Thorben Hülsdünker

Separate tests are usually used to assess an athlete's ability to meet the aerobic and anaerobic demands of ball sports. These tests often compromise ecological validity by relying on linear runs and sprints rather than multidirectional reactive agility. This study investigated the correlations between a novel motor-cognitive reactive agility (RA) test and aerobic and anaerobic performance indices. Twenty-two trained participants ( V ˙ O _2max : 56 ± 6.4 ml ∙ kg ^-1 ∙ min ^-1 ) performed a treadmill ramp test to determine maximum oxygen uptake ( V ˙ O ₂ max), a running-based anaerobic sprint test (RAST) to determine peak power output (PPO), average power putput (POAV), fatigue index (FI) and anaerobic capacity (AC) and a motor-cognitive RA test on the SKILLCOURT. The RA test required participants to perform four 150 m maximal multidirectional change of directions runs with a break of 30 s. Running time, heart rate and power output were determined for all runs and correlated to V ˙ O _2max and anaerobic performance indicators. Running time of the 4th SKILLCOURT run was correlated to V ˙ O _2max (r ₂₀ = −0.80, p < 0.001) and a strong relation was found between PPO determined in the RAST and SKILLCOURT test (r ₂₀ = 0.72, p < 0.001). The SKILLCOURT RA test provides a promising tool for sport coaches to monitor aerobic and anaerobic performance indices, considering reactive agility. This needs to be validated in future studies.

Introduction: Aerobic and anaerobic capacity are considered key performance indicators in team ball sports. However, diagnostics focus on treadmill testing or linear sprints, not considering multidirectional change of direction and reactive agility. This study evaluated the validity of a novel multidirectional reactive agility test (RA test) to determine aerobic and anaerobic capacity in high-level female handball athletes. Methods: Fourteen first-team female handball players performed four all-out 150 m multidirectional RA runs on the SKILLCOURT. Maximum oxygen uptake (VO _2max ) was determined using a mobile gas analyzer and compared to an incremental ramp test on the treadmill. For anaerobic performance, peak power output (PPOmax), average power output (PPOav), fatigue index (FI) and anaerobic capacity (AC) were calculated based on running time in the RA test and correlated to the repeated anaerobic sprint test (RAST). Results: Bland-Altman analyses revealed a mean difference in VO _2max between the RA test and the treadmill test of 0.07 mL × kg ⁻¹ × min ⁻¹ (0.1%) with upper and lower limits of agreement (LoA) at 4.03 (8%) and −3.88 (8%) mL × kg ⁻¹ × min ⁻¹ , respectively. Measured VO _2max values from the RA test and treadmill were strongly related (r = 0.91) and not significantly different ( p = 0.90, d = 0.04). No significant correlations were found for any of the anaerobic variables ( p ≥ 0.40). Discussion: The results support the suitability of a RA test protocol for directly measuring and estimating aerobic capacity (VO _2max ). This was not confirmed for anaerobic parameters. The RA test may provide a promising sport-specific alternative to existing lab and field protocols for determining VO _2max in team ball sports.

Age-related cognitive and motor decline impairs daily functioning and increases fall risk. Although both domains interact in everyday activities, they are often assessed separately, limiting ecological validity. This study examined reliability and construct validity of an assessment device for agility and motor–cognitive reactive stepping performance in older adults. In a test–retest design, 72 older adults (48 women; 73.7 ± 7.6 years) completed agility tests (Random Star Run and a dual task with multiple object tracking) and motor-cognitive tasks on the SKILLCOURT across four sessions: familiarisation, test day 1 and day 2 (7 days apart), and test day 3 (3 months later). Agility tasks required reactive changes of direction in response to visual cues, while motor-cognitive stepping tasks assessed simple and choice reaction time, task switching, 2-back, and Stroop word-color interference. Intersession Reliability was evaluated using intraclass correlation coefficients (ICC) and coefficients of variation (CV), learning effects with linear mixed models, and construct validity via age-adjusted regression against established motor (Timed-up-and-Go; TUG; single-/dual task) and seated PC-based cognitive measures of reaction speed and executive functions corresponding to the SKILLCORT tasks. Significant learning effects were observed mainly between test days 1 and 2. Relative reliability was moderate to excellent for SKILLCOURT agility, simple reaction time, and Stroop word-color performance (ICC = 0.70–0.94), but lower for choice reaction time, task switching, and the 2-back task (ICC = 0.49–0.66). Absolute reliability was generally good (CV = 4.6–7.2%), except for the SKILLCOURT task switching and 2-back (~12%) and, in particular, the dual task agility test (32%). Random Star Run agility was predicted by TUG single-task performance, PC-based Stroop interference control, and simple reaction time (R ² = 0.77), while dual task agility was predicted by TUG dual task and PC-based 2-back performance (R ² = 0.37). All motor-cognitive outcomes were significantly associated with corresponding PC-based cognitive measures (R ² = 0.20–0.41). The SKILLCOURT demonstrated good reliability for the Random Star Run agility test and most motor-cognitive measures, although adequate familiarisation appears necessary to minimise learning effects. Construct validity was confirmed for agility measures, while reactive stepping tasks appeared to involve greater motor demands and task interference, which may weaken correlations with comparable PC-based cognitive tests.

