Development and Reliability of 2 Visual-Cognitive Dual-Task Agility Assessments for Return to Sport

Context : Return to sport assessments after lower-extremity injury/surgery focus on anticipated movement. However, sport requires unanticipated movements with intense visual-cognitive processing. Thus, our purpose was to test the reliability of 2 agility tests augmented with visual-cognitive dual tasks that simulate the attentional demands of sport to improve the ecological validity of return to sport assessments. Design : Test–retest reliability. Methods : Twenty-six individuals (17 females, 23.1 [1.8] y, 170.9 [10.2] cm, 71.4 [14.5] kg, Tegner Activity Scale 5.1 [0.7]) participated in 2 study visits, 14 days apart. Each visit, participants completed a (1) Traditional 5-10-5 Shuttle, (2) Reactive 5-10-5 Shuttle (RS), (3) Traditional Agility T -test (AT), and (4) Visual-Cognitive Reactive Agility T test (VCR-AT) in randomized order. Outcomes for the 5-10-5 Shuttles, included fastest reaction time (RS only), split time, and total time. Fastest total time was quantified for the Agility T -tests. Test–retest reliability was established with intraclass correlation coefficients (ICC 3,1 ) using 2-way mixed effects models and 95% confidence intervals. Paired-samples t -tests assessed performance differences between traditional and visual-cognitive conditions (alpha = .05). Dual-task effect (DTE) was expressed by the percent change in performance when a cognitive challenge was added. Results : Traditional 5-10-5 Shuttle split (ICC 3,1 = .97 [.94 to .98]) and total time (ICC 3,1 = .99 [.96 to .99]) demonstrated excellent reliability. RS split (ICC 3,1 = .96 [.86 to .98]) and total time (ICC 3,1 = .96 [.88 to .98]) demonstrated good-to-excellent reliability. RS reaction time (ICC 3,1 = .75 [.45 to .89]) demonstrated poor-to-moderate reliability. The RS resulted in slower split (DTE = −24.24%, P < .001) and total time (DTE = −13.31%, P < .001) than the Traditional 5-10-5 Shuttle. AT and VCR-AT total time both demonstrated excellent reliability (AT: ICC 3,1 = .97 [.92 to .99]; VCR-AT: ICC 3,1 = .97 [.95 to .99]). The VCR-AT resulted in a slower total time (DTE = −1.51%, P = .119) than the AT. Conclusions : Augmented agility assessments demonstrated good-to-excellent test–retest reliability for all outcomes except RS reaction time. A visual-cognitive dual-task significantly impaired physical performance for the 5-10-5 shuttle but not the Agility T -test. Augmenting agility assessments with visual-cognitive dual tasks is reliable and may improve the ecological lens of return to sport assessments.