{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:33:58Z","timestamp":1792758838962,"version":"4.5.0"},"reference-count":20,"publisher":"National Athletic Trainers' Association","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Preseason testing can be time intensive and cost prohibitive. Therefore, using normative data for postconcussion interpretation in lieu of preseason testing is desirable.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To establish the recovery trajectory for clinical reaction time (RTclin) and assess the usefulness of changes from baseline (comparison of postconcussion scores with individual baseline scores) and norm-based cutoff scores (comparison of postconcussion scores with a normative mean) for identifying impairments postconcussion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Case-control study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Multisite clinical setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants<\/jats:title>\n                  <jats:p>An overlapping sample of 99 participants (age = 19.0 \u00b1 1.1 years) evaluated within 6 hours postconcussion, 176 participants (age = 18.9 \u00b1 1.1 years) evaluated at 24 to 48 hours postconcussion, and 214 participants (age = 18.9 \u00b1 1.1 years) evaluated once they were cleared to begin a return-to-play progression were included. Participants with concussion were compared with 942 control participants (age = 19.0 \u00b1 1.0 years) who did not sustain a concussion during the study period but completed preseason baseline testing at 2 points separated by 1 year (years 1 and 2).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s)<\/jats:title>\n                  <jats:p>At each time point, follow-up RTclin (ie, postconcussion or year 2) was compared with the individual year 1 preseason baseline RTclin and normative baseline data (ie, sex and sport specific). Receiver operating characteristic curves were calculated to compare the sensitivity and specificity of RTclin change from baseline and norm-based cutoff scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Clinical reaction time performance declined within 6 hours (18 milliseconds, 9.2% slower than baseline). The decline persisted at 24 to 48 hours (15 milliseconds, 7.6% slower than baseline), but performance recovered by the time of return-to-play initiation. Within 6 hours, a change from baseline of 16 milliseconds maximized combined sensitivity (52%) and specificity (79%, area under the curve [AUC] = 0.702), whereas a norm-based cutoff score of 19 milliseconds maximized combined sensitivity (46%) and specificity (86%, AUC = 0.700). At 24 to 48 hours, a change from baseline of 2 milliseconds maximized combined sensitivity (64%) and specificity (61%, AUC = 0.666), whereas a norm-based cutoff score of 0 milliseconds maximized combined sensitivity (63%) and specificity (62%, AUC = 0.647).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Norm-based cutoff scores can be used for interpreting RTclin scores postconcussion in collegiate athletes when individual baseline data are not available, although low sensitivity and specificity limit the use of RTclin as a stand-alone test.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-457-20","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T18:16:54Z","timestamp":1628619414000},"page":"851-859","source":"Crossref","is-referenced-by-count":22,"title":["Interpreting Clinical Reaction Time Change and Recovery After Concussion: A Baseline Versus Norm-Based Cutoff Score Comparison"],"prefix":"10.4085","volume":"56","author":[{"given":"Jaclyn B.","family":"Caccese","sequence":"first","affiliation":[{"name":"School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James T.","family":"Eckner","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Franco-MacKendrick","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph B.","family":"Hazzard","sequence":"additional","affiliation":[{"name":"Department of Exercise Science, loomsburg University, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Ni","sequence":"additional","affiliation":[{"name":"The Institute for Concussion Research & Services, Bloomsburg University, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven P.","family":"Broglio","sequence":"additional","affiliation":[{"name":"Michigan Concussion Center, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"McAllister","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Indiana University School of