Background/Objectives: This study examined age-related differences in ocular and cardiovascular responses to graded motor–cognitive task complexity in young and older adults. Methods: Forty-three healthy adults participated, including 21 young adults (27.1 ± 7.7 years) and 22 older adults (63.1 ± 7.8 years). Participants completed three tasks of progressively increasing motor–cognitive complexity. Intraocular pressure (IOP), ocular perfusion pressure (OPP), blood pressure, and heart rate were measured at baseline, after each task block, and at a post-task recovery assessment. Results: Significant condition effects were found for IOP (p = 0.012, η²p = 0.08), OPP (p < 0.001, η²p = 0.76), systolic blood pressure (p < 0.001, η²p = 0.51), and relative heart rate (p < 0.001, η²p = 0.40). Condition × group interactions were significant for IOP (p = 0.004, η²p = 0.09), OPP (p = 0.002, η²p = 0.10), and systolic blood pressure (p = 0.003, η²p = 0.11). Post hoc analyses showed that young adults exhibited a decrease in IOP from the first task block to recovery (p = 0.011, d = 0.35), whereas older adults showed a return toward baseline values. Relative heart rate was consistently higher in older adults across the protocol (p < 0.001, η²p = 0.29). Conclusions: Increasing motor–cognitive task complexity elicited progressive ocular and cardiovascular responses. The findings suggest that aging may influence the pattern of physiological adaptation to graded motor–cognitive load, particularly during early recovery. Concurrent assessment of ocular and cardiovascular measures may help characterize these response patterns.

Background: Conventional laboratory and field tests often underestimate VO _2max and fail to reflect the reactive agility, multidirectional demands of team ball sports. This study examined whether a motor-cognitive Reactive Agility (RA) Test can elicit a true VO _2max response and serve as a sport-specific alternative for assessing VO _2max in team sport athletes. Method: Fifty-three team ball sports athletes performed an exhaustive incremental treadmill test and a motor-cognitive RA Test. The RA Test was performed on the SKILLCOURT and contained four all-out reactive agility runs of 150 m with an intermittent break of 30 s. VO _2max was determined in both tests using a portable gas analyzer. Dependent t -tests, Blant-Altman analysis, concordance correlation coefficient (CCC), intraclass correlation coefficient (ICC) and correlation analyses were performed. Results: The mean difference in VO _2max between the tests was 0.25 mL × kg ⁻¹ × min ⁻¹ (0.5%, p = 0.55) with upper and lower 95% limits of agreement at 6.02 (11%) and −5.53 (10%) mL × kg ⁻¹ × min ⁻¹ , respectively. CCC ( p _c = 0.94), ICC (0.943) and correlation analysis ( r = 0.94) revealed a strong agreement and relation between VO _2max in the treadmill and RA Test. Conclusion: The RA Test reliably elicits a true VO _2max response and offers a valid and more sport-specific option when compared to laboratory treadmill assessment for measuring VO _2max in team ball sport athletes.

Background/Objectives : Falls are a major cause of injury and mortality in older adults. Numerous programs have been implemented to improve mobility and reduce fall risk but these focus on strength, balance, and coordination, while cognitive abilities remain unconsidered. This study compares an official state-funded rehabilitation sport program with a novel motor-cognitive training. Methods : Thirty-two participants ( M _age : 71 years) were assigned either to the accredited rehabilitation sport or the motor-cognitive training. Following the official regulations, participants trained once a week for 45 min over 6 the course of weeks. Motor-cognitive training was performed using the SKILLCOURT technology where cognitive tasks were integrated into locomotor or stepping exercises. Before and after the training, gait stability using the Dynamic Gait Index and timed-up-and-go test was measured. Moreover, endurance capacity (6-min walking test), executive function, dual-task performance, and reactive agility were assessed on the SKILLCOURT. Training motivation and intention to continue with the training were surveyed after the 6-week training intervention. Results : Results indicate stronger performance gains for the motor-cognitive training group in the Dynamic Gait Index ( p = .020, ) and timed-up-and-go ( p = .014, ). No differences were observed for the 6-min walking, dual task, and executive function tests ( p ≥ .174). Participants in the motor-cognitive group were more motivated to come to the training ( p = .002), and a higher proportion expressed their interest in training continuation ( p < .001). Conclusion : The results indicate that motor-cognitive training outperforms purely motor training programs in improving gait stability in older adults. Significance/Implications : Mobility training programs should be revised by integrating motor-cognitive components.

Purpose : This study investigated cognitive resilience in response to a repetitive motor-cognitive reactive agility exercise in high-level athletes. Methods : Thirty-seven (26 males, 11 females) high-level team ball sports athletes (mean age: 25 y) were tested on cognitive executive performance during rest (baseline) as well as immediately following 6 repeated all-out reactive agility runs of varying distances (2 × 50 m, 2 × 100 m, 2 × 150 m) with 90-second break in between. Reaction time, error rate, and inverse efficiency score were calculated using the SKILLCOURT technology to determine cognitive performance. Heart rate, rate of perceived exertion, and lactate concentrations were used as markers of physical load and subjective exertion induced by the reactive agility exercise. Results : Cognitive performance significantly declined from baseline to postexercise trials ( P < .001, ), as indicated by a higher inverse efficiency score. Post hoc analyses revealed significant effects after the 50-m ( P = .005), 100-m ( P = .002), and 150-m ( P = .012) bouts. No significant differences were observed between running distances, although physical fatigue (heart rate and rate of perceived exertion) was higher for longer running distances (150 m > 100 m > 50 m; all P < .001). Conclusions : The results suggest that high-intensity motor-cognitive exercise impairs executive functioning. The missing effect of running distance indicates that exercise intensity (all-out) and type (motor-cognitive) have a stronger influence on performance than duration and exertion. Assessing cognitive resilience provides important information on cognitive performance stability under motor-cognitive load.

Objective: Cognitive performance is typically assessed using computer-based tests where participants respond via a simple upper extremity motor task such as a button press. This type of assessment has been criticised for its low ecological validity that does not consider the interaction between cognitive and more complex motor skills in sports and everyday life situations, which results in motor-cognitive interference. Consequently, motor-cognitive assessments integrating a more complex motor response into a cognitive test have gained popularity. However, the cognitive costs in motor-cognitive tests due to the interference of cognitive and motor processes have not yet been determined. Therefore, this study aimed to quantify the cognitive costs in motor-cognitive tests.Methods: Thirty-three healthy athletes performed four cognitive tests (simple reaction, choice-reaction, working memory, cognitive flexibility) in a cognitive and motor-cognitive setting. For the cognitive task, participants performed a computer-based cognitive assessment by responding with a button press on a keyboard. In the motor-cognitive condition, participants conducted a stepping movement which was identified by a Light Detection and Ranging (LiDAR) system integrated into motor-cognitive testing and training technology (SKILLCOURT®). Cognitive costs were determined by comparing reaction time and error rate between conditions (cognitive vs. motor-cognitive) while controlling for differences in measurement technology, neuromuscular conduction delay, and movement amplitude. Correlation analyses quantified the relationship between cognitive and motor-cognitive performance.Results: There were cognitive costs, as indicated by slower reaction times in the motor-cognitive test, for the choice-reaction (p = 0.014) and working memory (p < 0.001) tests. There were inverse cognitive costs, denoted by faster reactions, in the motor-cognitive compared with the cognitive condition for the cognitive flexibility test (p < 0.001). There were strong correlations for the simple-reaction (r₃₁ = 0.79, p < 0.001), choice-reaction (r₃₁ = 0.60, p < 0.001), and cognitive flexibility (r₂₈ = 0.83, p < 0.001) tests. The working memory task revealed a moderate correlation (r₃₁ = 0.46, p = 0.009).Conclusion: The results confirm the presence of cognitive costs in motor-cognitive assessments. The type of motor response and test design influence cognitive costs and test performance and can even result in inverse cognitive costs during motor-cognitive tasks. This must be considered when interpreting motor-cognitive tests and suggest that computer-based assessments cannot simply be replaced by motor-cognitive alternatives.

Active breaks are suggested to support recovery and performance in sports. Previous research in ball and team sports focused on motor performance such as repetitive sprinting or change of direction. This does not account for the interaction between motor and cognitive task demands in sports. Therefore, this study is the first to investigate the effectiveness of an active motor‐cognitive break to support reactive agility performance. Twenty (7 female and 13 male) healthy trained young adults (mean age: 26 years) performed an active or passive 5 min break following a fatiguing protocol of six 100 m reactive agility runs with an intermittent break of 40 s. Prior to the experiment (pre), after fatigue (post), and following the rest condition (retention), a reactive agility test was performed using the SKILLCOURT technology. In addition, lactate, heartrate, and physical exertion were recorded. Active rest contained two motor‐cognitive training tasks on the SKILLCOURT combining low to moderate physical intensity with conflict inhibition and decision‐making. During passive rest, participants remained seated. When comparing post and retention agility tests, results indicate significantly stronger performance gains following the active when compared to the passive break condition (p = 0.02 and η_p² = 0.24). This was not associated with any differences in physiological parameters such as lactate, heart rate, or RPE (p ≥ 0.25). The results suggest that active motor‐cognitive breaks support recovery and improve sport‐related reactive agility performance. Performance gains in the active break are likely attributable to cognitive performance effects rather than physiological recovery, which may benefit athletes especially in ball and team sports.