Author: Matt Roda

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For February’s newsletter, we wanted to focus on one of the sports vision industry’s top gatherings, the International Sports Vision Association (ISVA) conference. After 4 days in Dallas earlier this month, there’s much to report.

ISVA is truly a multi-disciplinary event, with attendees having backgrounds in optometry, concussion management, or sports & coaching. In particular, optometry has always played an important role in sports vision training.

History of Sport Vision Training

The original sports vision trainers were optometrists, or ODs, with backgrounds in vision therapy. With extensive education around the eyes and brain, along with the knowledge of how to correct visual issues, optometrists were distinctly situated to lead the development of sports neuro training.

Reflexion’s ancestor, the Wayne Saccadic Fixator, was the first ever commercialized reaction-light board and developed by optometrist Harry Wayne in the 80s and 90s.

A Paradigm in Background

We’ve been attending this conference since 2018, and even in that short time period, we’ve seen the crowd change from primarily ODs to a much more even mix of backgrounds and experiences.

We see this as part of the broader trend happening in sport, as the brain gathers more attention for the role it plays in performance.

Dr. Alex Andrich, former president and executive board member of ISVA, has noticed too. “The education was exciting this year. Talks were balanced with research and multidisciplinary approaches. This gave a different perspective.”

Let’s briefly look at two of the sessions.

“Injury to Recovery to Elite Performance” by Dr. Deanne Fitzgerald and Nicole Morris.

The takeaway of this talk is summarized by one point: 20/20 vision is not enough for an athlete.

Dr. Fitzgerald and Morris spoke of the need to assess and train athletes with specific drills in order to improve their visual judgment. They outlined a three-phase approach to sports vision training, beginning with reconditioning and vision therapy, followed by speed and accuracy drills, and finally sport-specific skills and drills.

This presentation also included hands-on training with Reflexion, Senaptec, and Fitlight.

“Optometric Management of Concussion in Athletes” by Kristine Dalton

There are various drills used for concussion rehabilitation, but quite a few factors that can influence the recovery process. It is worth noting that no single test can diagnose a concussion and unsurprisingly, a comprehensive evaluation is necessary.

The discussion highlighted the importance of rest, symptom scoring sheets, light therapy, sleep hygiene, diet, and other therapies in the recovery process.

The Takeaway

ISVA was a valuable conference to connect with others in the industry and learn the latest science on sports vision training

The ISVA board member gave me his aspiration for the next conference. “Our goal for next year is to make it even more hands on,” Dr. Andrich said. “[We want to provide] more time to go through technologies so attendees learn it practically.”

If you’re interested in exploring the sports vision, ISVA is a conference we highly recommend! We hope to see you there next year.

Til’ next time

Matt Roda

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Is Reflexion just a video game? It’s a question worth exploring, and the answer isn’t a straightforward yes or no. 

The short answer is we gamify cognitive training exercises.

“No way you can beat my score.”

In athletics, gamification refers to the use of game design elements, such as points, levels, challenges, and leaderboards, to enhance the training and engagement of athletes. 

While there are specific reasons why neuro training makes particular sense to gamify, we are part of a much larger trend to turn exercise and daily activities into a game. 

For example, Fitbit users get badges for 10,000 steps, or Apple Watch awards you for closing your rings. Read more on this trend here. 

Gamification is especially important for cognitive tasks that require attention, since the brain is the obvious focus of neuro training.

While these are benefits, having drills that are too game-like can be bad in its own right.

“It’s just a game.”

A challenge gamification creates is the perceived loss of translation to sports. 

Athletes might ignore the value of effective exercises if they think neuro training is just playing a game. Bankers don’t play Monopoly to make more money at work, right?

But skipping out on neuro training because it just feels like a game is comparable to ignoring cardio training because it’s hard. Yes, that’s true, but it’s powerful and so we do it anyway. Read more here for our thoughts on the relationship between cardio and neuro training. 

It’s also important to make sure that the game elements do not detract from the primary purpose of the drill, and there is scientific justification for the connection to a cognitive skill.

To complicate the question further, there’s a cost not to having gamification in neuro training drills too.

