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Adding Vision to Concussion Testing: A Prospective Study of Sideline Testing In Youth and Collegiate Athletes

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Title Journal of Neuro-Ophthalmology, September 2015, Volume 35, Issue 3
Date 2015-09
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s62j9hxc
Setname ehsl_novel_jno
ID 227767
Reference URL https://collections.lib.utah.edu/ark:/87278/s62j9hxc

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Title Adding Vision to Concussion Testing: A Prospective Study of Sideline Testing In Youth and Collegiate Athletes
Creator Kristin M. Galetta; Jennifer Morganroth; Nicholas Moehringer; Bridget Mueller; Lisena Hasanaj; Nikki Webb; Courtney Civitano; Dennis A. Cardone; Arlene Silverio; Steven L. Galetta; Laura J. Balcer
Abstract BACKGROUND: Sports-related concussion commonly affects the visual pathways. Current sideline protocols test cognition and balance but do not include assessments of visual performance. We investigated how adding a vision-based test of rapid number naming could increase our ability to identify concussed athletes on the sideline at youth and collegiate levels. METHODS: Participants in this prospective study included members of a youth ice hockey and lacrosse league and collegiate athletes from New York University and Long Island University. Athletes underwent preseason baseline assessments using: 1) the King-Devick (K-D) test, a <2-minute visual performance measure of rapid number naming, 2) the Standardized Assessment of Concussion (SAC), a test of cognition, and 3) a timed tandem gait test of balance. The SAC and timed tandem gait are components of the currently used Sport Concussion Assessment Tool, 3rd Edition (SCAT3 and Child-SCAT3). In the event of a concussion during the athletic season, injured athletes were retested on the sideline/rink-side. Nonconcussed athletes were also assessed as control participants under the same testing conditions. RESULTS: Among 243 youth (mean age 11 3 years, range 5-17) and 89 collegiate athletes (age 20 1 years, range 18-23), baseline time scores for the K-D test were lower (better) with increasing participant age (P < 0.001, linear regression models). Among 12 athletes who sustained concussions during their athletic season, K-D scores worsened from baseline by an average of 5.2 seconds; improvement by 6.4 seconds was noted for the nonconcussed controls (n = 14). The vision-based K-D test showed the greatest capacity to distinguish concussed vs control athletes based on changes from preseason baseline to postinjury (receiver operating characteristic [ROC] curve areas from logistic regression models, accounting for age = 0.92 for K-D, 0.87 for timed tandem gait, and 0.68 for SAC; P = 0.0004 for comparison of ROC curve areas). CONCLUSIONS: Adding a vision-based performance measure to cognitive and balance testing enhances the detection capabilities of current sideline concussion assessment. This observation in patients with mild traumatic brain injury reflects the common involvement and widespread distribution of brain pathways dedicated to vision.
Subject Adolescent; Athletes; Brain Concussion; Child; Child, Preschool; Female; Gait; Humans; Male; Neurologic Examination; Neuropsychological Tests; Postural Balance; Prospective Studies; ROC Curve; Universities; Vision Disorders; Young Adult
OCR Text Show
Format application/pdf
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
Setname ehsl_novel_jno
ID 227738
Reference URL https://collections.lib.utah.edu/ark:/87278/s62j9hxc/227738
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