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

Shoulder Elbow · Jul 27 2026 · Recent

Stoddard SM, Lewis K, Riemann BL, Davies GJ

Department of Clinical Sciences, Georgia Southern University, Savannah

Sports Medicine Shoulder & Elbow

SUMMARY — THE REDUCTIONNew reactive neurocognitive variations of an upper extremity closed-chain functional test show moderate-to-good reliability, suggesting potential to improve return-to-sport testing though further validation is needed.
Abstract, as published

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, η p 2  = .29) and males (F 2,42 = 13.5, p < .001, η p 2  = .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, CIdiff = -56.78 to 15.43) and males (t 21 = 0.40, d = 0.05, p = .692, CIdiff = -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.

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