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April 26, 2011; 76 (17) Articles

The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters

K.M. Galetta, J. Barrett, M. Allen, F. Madda, D. Delicata, A.T. Tennant, C.C. Branas, M.G. Maguire, L.V. Messner, S. Devick, S.L. Galetta, L.J. Balcer
First published February 2, 2011, DOI: https://doi.org/10.1212/WNL.0b013e31821184c9
K.M. Galetta
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J. Barrett
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M. Allen
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F. Madda
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Citation
The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters
K.M. Galetta, J. Barrett, M. Allen, F. Madda, D. Delicata, A.T. Tennant, C.C. Branas, M.G. Maguire, L.V. Messner, S. Devick, S.L. Galetta, L.J. Balcer
Neurology Apr 2011, 76 (17) 1456-1462; DOI: 10.1212/WNL.0b013e31821184c9

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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

  • 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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