Medicine, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"McCrea","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul F.","family":"Pasquina","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences, Bethesda, MD"},{"name":"Walter Reed National Military Medical Center, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Applied Physiology, University of Delaware, Newark"},{"name":"Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"2022022515264830000_i1062-6050-56-8-851-b01","doi-asserted-by":"crossref","unstructured":"McCrory\n              P,\n            \n            \n              Meeuwisse\n              W,\n            \n            \n              Dvorak\n              J,\n            \n            et al.\n          \n          Consensus statement on concussion in sport\u2014the 5th International Conference on Concussion in Sport held in Berlin, October 2016.\n\t\t\t\t\tBr J Sports Med.\n\t\t\t\t\t2017;\n\t\t\t\t\t51(11):\n\t\t\t\t\t838\u2013\n\t\t\t\t\t847.\n\t\t\t\t\tdoi:10.1136\/bjsports-2017-097699","DOI":"10.1136\/bjsports-2017-097699"},{"key":"2022022515264830000_i1062-6050-56-8-851-b02","doi-asserted-by":"crossref","unstructured":"Lumba-Brown\n              A,\n            \n            \n              Yeates\n              KO,\n            \n            \n              Sarmiento\n              K,\n            \n            et al.\n          \n          Centers for Disease Control and Prevention guideline on the diagnosis and management of mild traumatic brain injury among children.\n\t\t\t\t\tJAMA Pediatr.\n\t\t\t\t\t2018;\n\t\t\t\t\t172(11):\n\t\t\t\t\te182853.\n\t\t\t\t\tdoi:10.1001\/jamapediatrics.2018.2853","DOI":"10.1001\/jamapediatrics.2018.2853"},{"key":"2022022515264830000_i1062-6050-56-8-851-b03","unstructured":"VA\/DoD clinical practice guidelines: management of concussion-mild traumatic brain injury.\n\t\t\t\t\tUS Department of Veterans Affairs website.\n\t\t\t\t\tPublished2016.\n\t\t\t\t\tAccessed December 16, 2020.https:\/\/www.healthquality.va.gov\/guidelines\/rehab\/mtbi\/"},{"key":"2022022515264830000_i1062-6050-56-8-851-b04","doi-asserted-by":"crossref","unstructured":"Harmon\n              KG,\n            \n            \n              Clugston\n              JR,\n            \n            \n              Dec\n              K,\n            \n            et al.\n          \n          American Medical Society for Sports Medicine position statement on concussion in sport.\n\t\t\t\t\tBr J Sports Med.\n\t\t\t\t\t2019;\n\t\t\t\t\t53(4):\n\t\t\t\t\t213\u2013\n\t\t\t\t\t225.\n\t\t\t\t\tdoi:10.1136\/bjsports-2018-100338","DOI":"10.1136\/bjsports-2018-100338"},{"key":"2022022515264830000_i1062-6050-56-8-851-b05","doi-asserted-by":"crossref","unstructured":"Schmidt\n              JD,\n            \n            \n              Register-Mihalik\n              JK,\n            \n            \n              Mihalik\n              JP,\n            \n            \n              Kerr\n              ZY,\n            \n            \n              Guskiewicz\n              KM.\n            \n          \n          Identifying impairments after concussion: normative data versus individualized baselines.\n\t\t\t\t\tMed Sci Sports Exerc.\n\t\t\t\t\t2012;\n\t\t\t\t\t44(9):\n\t\t\t\t\t1621\u2013\n\t\t\t\t\t1628.\n\t\t\t\t\tdoi:10.1249\/MSS.0b013e318258a9fb","DOI":"10.1249\/MSS.0b013e318258a9fb"},{"key":"2022022515264830000_i1062-6050-56-8-851-b06","doi-asserted-by":"crossref","unstructured":"Broglio\n              SP,\n            \n            \n              Harezlak\n              J,\n            \n            \n              Katz\n              B,\n            \n            et al.\n          \n          Acute sport concussion assessment optimization: a prospective assessment from the CARE consortium.\n\t\t\t\t\tSports Med.\n\t\t\t\t\t2019;\n\t\t\t\t\t49(12):\n\t\t\t\t\t1977\u2013\n\t\t\t\t\t1987.\n\t\t\t\t\tdoi:10.1007\/s40279-019-01155-0","DOI":"10.1007\/s40279-019-01155-0"},{"key":"2022022515264830000_i1062-6050-56-8-851-b07","doi-asserted-by":"crossref","unstructured":"Lempke\n              LB,\n            \n            \n              Howell\n              DR,\n            \n            \n              Eckner\n              JT,\n            \n            \n              Lynall\n              RC.\n            \n          \n          Examination of reaction time deficits following concussion: a systematic review and meta-analysis.\n\t\t\t\t\tSports Med.\n\t\t\t\t\t2020;\n\t\t\t\t\t50(7):\n\t\t\t\t\t1341\u2013\n\t\t\t\t\t1359.