To investigate whether slower reaction time (RT) was associated with higher concussion odds among middle school female soccer players.

We performed a retrospective cohort study, analyzing pre-participation computerized neurocognitive data (Immediate Postconcussion and Cognitive Testing) for 10-14-year-old female soccer players. We compared composite RT scores between those who did/did not sustain a concussion during the following year using Welch's t -test. We used binary logistic regression to determine the association between RT and subsequent concussion, adjusting for covariates.

A cohort of 2489 female soccer players were included (mean age = 13.2 ± 1.0 years; 12% with prior concussion). Of these, 226 (9.1%) athletes sustained a concussion. On univariable analysis, those who sustained a subsequent concussion demonstrated faster RT than those who did not (633.8 ± 87.2 vs 649.3 ± 90.1 milliseconds; Cohen's d = 0.17). After covariate adjustment, slower RT was associated with lower subsequent concussion odds (OR = 0.997, 95% CI: 0.996-0.999). Prior concussion was significantly associated with subsequent concussion (OR = 2.48, 95% CI: 1.73-3.52).

Contrary to our hypothesis, slower pre-participation RT was associated with lower odds of subsequent concussion, with a 3% decrease in concussion odds for every 10-millisecond RT increase. Prior concussion was the strongest predictor of subsequent concussion, consistent with past work.