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Vladimir Yevseyenkov, Kirk Kaupke, Shawn Lebsock, Matthew Kaminsky; Concussion Screening in High School Football Using the King-Devick Test. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2344.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effectiveness of the King-Devick (KD) test, a screening which evaluates saccadic eye movements, to identify football players who may have sustained a concussion during play. Secondary outcomes include evaluating whether performance of KD testing increases awareness of concussion in high School football players.
Forty seven high school football players ranging from freshmen to senior grade levels and all play levels were given a baseline KD test prior to beginning of the 2012 football season. Each student also filled out a survey gauging their level of awareness of concussion signs and symptoms. During the season, three varsity-level players sustained concussions on-field. Each of these players had the KD test performed within thirty minutes of impact. The concussion diagnosis was confirmed by a neurologist within days of the on-field incident. At the end of the season, the KD test was again administered to all students. Students also took a post-season survey which was identical to the one they took prior to the start of the season to gauge their awareness of concussion.
There was very little variance in athletes who did not have concussion when comparing pre- and post-season testing with LOA of 95% and confidence intervals of 95%. Test-retest reliability was analyzed using intraclass correlation coefficients (ICC) between baseline and end of the season data, showing correlation of 0.873 with significance of p < 0.05. The three football players whose concussion diagnosis was confirmed by a neurologist did in fact demonstrate diminished KD test performance times within thirty minutes of the on-field injury. Times were diminished by 41% in student 1, 100% in student 2, and 143% in student 3. Regarding the knowledge of concussions survey administered pre- and post-season, paired sample t-tests showed p > 0.05 significance for the question “I would say that my current knowledge level of concussions is very high.” Therefore, it is evident that the football students level of awareness of concussion significantly increased throughout the season.
This study showed that the King-Devick Test can potentially be used as a rapid sideline tool to identify athletes who have potential concussion in a time period of under one minute. A rapid sideline screening test for concussions in high school athletes could assist in recognizing whether an athlete is safe to return to play.
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