\n\t\t\t\t\tdoi:10.1007\/s40279-020-01281-0","DOI":"10.1007\/s40279-020-01281-0"},{"key":"2022022515264830000_i1062-6050-56-8-851-b08","doi-asserted-by":"crossref","unstructured":"Lempke\n              LB,\n            \n            \n              Schmidt\n              JD,\n            \n            \n              Lynall\n              RC.\n            \n          \n          Athletic trainers' concussion-assessment and concussion-management practices: an update.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2020;\n\t\t\t\t\t55(1):\n\t\t\t\t\t17\u2013\n\t\t\t\t\t26.\n\t\t\t\t\tdoi:10.4085\/1062-6050-322-18","DOI":"10.4085\/1062-6050-322-18"},{"key":"2022022515264830000_i1062-6050-56-8-851-b09","doi-asserted-by":"crossref","unstructured":"Eckner\n              JT,\n            \n            \n              Whitacre\n              RD,\n            \n            \n              Kirsch\n              NL,\n            \n            \n              Richardson\n              JK.\n            \n          \n          Evaluating a clinical measure of reaction time: an observational study.\n\t\t\t\t\tPercept Mot Skills.\n\t\t\t\t\t2009;\n\t\t\t\t\t108(3):\n\t\t\t\t\t717\u2013\n\t\t\t\t\t720.\n\t\t\t\t\tdoi:10.2466\/PMS.108.3.717-720","DOI":"10.2466\/pms.108.3.717-720"},{"key":"2022022515264830000_i1062-6050-56-8-851-b10","doi-asserted-by":"crossref","unstructured":"Eckner\n              JT,\n            \n            \n              Kutcher\n              JS,\n            \n            \n              Richardson\n              JK.\n            \n          \n          Between-seasons test-retest reliability of clinically measured reaction time in National Collegiate Athletic Association Division I athletes.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2011;\n\t\t\t\t\t46(4):\n\t\t\t\t\t409\u2013\n\t\t\t\t\t414.\n\t\t\t\t\tdoi:10.4085\/1062-6050-46.4.409","DOI":"10.4085\/1062-6050-46.4.409"},{"key":"2022022515264830000_i1062-6050-56-8-851-b11","doi-asserted-by":"crossref","unstructured":"Eckner\n              JT,\n            \n            \n              Kutcher\n              JS,\n            \n            \n              Broglio\n              SP,\n            \n            \n              Richardson\n              JK.\n            \n          \n          Effect of sport-related concussion on clinically measured simple reaction time.\n\t\t\t\t\tBr J Sports Med.\n\t\t\t\t\t2014;\n\t\t\t\t\t48(2):\n\t\t\t\t\t112\u2013\n\t\t\t\t\t118.\n\t\t\t\t\tdoi:10.1136\/bjsports-2012-091579","DOI":"10.1136\/bjsports-2012-091579"},{"key":"2022022515264830000_i1062-6050-56-8-851-b12","doi-asserted-by":"crossref","unstructured":"Caccese\n              JB,\n            \n            \n              Eckner\n              JT,\n            \n            \n              Franco-MacKendrick\n              L,\n            \n            et al.\n          \n          Clinical reaction-time performance factors in healthy collegiate athletes.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2020;\n\t\t\t\t\t55(6):\n\t\t\t\t\t601\u2013\n\t\t\t\t\t607.\n\t\t\t\t\tdoi:10.4085\/1062-6050-164-19","DOI":"10.4085\/1062-6050-164-19"},{"key":"2022022515264830000_i1062-6050-56-8-851-b13","doi-asserted-by":"crossref","unstructured":"Broglio\n              SP,\n            \n            \n              McCrea\n              M,\n            \n            \n              McAllister\n              T,\n            \n            et al.\n          \n          A national study on the effects of concussion in collegiate athletes and US military service academy members: the NCAA\u2013DoD Concussion Assessment, Research and Education (CARE) consortium structure and methods.\n\t\t\t\t\tSports Med.\n\t\t\t\t\t2017;\n\t\t\t\t\t47(7):\n\t\t\t\t\t1437\u2013\n\t\t\t\t\t1451.\n\t\t\t\t\tdoi:10.1007\/s40279-017-0707-1","DOI":"10.1007\/s40279-017-0707-1"},{"key":"2022022515264830000_i1062-6050-56-8-851-b14","doi-asserted-by":"crossref","unstructured":"Carney\n              N,\n            \n            \n              Ghajar\n              J,\n            \n            \n              Jagoda\n              A,\n            \n            et al.\n          \n          Concussion guidelines step 1: systematic review of prevalent indicators.\n\t\t\t\t\tNeurosurgery.\n\t\t\t\t\t2014;\n\t\t\t\t\t75(suppl 1):\n\t\t\t\t\tS3\u2013\n\t\t\t\t\tS15.