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Objectively Assessing Sports Concussion Utilizing Visual Evoked Potentials
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Relationship Between the King-Devick Test and Commonly Used Concussion Tests at Baseline.

James R Clugston1, Zachary M Houck2, Breton M Asken2

  • 1Department of Community Health and Family Medicine, Department of Neurology, and Division of Sports Health, University Athletic Association, University of Florida, Gainesville.

Journal of Athletic Training
|October 5, 2019
PubMed
Summary

The King-Devick (KD) test shows weak associations with cognitive measures like concentration and reaction time in sport-related concussion (SRC) evaluations. Other SRC assessments, including symptoms and balance, were unrelated to KD performance at baseline.

Keywords:
balancecognitionoculomotor evaluationrapid number namingsaccadessymptomsvestibular system

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Area of Science:

  • Neuroscience
  • Sports Medicine
  • Psychology

Background:

  • Sport-related concussion (SRC) requires comprehensive baseline assessments for accurate evaluation.
  • The unique contribution of the King-Devick (KD) test to SRC evaluations remains unclear.
  • Understanding the relationship between KD and other SRC tools is crucial for optimizing assessment protocols.

Purpose of the Study:

  • To determine the baseline relationships between the King-Devick (KD) test and other SRC assessments.
  • To investigate whether the KD test provides unique information within a multimodal SRC assessment framework.
  • To explore the overlap between KD performance and various cognitive, symptom, and physical measures in athletes.

Main Methods:

  • A cross-sectional study involving 2258 NCAA student-athletes from five institutions within the CARE Consortium.
  • Participants completed baseline assessments including the KD test, Symptom Inventory, Brief Symptom Inventory-18, Balance Error Scoring System, Standardized Assessment of Concussion (SAC), ImPACT test battery, and Vestibular/Ocular Motor Screening.
  • Correlation coefficients and multivariate linear regression analyses were used to assess the relationships between the KD test and other measures.

Main Results:

  • The Standardized Assessment of Concussion (SAC) concentration, ImPACT visual motor speed, and ImPACT reaction time were correlated with the KD test (ρ = -0.216, -0.276, and 0.164, respectively).
  • These cognitive measures explained 16.8% of the variance in baseline KD time (P < .001).
  • While better cognitive performance was associated with faster KD times, the effect sizes were small, indicating a weak association.

Conclusions:

  • Cognitive functions including concentration, visual motor speed, and reaction time demonstrate a weak association with baseline King-Devick (KD) test performance.
  • SRC assessments related to symptoms, psychological distress, balance, and vestibular-oculomotor function showed no significant relationship with KD performance.
  • The findings suggest limited overlap between the KD test and other comprehensive SRC assessments at baseline, highlighting the need for careful consideration of its role in multimodal evaluations.