Intersession Reliability and Within-Session Stability of a Novel Perception-Action Coupling Task

BACKGROUND: The perception-action coupling task (PACT) was designed as a more ecologically valid measure of alertness/reaction times compared to currently used measures by aerospace researchers. The purpose of this study was to assess the reliability, within-subject variability, and systematic bias associated with the PACT. METHODS: There were 16 subjects (men/women = 9/7; age = 27.8 +/- 3.6 yr) who completed 4 identical testing sessions. The PACT requires subjects to make judgements on whether a virtual ball could fit into an aperture. For each session, subjects completed nine cycles of the PACT, with each cycle lasting 5 min. Judgement accuracy and reaction time parameters were calculated for each cycle. Systematic bias was assessed with repeated-measures ANOVA, reliability with intraclass correlation coefficients (ICC), and within-subject variability with coefficients of variation (CVTE). RESULTS: Initiation time (Mean = 0.1065 s) showed the largest systematic bias, requiring the elimination of three cycles to reduce bias, with all other variables requiring, at the most, one. All variables showed acceptable reliability (ICC > 0.70) and within-subject variability (CVTE <20%) with only one cycle after elimination of the first three cycles. CONCLUSIONS: With a three-cycle familiarization period, the PACT was found to be reliable and stable

Action Boundary Proximity Effects on Perceptual-Motor Judgments

INTRODUCTION: Designed as a more ecological measure of reaction times, the Perception-Action Coupling Task (PACT) has shown good reliability and within-subject stability. However, a lengthy testing period was required. Perceptual-motor judgments are known to be affected by proximity of the stimulus to the action boundary. The current study sought to determine the effects of action boundary proximity on PACT performance, and whether redundant levels of stimuli, eliciting similar responses, can be eliminated to shorten the PACT.METHODS: There were 9 men and 7 women who completed 4 testing sessions, consisting of 3 familiarization cycles and 6 testing cycles of the PACT. For the PACT, subjects made judgments on whether a series of balls presented on a tablet afford "posting" (can fit) through a series of apertures. There were 8 ratios of ball to aperture size (B-AR) presented, ranging from 0.2 to 1.8, with each ratio appearing 12 times (12 trials) per cycle. Reaction times and judgment accuracy were calculated, and averaged across all B-ARs. Ratios and individual trials within each B-AR were systematically eliminated. Variables were re-averaged, and intraclass correlation coefficients (ICC) and coefficients of variation (CVTE) were calculated in an iterative manner.RESULTS: With elimination of the 0.2 and 1.8 B-ARs, the PACT showed good reliability (ICC = 0.81-0.99) and consistent within-subject stability (CVTE = 2.2-14.7%). Reliability (ICC = 0.81-0.97) and stability (CVTE = 2.6-15.6%) were unaffected with elimination of up to 8 trials from each B-AR.DISCUSSION: The shortened PACT resulted in an almost 50% reduction in total familiarization/testing time required, significantly increasing usability.Johnson CD, LaGoy AD, Pepping G-J, Eagle SR, Beethe AZ, Bower JL, Alfano CA, Simpson RJ, Connaboy C. Action boundary proximity effects on perceptual-motor judgments. Aerosp Med Hum Perform. 2019; 90(12):1000-1008

Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study.

OBJECTIVES: An estimated 14-23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort. METHODS: Data from hospitalized subjects with Glasgow Coma Scale score of 3-12 were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (enrollment period: 2014-2019). Prior TBI with amnesia or alteration of consciousness was assessed using the Ohio State University TBI Identification Method. Competing risk regressions adjusting for age, sex, psychiatric history, cranial injury and extracranial injury severity examined the associations between prior TBI and in-hospital mortality, with hospital discharged alive as the competing risk. Adjusted HRs (aHR (95% CI)) were reported. Multivariable logistic regressions assessed the associations between prior TBI, mortality, and unfavorable outcome (Glasgow Outcome Scale-Extended score 1-3 (vs. 4-8)) at 3, 6, and 12 months after injury. RESULTS: Of 405 acute msTBI subjects, 21.5% had prior TBI, which was associated with male sex (87.4% vs. 77.0%, p=0.037) and psychiatric history (34.5% vs. 20.7%, p=0.010). In-hospital mortality was 10.1% (prior TBI: 17.2%, no prior TBI: 8.2%, p=0.025). Competing risk regressions indicated that prior TBI was associated with likelihood of in-hospital mortality (aHR=2.06 (1.01-4.22)), but not with hospital discharged alive. Prior TBI was not associated with mortality or unfavorable outcomes at 3, 6, and 12 months. CONCLUSIONS: After acute msTBI, prior TBI history is independently associated with in-hospital mortality but not with mortality or unfavorable outcomes within 12 months after injury. This selective association underscores the importance of collecting standardized prior TBI history data early after acute hospitalization to inform risk stratification. Prospective validation studies are needed. LEVEL OF EVIDENCE: IV. TRIAL REGISTRATION NUMBER: NCT02119182

