Current Research
Saccades and Memory: Baseline associations of the King-Devick and SCAT2 SAC tests in professional ice hockey players
Journal of the Neurological Sciences. May15, 2013; 328(1-2): 28-31.
Objective
The Sports Concussion Assessment Tool 2 (SCAT2) and King-Devick (K-D) tests have both been proposed as sideline tools to detect sports-related concussion. We performed an exploratory analysis to determine the relation of SCAT2 components, particularly the Standardized Assessment of Concussion (SAC), to K-D test scores in a professional ice hockey team cohort during pre-season baseline testing. We also examined changes in scores for two athletes who developed concussion and had rinkside testing.
Methods
A modified SCAT2 (no balance testing) and the K-D test, a brief measure of rapid number naming, were administered to 27 members of a professional ice hockey team during the 2011-2012 pre-season. Athletes with concussion also underwent rinkside testing.
Results
Lower (worse) scores for the SCAT2 SAC Immediate Memory Score and the overall SAC score were associated with greater (worse) times required to complete the K-D test at baseline. On average, for every 1-point reduction in SAC Immediate Memory Score, we found a corresponding increase (worsening) of K-D time score of 7.3s (95% CI 4.9, 9.7 p < 0.001, R2 = 0.62, linear regression, accounting for age). For the overall SAC score, 1-point reductions were associated with K-D score worsening of 2.2s (95% CI 0.6, 3.8, p = 0.01, R2 = 0.25, linear regression). In two players tested rinkside immediately following concussion, K-D test scores worsened from baseline by 4.2 and 6.4s. These athletes had no differences found for SCAT2 SAC components, but reported symptoms of concussion.
Conclusion
In this study of professional athletes, scores for the K-D test, a measure for which saccadic (fast) eye movements are required for the task of rapid number naming, were associated with reductions in Immediate Memory at a pre-season baseline. Both working memory and saccadic eye movements share closely related anatomical structures, including the dorsolateral prefrontal cortex (DLPFC). A composite of brief rapid sideline tests, including SAC and K-D (and balance testing for non-ice hockey sports), is likely to provide an effective clinical tool to assess the athlete with suspected concussion.
Further Reading
Read the whole study at the Journal of the Neurological Sciences
Objective
The Sports Concussion Assessment Tool 2 (SCAT2) and King-Devick (K-D) tests have both been proposed as sideline tools to detect sports-related concussion. We performed an exploratory analysis to determine the relation of SCAT2 components, particularly the Standardized Assessment of Concussion (SAC), to K-D test scores in a professional ice hockey team cohort during pre-season baseline testing. We also examined changes in scores for two athletes who developed concussion and had rinkside testing.
Methods
A modified SCAT2 (no balance testing) and the K-D test, a brief measure of rapid number naming, were administered to 27 members of a professional ice hockey team during the 2011-2012 pre-season. Athletes with concussion also underwent rinkside testing.
Results
Lower (worse) scores for the SCAT2 SAC Immediate Memory Score and the overall SAC score were associated with greater (worse) times required to complete the K-D test at baseline. On average, for every 1-point reduction in SAC Immediate Memory Score, we found a corresponding increase (worsening) of K-D time score of 7.3s (95% CI 4.9, 9.7 p < 0.001, R2 = 0.62, linear regression, accounting for age). For the overall SAC score, 1-point reductions were associated with K-D score worsening of 2.2s (95% CI 0.6, 3.8, p = 0.01, R2 = 0.25, linear regression). In two players tested rinkside immediately following concussion, K-D test scores worsened from baseline by 4.2 and 6.4s. These athletes had no differences found for SCAT2 SAC components, but reported symptoms of concussion.
Conclusion
In this study of professional athletes, scores for the K-D test, a measure for which saccadic (fast) eye movements are required for the task of rapid number naming, were associated with reductions in Immediate Memory at a pre-season baseline. Both working memory and saccadic eye movements share closely related anatomical structures, including the dorsolateral prefrontal cortex (DLPFC). A composite of brief rapid sideline tests, including SAC and K-D (and balance testing for non-ice hockey sports), is likely to provide an effective clinical tool to assess the athlete with suspected concussion.
Further Reading
Read the whole study at the Journal of the Neurological Sciences
The King-Devick Test as a Determinant of Head Trauma and Concussion in Boxers and MMA Fighters
Neurology. April 26, 2011; 76(17): 1456-62.
Objective
Sports-related concussion has received increasing attention as a cause of short- and long-term neurologic symptoms among athletes. The King-Devick Test is based on measurement of the speed of rapid number naming (reading aloud single digit numbers from three test cards), and captures impairment of eye movements, attention, language, and other correlates of suboptimal brain function. We investigated the King-Devick Test as a potential rapid sideline screening for concussion in a cohort of boxers and mixed martial arts (MMA) fighters.
Methods
The K-D test was administered prefight and postfight. The Military Acute Concussion Evaluation (MACE) was administered as a more comprehensive but longer test for concussion. Differences in postfight K-D scores and changes in scores from prefight to postfight were compared for athletes with head trauma during the fight vs those without.
Results
Postfight K-D scores (n=39 participants) were significantly higher (worse) for those with head trauma during the match (59.1+/- 7.4 vs 41.0 +/- 6.7 seconds, p<0.0001, Wilcoxon rank sum test). Those with loss of consciousness showed the greatest worsening from prefight to post fight. Worse post fight K-D scores (rs= -0.79, p=0.0001) and greater worsening of scores (rs= 0.90, p<0.0001) correlated well with post fight MACE scores. Worsening of K-D scores by >/= 5 seconds was a distinguishing characteristic noted only among participants with head trauma. High levels of test-retest reliability were observed (intraclass correlation coefficient 0.97 [95% confidence interval 0.90-1.0]).
Conclusions
The King-Devick Test is an accurate and reliable method for identifying athletes with head trauma, and is a strong candidate rapid sideline screening test for concussion.
Further Reading
Read the whole study at Neurology
Objective
Sports-related concussion has received increasing attention as a cause of short- and long-term neurologic symptoms among athletes. The King-Devick Test is based on measurement of the speed of rapid number naming (reading aloud single digit numbers from three test cards), and captures impairment of eye movements, attention, language, and other correlates of suboptimal brain function. We investigated the King-Devick Test as a potential rapid sideline screening for concussion in a cohort of boxers and mixed martial arts (MMA) fighters.
Methods
The K-D test was administered prefight and postfight. The Military Acute Concussion Evaluation (MACE) was administered as a more comprehensive but longer test for concussion. Differences in postfight K-D scores and changes in scores from prefight to postfight were compared for athletes with head trauma during the fight vs those without.
Results
Postfight K-D scores (n=39 participants) were significantly higher (worse) for those with head trauma during the match (59.1+/- 7.4 vs 41.0 +/- 6.7 seconds, p<0.0001, Wilcoxon rank sum test). Those with loss of consciousness showed the greatest worsening from prefight to post fight. Worse post fight K-D scores (rs= -0.79, p=0.0001) and greater worsening of scores (rs= 0.90, p<0.0001) correlated well with post fight MACE scores. Worsening of K-D scores by >/= 5 seconds was a distinguishing characteristic noted only among participants with head trauma. High levels of test-retest reliability were observed (intraclass correlation coefficient 0.97 [95% confidence interval 0.90-1.0]).
Conclusions
The King-Devick Test is an accurate and reliable method for identifying athletes with head trauma, and is a strong candidate rapid sideline screening test for concussion.
Further Reading
Read the whole study at Neurology
The King–Devick Test and Sports-Related Concussion: Study of a Rapid Visual Screening Tool in a Collegiate Cohort
Journal of the Neurological Sciences. October 15, 2011; 309(1-2): 34-9.
Objective
Concussion, defined as an impulse blow to the head or body resulting in transient neurologic signs or symptoms, has received increasing attention in sports at all levels. The King–Devick (K–D) test is based on the time to perform rapid number naming and captures eye movements and other correlates of suboptimal brain function. In a study of boxers and mixed martial arts (MMA) fighters, the K–D test was shown to have high degrees of test–retest and inter-rater reliability and to be an accurate method for rapidly identifying boxers and mixed martial arts fighters with concussion. We performed a study of the K–D test as a rapid sideline screening tool in collegiate athletes to determine the effect of concussion on K–D scores compared to a pre-season baseline.
Methods
In this longitudinal study, athletes from the University of Pennsylvania varsity football, sprint football, and women's and men's soccer and basketball teams underwent baseline K–D testing prior to the start of the 2010–11 playing season. Post-season testing was also performed. For athletes who had concussions during the season, K–D testing was administered immediately on the sidelines and changes in score from baseline were determined.
Results
Among 219 athletes tested at baseline, post-season K–D scores were lower (better) than the best pre-season scores (35.1 vs. 37.9 s, P = 0.03, Wilcoxon signed-rank test), reflecting mild learning effects in the absence of concussion. For the 10 athletes who had concussions, K–D testing on the sidelines showed significant worsening from baseline (46.9 vs. 37.0 s, P = 0.009), with all except one athlete demonstrating worsening from baseline (median 5.9 s).
Conclusion
This study of collegiate athletes provides initial evidence in support of the K–D test as a strong candidate rapid sideline visual screening tool for concussion. Data show worsening of scores following concussion, and ongoing follow-up in this study with additional concussion events and different athlete populations will further examine the effectiveness of the K–D test.
