Pre-Participation Reaction Time and Concussion Risk among Middle School Female Soccer Players

To investigate whether slower reaction time (RT) was associated with higher concussion odds among middle school female soccer players.

We performed a retrospective cohort study, analyzing pre-participation computerized neurocognitive data (Immediate Postconcussion and Cognitive Testing) for 10-14-year-old female soccer players. We compared composite RT scores between those who did/did not sustain a concussion during the following year using Welch's t-test. We used binary logistic regression to determine the association between RT and subsequent concussion, adjusting for covariates.

A cohort of 2489 female soccer players were included (mean age = 13.2 ± 1.0 years; 12% with prior concussion). Of these, 226 (9.1%) athletes sustained a concussion. On univariable analysis, those who sustained a subsequent concussion demonstrated faster RT than those who did not (633.8 ± 87.2 vs 649.3 ± 90.1 milliseconds; Cohen's d = 0.17). After covariate adjustment, slower RT was associated with lower subsequent concussion odds (OR = 0.997, 95% CI: 0.996-0.999). Prior concussion was significantly associated with subsequent concussion (OR = 2.48, 95% CI: 1.73-3.52).

Contrary to our hypothesis, slower pre-participation RT was associated with lower odds of subsequent concussion, with a 3% decrease in concussion odds for every 10-millisecond RT increase. Prior concussion was the strongest predictor of subsequent concussion, consistent with past work.