Citation

Galetta KM, Barrett J, Allen M, Madda F, Delicata D, Tennant AT, Branas CC, Maguire MG, Messner LV, Devick S, Galetta SL, Balcer LJ. Neurology 2011; 76(17): 1456-1462.

Affiliation

From the Departments of Neurology (K.M.G., J.B., S.L.G., L.J.B.), Ophthalmology (S.L.G., M.G.M., L.J.B.), Biostatistics (M.G.M.), and Epidemiology (C.C.B., L.J.B.), University of Pennsylvania School of Medicine, Philadelphia; Illinois College of Optometry (M.A., L.V.M.), Chicago; King-Devick Test, LLC (S.D.), Downers Grove, IL; Nefilim Associates, LLC (A.T.T.), Swampscott, MA; Department of Surgery (F.M.), University of Illinois Medical Center, