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Context : Functional tests are limited primarily by measuring only physical performance. However, athletes often multitask, and deal with complex visual-spatial processing while being engaged in physical activity.  Objective : To present the development and reliability of 4 new neurocognitive single-leg hop tests that provide more ecological validity to test sport activity demands than previous functional return to sport testing.  Design : Cross-sectional.  Setting : Gymnasium.  Participants : Twenty-two healthy participants (9 males and 13 females; 20.9 [2.5] y, 171.2 [11.7] cm, 70.3 [11.0] kg) were recruited.  Interventions : Maximum distance (physical performance) and reaction time (cognitive performance) were measured for 3 of the neurocognitive hop tests all testing a different aspect of neurocognition (single-leg central-reaction hop-reaction time to 1 central stimulus, single-leg peripheral-reaction crossover hop-reaction time between 2 peripheral stimuli, and single-leg memory triple hop-reaction to memorized stimulus with distractor stimuli). Fastest time (physical performance) and reaction time (cognitive performance) were measured for the fourth neurocognitive hop test (single-leg pursuit 6m hop-requiring visual field tracking [pursuit] and spatial navigation).  Main Outcome Measures : Intraclass correlation coefficients were calculated to assess reliability of the 4 new hop tests. Additionally, Bland-Altman plots and 1-sample t tests were conducted for each single-leg neurocognitive hop to evaluate any systematic changes.  Results : Intraclass correlation coefficients based on day 1 and day 2 scores ranged from .87 to .98 for both legs for physical and cognitive performance. The Bland-Altman plots and 1-sample t tests ( P  &gt; .05) indicated that all 4 single-leg neurocognitive hop tests did not change systematically.  Conclusions : These data provide evidence that a neurocognitive component can be added to the traditional single-leg hop tests to provide a more ecologically valid test that incorporates the integration of physical and cognitive function for return to sport. The test-retest reliability of the 4 new neurocognitive hop tests is highly reliable and does not change systematically.

The Development and Reliability of 4 Clinical Neurocognitive Single-Leg Hop Tests: Implications for Return to Activity Decision-Making