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 "In the youth leagues in particular, when there may not be doctors
or athletic trainers on the sidelines when a kid gets hit, this
enables parents with proper training to participate in the
preliminary assessment of concussions," said study author Dr. Steven
Galetta, a researcher at New York University Langone Concussion
Center. "It's so affordable and easy to administer that any coach or
parent could use it to determine when an injured child can return to
the game and when they need to sit out."
Many injured athletes currently get a standard concussion
assessment. These evaluations test coordination, using exercises
like jumping jacks, and memory and cognitive function by asking
athletes to memorize and recall short lists of words and quizzing
them about simple facts like the date or the name of the president.
The current study focuses on an exam, the King-Devick test, that
requires speed reading numbers on a card from left to right as
quickly as possible. Numbers are arranged in pattens that are harder
to read after a concussion, making the answers slower and less
accurate after an injury.
At the start of the study, researchers tested 243 youth league
hockey and lacrosse players, ranging in age from 5 to 17, and 89
college athletes, to see how quickly and accurately they could read
the numbers on the cards.
Later in the season, the researchers repeated the eye exams on 12 of
those players who had concussions. Screened on the sidelines, these
athletes' average time on the test was 5.2 seconds slower than the
average time before the concussion.
But among 14 athletes who repeated the test after a game, but who
hadn’t been injured, the average time on the test was 6.4 seconds
faster than before, the researchers reported in the Journal of Neuro-Ophthalmology.
"A lay person can see if a kid gets hit, and then it's standard for
them to remain out for that game, but this test gives you a way to
measure the injuries you might not see and decide what to do when
the kid says they're good to go back in the game and you don't know
what really happened," said Dr. Laura Balcer, another author on the
study and co-director of the concussion center at NYU.
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The NYU researchers did a separate study looking at how concussions
impact sight and found that visual performance tests can improve
detection and management of concussions. Approximately half of the
brain's circuits are related to vision and many of these pathways
can be damaged by a concussion, the researchers found.
One advantage of the rapid vision test used in the study is that
it's easy to administer with relatively little training, said Dr.
Robert Dimeff, director of primary care sports medicine at the
University of Texas Southwestern Medical Center in Dallas.
The hardest thing to control for in this test is the kids, he said.
"You worry with a test like this that there will be some athletes
who might go deliberately slower at baseline if they know it will be
used against them to be pulled out of a game later," said Dimeff,
who wasn't involved in the study.
"This vision test is one piece of the puzzle, not the only piece,"
Dimeff said. "For the 11-year-old youth league where you don't have
any health professionals on the sidelines, it can help."
SOURCE: http://bit.ly/1Cdqlin Journal of Neuro-Ophthalmology, online
February 18, 2015.
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