Thursday, August 25, 2011

King Devick Test to Predict Concussions

I was reading an article online regarding current concussion management, and an interesting advertisement displayed on the side of my screen.  It read "King Devick Test: Eye Test for concussions!"   I hadn't heard of it.  So began the search. Unlike ImPact, or other assessment tools, it is designed to be administered directly on the sideline.  The big selling point to ATC's: it only takes 2 minutes to administer.
Basically, it begins with administering a baseline to the athlete prior to athletic competition (this is similar to others) to be sure you are directly comparing themselves with, well, themselves.
After that, when you have an athlete on the sideline you are concerned about, you can use a card (or an IPad or laptop) in which the athlete has a set amount of time to read a series of numbers which are connected by arrows in a left to right fashion, and then downwards.  To view a demo card,which likely shows you better than I can explain, click here.  A more detailed description can be found here:

Surprisingly, this test isn't all that new.  It has been used for the past couple of decades to evaluate eye movements and reading difficulties.  It was originally developed to evaluate  saccadic eye movement.  Saccadic basically means fast, voluntary eye movements.  For more detail on how this relates, check out this fantastic explanation .here.

Moreover, the test has some early applicable data attached to it.  The American Academy of Neurology recently published a study in which it was used on boxers and MMA fighters, and their study showed that it had a high accuracy rating.  Although, the authors fully disclose that in order for it to be utilized more widely in athletics by athletic trainers, both interrater and test-retest reliability need to be further examined.  It should also be noted that one of the researchers is Dr. Devick, a developer of the test itself. 

One last bit, it's not free. The test costs anywhere from $45-$1750 per year, which some may balk at.  I challenge this initial thought.  At what point is a test of this importance too expensive?  Think of how ImPact has revolutionized concussion assessment.  We are at a point where we need to start looking at preventative measures and diagnostic procedures closely, and weighing that against the more long term effects/costs of brain injury.

It will be interesting to see if/when this is integrated into current concussion management on the sidelines.  So check it out, and decide for yourself!

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