Use of the King–Devick test for sideline concussion screening in junior rugby league

D, King; Hume, Patria A.; Gissane, Conor; Clark, Trevor

doi:10.1016/j.jns.2015.06.069

Cited by 65 publications

(54 citation statements)

References 46 publications

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“…It has been shown to be associated with medically diagnosed concussion, the ImPACT battery, and other markers of concussion. 10,11,16–19 It has been used at the boxing ringside, on the sideline at football games, and the rugby pitch among other venues. 10,11,16–19 Testing has also been accomplished by both parents and lay personnel.…”

Section: Discussionmentioning

confidence: 99%

“…10,11,16–19 It has been used at the boxing ringside, on the sideline at football games, and the rugby pitch among other venues. 10,11,16–19 Testing has also been accomplished by both parents and lay personnel. 19 In this study, we were able to effectively administer the KD test to an adolescent population in the setting of a mass athlete screening.…”

Section: Discussionmentioning

confidence: 99%

“…In a study of junior rugby players (mean aged 10 years), greater than 3 seconds was associated with concussion with the average slowing over 7 seconds. 11 Many of these studies show prolonged retest times well beyond any question of a true difference. The minimum times reported are, however, quite near the smallest real difference we note.…”

Section: Discussionmentioning

confidence: 99%

“…9 More recently, the KD has been studied as a remove-from-play sideline test in college-age athletes and older; however, studies in junior high and high school athletes are limited. 10–11 If the test is to be used as part of sideline assessment, an understanding of the psychometric properties of the test under the conditions it is likely to be employed and its association with other vision function measures in this age group are needed. The purpose of this project was to assess the repeatability of the King Devick test in the setting of mass athletic screening in high school and junior high athletes.…”

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confidence: 99%

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King-Devick and Pre-season Visual Function in Adolescent Athletes

et al. 2017

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Purpose The King-Devick Test (KD) has been studied as a remove-from-play sideline test in college-age athletes and older; however, studies in younger athletes are limited. A cross-sectional study of the KD and other vision correlates was completed on school-aged athletes during pre-season physicals for a variety of sports to determine the repeatability of the KD. The study also evaluated how convergence, alignment, or pupil function contributed to a slower King-Devick baseline reading. Methods 785 athletes underwent vision screenings in a hospital or school setting by trained/certified staff as part of pre-season physicals. 619 had KD testing completed per the manufacturer’s suggested protocol and repeated. Other baseline vision testing included visual acuity, Modified Thorington testing for alignment, convergence testing, and pupil function using the NeurOptics (NPI-200) NPi. Results The mean fastest, error-minimized KD time for all participants was 43.9 seconds(s) (sd±11.6, range 24–120). Median KD time got faster (+) with age (p <.0001). The inter-class correlation coefficient for all scores was 0.92. The absolute mean time difference for any two tests was 3.5s (sd±2.5, range 0–23). There was no association between the best KD time and reduced NPC (p=0.63), Modified Thorington measure of alignment (p = 0.55), or NPi pupil function (p=0.79). The Bland Altman repeated measure limits of agreement was ±6.5s for those in the 10th–12th grades, and ±10.2s for those in 6th–9th grades. Conclusions King-Devick score in junior high and high-school athletes is variable but gets faster and more repeatable with increasing age. The KD does not correlate significantly with reduced convergence, alignment, or pupil function. Based on grouped data, a slowing of 10 seconds for younger athletes and 6 seconds for older athletes on a second administration represents a true difference in testing speed. Within-player variability should be considered when removal-from-play decisions are influenced by KD results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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King-Devick and Pre-season Visual Function in Adolescent Athletes

et al. 2017

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“…It can be administered by non-physician personnel or even sports parents. It was originally designed to assess reading ability, 23 though its use has extended to the detection of various neurological conditions, including concussion, 24,25 Parkinson’s disease, 26 and multiple sclerosis. 27 However, to date, no published study has examined the K-D as a screening tool for MCI or AD dementia.…”

