A Better Concussion Test?

Concussions from sports activities are all over the news these days. This injury is particularly important when dealing with the developing brains of student athletes. Most organized sporting activities take advantage of existing concussion testing on the sidelines, such as the Standardized Assessment of Concussion test (SAC, a cognitive test), and the tandem gait test (balance). 

However, sports concussions frequently involve the visual pathways as well. In an effort to improve concussion recognition, a New York group studied the addition of a visual test (King-Devick test, K-D) to their concussion battery. A large group of youth and collegiate hockey and lacrosse players were evaluated at their baseline with K-D, SAC, and tandem gait. During games, athletes with potential concussions were tested on the sidelines. They were compared to non-concussed athletes who were also tested on the sidelines.

Here are the factoids:

  • 243 student athletes were studied, average age 11
  • 12 athletes sustained concussions, and their performance on the K-D test worsened significantly
  • The K-D test identified concussions better than the cognitive and balance tests

Bottom line: The addition of the King-Devick test appears to improve concussion identification in young athletes. In fact, it may be possible to use just this test alone. But practically speaking, it is probably better to use as part of a battery of tests to identify possible concussion after a significant impact. This enables coaches to minimize the number of players that might sustain additional injury and develop the risk for later sequelae of concussion. 

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Reference: Adding vision to concussion testing: a prospective study of sideline testing in youth and collegiate athletes. J Neuro-opthalmology 2015 Feb 18, epub ahead of print.