Boring Drills = Bad Data

The value of gamification was something we learned the hard way in 2018 while conducting a clinical study at Penn State. When brainstorming effective tests, we took a laboratory approach to drill design: strictly control the timing and location of targets, and change only one variable at a time.  

An early rendition of an inhibitory control test involved staying still and paying attention to slow moving targets for five minutes straight. After early experimentation, comparing scores at the beginning and end of the test was like looking at two different people.

In essence, boredom caused a difference in early and late scores by as much as 30%. We modified the test to be more rapid fire, and expanded the range in which targets could appear. Both anecdotally and in the data, the test results were significantly better.

The Takeaway

Adding gamification makes athletes more attentive, a relevant consideration when the drill involves brain activity. But this needs to be balanced with design elements that don’t go so far as to become a classic arcade game. 

And understanding the reasons neuro training is gamified can make it click as to why these things go together. 

 

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As part of a collaborative effort, this article is authored by Michael Cummings at Blazepod, a flash reflex training company. Michael can be reached at [email protected].

You may have noticed an overwhelming surge in reaction training systems being used in professional sports as well as rehabilitation therapy. Recently I have seen video ranging from Formula One champion Max Verstappen using these lights to the legendary physiotherapist Kevin Wilk. It seems everyone is drinking the “Flashing Light Kool-aid”… and they might have good reason for it.

The essence of this type of training is complex, but not complicated. The user recognizes a stimulus, processes their next move and then reacts as quickly and accurately as they can. Key words being quick and accurate, as it is easy to quickly make the wrong decision or slowly make the right decision. The secret sauce is in training your physical abilities together with your cognitive abilities.

Combining physical and cognitive activities has positive synergistic effects that exceed the pure addition of the positive effects of cognitive and physical exercises by themselves. (Fabian, et al, 2015) This 1 + 1 = 3 summation for enhancing athletic performance may attribute to the growth in popularity for these types of Smart Lights.

Another reason may be because sport requires the application of cognitive, perceptual and motor skills. One meta-analysis states that “outstanding” athletes were shown to have an enhanced ability to make decisions and extrapolate relevant information from their environment to anticipate future events and outcomes. They also seem to have a more effective visuo-spatial processing and greater selective attention. (Mann, et al, 2007/ Fabian, et al 2015)

These cognitive enhancements coupled with their physical strengths were noted as reasons why they perform better than others. They were able to anticipate their opponents’ intentions quicker, were more accurate and proficient in their decision making, and possessed an unparalleled ability to foreshadow or predict future events and outcomes relative to their lesser skilled counterparts. (Mann, et al, 2007/ Fabian, et al 2015)

These results are consistent with the notion that the use of advanced perceptual cues have been demonstrated to facilitate sport performance by means of aiding in the anticipation of opponent’s actions and decreasing overall response time. 

 

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Neuro training is broadly applicable to many different use cases: improving sports performance, neuro and vestibular rehabilitation, physical therapy, general wellness, etc.

But there isn’t one set way to do it, and there are many “forms” of neuro training already available, beyond just Reflexion’s light-board based products. In issue number 4 of this newsletter, we’ll cover some of the different ways neuro training is available.

Low Tech or No Tech

Pros: Low cost, flexible setup
Cons: Time and coach intensive, no data
Rough Cost: <$25

By getting creative with colored cones and tennis balls you can come up with engaging drills for your athletes.

The problem with this category is it requires a coach to oversee and come up with the drills. For ideas on how to do this, Reflexion created a short youtube playlist of four different drills you can try out!

Strobe Goggles

Pros: Sport-specific training, easy to use
Cons: No data tracking
Companies: Senaptec, Strobe Sport
Rough Cost: $300+

Strobe goggles impede an athlete’s vision for brief moments (tenths of a second), making the eyes and brain work harder to process the world with less visual information.

The advantage of goggles is they don’t require special exercises or training, rather you can wear them while shooting baskets or playing volleyball, adding an extra challenge.

While strobes don’t have any way to track data or progress, they’re a great way to train your sport under more challenging conditions.

