Enhancing Athletic Performance Through Neurocognitive Skill Training: A Guide for Sports Physical Therapists and Performance Clinicians
- Olivia Abdoo
- Jun 30
- 9 min read
Updated: 4 days ago
Discover how neurocognitive skills like focus, memory, and reaction time impact elite athletic performance, especially in high-pressure sports like MMA. Dr. Olivia Abdoo, a sports physical therapist and Physical Therapy Manager at the UFC, shares real-world insights from her work with top-level athletes across MMA, WNBA, NFL, and NBA. Drawing from both research and hands-on experience, she breaks down how these mental skills can be tested, trained, and built into everyday rehab and performance work. You’ll find practical tips, sport-specific examples, and a fresh take on why brain performance is just as important as physical strength.
In combat sports, survival hinges on one split-second decision: fight, flight, or freeze. At the elite level, where athletes choose to fight, success depends on more than physical readiness — it demands an exceptional neurocognitive skillset.
In my experience working with professional MMA athletes, the ability to sustain focus, process information rapidly, and execute under extreme duress is not optional — it’s essential. Skills like working memory, attentional control, reaction time, and dual-tasking become the backbone of performance. Five-minute rounds can feel like hours; a one-minute rest, like a blink. This isn’t just a sport — it’s a constant test of mental resilience, cognitive precision, and physical execution under pressure.
As sports physical therapists and performance clinicians, we must recognize that neurocognitive training is not supplemental — it's foundational. Developing and integrating these skills into both clinical rehabilitation and sport-specific scenarios is now a critical priority in preparing fighters for the reality of their environment — where milliseconds matter and everything is on the line. While the demands may be most extreme in combat sports, these neurocognitive skills are essential across all sports where decision-making, adaptability, and performance under pressure define success.
This article explores the core neurocognitive domains that influence sport performance, reviews evidence from performance literature, and offers practical strategies for integrating neurocognitive training into your athlete care model.
The Pillars of Neurocognitive Performance
Neurocognitive performance in sport can be broken down into three foundational domains:
Working Memory
Attentional Control
Response Time
These domains form the fundamental for an athlete’s ability to dual-task, which is the essence of sport: simultaneously processing information, making decisions, and executing precise motor actions under pressure. Importantly, these cognitive skills are highly trainable and should be a consistent focus in both clinical rehabilitation and performance training environments.
Before progressing to dual-task interventions, it’s important to confirm the athlete has the foundational abilities needed for both the physical and cognitive demands. Start by determining if they can perform each task independently. For instance, if you're combining a change-of-direction drill with a working memory task, assess whether they can first run and cut safely, and complete the cognitive task in a controlled environment.
The next step is evaluating their ability to perform tasks concurrently, even if the success of one does not depend on the other—such as single-leg balance paired with solving math problems. As they improve, progress to interdependent tasks where the outcome of one skill influences the other—like catching specific colored balls with the correct hand based on a rule set.
Ultimately, these skills should be tested in more dynamic, variable environments that resemble the chaos of sport. As we move through these domains, remember there will be overlap — so always anchor your drill selection to the specific goal you're targeting.
1. Working Memory
Definition: The ability to store and manipulate information to guide goal-directed behavior (Vaughan RS, 2020). Working memory is the ability to maintain and manipulate information even amid interference. These functions support an athlete’s ability to perceive, interpret, and respond to stimuli under pressure, forming the basis for decision-making, coordination, and motor execution. There are two components of Working Memory:
Working Memory Capacity: the amount of information that can be stored and recalled in the short-term.
Example - An athlete is told a four-strike combo (e.g., jab-cross-hook-uppercut) and must remember and execute it on the bag after a brief delay while doing footwork. The ability to recall and perform the full combo reflects their working memory capacity.
Working Memory Control: the ability to manipulate, adapt, and update information.
Example - An athlete performs a ladder drill while remembering a number sequence, then repeats the numbers in reverse order afterward. This requires holding, manipulating, and recalling information under physical and cognitive load.
