King-Devick testing and concussion recovery time in collegiate athletes

Area of Science:

• Sports Medicine
• Neurology
• Concussion Research

Background:

• Concussion diagnosis and prognosis remain challenging, particularly in distinguishing athletes with prolonged recovery.
• The King-Devick (KD) test, a rapid naming task, has shown potential in assessing cognitive function after head injury.
• Identifying reliable prognostic markers is crucial for guiding return to play (RTP) decisions and athlete management.

Purpose of the Study:

• To evaluate the King-Devick (KD) test's utility as a prognostic tool for concussion recovery.
• To examine the relationship between KD test performance (change from baseline and absolute post-injury score) and time to return to play (RTP).

Main Methods:

• A prospective cohort study involving collegiate varsity athletes within the Concussion Assessment, Research, and Education (CARE) Consortium.
• Baseline and post-injury KD tests were administered to 309 athletes diagnosed with concussion between 2014 and 2018.
• Cox proportional hazards models were used to analyze the association between KD test metrics and time to RTP.

Main Results:

• A total of 309 concussions were analyzed, with a median RTP of 11 days.
• Higher absolute post-injury KD scores, adjusted for baseline, showed a statistically significant association with longer RTP duration (HR: 0.99, p=0.03).
• The change in KD score from baseline to post-injury was less strongly associated with RTP duration (HR: 0.99, p=0.07).

Conclusions:

• Elevated post-injury King-Devick (KD) test scores are linked to extended recovery periods and longer return to play (RTP) times in collegiate athletes.
• The KD test demonstrates potential as a prognostic indicator for concussion recovery.
• Further research is recommended to validate the KD test's clinical utility for concussion prognostication.