Presentation at the American Medical Society for Sports Medicine 2017 Annual Meeting

The Effect of Moderate Levels of Physical Activity on the Performance of Baseline Concussion Tests in an Athletic Pediatric Population

Authors: Okamura A, Slattery E, Gubanich P
Publication: Presentation at the American Medical Society for Sports Medicine 2017 Annual Meeting
Date: April 25, 2017
Tags: Youth Athletes,

Purpose: There is a paucity of validated outcomes tools in the pediatric population to aid in the diagnosis or prognosis of concussion. This study examined the baseline test performance of 3 concussion assessments and investigated the effect of moderate levels of physical activity on test reliability.

Methods and Study Design: Youth (ages 6-17) actively participating in sports were eligible for study participation. Subjects with a recent history of concussion or current LE injury were excluded. Testing was administered immediately before a training session, practice, or game and included the King Devick (KD), clinical reaction time test (CRT), and postural control assessment (PC). The KD and CRT tests were performed using previously published protocols. PC testing consisted of one 60s trial standing relaxed with eyes closed on a force plate. During a second trial, subjects also completed a Batting Montague (categorization) test. Testing was repeated after completion of the subjects’ physical activity session.

Results: Sixty-six subjects (ages 6-15) were enrolled in the study. Paired samples t-tests of the KD and CRT tests pre to post physical activity indicated no differences: KD (d=0.44+1.67, p=0.80); CRT (d=4.02+3.05, p=0.19). Similarly, no differences were observed for PC measures pre to post physical activity for mean path length (p=0.37) or velocity (max, min, av) in the resting or dual task state. Higuchi’s fractal dimension, a measure of system stability were found to differ pre to post physical activity (HFDx p < 0.01; HFDy p=0.01). Model analysis by age group (6-9 or 10-15) revealed no significant differences across ages.

Conclusions: This study supports preliminary reliability of KD, CRT, and PC test measures in an athletic pediatric population. Moderate amounts of physical activity as encountered in routine training did not alter test performance. Future studies will need to examine the effect of concussive injury and other confounders on test performance.

Summary Points:

  • K-D Test is reliable in an athletic pediatric population.
  • Physical activity commonly encountered in routine training did not alter K-D Test performance.