Test-retest Reliability of the BrainFx 360 performance assessment
Chelsea Searles, ATC, LAT
INTRODUCTION
Concussion testing batteries have been designed to compare post injury performance with pre- season baselines. Examples of these testing batteries include the Standardized Assessment of Concussion (SAC), Balance Error Scoring System (BESS), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Automated Neurocognitive Assessment Metrics (ANAM) and CogSport. However, to date there is no gold standard and many of these tests lack good reliability. Good reliability can establish the existence of an effective concussion assessment testing program for clinical use so the purpose of this study was to determine the test- retest reliability of the BrainFx 360 performance assessment.
METHODS
The design of this study was test-retest. Fifteen participants were recruited to participate in this study. The participants were healthy adults comprised of nine males and six females. The age of participants ranged from 20 to 27 and the average age was 22.9. The assessment took approximately one hour to complete and the retest was given 7 to 14 days following the initial assessment. The data analyses included descriptive statistics, test retest reliability was calculated using ICC and all analyses were done using SPSS 21.
RESULTS
The overall performance score for both tests had good reliability. The results of most categories and subsections display moderate to acceptable reliability. The BrainFx 360 performance assessment is broken up into five categories that include subsections. Four of the five categories had acceptable composite reliability. However, the composite reliability of the fifth category was unacceptable.
When the reliability of the BrainFx 360 performance assessment subsections are compared to other assessment subsections it shows to have better reliability. The five subsections of BrainFx displayed good reliability when compared to the comparable subsections within ANAM, CogSport and ImPACT.
Table 1 BrainFx 360 compared with other assessments | ||||
ImPACT | CogSport | ANAM | BrainFx 360 | |
Overall | 0.23 to 0.88 | 0.45 to 0.90 | 0.14 to 0.86 | 0.85 |
Working Memory | -- | 0.24 | 0.48 | 0.86 |
Decision Making | -- | -0.08 | -- | 0.78 |
Fine Motor Coordination | 0.61 | 0.20 | -- | 0.81 |
Visual Memory | 0.32 | -- | -- | 0.88 |
Verbal Memory | 0.29 | -- | -- | 0.84 |
DISCUSSION
There were a few subsections with the BrainFx 360 performance assessment that had unacceptable reliability. Whether these task directions are actually unclear or the participant is not fully reading and understanding the directions before he or she begins the task is unknown. Sometimes on the initial assessment, a participant skipped an entire task but will then complete the task during the retest assessment. This may be due to a better understanding of directions the second time around. It is important that the specific tasks which displayed poor reliability are altered or thrown out in order to increase not only the reliability of each subsection but of the overall performance of the assessment. Altering these tasks to include easy, simple and clear direction may better the tasks performance.
The BrainFx 360 Performance Assessment has the ability to be a reliable test for concussion injuries. The findings of this study have the potential to help alter the assessment and make it more reliable.
FUTURE DIRECTION
Future research of the BrainFx 360 performance assessment might consider creating an assessment with a randomized test order to assess the test-retest reliability.