Flash Reflex Training

Pros: Flexible set up, portable
Cons: Time and coach intensive
Companies: Blazepod, Fitlight, A-Champs
Rough Cost: $300+

Flash reflex training involves touch sensitive LED “cones” that can be placed in different configurations to run drills. This allows for a ton of flexibility to add reaction time and decision making tasks to stationary or agility based exercises.

If you’ve mastered No Tech neuro training, you’ll be able to use these products to take it to the next level.

Light Board Technology

Pros: Comprehensive testing, long term data tracking
Cons: Cost
Companies: Reflexion, Dynavision, Senaptec
Rough Cost: $4,000+ (typically $15,000+)

Light board technology is using LED touchscreens to run different drills and exercises. These are capable of training and assessing a wide swath of cognitions (reaction time, eye-hand coordination, etc) and offer detailed data tracking.

The clear disadvantage is cost- most products are greater than fifteen or even twenty thousand dollars. Reflexion is the only company to offer light board based training for under $4,000 with our Flex product.

Software/Apps

Pros: Varies
Cons: Varies
Rough Cost: Varies

To put it mildly, this is a broad category. And while it almost didn’t get included for that reason, there are a few well known products that are worth mentioning. Righteye and Neuro Tracker are both custom devices used for eye tracking and multi-object tracking.

As this industry advances, I’m confident that software and apps will play a key role in neurocognitive training/assessment. It’s an area to keep an eye out.

Virtual Reality

Pros: Affordable, Portable, Personalized
Cons: Peripheral Vision Limited
Rough Cost: <$40/mo

Virtual Reality (VR) technology has come a long way in recent years, and it’s now being used in a wide range of applications, including sports training. This type of training can help athletes develop better anticipation, reaction time, decision-making skills, and spatial awareness. Additionally, VR training can help athletes overcome psychological barriers that may prevent them from performing at their best.

Research has shown that cognitive training can improve sports performance by enhancing the perceptual-cognitive processes that are critical for success in sports. For example, a study by McRobert et al. found that manipulating context-specific information improved perceptual-cognitive processes during a simulated anticipation task, which could have important implications for sports training [1].

At Reflexion, we believe that cognitive training is an essential part of any athlete’s training regimen. That’s why we’ve developed Reflexion GO, a portable cognitive training system that can be used anywhere, anytime. With Reflexion GO, athletes can train their cognitive skills including tracking, eye-hand coordination, inhibition, prioritization, and reaction time and improve their sports performance, all while having fun. You can learn more about Reflexion GO for the Meta Quest 2 at https://reflexion.co/go.

The Takeaway

This list shouldn’t be viewed as all the methods for neuro training- there’s a plethora of companies and methodologies out there, and the space is only growing. Especially if you would categorize parts of sport psychology under neuro training, this list is very incomplete.

Nonetheless, this list can serve as a springboard to ways neuro training can help athletes and patients alike.

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What’s a trainable skill, versus what are you born with?

If we treat human performance like a pyramid, the bottom level is inherited human physiology. This would be the foundation for any specific ability and varies from person to person.

At this bottom level, genetics plays the lead role – some people are born with larger bone structure and sharper eyes, and this can give them an advantage from an early age.

Intuitively, this makes sense. Naturally good eyes will give you an advantage as you rank up through leagues. A publication found major league MLB players to have slightly better visual acuity (20/12) than minor leaguers, and much better acuity than the general population (20/20).

As you climb the pyramid, you enter abilities that are trainable. That includes areas such as muscle mass, cardio endurance, and eye-hand coordination. They’re improved with weight training, cardio training, and neuro training, respectively. This mid-tier level is where Reflexion trains neuro skills.

Let’s Talk Real World

One step above that is sport or action specific tasks – hitting a baseball, shooting a basket, and serving a tennis ball are all examples. These are skills that have specific techniques and require practice.

For example, the best way to learn bowling is to… bowl. No surprises there.

It’s why many athletes can switch easily between sports. Shooting a basketball doesn’t make you good at volleyball, but they both require excellent eye-hand coordination. If you’re good enough at one, you can probably pick up the other relatively easily.

An Example in Baseball

So how do cognitions play into the real world?

