DEVELOPMENT AND PSYCHOMETRIC EVALUATION OF THE NEUROCOGNITIVE UPPER EXTREMITY TESTS: A RELIABILITY AND VALIDITY STUDY

Overview

The goal of this observational study is to develop an upper extremity neurocognitive performance test battery, determine its reliability and validity, and investigate the effect of neurocognitive load on test performance in athletes and healthy volunteers aged 18-40. The main questions it aims to answer are: Are the developed upper extremity neurocognitive tests reliable and valid tool for assessment? Does the addition of neurocognitive load significantly affect upper extremity physical performance scores? Are the neurocognitive performance test results related to shoulder rotator cuff muscle strength, rate of force development, and shoulder function? Researchers will compare the neurocognitive performance of athletes to healthy non-athlete individuals to see if the test battery can effectively differentiate between these two groups (discriminative validity). Participants will: Complete demographic forms and questionnaires regarding activity level and shoulder function. Undergo shoulder range of motion and isometric strength/rate of force development assessments. Perform a battery of 4 neurocognitive tests integrated with a light-based reaction system. Perform the same functional tests without neurocognitive load to serve as a baseline for comparison. (Athletes only) Attend additional sessions to evaluate the feasibility of the tests and to assess test-retest reliability with a one-week interval.

This study focuses on the integration of physical and cognitive components to assess athletic performance through the development of a specific Upper Extremity Neurocognitive Performance Tests. While traditional functional tests often focus on pre-planned motor tasks, this research aims to simulate real-world sports environments by incorporating reactive and cognitive demands. Study Methodology and Testing Protocol The research is conducted at the Hacettepe University, Department of Sports Physiotherapy and Rehabilitation. The evaluation involves several specialized assessments: Neurocognitive Performance Test Battery: Utilizing a light-based reaction system, four specific tests have been developed to measure reactive agility and decision-making under load: Neurocognitive Closed Kinetic Chain Upper Quarter Stability Test (N-CKCUQST): Participants perform hand transfer tasks in a plank position while responding to specific target colors. Neurocognitive Open Kinetic Chain 90-90 Wall Throw Test (N-OKCWTT): Participants perform rhythmic wall throws while reacting to light stimuli. Neurocognitive 90-90 Medicine Ball Drop Test (N-MBDT): Assesses reactive catching control and hand-eye coordination under cognitive load. Neurocognitive Upper Quarter Y-Balance Test (N-UQYBT): A modified version of the traditional Y-Balance test that incorporates a visual-motor response at 80% of the participant's maximum reach. Physical Performance Comparisons: To isolate the impact of cognitive load, participants also perform traditional versions of these tests without the light-based reaction stimuli. Strength and Power Metrics: Isometric strength and the Rate of Force Development (RFD) for the shoulder internal and external rotators are measured using the ForceFrame dynamometer. Additionally, the Athletic Shoulder (ASH) Test is utilized on a force platform to evaluate bilateral functional strength in the I, Y, and T positions. Session Structure Athlete Group: Participation consists of three separate sessions. The first session focuses on feasibility and familiarization. The second session involves comprehensive evaluation and validity analysis. The third session, conducted one week later, is dedicated to test-retest reliability. Control Group: Healthy, non-athlete volunteers participate in a single evaluation session to establish the discriminative validity of the test battery. Safety and Data Integrity: All assessments are non-invasive and conducted by experienced physiotherapists. To ensure the accuracy of the performance evaluation, video recordings are taken during the neurocognitive tests, which are stored in encrypted digital environments and deleted five years after the study's completion. All participants are required to avoid high-intensity physical activity for 48 hours prior to testing.