session program for assessment and training of perceptual-motor efficiency. Performance metrics derived from single- and dual-task whole-body lateral and diagonal reactive movements to virtual reality targets in left and right directions were analyzed separately and combined in various ways to create composite representations of global function. Intra-individual variability across performance domains demonstrated very good SRC history classification accuracy for the earliest 3-session phase of the program (Reaction Time Dispersion AUC = 0.841; Deceleration Dispersion AUC = 0.810; Reaction Time Discrepancy AUC = 0.825, Deceleration Discrepancy AUC = 0.794). Good earliest phase discrimination was also found for Composite Asymmetry between left and right movement directions (AUC = 0.778) and Excursion Average distance beyond the minimal body displacement necessary for virtual target deactivation (AUC = 0.730). Sensitivity derived from Youden's Index for the 6 global factors ranged from 67 to 89% and an identical specificity value of 86% for all of them. Median values demonstrated substantial improvement from the first 3-session phase to the last 3-session phase for Composite Asymmetry and Excursion Average. The results suggest that a Composite Asymmetry value ≥ 0.15 and an Excursion Average value ≥ 7 m, provide reasonable qualitative approximations for clinical identification of suboptimal perceptual-motor performance. Despite acknowledged study limitations, the findings support a hypothesized relationship between whole-body reactive agility performance and functional connectivity among brain networks subserving sensory perception, cognitive decision-making, and motor execution. A complex systems approach appears to perform better than traditional data analysis methods for detection of subtle perceptual-motor impairment, which has the potential to advance both clinical management of SRC and training for performance enhancement.

Subtle impairments of perceptual-motor function and well-being are detectable among military cadets and college athletes with self-reported history of concussion

“…Thus, previous research that has linked excessive dispersion to early development of aging-related neurodegenerative conditions may have relevance to neural impairment caused by mTBI among adolescents and young adults ( 46 ). Consistent with the findings of a recent study involving elite athletes ( 29 ), dispersion of multiple standardized values for test metrics representing somewhat different performance domains provided greater discriminatory power for identification of HxC cases than any single test metric. The diffuse and heterogenous nature of mTBI might explain the greater discriminatory power of a multifaceted composite metric compared to a single test result ( 50 ).…”

“…Perception of proprioceptive, vestibular, and auditory inputs to the central nervous system supplement vision in generation of an internal representation of the external environment, which is fundamentally a cognitive process driven by behavioral goals ( 28 ). Although perceptual, cognitive, and motor processes can be viewed as somewhat distinct from one another, perceptual-motor efficiency refers to the optimal integration of spatially separated brain processing modules that produce rapid and accurate responses to goal-related stimuli ( 29 ). Because otherwise healthy young athletes can recruit additional neural resources to compensate for an impairment of normal processing capability, dual-task assessments are often used to impose combined cognitive and motor demands that approach or exceed the limit of available cognitive reserve ( 30 ).…”

Validity and Reliability of Methods to Assess Movement Deficiencies Following Concussion: A COSMIN Systematic Review

“…Although these assessments tend to provide greater sensitivity than single-task versions, limitations still exist beyond two weeks post-concussion [ 95 ]. The use of a virtual reality system three months post-concussion displayed sufficient AUC (0.79–0.84) and significant between-group differences for reaction time and lateral movement asymmetries during a reactive movement task [ 94 ]. However, further research is warranted due to the small sample size used within this study.…”

A Narrative Review of the Link between Sport and Technology

“…• determining the power of the lower train [3] • measuring linear sprint performance [40] • knowledge of force, power, and speed variables in horizontal and vertical jumps [41] • determining external and internal training tasks [42] • the association of the external load with the athlete's fatigue [18,43] • monitoring and prescribing resistance training tasks [28] • knowledge of physical demands in correlation with the following variables: locomotion speed, body load, and total body load [44] • tracking running and inertia indicators [27] • recording information related to force, accuracy, impact over time, and direction of hitting the volleyball ball [45] Table 2. Cont.…”