Objective Our previous work has consistently shown a decline in cognitive-motor integration (CMI) in those with a history of concussion, those with less sport experience, and older individuals. Here we characterize CMI performance of individuals as a function of these factors. Based on rodent models, we hypothesized that those with multiple concussions would experience significantly greater neuropathological effects on the brain networks required for visuomotor performance. We predicted that performance variance (reflecting brain network function) would be accounted for by concussion group (one versus >1), after accounting for age and experience. Sex was an exploratory factor.

Design Retrospective.

Setting Community, University.

Participants 223 asymptomatic individuals 9–53 years old (29.2% female, mean 18.9±7.0) with a history of 1–10 concussions (mean 1.7±1.4).

Interventions (or Assessment of Risk Factors) Two eye-hand coordination tasks: Standard task-direct interaction with visual targets, CMI task-hand displaced from viewed targets, visual feedback reversal.

Outcome Measures Six planned kinematic variables (RT, MT, variable error, constant error, peak velocity, path length). Analysis: Linear regression of experience, age, concussion number, and sex on visuomotor performance.

Main Results In contrast to our hypothesis, a significant percentage of the variance was explained only by age and sport experience (p<0.05) in our sample of younger, mainly select-level athletes.

Conclusions We suggest that motor developmental stage and skill experience provide brain network resilience that can compensate for concussion-related performance declines. These data emphasize the clinical importance of accounting for such factors when assessing the effects of multiple concussion on complex visuomotor skill. Future work will look at older and retired athletes.