The effects of fatiguing exercise and load carriage on the perception and initiation of movement

Perceptual-motor coordination relies on the accurate coupling of the perceptual and movement systems. However, individuals must also be able to recalibrate to perturbations to perceptual and movement capabilities. We examined the effects of fatigue and load carriage on perceptual-motor coordination for a maximal leaping task. 23 participants completed an incremental fatigue protocol (light to fatiguing intensity stages) on two separate occasions (loaded/unloaded). At baseline and the end of every stage of the protocol, participants made perceptual judgments for the affordance of leaping. The accuracy of responses and reaction times were calculated and mean differences were assessed across exercise intensity and load carriage conditions. No interaction of exercise intensity and load carriage was detected, or main effect of load carriage. A main, quadratic effect of exercise intensity was detected on reaction times, with times decreasing through the moderate stage and increasing through post-fatigue. No effect of exercise/fatigue was detected on perceptual accuracy. The results indicate that exercise at high intensities through fatigue has a significant effect on perceptual-motor calibration. Contrastingly, in response to an action-scaled task, individuals can adequately recalibrate to increased load carriage

Establishing and applying measurement reliability in perceptual-motor coordination tasks

Over a large body of literature focused on perceptual-motor coordination for action-based affordance tasks, little regard has been given for measurement reliability. The purpose of this paper was to outline this issue and provide an example reliability study for a measure of an individual’s ability to perceive action opportunities for leaping. Ten participants completed three testing sessions, each consisting of 24 trials of the task. Reaction times and accuracy of perceptual responses were calculated. Analysis of variance was used to test for systematic mean changes. Intraclass correlation coefficients (ICCs) and coefficients of variation (CV) were used to quantify intersession agreement and within-subject variability. With the removal of six trials for familiarization, acceptable agreement (ICC= 0.930) and within-subject variability (CV= 9.5%) were established, using six further testing trials. Overall, this paper provides the rationale and simple methods for addressing measurement reliability in perceptual-motor coordination research

Increased Risk of Musculoskeletal Injury Following Sport-Related Concussion: A Perception–Action Coupling Approach

Recent studies have concluded that athletes have increased risk of musculoskeletal injury following sport-related concussion. While an underlying explanation is still unknown, perceptual-motor control may be implicated in this increased risk. Some authors have purported that indirect perception (i.e., a “top-down” view of neuromuscular control) may be disrupted following sport-related concussion. Direct perception theory states that the athlete and environment are inextricably linked in a continuous perception–action coupling loop. That is, the athlete is able to directly perceive opportunities for action (e.g., “affordances”) in the environment. Based on these notions, the aim of the current paper was to introduce a theoretical model that argues that sport-related concussion may dysregulate the direct perception process, potentially increasing behavioral risk of musculoskeletal injury during sport. Our model is integrated with a sport-related concussion clinical treatment model, which highlights individualized profiles that characterize the heterogeneous response to sport-related concussion. These profiles have a typical constellation of symptoms (e.g., anxiety, fatigue, ocular dysfunction, etc.), which themselves have been associated with disrupted perception–action coupling, independent of sport-related concussion. Therefore, we argue that athletes who have not re-established perception–action coupling loops following sport-related concussion may be at increased risk of subsequent musculoskeletal injury

Effects of Additional Load on the Occurrence of Bilateral Deficit in Counter-Movement and Squat Jumps

Purpose: A vertical jump (VJ) is a common task performed in several sports, with the height achieved correlated to skilled performance. Loaded VJs are often used in the training of recreational and professional athletes. The bilateral deficit (BLD), which refers to the difference between the heights achieved by a bilateral jump and the sum of two unilateral jumps, has not been reported for loaded jumps and the findings for unloaded jumps are inconclusive. The purpose of this study was threefold: (a) to quantify and compare BLD in countermovement (CMJ) and squat jumps (SJ), (b) to explore the effects of an additional 10% of body weight (BW) load on the BLD in both CMJ and SJ, and (c) examine the relationship between magnitude of BLD and jump performance in both jumps and conditions. Methods: Forty participants (22 for CMJ and 18 for SJ) performed a bilateral jump and unilateral jumps on each leg with and without an added load equivalent to 10% of each participant’s bodyweight. Results: BLD was evident in all conditions, with CMJ BLD values nearly double those for the SJ. The extra load did not affect the magnitude of BLD. BLD had a significant correlation with unilateral jump height, expect for the 110%BW SJ. Conclusions: BLD is present in SJs and CMJs at both loaded and unloaded conditions. The SJs have about half of the BLD observed in CMJs regardless of additional load. Participants who had higher single leg jumps seemed to also have higher BLDs, but there was no evidence of association between the bilateral jump height and BLD