Section: Introductionmentioning

confidence: 99%

Screening Utility of the King-Devick Test in Mild Cognitive Impairment and Alzheimer Disease Dementia

Galetta

Chapman

Essis

et al. 2017

Alzheimer Disease &Amp; Associated Disorders

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The King-Devick Test (K-D) is a 1–2-minute, rapid number naming test, often used to assist with detection of concussion, but also has clinical utility in other neurological conditions (e.g., Parkinson’s disease). The K-D involves saccadic eye and other eye movements, and abnormalities thereof may be an early indicator of Alzheimer’s disease (AD)-associated cognitive impairment. No study has tested the utility of the K-D in AD and we sought to do so. The sample included 206 (135 controls, 39 MCI, and 32 AD dementia) consecutive subjects from the Boston University Alzheimer’s Disease Center registry undergoing their initial annual evaluation between March 2013 and July 2015; the timeframe the K-D was administered. Areas under the receiver operating characteristic (ROC) curves generated from logistic regression models revealed the K-D test distinguished controls from subjects with cognitive impairment (MCI and AD dementia) (AUC=0.72), MCI (AUC=0.71) and AD dementia (AUC=0.74). K-D time scores between 48 and 52 seconds were associated with high sensitivity (>90.0%) and negative predictive values (>85.0%) for each diagnostic group. The K-D correlated strongly with validated attention, processing speed, and visual scanning tests. The K-D test may be a rapid and simple effective screening tool to detect cognitive impairment associated with AD.

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Neuro-Ophthalmologic Response to Repetitive Subconcussive Head Impacts

et al. 2020

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IMPORTANCE Subconcussive head impacts have emerged as a complex public health concern. The oculomotor system is sensitive to brain trauma; however, neuro-ophthalmologic response to subconcussive head impacts remains unclear.OBJECTIVE To examine whether subconcussive head impacts cause impairments in neuro-ophthalmologic function as measured by the King-Devick test (KDT) and oculomotor function as measured by the near point of convergence. DESIGN, SETTING, AND PARTICIPANTSIn this randomized clinical trial, adult soccer players were randomized into either a heading group or kicking (control) group. The heading group executed 10 headers with soccer balls projected at a speed of 25 mph. The kicking-control group followed the same protocol but with 10 kicks. Peak linear and rotational head accelerations were assessed with a triaxial accelerometer. The KDT speed and error and near point of convergence were assessed at baseline (preheading or prekicking) and at 0, 2, and 24 hours after heading or kicking.EXPOSURES Ten soccer-ball headings or kicks. MAIN OUTCOMES AND MEASURESThe primary outcome was the group-by-time interaction of KDT speed at 0 hours after heading or kicking. The secondary outcomes included KDT speed at 2 hours and 24 hours after heading or kicking, KDT error, and near point of convergence.RESULTS A total of 78 individuals enrolled (heading group, n = 40; kicking-control group, n = 38). Eleven individuals (heading group: 4 women; mean [SD] age, 22.5 [1.0] years; kicking-control group, 3 women and 4 men; mean [SD] age, 20.9 [1.1] years) voluntarily withdrew from the study. Data from 67 participants with a mean (SD) age of 20.6 (1.7) years were eligible for analysis (heading, n = 36; kicking-control, n = 31). Mean (SD) peak linear accelerations and peak rotational accelerations per impact for the heading group were 33.2 (6.8) g and 3.6 (1.4) krad/s 2 , respectively. Conversely, soccer kicking did not induce a detectable level of head acceleration. Both groups showed improvements in KDT speed (heading group: 0

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Use of the King–Devick test for sideline concussion screening in junior rugby league

Cited by 65 publications

References 46 publications

King-Devick and Pre-season Visual Function in Adolescent Athletes

King-Devick and Pre-season Visual Function in Adolescent Athletes

Screening Utility of the King-Devick Test in Mild Cognitive Impairment and Alzheimer Disease Dementia

Neuro-Ophthalmologic Response to Repetitive Subconcussive Head Impacts

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