Last December, we had Dr. Dan Laby on one of our podcast episodes. He’s a very well respected researcher in the sports vision space, and the author of the MLB visual acuity paper referenced above. Here’s what he had to say on vision training’s impact on the field.

“Having a faster reaction time doesn’t mean you’re going to swing at more pitches or swing the bat faster. What it seems to mean from the data is that it gives you the option to sit back a little bit more, to see more of the pitch…[and] to make a better decision. Is this [pitch] the ball you want to hit, or can you let it go?

And so we see people that have these faster reaction times actually allow more strikes, because they’re waiting for the right pitch. Now they don’t strike out, in fact they walk more…but if they have the count in their favor, and this pitch isn’t exactly where they want to hit it, they’ll take the strike.”

The Research Gap

Knowing where neuro training fits into this hierarchy is important for understanding how it will translate to the real world, and why there isn’t more research in this space yet.

Trying to analyze how neuro training improves on-field performance is like trying to determine how bench press translates to QB sacks for a lineman. Very few would argue bench press isn’t an important exercise, but scientifically proving and showing that sort of relationship is a challenging task.

The Takeaway

When looking at ways to improve human performance, sport-specific tasks represent only a portion of an athlete’s opportunity. Fundamental abilities related to strength, cardio, and neuro all offer ways to train.

And as the neuro training and assessment industry grows, more research will be needed to better validate its effectiveness and reliability, and we hope to be a leader in this field.

If you’re interested in seeing some of the research supporting neuro training now, including topics beyond just sports, take a look at this database we put together.

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The brain communicates like a complex, interstate highway system. When the brain wants to make a decision or take action, signals travel through this network like messenger cars carrying instructions.

Just like travel in real life, the shorter and more efficient the brain’s highway system is between regions, the better and faster communication happens.

One of the most incredible facts about the brain is its ability to reshape this highway network, also known as neuroplasticity. That’s when the brain makes adaptive changes to itself (structural and functional) in response to intrinsic or external stimuli.

Beyond the technical definition, it’s something we experience every day and is basic enough in its application- if you order food at a restaurant and it’s bad, your brain knows not to go back!

In order to get a broader understanding of how neuroplasticity works in sports and training, it’s easiest to understand it in the context of injuries.

Neuro Rehab & Injury Recovery

Neuroplasticity was originally researched in relation to brain injuries, and is what’s allowed for the development of neuro rehabilitation.

When an injury to the brain occurs, like a stroke or concussion, picture a traffic jam in the highway system. With the existing path blocked due to the injury, the brain will naturally create a detour around the damaged area, allowing operations to continue. The tradeoff is that it uses a slower and less efficient route.

This automatic rewiring is an incredible adaptation of the brain, but even after the brain heals the damage to that highway network, the brain will not return to using the original, better communication path.

By now, the brain doesn’t care that it’s less efficient, it sticks to the working path that it reformed after the injury.

Using the right exercises and techniques, neuroplasticity can be used like Waze or Google Maps, creating the quickest and most efficient path to navigate that highway system. That’s how a medical professional can rehabilitate the brain to use faster routes, like it did prior to injury.

Practice Makes… Better

That’s how neuro rehab works, but even for a healthy individual, there’s no such thing as a perfect brain. Neuro training takes the same principles and offers the potential to optimize the communication networks within the brain.

A shorter and more efficient pathway means increasing the speed and efficiency in which you make decisions and take action. For an athlete, that can provide a competitive edge versus their peers.

There are different forms of neuro training (that we’ll cover in future newsletters), but all of them operate around this same principle of training and changing the brain pathways to respond faster and more efficiently.

The Takeaway

Whether the goal is to recover an injured patient to normal, or train an athlete to respond more efficiently, the basic principles of neuro training are the same. Optimizing communication between different parts of the brain will result in faster, more efficient decisions and actions.

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Reflexion has launched newsletter, where we advance the education behind neuro training and highlight trends in the world of sports vision.

Our mission is to make neuro training mainstream at all levels of athletics, not just with the pros or elites. A lofty task, but one that we believe is already well under way.

