Author(s): AKKUS, C., INANÇ, I., PAKÖZ, B., BAYRAKCI TUNAY, V., DÜZGÜN, I., TURGUT, E., Institution: HACETTEPE UNIVERSITY, Country: TURKEY, Abstract-ID: 1351

INTRODUCTION:
Despite the well-established importance of physical and dual-task neurocognitive demands in athletic performance, neurocognitive assessments for upper extremity performance remain limited. We aimed to develop tests that combine motor and cognitive tasks simultaneously to assess functional upper quadrant stability (UQS) in athletes and to determine their test–retest reliability. Furthermore, the effect of neurocognitive load on Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) performance and the association between the Neurocognitive Upper Quadrant Y Balance Test (NC-UQYBT) and the traditional Upper Quadrant Y Balance Test (UQYBT) were investigated.
METHODS:
Nineteen healthy male athletes (age: 19.8±0.4 years; body mass index: 24.9±0.6 kg/m²; dominant shoulder: right 100%; Kerlan–Jobe Shoulder and Elbow Score: 74.1±7.2; Tegner Activity Level: 8.8±0.1) participated in the study. Neurocognitive test protocols were developed based on the UQYBT and CKCUEST and integrated with standardized cognitive tasks targeting attention, reaction, and decision-making. The NC-UQYBT assessed bilateral reaction time (ms), while the Neurocognitive Closed Kinetic Chain Stability Test (NC-CKCUEST) measured reaction time (ms) and total touches. Test performance was evaluated under single-task and dual-task conditions. For reliability analysis, all participants completed the tests twice within a one-week interval. Neurocognitive load was calculated as the percentage change in performance between the single-task and dual-task performance. Pearson and Spearman correlation analysis was performed to examine the relationship between the NC-UQYBT and the UQYBT.
RESULTS:
For the NC-UQYBT, test–retest reliability was excellent for the dominant [(ICC = 0.91 (95% CI: 0.80–0.96; SEM: 30.46; MDC: 84.43)], and non-dominant sides [ICC = 0.96 (95% CI: 0.88–0.98; SEM: 24.41; MDC: 67.66)]. For the NC-CKCUEST, test–retest reliability was good for reaction time [ICC = 0.88 (95% CI: 0.71–0.95; SEM: 39.12; MDC: 108.43)], and touches [ICC = 0.75 (95% CI: 0.47–0.89; SEM: 0.93; MDC: 2.57)]. Neurocognitive load resulted in a 54.92 ± 1.75% reduction in CKCUEST performance. No significant correlations were found between the NC-UQYBT and UQYBT for either the dominant (r=-0.22, p=0.36) or non-dominant side (r=-0.26, p=0.27).
CONCLUSION:
The neurocognitive UQS Tests demonstrated good to excellent test–retest reliability in athletes, indicating that they are reliable tools for assessing upper extremity performance under combined motor and cognitive demands. The substantial reduction in performance under neurocognitive load highlights the importance of incorporating cognitive challenges into UQS assessments. However, the lack of correlation between the neurocognitive and traditional Y Balance Tests suggests that these assessments may capture distinct aspects of upper quadrant function. Therefore, the proposed neurocognitive test battery may be useful in clinical and sports settings for performance assessments.