Table 3 Overview of reliability, validity and measurement error for dynamic motor assessments used to monitor movement changes following a concussion
| Â | Time taken | Equipment | Test procedure | Outcome variable | Reliability | Validity | Measurement error | Optimal conditions |
|---|---|---|---|---|---|---|---|---|
Non-instrumented dynamic assessments | ||||||||
Clinical reaction time | ||||||||
[50] |  ~ 3-min | Pole | Stick drop test: converted to speed | Distance on stick, speed | r = 0.32 | – | – |  |
Kasch pulse recovery (KPR) | ||||||||
[48] |  ~ 5-min | NA | 3-min stair climb at rate of 24-steps.min Exercise HR and HR recovery (1-min seated) recorded | HR pre, during, and post | – | Sens = 1.00 Spec = 0.96 AUC = 0.98 | – | Performed on children |
Physical and neurological examination of subtle signs (PANESS) | ||||||||
[75] |  ~ 10–15-min | Stopwatch | Gait: heel walk, toe walk, walk on side of feet, tandem gait Stations: 20-s stance (a) feet together, eyes closed, arms out, (b) eyes closed, tongue protruding, (c) tandem stance, hop each foot (50 hops) | Number of errors | – | Sens = 0.76 Spec = 0.90 | – |  |
Instrumented dynamic assessment | ||||||||
Instrumented Y balance test (instrumented YBT) | ||||||||
 ~ 5-min | IMU | Standing on 1 leg, tap toe of non-standing leg in anterior, posterior-medial, and posterior lateral directions | Reach distance, COM displacement | r = 0.76–0.99 | Sens = 0.76 Spec = 0.53 | – | Improved validity with use of lumbar IMU | |
Instrumented limits of stability test (instrumented LOS) | ||||||||
 ~ 5–10-min | Force plate | 8 trials shifting centre of gravity in directions: forward, right/forward, right, right/back, back, left/back, left, left/forward | COP displacement | r = 0.973–0.96 | – | SEM = 0.35–1.17 |  | |
Dynamic postural stability index (DPSI) and DPSI with dual task | ||||||||
[64] |  ~ 2–5-min | Force plate | 3 trials of jumps: forward, lateral, and 90° rotation | COP during landing | DPSI: r = 0.58–0.93 DPSI DT: r = 0.32–0.80 | – | DPSI SEM = 0.0047–0.023 DPSI + DT SEM = 0.004–0.019 | Improved reliability with standard DPSI |
Postural stress test (PST) | ||||||||
[78] |  ~ 5–10-min | Pulley system | Pulley system providing external perturbations. Participant required to maintain upright position. Amount of weight required to cause stepping postural adjustment is recorded | Amount of weight required to maintain balance | – | Between-group differences: p = 0.027–0.024 | – |  |
Computer-assisted rehabilitation environment (CAREN) system | ||||||||
[79] |  | Accelerometry, motion capture | Virtual reality standing and walking with external perturbations | COM displacement | – | Sens = 0.65–0.90 | – | Walking with perturbations more sensitive 10 trials performed |
Battery combined: grip strength, single leg jump, MCTSIB | ||||||||
[73] |  ~ 10–15-min | Force plate, tape measure, handheld dynamometer | Grip strength using handheld dynamometer Standing long jump: participants to jump maximum distance off a single leg MCTSIB: Double leg stance; stable surface eyes open, stable surface eyes closed, unstable surface eyes open, unstable surface eyes closed | Number of errors, COP displacement, grip strength | – | Sens = 0.41 Spec = 0.77 | – | Individual measures of MCTSIB, grip strength, and standing long jump displayed poor sensitivity Higher sensitivity with combined score |
Bruininks–Oseretsky test of motor proficiency | ||||||||
[78] | 15–60-min total Balance component includes 8 items ~ 15-min | Requires specialised equipment | Gross motor: running speed and agility, balance, bilateral coordination, strength Fine motor: response speed, visual motor control, upper-limb dexterity | Number of errors, time to complete trials | – | Between-group differences: p = 0.024–0.001 | – |  |