\n\t\t\t\t\tdoi:10.1227\/NEU.0000000000000433","DOI":"10.1227\/NEU.0000000000000433"},{"key":"2022022515264830000_i1062-6050-56-8-851-b15","doi-asserted-by":"crossref","unstructured":"Eckner\n              JT,\n            \n            \n              Lipps\n              DB,\n            \n            \n              Kim\n              H,\n            \n            \n              Richardson\n              JK,\n            \n            \n              Ashton-Miller\n              JA.\n            \n          \n          Can a clinical test of reaction time predict a functional head-protective response?\n          \n            Med Sci Sports Exerc\n          .\n\t\t\t\t\t2011;\n\t\t\t\t\t43(3):\n\t\t\t\t\t382\u2013\n\t\t\t\t\t387.\n\t\t\t\t\tdoi:10.1249\/MSS.0b013e3181f1cc51","DOI":"10.1249\/MSS.0b013e3181f1cc51"},{"key":"2022022515264830000_i1062-6050-56-8-851-b16","doi-asserted-by":"crossref","unstructured":"Eckner\n              JT,\n            \n            \n              Kutcher\n              JS,\n            \n            \n              Richardson\n              JK.\n            \n          \n          Effect of concussion on clinically measured reaction time in 9 NCAA Division I collegiate athletes: a preliminary study.\n\t\t\t\t\tPM R.\n\t\t\t\t\t2011;\n\t\t\t\t\t3(3):\n\t\t\t\t\t212\u2013\n\t\t\t\t\t218.\n\t\t\t\t\tdoi:10.1016\/j.pmrj.2010.12.003","DOI":"10.1016\/j.pmrj.2010.12.003"},{"key":"2022022515264830000_i1062-6050-56-8-851-b17","doi-asserted-by":"crossref","unstructured":"Eckner\n              JT,\n            \n            \n              Chandran\n              S,\n            \n            \n              Richardson\n              JK.\n            \n          \n          Investigating the role of feedback and motivation in clinical reaction time assessment.\n\t\t\t\t\tPM R.\n\t\t\t\t\t2011;\n\t\t\t\t\t3(12):\n\t\t\t\t\t1092\u2013\n\t\t\t\t\t1097.\n\t\t\t\t\tdoi:10.1016\/j.pmrj.2011.04.022","DOI":"10.1016\/j.pmrj.2011.04.022"},{"key":"2022022515264830000_i1062-6050-56-8-851-b18","doi-asserted-by":"crossref","unstructured":"Eckner\n              JT,\n            \n            \n              Kutcher\n              JS,\n            \n            \n              Richardson\n              JK.\n            \n          \n          Pilot evaluation of a novel clinical test of reaction time in National Collegiate Athletic Association Division I football players.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2010;\n\t\t\t\t\t45(4):\n\t\t\t\t\t327\u2013\n\t\t\t\t\t332.\n\t\t\t\t\tdoi:10.4085\/1062-6050-45.4.327","DOI":"10.4085\/1062-6050-45.4.327"},{"key":"2022022515264830000_i1062-6050-56-8-851-b19","doi-asserted-by":"crossref","unstructured":"Eckner\n              JT,\n            \n            \n              Richardson\n              JK,\n            \n            \n              Kim\n              H,\n            \n            \n              Joshi\n              MS,\n            \n            \n              Oh\n              YK,\n            \n            \n              Ashton-Miller\n              JA.\n            \n          \n          Reliability and criterion validity of a novel clinical test of simple and complex reaction time in athletes.\n\t\t\t\t\tPercept Mot Skills.\n\t\t\t\t\t2015;\n\t\t\t\t\t120(3):\n\t\t\t\t\t841\u2013\n\t\t\t\t\t859.\n\t\t\t\t\tdoi:10.2466\/25.15.PMS.120v19x6","DOI":"10.2466\/25.15.PMS.120v19x6"},{"key":"2022022515264830000_i1062-6050-56-8-851-b20","doi-asserted-by":"crossref","unstructured":"Cohen\n              J.\n            \n          \n          \n            Statistical Power Analysis for the Behavioral Sciences\n          .\n\t\t\t\t\tElsevier Science;\n\t\t\t\t\t2013:\n\t\t\t\t\t40.","DOI":"10.4324\/9780203771587"}],"container-title":["Journal of Athletic Training"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/meridian.allenpress.com\/jat\/article-pdf\/56\/8\/851\/3019726\/i1062-6050-56-8-851.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/meridian.allenpress.com\/jat\/article-pdf\/56\/8\/851\/3019726\/i1062-6050-56-8-851.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T18:58:24Z","timestamp":1749668304000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/56\/8\/article-p851.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,22]]},"references-count":20,"aliases":["10.4085\/jat0457-20"],"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,12,22]]},"published-print":{"date-parts":[[2021,8,1]]}},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-457-20","relation":{},"ISSN":["1062-6050"],"issn-type":[{"value":"1062-6050","type":"print"}],"subject":[],"published":{"date-parts":[[2020,12,22]]}}}