Vision Test Improves Concussion Detection Sue Hughes March 05, 2014 A simple vision test performed on the sidelines can improve the identification of concussion in sports players who have experienced a head injury, a new study suggests. The visual pathways are commonly affected in concussion, said lead author, Laura Balcer, MD, New York University School of Medicine. Adding a vision-based test to evaluate athletes on the sidelines may allow us to better detect more athletes with concussion more quickly. This is particularly important since not all athletes reliably report their symptoms of concussion, including any vision problems. Coauthor James Clugston, MD, team physician, University of Florida Athletic Department, Gainesville, explained to Medscape Medical News, We have been doing standard tests based on balance symptoms and cognition tasks but we are not altogether sure that we are picking up subtle concussion injuries with these. So we have started using this vision test to see if we can improve detection rates. Sometimes, the athlete does not know they are concussed or they may hide symptoms so as to get back into the game quickly, so we are looking for a test to pick up concussions like this that may not have been identified before. The study will be presented at the American Academy of Neurology (AAN) 66th Annual Meeting in Philadelphia, April 26 to May 3, 2014. 100% Detection With Combination The King-Devick test involves the reading of a series of numbers from index cards or an iPad screen, and it takes about 1 minute. This is done at the start of the season as the baseline assessment. After injury the same set of tests are conducted — often on the side of the pitch — and if the time taken is longer than at baseline, then concussion is diagnosed. The test would be repeated every day until the baseline time was reached. Dr. Clugston noted that there was not a set reduction in score that was classified as concussion; rather, anything less than baseline should raise concern. After exercise, scores will usually be the same as or faster than baseline. Any slowing in the time taken to complete the tests was the definition of concussion used in this study. For the study, baseline data for 217 athletes aged 18 to 22 years playing on the University of Florida mens football, womens soccer, and womens lacrosse teams were collected. These included scores on the King-Devick vision test, along with the standard tests currently used: the Standardized Assessment of Concussion (SAC) and Balance Error Scoring System (BESS). The Post-Concussion Scale (PCS) was also used to assess symptom reporting. These tests were performed again after head injury, and analyses examined changes in scores from baseline to postinjury. Results showed that among 30 athletes with first concussion during their athletic season, 79% showed worsening of time scores in the King-Devick vision test. In contrast, the SAC test identified 52% of concussions and the BESS test picked up 70%. Combining the King-Devick vision test and SAC captured 89% of concussions, and using all 3 tests identified 100%. In addition, symptom severity scores on the PCS worsened from baseline with increases in King-Devick scores; among specific symptoms, light and noise sensitivities were particularly well correlated with worsening performance on the vision test. Baseline scores for the ImPACT testing visual motor speed subscore were also worse for athletes who required longer times to complete the King-Devick test at baseline. I do think this is enough to recommend this vision test be used routinely, Dr. Clugston commented. This test is less subjective than some of the other tests used currently. An assessment of balance is always very subjective, and cognition tests can be too. But the vision test just involves reading numbers from a screen as fast you can. It is very simple and less easily manipulated by the athlete. But it is best used in combination with the standard tests. The study was supported by the National Institutes of Health. American Academy of Neurology (AAN) 66th Annual Meeting, Philadelphia, April 26 to May 3, 2014. Abstract 1977. Medscape Medical News © 2014 WebMD, LLC
Posted on: Wed, 05 Mar 2014 18:42:40 +0000
Trending Topics
Recently Viewed Topics
© 2015