Sport-Specific Examples:
x A setter recalls hitter availability, opponent blocking tendencies, and the game plan to choose the optimal set within seconds of a chaotic dig.
x During a scramble, a wrestler remembers the opponent’s typical transition from single- to double-leg and adjusts grip and body position to counter in real time.
x A midfielder pushes transition, recalls the man-up scenario and teammates’ preferences, and delivers a skip pass exploiting a defensive rotation.
2. Attentional Control:
Definition: Attentional control is the capacity to regulate information processing for goal directed behavior including two key components: maintenance attention and disengagement from interference whether that is external and/or internal sensory information. Attentional control has been linked to a multitude of outcomes including cognitive performance, academic achievement, health behaviors and emotional regulation (Burgoyne AP, 2023). This neuro-cognitive skill is essential for multi-tasking as it requires the ability to maintain specific goals throughout activity, seamlessly switch between tasks, minimize mind wandering while focusing on task-relevant information, and effectively disengage from no-longer relevant information. Attentional control strongly correlates with fluid intelligence, working capacity and processing speed making this a crucial skill to assess and address in this population.
To get a better understanding of how you may implement attentional control training, there is a theoretical model of the levels of attention including 5 different stages or levels that challenge attention in variable ways (Collins LK. 2023, Lee HY. 2022).
Focused: Directing attention to a single task.
x Sustained: Maintaining attention over time.*
x Selective: Filtering out distractions.
x Divided: Managing multiple stimuli or tasks simultaneously.
x Alternating: Switching between tasks as needed.
*Don’t sleep on sustained attention — it’s one of the most under-trained skills in rehab. Athletes stay locked in for entire games, but how often do we actually challenge their focus for more than a minute? Even just two minutes of continuous cognitive demand can expose gaps you won’t catch in shorter tasks.
One cognitive task I really like that challenges both attention and working memory is the Simon task, a stimulus-response compatibility test. It’s easy to adapt across different drills, which makes it simple to tailor to sport-specific movements. It’s also a great fit at the UFC, where we work with athletes from all over the world with varying languages and education levels.
Here’s a basic example: you have two lights—if a blue light appears, you tap it with your right hand; if it’s green, tap with your left, regardless of which side the light appears on. This challenges working memory (remembering which color maps to which hand) and attention (staying focused and responding correctly).
2) Reaction or Response Time:
Definition: Reaction time (RT) is the speed at which an athlete can perceive a stimulus and initiate an appropriate motor response (Brinkman C. 2020, Churchill NW. 2021). It reflects processing speed and underpins every movement in sport. While commonly referred to as "reaction time," what we are truly assessing in most sport and clinical tests is response time—a more comprehensive measure that includes not only the initial sensory detection and cognitive reaction to a stimulus, but also the processing of that information, selection of an appropriate motor plan, and execution of a physical response. Reaction time is related to a plethora of factors that influence overall performance including stimuli processing, muscle coordination, technical abilities and achieving optimal mental states (Balko S. 2016).
Simple reaction time—responding to a single stimulus with a single response—is the easiest and most commonly assessed type in the clinic. But athletes compete in fast, unpredictable environments, and it's crucial to train other types of reaction skills that better reflect those demands (Miller JO. 2001).
These include:
x Go/No-go: React to one stimulus (e.g., tap with your right hand for X) and ignore another (do nothing for O).
x Choice reaction: React differently depending on the stimulus (e.g., right hand for X, left hand for O).
x Central vs. Peripheral Reaction (Clark JF. 2017): Central reaction time involves responding to stimuli directly in front of you, while peripheral reaction time challenges your ability to react to stimuli in your side or peripheral visual field.
Training across these reaction types helps build more sport-relevant neurocognitive agility.