Further Reading
Read the whole study at the Journal of the Neurological Sciences
Objective
Concussion, defined as an impulse blow to the head or body resulting in transient neurologic signs or symptoms, has received increasing attention in sports at all levels. The King–Devick (K–D) test is based on the time to perform rapid number naming and captures eye movements and other correlates of suboptimal brain function. In a study of boxers and mixed martial arts (MMA) fighters, the K–D test was shown to have high degrees of test–retest and inter-rater reliability and to be an accurate method for rapidly identifying boxers and mixed martial arts fighters with concussion. We performed a study of the K–D test as a rapid sideline screening tool in collegiate athletes to determine the effect of concussion on K–D scores compared to a pre-season baseline.
Methods
In this longitudinal study, athletes from the University of Pennsylvania varsity football, sprint football, and women's and men's soccer and basketball teams underwent baseline K–D testing prior to the start of the 2010–11 playing season. Post-season testing was also performed. For athletes who had concussions during the season, K–D testing was administered immediately on the sidelines and changes in score from baseline were determined.
Results
Among 219 athletes tested at baseline, post-season K–D scores were lower (better) than the best pre-season scores (35.1 vs. 37.9 s, P = 0.03, Wilcoxon signed-rank test), reflecting mild learning effects in the absence of concussion. For the 10 athletes who had concussions, K–D testing on the sidelines showed significant worsening from baseline (46.9 vs. 37.0 s, P = 0.009), with all except one athlete demonstrating worsening from baseline (median 5.9 s).
Conclusion
This study of collegiate athletes provides initial evidence in support of the K–D test as a strong candidate rapid sideline visual screening tool for concussion. Data show worsening of scores following concussion, and ongoing follow-up in this study with additional concussion events and different athlete populations will further examine the effectiveness of the K–D test.
Further Reading
Read the whole study at the Journal of the Neurological Sciences
Use of a rapid visual screening tool for the assessment of concussion in amateur rugby league: A pilot study
Journal of the Neurological Sciences. September 15, 2012; 320(1-2): 16-21.
Aim
This study undertook to use the K-D sideline test with the SCAT2 to see if concussions could be identified in amateur rugby league players over a representative competition period.
Method
A prospective cohort study was conducted on two teams participating in an amateur rugby league. All players were tested for signs of concussion utilising the K-D test and players with longer times than their baseline scores undertook a further concussion assessment with the SCAT2.
Results
Five athletes with suspected concussion were evaluated by K-D testing. Three concussions were associated with witnessed events during the matches and two athletes were identified by the team medic as having longer K-D time scores incidentally post-match compared to baseline. Post-match K-D scores for all concussed athletes were worse than baseline for those with reported or witnessed concussion events (7 s; 5.0–7.1; p = 0.025) and for those identified incidentally (> 5 s; 8.9–9.1 s). Both groups also reported more symptoms on the PCSS (a part of the SCAT2) post-match.
Discussion
In this rugby cohort, the K-D test was not only useful in identifying changes in players with witnessed head trauma, but in identifying changes in players with an un-witnessed suspected concussion.
Further Reading
Read the whole study at the Journal of the Neurological Sciences
Aim
This study undertook to use the K-D sideline test with the SCAT2 to see if concussions could be identified in amateur rugby league players over a representative competition period.
Method
A prospective cohort study was conducted on two teams participating in an amateur rugby league. All players were tested for signs of concussion utilising the K-D test and players with longer times than their baseline scores undertook a further concussion assessment with the SCAT2.
Results
Five athletes with suspected concussion were evaluated by K-D testing. Three concussions were associated with witnessed events during the matches and two athletes were identified by the team medic as having longer K-D time scores incidentally post-match compared to baseline. Post-match K-D scores for all concussed athletes were worse than baseline for those with reported or witnessed concussion events (7 s; 5.0–7.1; p = 0.025) and for those identified incidentally (> 5 s; 8.9–9.1 s). Both groups also reported more symptoms on the PCSS (a part of the SCAT2) post-match.
Discussion
In this rugby cohort, the K-D test was not only useful in identifying changes in players with witnessed head trauma, but in identifying changes in players with an un-witnessed suspected concussion.
Further Reading
Read the whole study at the Journal of the Neurological Sciences
Sports-Related Concussion Testing
Current Neurology & Neuroscience Reports. October 2012, Volume 12, Issue 5, pp 547-559.
Abstract
Due to the recent focus on concussion in sports, a number of tests have been developed to diagnose and manage concussion. While each test measures different brain functions, no single test has been shown to quickly and reliably assess concussion in all cases. In addition, most of the current concussion tests have not been validated by scientific investigation. This review identifies the pros and cons of the most commonly used noninvasive tests for concussion in order to provide a more complete picture of the resources that are available for concussion testing. The potential utility of research tools such as the head impact telemetry system, advanced magnetic resonance imaging protocols, and biomarkers are discussed in the context of the currently employed tools.
