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Student-Athletes' Perceptions of the Serial 7s Dual-Task Concussion Testing Paradigm.

Tyler A Wood¹, Nicholas E Grahovec¹, Ashley Harris²

¹Department of Kinesiology and Physical Education, College of Education, Northern Illinois University, DeKalb.

Journal of Athletic Training

|May 25, 2026

Summary

Student-athletes found the Serial 7s concussion test challenging due to cognitive load and math anxiety. Understanding these perceptions is key for accurate concussion assessments in athletes.

Keywords:

cognition movement postural control traumatic brain injury

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Area of Science:

Sports Medicine
Neuroscience
Psychology

Background:

The Serial 7s test is a standard cognitive assessment in concussion protocols like the Sport Concussion Assessment Tool (SCAT6).
While useful for dual-task evaluation, math anxiety may impact its effectiveness in student-athletes.

Purpose of the Study:

To explore student-athletes' experiences and perceptions of the Serial 7s cognitive test used in concussion assessments.
To identify factors influencing performance and emotional responses during the Serial 7s test.

Main Methods:

A qualitative study involving 14 university student-athletes (7 male, 7 female).
Participants completed SCAT6 gait assessments followed by semi-structured interviews.
Data analysis utilized the Colaizzi phenomenological approach with member checking and data triangulation.

Main Results:

Student-athletes reported cognitive load and multitasking difficulties with the Serial 7s test.
Math anxiety and variable confidence in mental math were significant themes.
Emotional/psychological reactions, prior experience, and task-specific strategies influenced perceptions.

Conclusions:

The Serial 7s test is cognitively demanding, eliciting varied responses in student-athletes.
Clinicians must consider factors like math anxiety and confidence for accurate concussion assessment.
Further research should investigate changes in math anxiety and confidence during recovery for personalized protocols.