A Trend In Our Training Habits

Among sports scientists, it’s been well understood for decades that visual and cognitive training (shortened down to neuro training) can improve on-field performance.

But the technology available for this is either far too simple – like bouncing a colored tennis ball – or far too complex – like requiring specialized staff for one-on-one instruction. It’s time someone filled the void to offer neuro training capable of integrating into any workout.

It’s part of a trend that goes well beyond just sports. The brain is finally getting the attention it deserves in performance, whether it be through conversations like

• Simone Biles withdrawing from the Olympics for mental health issues
• Exploding meditation adoption
• Growing mental health market expected to reach $245 billion by 2027.

Problems In A Developing Market

The issue with a developing market is it leaves questions among the populus as education lags behind. Questions like

• How does neuro training work? What’s effective vs what’s a gimmick?
• How can I integrate neuro training into other workouts?
• What are the different kinds of neuro training?

 

It’s our goal to not only provide the best neuro training products available on the market, but simultaneously cultivate a higher level of understanding behind this industry. This newsletter will answer these questions, and many more.

The Takeaway

What started out as a niche development for pro athletes – vision and cognitive training – has grown in popularity over the last decade, and is starting to take shape as a more developed practice.

Now known as neuro training, this fits into an athlete’s workout in a similar way to strength, agility, or cardio training. It’s all part of a holistic approach aimed at maximizing performance.

But as interest in neuro training grows, so does the demand for information and research surrounding it.

Beyond offering powerful products to improve the implementation of that training, Reflexion’s mission is to increase the understanding of this industry as a whole. This newsletter is one small step in that direction.

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Bryan Jovick is a former strength and conditioning coach for five NCAA Division I universities, ending his coaching career at the St. Louis Cardinals organization. Jovick now leads Reflexion’s expansion into schools and universities, and we asked him to answer one of our most common question. 

I often get asked “how does this improve reaction time?”, “how does getting better at your light board drills make athletes a better basketball player?”, or “I believe reaction time is task-specific, so how would your system work to improve performance?”

Improving things like reaction time is about 1/10 of what we are trying to accomplish here. The other cognitive abilities we assess and track progress in are peripheral vision, eye tracking, depth perception in various contrasts, eye-hand coordination, memory & pattern recognition, and ultimately, prioritization & decision making under pressure. We have an assessment that takes 3 min and provides a report card of all abilities and gives an overall score. This is their “baseline”.

From there, the possibilities are endless as far an applications are concerned. My favorite application for strength coaches is to run assessments in a fatigued state and compare those scores to their fresh baseline scores. Measuring cognitive decline in a fatigued state puts data behind the pursuit of creating fatigue-resistant athletes, who can not only perform at a high level, but who can also absorb more information in practice and process more variables in games.

To the specific question about “how does getting better at a reactive light board make you a better basketball player”? The answer is “we can’t prove that”. However, it’s the same answer if you’re asked to prove that squatting makes athletes better basketball players…The value of squatting is increased lower body control, joint integrity while cutting/pivoting, accelerating & decelerating, and putting force through the floor. Improvements in these athletic characteristics have been shown to lead to enhanced basketball performance, but not squatting directly.

Lastly, without data measuring all parts of what goes behind a cognitive performance, like reaction time, it’s very hard to isolate what the actual problem is. In the example of reaction time, if there was a concern, you would not be able to discern whether it was a brain processing issue, prioritization, cognitive decline through being distracted, or simply a peripheral vision deficiency. All of these play into reaction time and it’s hard to isolate what the problem is without a data-driven system that can separate all cognitive functions that are involved.

Overall, it’s another tool in the toolbox in the pursuit of helping athletes reach their full potential.

Reflexion has just released a new assessment tool to assist in neuro-cognitive training: Reflexion Score 2021. This is a set of five values that relate to five important cognitions that determine performance during every sport: Eye-Hand Coordination, Inhibition, Prioritization, Reaction Time, and Tracking.

The Reflexion Score Assessment

The assessment can be taken once a month. During the assessment you will play through several drills that best determine your capability in these five cognitive areas. Do your absolute best during the assessment! Training daily on different Reflexion drills will give you the best practice.

