My colleagues and I have a new paper out in the Journal of Sport Rehabilitation (JSR). Shout out to Ellen Smith, MS, ATC and Sam Duncan, MS, ATC for their work on this project as part of their Masters’ Thesis! We believe it develops new tools for making return to sport decisions for athletes.

How should physical therapists determine readiness for sport?

Recent studies in sports rehabilitation emphasize the need for tests that accurately predict an athlete's readiness to return to sport post-injury. Traditional tests often overlook critical dynamics like visual search and reactive decision-making, which are integral during actual sports play. Our research aims to fill this gap by investigating the reliability of reactive agility tasks and the impact of visual perturbations on these tasks. This study not only enhances our understanding of agility performance but also proposes a refined approach to assessing athletes' readiness for sport.

Our reactive agility tasks were specifically developed to include components of reaction time, visual search, working memory, and endurance/aerobic energy systems.

Study Design: Examining Reactive Agility and Visual Dependence

We conducted a controlled laboratory study with physically active individuals who underwent two types of agility tasks: the 4-corner agility task and the color recall task. Each participant completed these tasks under normal and visually perturbed conditions using stroboscopic goggles. Our evaluation focused on reaction time, number of targets hit, time to target, and total time, providing a comprehensive measure of performance under different sensory conditions.

Results: Performance was highly stable in both reactive agility tasks.

Our findings reveal several key insights:

1. **High Reliability:** Both tasks demonstrated high test-retest reliability, indicating they are dependable measures of agility performance.

2. **Effect of Visual Perturbation:** Introducing visual perturbations significantly affected performance, with participants showing a decrease in the number of targets hit and an increase in the time to target.

3. **Task-Specific Impacts:** The 4-corner agility task, focusing on rapid target engagement, showed different performance impacts under visual perturbation than the color recall task, which involves memory and sequencing.

4. **Practical Thresholds:** The minimal detectable changes (MDC) were established, offering practical benchmarks for significant performance changes, vital for clinical assessments.

Discussion: Improving Return to Sport Assessments

The introduction of visual perturbations simulates real-world sports environments where athletes often face visual and physical distractions. The significant decline in performance with perturbations underscores the importance of incorporating these factors into return-to-sport assessments. Furthermore, the high reliability of these tasks suggests they could effectively supplement traditional testing protocols, providing a more nuanced evaluation of an athlete's readiness to return to play.

For more work on the future of return to sport testing, check out our other paper in IJSPT. That study covers work to develop new agility tasks that challenge interpersonal dynamics - or how two athlete coordinate their behavior on field.

Implications and Future Directions

This study advocates for a paradigm shift in athletic testing, promoting the inclusion of reactive agility tasks in return-to-sport batteries. Future research should explore these tasks in injured populations and develop standardized performance benchmarks. Clinicians are encouraged to adopt these tasks, considering their robustness and relevance in reflecting true sports performance conditions.

This research advances our tools and understanding in sports rehabilitation, promising to enhance the accuracy and safety of return-to-sport decisions. By integrating complex and dynamic testing elements, we can better prepare athletes for the demands of competitive play, potentially reducing the incidence of re-injury.