Test-retest reliability of the KINARM end-point robot for assessment of sensory, motor and neurocognitive function in young adult athletes

PLoS One. 2018 Apr 24;13(4):e0196205. doi: 10.1371/journal.pone.0196205. eCollection 2018.


Background: Current assessment tools for sport-related concussion are limited by a reliance on subjective interpretation and patient symptom reporting. Robotic assessments may provide more objective and precise measures of neurological function than traditional clinical tests.

Objective: To determine the reliability of assessments of sensory, motor and cognitive function conducted with the KINARM end-point robotic device in young adult elite athletes.

Methods: Sixty-four randomly selected healthy, young adult elite athletes participated. Twenty-five individuals (25 M, mean age±SD, 20.2±2.1 years) participated in a within-season study, where three assessments were conducted within a single season (assessments labeled by session: S1, S2, S3). An additional 39 individuals (28M; 22.8±6.0 years) participated in a year-to-year study, where annual pre-season assessments were conducted for three consecutive seasons (assessments labeled by year: Y1, Y2, Y3). Forty-four parameters from five robotic tasks (Visually Guided Reaching, Position Matching, Object Hit, Object Hit and Avoid, and Trail Making B) and overall Task Scores describing performance on each task were quantified.

Results: Test-retest reliability was determined by intra-class correlation coefficients (ICCs) between the first and second, and second and third assessments. In the within-season study, ICCs were ≥0.50 for 68% of parameters between S1 and S2, 80% of parameters between S2 and S3, and for three of the five Task Scores both between S1 and S2, and S2 and S3. In the year-to-year study, ICCs were ≥0.50 for 64% of parameters between Y1 and Y2, 82% of parameters between Y2 and Y3, and for four of the five Task Scores both between Y1 and Y2, and Y2 and Y3.

Conclusions: Overall, the results suggest moderate-to-good test-retest reliability for the majority of parameters measured by the KINARM robot in healthy young adult elite athletes. Future work will consider the potential use of this information for clinical assessment of concussion-related neurological deficits.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Athletes
  • Brain Concussion / diagnosis*
  • Brain Concussion / physiopathology
  • Cognition / physiology*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Motor Skills / physiology*
  • Neuropsychological Tests
  • Prospective Studies
  • Psychomotor Performance
  • Reproducibility of Results
  • Robotics / instrumentation*
  • Sensation / physiology*
  • Young Adult

Grant support

This work was funded by Own the Podium Canada, the Canadian Academy of Sport and Exercise Medicine Research Fund, the Canadian Sport Institute Calgary and Jim Smith of Calgary, Alberta (BWB). CSM was funded by post-doctoral fellowships from the Canadian Institutes of Health Research and Alberta Innovates Health Solutions. TAW was funded by a Mitacs fellowship in partnership with Own the Podium Canada.