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Abstract
Objective: Sports-related concussion has received increasing attention as a cause of short- and long-term neurologic symptoms among athletes. The King-Devick (K-D) test is based on measurement of the speed of rapid number naming (reading aloud single-digit numbers from 3 test cards), and captures impairment of eye movements, attention, language, and other correlates of suboptimal brain function. We investigated the K-D test as a potential rapid sideline screening for concussion in a cohort of boxers and mixed martial arts 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 postfight. Worse postfight K-D scores (rs = −0.79, p = 0.0001) and greater worsening of scores (rs = 0.90, p < 0.0001) correlated well with postfight 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 K-D test is an accurate and reliable method for identifying athletes with head trauma, and is a strong candidate rapid sideline screening test for concussion.
Footnotes
Editorial, page 1450
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- CI
- confidence interval
- CTE
- chronic traumatic encephalopathy
- ICC
- intraclass correlation coefficient
- K-D
- King-Devick
- ImPACT
- Immediate Post-Concussion and Cognitive Testing
- LOC
- loss of consciousness
- MACE
- Military Acute Concussion Evaluation
- MMA
- mixed martial arts
- MRS
- magnetic resonance spectroscopy
- SAC
- Standardized Assessment of Concussion.
- Received September 21, 2010.
- Accepted November 23, 2010.
- Copyright © 2011 by AAN Enterprises, Inc.
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