Dual-Task Training
Dual-tasking represents the integration of sensory perception, cognitive processing, and motor execution—bringing together key neurocognitive skills such as attention, working memory, and response time into a functional, movement-based challenge. While these cognitive domains can be assessed in relative isolation, dual-task training reflects how they are used collectively in sport: to perceive and interpret information, make rapid decisions, and execute precise motor actions under real-world conditions. In the clinic, dual-tasking is how we bridge cognitive demand with physical performance, making training more sport-relevant and ecologically valid.
Neurocognition as a Trainable Capacity
Neurocognitive skills are not fixed—they are dynamic, adaptable, and trainable with intention. Integrating cognitive assessments and drills into daily practice is no longer optional; it’s essential for developing resilient, high-performing athletes.
For example, I worked with an MMA athlete in the final stages of ACL reconstruction rehab, assessing readiness to return to full training and ultimately begin a fight camp—an intense preparation phase involving live sparring, wrestling, and jiu-jitsu. To support both physical and neurocognitive readiness, we used a progressive, domain-specific approach.
In striking, we started with bag work focused on clean mechanics. We then increased the cognitive load by layering in complex strike combinations the athlete had to remember and perform—targeting working memory. Next, we extended the duration, progressing from 3-minute rounds to full 5-minute rounds across five rounds, mimicking fight conditions and challenging sustained attention.
For wrestling, the focus shifted to reaction time and decision-making. The athlete drilled controlled takedowns with a trusted partner, who would randomly cue left or right. This required rapid recognition and execution, training choice reaction and attentional control in a dynamic but controlled environment.
We're also seeing neurocognitive challenges increasingly embedded in return-to-sport testing, including hop testing, as highlighted by Grooms et al., who emphasize the importance of visual-motor integration and brain-behavior interaction in ACL rehab.
By weaving these neurocognitive demands into sport-specific training, we were able to evaluate not just physical capacity but also cognitive readiness for the chaotic, high-speed nature of live MMA performance.
As sports physical therapists and performance clinicians, we must:
x Recognize cognitive readiness as foundational to motor execution and injury mitigation
x Employ progressive, sport-specific neurocognitive training throughout rehab
x Collaborate across disciplines to assess, challenge, and optimize these domains
By investing in neurocognitive skill development, we not only enhance performance but also protect long-term athlete health and career longevity.
OLIVIA ABDOO
Meet Olivia: a sports physical therapist and Physical Therapy Manager at the UFC, where she works with elite MMA, WNBA, NFL, and NBA athletes. She earned her DPT from Cal State Long Beach and completed advanced training through the Duke Sports Residency and Wake Forest Division 1 Fellowship. Dr. Olivia Abdoo is a board-certified Sports Clinical Specialist and Certified Strength and Conditioning Specialist. She also serves as the Practice Chair for the AASPT Concussion Special Interest Group, focusing on athlete health and performance.
References:
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Burgoyne AP, Tsukahara JS, Mashburn CA, Pak R, Engle RW. Nature and measurement of attention control. J Exp Psychol Gen. 2023;152(8):2369-2402. doi:10.1037/xge0001408
Collins, Lacee K, Sione A. Ofa, Cadence Miskimin, and Mary Mulcahey. 2023. “Cognitive Deficits Following Concussion: A Systematic Review.” Journal of Orthopaedic Experience & Innovation, June. https://doi.org/10.60118/001c.68393.
Lee HY, Hyun SE, Oh BM. Rehabilitation for Impaired Attention in the Acute and Post-Acute Phase After Traumatic Brain Injury: A Narrative Review. Korean J Neurotrauma. 2022;19(1):20-31. Published 2022 Nov 21. doi:10.13004/kjnt.2023.19.e1
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Physiopedia. Anterior Cruciate Ligament (ACL) Injury. Physiopedia. Published 2017. https://www.physio-pedia.com/Anterior_Cruciate_Ligament_(ACL)_Injury
Grooms DR, Appelbaum G, Onate JA. Neuroplasticity following anterior cruciate ligament injury: a framework for visual-motor training approaches in rehabilitation. J Orthop Sports Phys Ther. 2015;45(5):381-393. doi:10.2519/jospt.2015.5549
