Gianluca Del Rossi, Alfonso Malaguti, Samanta Del Rossi

Context: Researchers have confirmed that the ruler-drop test could be included as part of a multifaceted concussion-assessment battery and potentially as a way to track recovery from head injury. However, it is unclear if this clinical test of reaction time would be characterized by inconsistent performance because of practice effects. Objective: To determine if the ruler-drop test is susceptible to practice effects after serial administration. Design: Descriptive laboratory study. Setting: Sports medicine research laboratory. Patients or Other Participants: Forty-three persons (age = 21.8 ± 2.6 years). Intervention(s): Ten sessions were completed over 5 weeks. Participants completed 10 trials of the ruler-drop test during each session. Main Outcome Measure(s): The mean reaction times calculated for all participants from each test session were analyzed to determine if there was any meaningful change (ie, improvement) in reaction time over the course of the investigation. Results: Simple reaction time improved (ie, decreased) after repeated administration of the ruler-drop test, and the most pronounced improvement occurred between the first 2 test sessions. Between the first and second test sessions, reaction time decreased by almost 7 milliseconds, and there was an overall improvement of almost 13 milliseconds between the first and tenth sessions. Although the pairwise comparisons between the first and second and the first and third sessions were not significant, the change in mean reaction time between the first session and most of the other sessions was significant. We noted no differences when successive sessions were compared. Conclusions: To prevent practice-related improvements in reaction time, practitioners should allow at least 1 practice session before recording baseline results on the ruler-drop test.