DEVELOPMENT AND PSYCHOMETRIC EVALUATION OF THE NEUROCOGNITIVE UPPER EXTREMITY TESTS: A RELIABILITY AND VALIDITY STUDY

This study focuses on the integration of physical and cognitive components to assess athletic performance through the development of a specific Upper Extremity Neurocognitive Performance Tests. While traditional functional tests often focus on pre-planned motor tasks, this research aims to simulate real-world sports environments by incorporating reactive and cognitive demands. Study Methodology and Testing Protocol The research is conducted at the Hacettepe University, Department of Sports Physiotherapy and Rehabilitation.

The evaluation involves several specialized assessments:

Neurocognitive Performance Test Battery: Utilizing a light-based reaction system, four specific tests have been developed to measure reactive agility and decision-making under load:

Neurocognitive Closed Kinetic Chain Upper Quarter Stability Test (N-CKCUQST): Participants perform hand transfer tasks in a plank position while responding to specific target colors.

Neurocognitive Open Kinetic Chain 90-90 Wall Throw Test (N-OKCWTT): Participants perform rhythmic wall throws while reacting to light stimuli. Neurocognitive 90-90 Medicine Ball Drop Test (N-MBDT): Assesses reactive catching control and hand-eye coordination under cognitive load. Neurocognitive Upper Quarter Y-Balance Test (N-UQYBT): A modified version of the traditional Y-Balance test that incorporates a visual-motor response at 80% of the participant's maximum reach.

Physical Performance Comparisons: To isolate the impact of cognitive load, participants also perform traditional versions of these tests without the light-based reaction stimuli.

Strength and Power Metrics: Isometric strength and the Rate of Force Development (RFD) for the shoulder internal and external rotators are measured using the ForceFrame dynamometer. Additionally, the Athletic Shoulder (ASH) Test is utilized on a force platform to evaluate bilateral functional strength in the I, Y, and T positions.

Session Structure Athlete Group: Participation consists of three separate sessions. The first session focuses on feasibility and familiarization. The second session involves comprehensive evaluation and validity analysis. The third session, conducted one week later, is dedicated to test-retest reliability.

Control Group: Healthy, non-athlete volunteers participate in a single evaluation session to establish the discriminative validity of the test battery.

Safety and Data Integrity: All assessments are non-invasive and conducted by experienced physiotherapists. To ensure the accuracy of the performance evaluation, video recordings are taken during the neurocognitive tests, which are stored in encrypted digital environments and deleted five years after the study's completion. All participants are required to avoid high-intensity physical activity for 48 hours prior to testing.

Inclusion criteria

General Inclusion Criteria (Both Groups):

• Individuals between the ages of 18 and 40
• No passive range of motion limitations in the shoulder joint
• Classified as healthy with no history of injury in the past year according to the Extended Nordic Musculoskeletal Questionnaire
• Volunteered to participate in the study[cite: 1].

Athlete Group Specific Criteria:

• Physically active individuals
• Currently active in sports clubs in Ankara and/or applied to the Hacettepe University Department of Sports Physiotherapy and Rehabilitation
• History of training or physical activity at least three times a week for the past year
• Participation in recreational or competitive above or below shoulder height sports

Control Group Specific Criteria:

• Healthy individuals who have applied to the Hacettepe University Department of Sports Physiotherapy and Rehabilitation Unit
• Does not engage in regular physical activity
• History of training or physical activity fewer than three times a week over the past year
• No participation in recreational or competitive sports

Exclusion criteria

• Presence of symptomatic upper extremity pathology
• History of upper extremity and/or trunk injury or surgery in the last 12 months
• History of ongoing neck pain, neurological symptoms in any extremity, or back, hip, or knee pain in the last 12 months
• Presence of a health condition that could cause a decrease in shoulder strength, such as inflammatory arthritis or neurological disorders
• Presence of any systemic disease
• Presence of visual or hearing impairments