Related Experiment Video
Updated: Mar 31, 2026
Objectively Assessing Sports Concussion Utilizing Visual Evoked Potentials
Published on: April 27, 2021
Test-Retest Reliability of a Computerized Concussion Test: CNS Vital Signs
Ashley C Littleton1, Johna K Register-Mihalik2, Kevin M Guskiewicz2
1The University of North Carolina at Chapel Hill Human Movement Science Curriculum, Chapel Hill, North Carolina Department of Exercise & Sport Science Department, The University of North Carolina, Chapel Hill, North Carolina Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, The University of North Carolina, Chapel Hill, North Carolina alittlet@live.unc.edu.
Background:
Neurocognitive testing is an important concussion evaluation tool, but for neurocognitive tests to be useful, their psychometric properties must be well established. Test-retest reliability of computerized neurocognitive tests can influence their clinical utility. The reliability for a commonly used computerized neurocognitive test, CNS Vital Signs, is not well established. The purpose of this study was to examine test-retest reliability and reliable change indices for CNS Vital Signs in a healthy, physically active college population.
Hypothesis:
CNS Vital Signs yields acceptable test-retest reliability, with greater reliability between the second and third test administration compared with between the first and second administration.
Study Design:
Cohort study.
Level Of Evidence:
Level 3.
Methods:
Forty healthy, active volunteers (16 men, 24 women; mean age, 21.05 ± 2.17 years) reported to a clinical laboratory for 3 sessions, 1 week apart. At each session, participants were administered CNS Vital Signs. Outcomes included standard scores for the following CNS Vital Signs domains: verbal memory, visual memory, psychomotor speed, cognitive flexibility, complex attention, processing speed, reaction time, executive functioning, and reasoning.
Results:
Participants performed significantly better on the second session and/or third session than they did on the first testing session on 6 of 9 neurocognitive domains. Pearson r test-retest correlations between sessions ranged from 0.11 to 0.87. Intraclass correlation coefficients ranged from 0.10 to 0.86.
Conclusion:
Clinicians should consider using reliable change indices to account for practice effects, identify meaningful score changes due to pathology, and inform clinical decisions.
Clinical Relevance:
This study highlights the importance of clinicians understanding the psychometric properties of computerized neurocognitive tests when using them in the management of sport-related concussion. If CNS Vital Signs is administered twice within a small time frame (such as 1 week), athletes should be expected to improve between the first and second administration.
