The King-Devick (KD) oculomotor test has recently been advocated for sideline diagnosis of concussion. Although visual processing and performance are often impaired in concussion patients, the utility of KD as a concussion diagnostic tool is not validated.
To examine the diagnostic value of KD, by comparing KD with post-concussion symptom scale (PCSS) and ImPACT® composite scores. We hypothesized that KD would be correlated with visual motor speed/memory (VMS, VIS) and reaction time (RT), because all require cognitive visual processing. We also expected parallel changes in KD and PCSS across recovery.
Thirty-five concussed individuals (12–19 y; 18 females, 17 males) were evaluated with PCSS, ImPACT® composite and KD scores over four clinical visits (V).
KD times improved with each visit (ΔV1–V2: 7.86 ± 11.82; ΔV2–V3: 9.17 ± 11.07; ΔV3–V4: 5.30 ± 7.87 s) and paralleled improvements in PCSS (ΔV1–V2: 8.97 ± 20.27; ΔV2–V3: 8.69 ± 14.70; ΔV3–V4: 6.31 ± 7.71), RT (ΔV1–V2: 0.05 ± 0.21; ΔV2–V3: 0.09 ± 0.19; ΔV3–V4 0.03 ± 0.07) and VMS (ΔV1–V2: −5.27 ± 6.98; ΔV2–V3: −2.61 ± 6.48; ΔV3–V4: −2.35 ± 5.22). Longer KD times were associated with slower RT (r = 0.67; P < 0.0001) and lower VMS (r = −0.70; P < 0.0001), respectively.
Cognitive visual performance testing using KD has utility in concussion evaluation. Validation would further establish KD as an effective ancillary tool in longitudinal concussion management and research.
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Published online: September 05, 2013
Accepted: August 11, 2013
Received in revised form: August 7, 2013
Received: May 7, 2013
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