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Correlating the King-Devick Test With Vestibular/Ocular Motor Screening in Adolescent Patients With Concussion: A Pilot Study.
Sports Health 2018 Jul/Aug; 10(4):334-339SH

Abstract

BACKGROUND

The King-Devick (K-D) test is a rapid number-naming task that has been well validated as a sensitive sideline performance measure for concussion detection. Patients with concussion take significantly longer to complete the K-D test than healthy controls. Previous research suggests that ocular motor deficits, specifically saccadic abnormalities, may be an underlying factor for the prolonged time. However, these findings have not been studied at length.

HYPOTHESIS

K-D testing time of concussed adolescents at the initial clinical concussion visit will positively correlate with vestibular/ocular motor screening (VOMS) total scores.

STUDY DESIGN

Case series.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 71 patient charts were retrospectively analyzed between October 1, 2016, and January 31, 2017. Included charts consisted of patients between the ages of 10 and 18 years with a diagnosis of concussion and who had completed K-D testing and VOMS assessment at the initial physician visit. Univariate correlation between K-D testing time and the 7 VOMS items was assessed using Pearson correlation coefficients.

RESULTS

K-D testing time strongly correlated with all 7 VOMS items (r(69) = 0.325-0.585, P < 0.01). In a linear regression model that accounted for each VOMS item, the convergence (near point) item and the visual motion sensitivity item significantly predicted K-D testing time (β = 0.387, t(63) = 2.81, P < 0.01 and β = 0.375, t(63) = 2.35, P = 0.02, respectively). Additionally, 37.5% of the 24 patients with worsening symptoms after K-D testing freely reported increased visual problems.

CONCLUSION

Our study suggests that prolonged K-D testing times in adolescents with concussion may be related to subtypes of vestibular/ocular motor impairment that extend beyond saccadic abnormalities.

CLINICAL RELEVANCE

Poor K-D testing performance of adolescents with concussion may indicate a range of vestibular/ocular motor deficits that need to be further identified and addressed to maximize recovery.

Authors+Show Affiliations

Multiple Sclerosis Comprehensive Care Center, RWJBarnabas Health, Livingston, New Jersey.Matthew J. Morahan III Health Assessment Center for Athletes, RWJBarnabas Health, Livingston, New Jersey.Matthew J. Morahan III Health Assessment Center for Athletes, RWJBarnabas Health, Livingston, New Jersey.Matthew J. Morahan III Health Assessment Center for Athletes, RWJBarnabas Health, Livingston, New Jersey.Matthew J. Morahan III Health Assessment Center for Athletes, RWJBarnabas Health, Livingston, New Jersey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29553882

Citation

Russell-Giller, Shira, et al. "Correlating the King-Devick Test With Vestibular/Ocular Motor Screening in Adolescent Patients With Concussion: a Pilot Study." Sports Health, vol. 10, no. 4, 2018, pp. 334-339.
Russell-Giller S, Toto D, Heitzman M, et al. Correlating the King-Devick Test With Vestibular/Ocular Motor Screening in Adolescent Patients With Concussion: A Pilot Study. Sports Health. 2018;10(4):334-339.
Russell-Giller, S., Toto, D., Heitzman, M., Naematullah, M., & Shumko, J. (2018). Correlating the King-Devick Test With Vestibular/Ocular Motor Screening in Adolescent Patients With Concussion: A Pilot Study. Sports Health, 10(4), pp. 334-339. doi:10.1177/1941738118765450.
Russell-Giller S, et al. Correlating the King-Devick Test With Vestibular/Ocular Motor Screening in Adolescent Patients With Concussion: a Pilot Study. Sports Health. 2018;10(4):334-339. PubMed PMID: 29553882.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlating the King-Devick Test With Vestibular/Ocular Motor Screening in Adolescent Patients With Concussion: A Pilot Study. AU - Russell-Giller,Shira, AU - Toto,Diana, AU - Heitzman,Mike, AU - Naematullah,Mustafa, AU - Shumko,John, Y1 - 2018/03/19/ PY - 2018/3/20/pubmed PY - 2018/7/3/medline PY - 2018/3/20/entrez KW - King-Devick test KW - concussion KW - vestibular/ocular motor screening SP - 334 EP - 339 JF - Sports health JO - Sports Health VL - 10 IS - 4 N2 - BACKGROUND: The King-Devick (K-D) test is a rapid number-naming task that has been well validated as a sensitive sideline performance measure for concussion detection. Patients with concussion take significantly longer to complete the K-D test than healthy controls. Previous research suggests that ocular motor deficits, specifically saccadic abnormalities, may be an underlying factor for the prolonged time. However, these findings have not been studied at length. HYPOTHESIS: K-D testing time of concussed adolescents at the initial clinical concussion visit will positively correlate with vestibular/ocular motor screening (VOMS) total scores. STUDY DESIGN: Case series. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 71 patient charts were retrospectively analyzed between October 1, 2016, and January 31, 2017. Included charts consisted of patients between the ages of 10 and 18 years with a diagnosis of concussion and who had completed K-D testing and VOMS assessment at the initial physician visit. Univariate correlation between K-D testing time and the 7 VOMS items was assessed using Pearson correlation coefficients. RESULTS: K-D testing time strongly correlated with all 7 VOMS items (r(69) = 0.325-0.585, P < 0.01). In a linear regression model that accounted for each VOMS item, the convergence (near point) item and the visual motion sensitivity item significantly predicted K-D testing time (β = 0.387, t(63) = 2.81, P < 0.01 and β = 0.375, t(63) = 2.35, P = 0.02, respectively). Additionally, 37.5% of the 24 patients with worsening symptoms after K-D testing freely reported increased visual problems. CONCLUSION: Our study suggests that prolonged K-D testing times in adolescents with concussion may be related to subtypes of vestibular/ocular motor impairment that extend beyond saccadic abnormalities. CLINICAL RELEVANCE: Poor K-D testing performance of adolescents with concussion may indicate a range of vestibular/ocular motor deficits that need to be further identified and addressed to maximize recovery. SN - 1941-0921 UR - https://www.unboundmedicine.com/medline/citation/29553882/Correlating_the_King-Devick_Test_With_Vestibular/Ocular_Motor_Screening_in_Adolescent_Patients_With_Concussion:_A_Pilot_Study L2 - http://journals.sagepub.com/doi/full/10.1177/1941738118765450?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -