Effects of Youth Football on Selected Clinical Measures of Neurologic Function

Abstract

We assessed 10 youth football players (13.4 ± 0.7 y) immediately before and after their season to explore the effects of football participation on selected clinical measures of neurologic function. Postseason postural stability in a closed-eye condition was improved compared to preseason (P = .017). Neurocognitive testing with the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery revealed that reaction time was significantly faster at postseason (P = .015). There were no significant preseason versus postseason differences in verbal memory (P = .507), visual memory (P = .750), or visual motor speed (P = .087). Oculomotor performance assessed by the King-Devick test was moderately to significantly improved (P = .047-.115). A 12-week season of youth football did not impair the postural stability, neurocognitive function, or oculomotor performance measures of the players evaluated. Though encouraging, continued and more comprehensive investigations of this at-risk population are warranted.

Adding Vision to Concussion Testing

“…Controls were in place to examine the potential role for fatigue or other factors related to play/practice on test scores in the absence of concussion. Previous studies of the K-D test have demonstrated that vigorous exercise/scrimmage alone is associated with improvements in scores, consistent with learning effects inherent in performance measures in the absence of injury (15,17).…”

“…Higher testing times compared with baseline indicate worsening of performance. Worsening scores are not observed after competition/fatigue alone (15); healthy athletes typically show improvement with exercise (15,17). Because shorter times are expected in nonconcussed athletes, any worsening of K-D scores from baseline is consistent with concussion.…”

“…Worsening of K-D times was associated with worsening SAC immediate memory scores (P , 0.001, R 2 = 0.62) (16). Studies have shown that K-D scores correlate with Immediate Post-Concussion Assessment and Cognitive Testing (IMPACT) subscores that are visual in nature (14,17,28). As an added benefit, the K-D test can accurately and easily be performed by non-medically trained observers, including parents of youth athletes (18).…”

“…The King-Devick (K-D) test requires intact saccades and other eye movements to perform quickly; literature to date on the K-D test has shown worsening of time scores from a preseason/competition baseline in 60+ concussed athletes (15,16). Given its simplicity (timed rapid number naming), rapid administration (,1 minute in collegiate athletes), and high test-retest reliability (ICC = 0.96-0.97) (16,17), the K-D test can be used by nonmedical personnel, including parents-frequently the only adults present on the sidelines for youth sports (18). Having a preseason baseline score for each athlete available in the event of a concussion adds to the simplicity of the K-D test; based on studies in multiple athlete cohorts to date, any worsening (slowing) of the time score from baseline should raise concern (14)(15)(16)(18)(19)(20)(21)(22).…”

Arterial Spin Labeling Magnetic Resonance Perfusion for Traumatic Brain Injury

“…In addition, there is mixed consensus regarding reported neuropsychological test results, as typified by reaction time measures and neuropsychological testing following exposure to subconcussive head blows in sports; for example, in adolescent sports (soccer and football), some authors report no measurable difference, [41][42][43][44][45][46][47] while others report changes following chronic HIE. [48][49][50][51][52][53] These disparities invite further debate regarding the value of such tests.…”