Impact monitoring and king-devick ocular testing provide a relatively simple process for objectively identifying and managing concussion in sports participants

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Abstract

Objective

This study presents data using multimodal assessment via impact sensors and oculomotor function to quantify neurophysiological changes in the acute period following concussion.

Design

Cohort study.

Participants

Data on impact magnitude and frequency were collected with a wireless head impact sensor (XPatch1) worn by senior amateur rugby players participating in a domestic season. King-Devick Tests2 were performed pre-season and after significant impact scores (PLA>100 g, PRA>10,000 rads/sec/sec).). Participants underwent a one hour baseline assessment of balance, cognition and transcranial magnetic stimulation testing. Following concussive episodes or significant head impacts (as measured by impact sensors), players were re-tested to elicit any differences and to assist in providing objective criteria for the return to play process.

Interventions

Any impact that resulted in a witnessed concussion or that was suspected on the basis of significant impact scores required post-match testing utilising the King-Devick test to help determine appropriate return to play readiness.

Outcome measures

Impact number, peak linear and peak rotational acceleration, risk weighted exposure. Time and errors completing the King-Devick test.

Main result

20 concussions were detected in all, of which only 3 were witnessed (2 players unconscious on the field, one with balance disturbance resulting in removal from play).

Conclusions

A combination of regular impact monitoring and King-Devick Ocular testing provides a relatively simple process for objectively identifying and managing concussion in sports participants.

Competing interests

AJP is supported, in part, by a research grant by the Australian Football League

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