The results are presented as scores from 0-100, showing where you stand compared to the theoretical maximum limits of human performance. Reflexion drills are no cake walk, so don’t expect to hit the top scores without undergoing extensive cognitive training.

The results are also presented in a spider graph, comparing each cognition to the others. This shows where your cognitive strengths are, and any potential room for improvements. A filled-in circular area indicates that you are well-rounded, while spikes or dips show exceptional skill in that cognition compared to the others (or lack thereof). The more overall area that’s filled-in shows that you’re overflowing with cognitive excellence!

Your ratings in these five cognitive skills can help direct where you need to focus training and specialization. Each cognition is meaningful to different people in different ways based on the skills that pay the bills. No matter what you do or what your role is, you’re likely to find yourself engaging in these cognitions every day and with every play.

Eye-Hand Coordination

Measures how well you can accurately move your hands and fingers to a specific place in your visual field. Eye-hand coordination is the most fundamental cognition for every athlete. This is connecting with the ball, blocking the punch while connecting with your own, intercepting with more than just luck, and so much more. Given the high standards of professionals, we assess this ability with sub-millimeter precision, so don’t miss the center of the target!

The importance of eye-hand coordination is limitless. Nearly every physical activity with the hands requires accurate interaction with vision. The better the cognitive skill of coordinating hand motor activity with the visual information in your brain, the more you’re able to fine-tune and control how you engage with the world around you.

Inhibition

This measures how well you can stop yourself from an action that you are prepared to conduct and how quickly you can determine when to act in the face of distractions. Your brain is constantly being bombarded with information, most of which is inhibited so that limited attention resources are engaged with meaningful information. High Inhibition scores means that you can throw out the noise in order to act meaningfully and react to the things you want to.

It might seem odd that not doing something is a cognitive ability. But you know what they say: “Check it before you wreck it.” Wise words, because being better able to inhibit inappropriate actions helps you maintain focus on appropriate actions and being prepared to respond to what matters. Proper training in Inhibition means you won’t be tricked out by a feint maneuver or distraction from your opponents.

Prioritization

Understanding what needs to be done now versus later is critical in many circumstances. Prioritization measures how well you can manage multiple competing demands for your attention in a limited time frame. You can survive longer and achieve a higher score in our assessment drill by making sure you hit high-priority targets before it’s too late and ignoring low-priority targets when you’re running short on time.

Prioritization comes in many different forms in life. Many decisions in sports have to be made in less than one second. The kind of Prioritization we measure with the Reflexion Score is very fast-paced, assessing your capability to make many split-second decisions while following through with rapid action in a constantly changing visual environment.

Reaction Time

Reaction Time is a measure of how quickly you can initiate an action, whatever that action might be. Slowness to react to events around you can lead to injury and tragedy of all sorts, while quickness of response wins the day. We measure your Reaction Time capabilities to the sub-millisecond. Delaying will lose the game, and you’ll get a lousy assessment score.

The neural circuits that send information from your eyes, through the brain, down the spinal cord, and to the muscles for motor activity have a mechanical limit. But don’t be fooled by a neuroscientist like me! Those circuits can be trained and developed to operate faster than fast, reducing the time it takes to initiate correct responses to less than ¼ of a second.

Tracking

Most activities in sports do not have you engaging with a static environment. You might need to follow a hockey puck blasting back and forth across the ice, the pace of a dribbled basketball right before you go in for the swipe-and-steal, or the shifting legwork controlling a soccer ball. Objects are often moving at different speeds compared to your own movement, becoming larger or smaller in your visual field, and changing directions. Tracking is the cognition of how well you can follow a target and maintain hand coordination in response to rapid velocity changes.

Anything from watching cars in traffic moving around you while driving to following a ball as it’s thrown around a field from person to person involves good Tracking cognition. If you lose sight of the object you’re tracking, you might not be able to find it again fast enough to avoid disaster! Efficient Tracking keeps your eyes and coordinated body movements locked on target for as long as needed, responding as quickly as needed. Tracking means you can monitor your opponent’s every move as they make it, and be ready to respond with the right moves.