This is a concentration chart with arrows.  REMEMBER, USING A METRONOME IS MANDATORY. Obviously, the first run-through should be to state the arrow direction. (i.e. first row reads " up, down, right, down, left, right ") or name the opposite direction.  Then add hand motions to coincide with the arrow direction (like conducting) while stating the direction.  The next degree of difficulty would be to state the arrow direction while conducting the OPPOSITE direction.  See how this works?  Sometimes, just increasing the tempo will raise the level of difficulty.  As always, these charts can be tailored to your specific instrument.  For instance, a pianist could assign chords to each arrow direction. (i.e. up = major, down = minor, left = augmented,
right = diminished). Get the idea?