Further Reading
Read the whole study at the Current Neurology & Neuroscience Reports
Abstract
Due to the recent focus on concussion in sports, a number of tests have been developed to diagnose and manage concussion. While each test measures different brain functions, no single test has been shown to quickly and reliably assess concussion in all cases. In addition, most of the current concussion tests have not been validated by scientific investigation. This review identifies the pros and cons of the most commonly used noninvasive tests for concussion in order to provide a more complete picture of the resources that are available for concussion testing. The potential utility of research tools such as the head impact telemetry system, advanced magnetic resonance imaging protocols, and biomarkers are discussed in the context of the currently employed tools.
Further Reading
Read the whole study at the Current Neurology & Neuroscience Reports
Concussions in amateur rugby union identified with the use of a rapid visual screening tool
Journal of the Neurological Sciences. January 29 2013. pii S0022-510X(13)00014-2. doi: 10.1016/j.jns.2013.01.012. [Epub ahead of print].
Aim
To use the King-Devick (KD) test and Sports Concussion Assessment Tool 2 (SCAT2) in amateur rugby union players to identify witnessed and unrecognized episodes of concussion that occurred from match participation.
Methods
A prospective observational cohort study was conducted on a premier club level amateur rugby union team during the 2012 competition in New Zealand. Every player completed a pre-competition questionnaire on concussion history, a baseline PCSS and two trials of the KD before the participated in any match activities.
Results
For players reporting a concussion in the previous three years there was an average of 4.0 +/- 2.8 concussions per player. There were 22 concussive incidents recorded over the duration of the competition (46 per 1000 match hours). Five concussive incidents were witnessed (11 per 1000 match hours) and 17 unrecognized concussive incidents were identified with the KD (37 per 1000 match hours). Witnessed concussions recorded, on average, a longer KD on the day of the injury (5.5 +/- 2.4 s) than unrecognized concussions (4.4 +/- 0.9 s) when compared with their baseline KD.
Discussion
The KD was able to identify players that had not shown, or reported, any signs or symptoms of a concussion but who had meaningful head injury. The current rate of concussion reported was a ten-fold increase in previously reported concussion injury rates. This makes the KD suitable for rapid assessment in a limited time frame on the sideline such as a five-minute window to assess and review suspected concussed players in rugby union.
Further Reading
Read the whole study at the Journal of the Neurological Sciences
Aim
To use the King-Devick (KD) test and Sports Concussion Assessment Tool 2 (SCAT2) in amateur rugby union players to identify witnessed and unrecognized episodes of concussion that occurred from match participation.
Methods
A prospective observational cohort study was conducted on a premier club level amateur rugby union team during the 2012 competition in New Zealand. Every player completed a pre-competition questionnaire on concussion history, a baseline PCSS and two trials of the KD before the participated in any match activities.
Results
For players reporting a concussion in the previous three years there was an average of 4.0 +/- 2.8 concussions per player. There were 22 concussive incidents recorded over the duration of the competition (46 per 1000 match hours). Five concussive incidents were witnessed (11 per 1000 match hours) and 17 unrecognized concussive incidents were identified with the KD (37 per 1000 match hours). Witnessed concussions recorded, on average, a longer KD on the day of the injury (5.5 +/- 2.4 s) than unrecognized concussions (4.4 +/- 0.9 s) when compared with their baseline KD.
Discussion
The KD was able to identify players that had not shown, or reported, any signs or symptoms of a concussion but who had meaningful head injury. The current rate of concussion reported was a ten-fold increase in previously reported concussion injury rates. This makes the KD suitable for rapid assessment in a limited time frame on the sideline such as a five-minute window to assess and review suspected concussed players in rugby union.
Further Reading
Read the whole study at the Journal of the Neurological Sciences
Find The King-Devick Test That Is Right For You
King-Devick Test
Quickly and easily administer King-Devick Test anytime and anywhere with our Physical Test. All you need is the athlete’s baseline, a King-Devick Test score sheet, and a stopwatch (timer or smartphone).
Quickly and easily administer King-Devick Test anytime and anywhere with our Physical Test. All you need is the athlete’s baseline, a King-Devick Test score sheet, and a stopwatch (timer or smartphone).
King-Devick Test iPad App
Administer King-Devick Test for iPad even when an internet connection is not available. All offline user data will be synchronized to your secure account once an internet connection is available.
Administer King-Devick Test for iPad even when an internet connection is not available. All offline user data will be synchronized to your secure account once an internet connection is available.
King-Devick Test Online
The secure browser-based King-Devick Test Online allows you to administer the test from a computer, laptop or iPad that is connected to the internet and conveniently stores up to 1000 athletes’ baseline data.
The secure browser-based King-Devick Test Online allows you to administer the test from a computer, laptop or iPad that is connected to the internet and conveniently stores up to 1000 athletes’ baseline data.
