Sideline assessment tools are an important component of concussion evaluations. To date, there has been little data evaluating the clinical utility of these tests in professional football. The purpose of this study was to evaluate the clinical utility of the King-Devick (K-D) test in evaluating concussions in professional football players. Baseline data was collected over two consecutive seasons in the Canadian Football League as part of a comprehensive medical baseline evaluation. A pilot study with the K-D test began in 2015 with 306 participants and the next year (2016) there were 917 participants. In addition, a sample of 64 participants completed testing after physical exertion (practice or game). Participants with concussion demonstrated significantly higher (slower) results compared with baseline and the exercise group (F[2,211] = 5.94; p = 0.003). The data revealed a specificity of 84% and sensitivity of 62% for our sample. Reliability from season to season was good (intraclass correlation coefficient [ICC] 2,1 = 0.88; 95% confidence interval [CI]: 0.83, 0.91). On average, participants improved performances by a mean of 1.9 sec (range, -26.6 to 23.8) in subsequent years. High reliability was attained in the exercise group. (ICC2,1 = 0.93; 95% CI: 0.89, 0.96). The K-D test presents as a reliable measure although sensitivity and specificity data from our sample indicate it should be used in conjunction with other measures for diagnosing concussion. Further research is required to identify stability of results over multiple usages.
Damage to the temporal-parietal cortex in the right hemisphere often leads to spatial neglect – a disorder in which patients are unable to attend to sensory input from their contralesional (left) side. Neglect has been associated with both attentional and premotor deficits. That is, in addition to having difficulty with attending to the left side, patients are often slower to initiate leftward vs. rightward movements (i.e., directional hypokinesia). Previous research has indicated that a brief period of adaptation to rightward shifting prisms can reduce symptoms of neglect by adjusting the patient’s movements leftward, towards the neglected field. Although prism adaptation has been shown to reduce spatial attention deficits in patients with neglect, very little work has examined the effects of prisms on premotor symptoms. In the current study, we examined this in healthy individuals using leftward shifting prisms to induce a rightward shift in the egocentric reference frame, similar to neglect patients prior to prism adaptation. Specifically, we examined the speed with which healthy participants initiated leftward and rightward reaches (without visual feedback) prior to and following adaptation to either 17° leftward (n=16) or 17° rightward (n=15) shifting prisms. Our results indicated that, following adaptation, participants were significantly faster to initiate reaches towards targets located in the direction opposite the prism shift. That is, participants were faster to initiate reaches to right targets following leftward prism adaptation, and were faster to initiate reaches to left targets following rightward prism adaptation. Overall these results are consistent with the idea that prism adaptation can influence the speed with which a reach can be planned toward a target in the direction opposite the prism shift, possibly through altering activity in neural circuits involved in reach planning.
ObjectiveTo evaluate psychometric properties of the Sport Concussion Assessment Tool (SCAT).DesignRetrospective clinical study in which athletes completed the SCAT over 2 consecutive seasons. Athletic therapists administered the SCAT and a pre-season medical questionnaire.SettingUniversity setting.Participants165 college athletes who were enrolled at a university in Western Canada who played collision sports.Interventionthe SCAT2 and subsequently the SCAT3 was administered to all participants at baseline.Main outcome measuresIntraclass coefficients (ICC’s) and paired sample t-tests.Main resultsThe intraclass reliability coefficients for demographic variables ranged from moderate to good (0.66 to 0.94). The reliability of the cognitive test results and balance error scoring system (BESS) was rated as good (0.83 and 0.88 respectively). Total symptom report and symptom severity report was moderate, with significant differences noted between males and females. History of concussion did not significantly impact reliability coefficients. Among the 22 athletes who suffered concussions during a competitive season, the reliability of the core components of the SCAT remained high.ConclusionsThe reliability of the SCAT2/3 is classified as good although symptom report is more variableCompeting interestsNone.Keywords: concussion, sport concussion assessment tool, psychometric properties
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