One-Week Reliability of the Multimodal Exertional Test for Concussion in Healthy Athletes

Context (Aim): To estimate the test-retest reliability of performance metrics, heart rates, and symptoms collected during the Multimodal Exertional Test (MET) in healthy interuniversity athletes.

Test-retest reliability.

Twenty-five participants (n = 14 males, n = 11 females) completed the MET twice, 1 week apart. Participants' performance metrics and symptom severity scores were obtained following each task, and average and maximum heart rates were collected prior to the MET and during each stage.

In both females and males, the completion times for 7 out of 9 MET tasks were performed between 1 and 6 seconds faster at time point 2 in comparison with time point 1; however, the majority of the concordance correlation coefficients (CCC) fell within the range of good agreement (.61 < CCC < .80). Males performed all 9 tasks faster compared with females. All MET count data performance metrics (ie, number of words, step-down + lateral jumps, and jump-overs) were consistent between time points as no differences were observed. Average and maximum heart rates were consistent between sessions, typically differing by approximately 2 beats/min, with good agreement (CCCs of .64-.74). Male and female symptom severity scores did not differ between instances.

The MET demonstrates good reliability across key domains, including symptom reporting, physiological responses, and several performance-based metrics. Clinicians should consider potential practice effects in task completion times and account for sex differences when applying these findings to concussion assessment and establishing clinical benchmarks.