King-devick (kd) test as a rinkside tool for concussion assessment

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Abstract

Objective

King-Devick test as a rinkside tool for concussion diagnosis.

Design

KD was administered to hockey players immediately after removal from the game with a suspected concussion. Results were compared to baseline. Concussion was suspected with slowing by >5.2 sec.1

Setting

Hockey games.

Participants

Hockey players (male/female) – school-based hockey academy and a Canadian junior hockey team

Interventions

Athletic trainers were trained in the use of KD and obtained baseline KD times for players. AT’s administered the KD test to hockey players immediately after removal from the game with a suspected concussion.

Main outcome measures

KD time post-injury was compared to the KD time baseline.

Results

During the 2015–16 season, KD testing was collected on players with suspected concussion (42 concussions identified out of 148 players). Of the 42 concussions, 13 had KD sideline testing done immediately post-injury; 8/13 demonstrated >5.2 sec slowing in their KD baseline scores. All were further evaluated with a comprehensive concussion assessment protocol that included symptom scoring-balance assessments-cognitive testing. Concussion was confirmed with this diagnostic approach in 8/8 players with KD times slowed by more than 5.2 sec.

Conclusions

An ideal concussion sideline diagnostic tool should be inexpensive, portable, reproducible, fatigue-tolerant, resistant to test-retest learning and suitable for non-medical personnel.23 The King-Devick test, that assesses saccadic eye movements, has these characteristics. It can be administered in less than 2-minutes. It has been reported that a post-injury slowing of KD times >5.2 seconds is diagnostic of concussion.4 Sideline/rinkside KD testing with > 5.2 sec slowing compared to baseline results accurately identified concussion with 100% accuracy.

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