Sanda is a combat sport in which athletes adopt offensive and defensive techniques for barehanded confrontations. Inhibition of return (IOR) describes a phenomenon in which an individual’s response time to a target appearing at a previously cued location is slower than to a target appearing at an un-cued location. Because Sanda requires attention skills and fast response times in dynamic situations, a good understanding of IOR among Sanda athletes is important for enhancing their performance. We recruited 180 research participants for a 3-part study — 90 Sanda athletes (age M = 21.56, SD = 2.68; 52 males, 38 females) and 90 college student controls (age M = 21.64, SD = 2.40; 45 males, 45 females). We used the IOR paradigm with virtual reality technology to explore Sanda athletes’ IOR in three experimental conditions: three-dimensional (3-D) static, dynamic, and mixed. There was a robust IOR effect in the 3-D static scenario, with the IOR effect larger among Sanda athletes than controls. There were different IOR spread patterns between Sanda athletes and controls, and the IOR effect was weaker or absent when the objects moved. There was a speed advantage for Sanda athletes once a static object started moving. In conclusion, the Sanda athletes’ faster response times and more fine-graded IOR in 3-D environments may benefit their visual search in combat, and the reference of the static location may be critical for the IOR effect.

Background: Rates of sports-related concussion (SRC) are high in adolescents. Ambiguity exists regarding the effect of SRC on cognitive function in adolescents. Purpose: To rigorously examine adolescents’ cognitive function after SRC. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: Web of Science, Scopus, and PubMed were searched from database inception until September 2021. Studies were included if participants were adolescents aged 13 to 18 years, if the definition of SRC was fully consistent with the Berlin Consensus Statement on Concussion in Sport, if the study included a control group or in-group baseline test, and if the study reported cognitive outcomes (eg, visual memory, processing speed) that could be separately extracted. Results: A total of 47 studies were included in the systematic review, of which 31 were included in the meta-analysis, representing 8877 adolescents with SRC. Compared with individuals in the non-SRC group, individuals with SRC had worse performance in cognitive function and reported more symptoms not only in the acute phase but also in the prolonged phase (1-6 months after injury) (visual memory: d = −0.21, 95% CI, −0.37 to −0.05, P = .012; executive function: d = −0.56, 95% CI, −1.07 to −0.06, P = .028; and symptoms: d = 1.17, 95% CI, 0.13 to 2.22, P = .028). Lower scores in most of the outcomes of cognitive function were observed at <3 days and at 3 to 7 days, but higher scores for verbal memory ( d = 0.10; 95% CI, 0.03 to 0.17; P = .008) and processing speed ( d = 0.17; 95% CI, 0.10 to 0.24; P < .001) were observed at 7 to 14 days after SRC relative to baseline. The effects of SRC on cognitive function decreased over time (100% of the variance in reaction time, P < .001; 99.94% of the variance in verbal memory, P < .001; 99.88% of the variance in visual memory, P < .001; 39.84% of the variance in symptoms, P = .042) in control group studies. Study design, participant sex, measurement tools, and concussion history were found to be modulators of the relationship between cognitive function and SRC. Conclusion: This study revealed that adolescent cognitive function is impaired by SRC even 1 to 6 months after injury. Results of this study point to the need for tools to measure cognitive function with multiple parallel versions that have demographically diversiform norms in adolescents. Effective prevention of SRC, appropriate treatment, and adequate evaluation of cognitive function before return to play are needed in adolescent SRC management. Moreover, caution is warranted when using the baseline-to-postconcussion paradigm in return-to-play decisions.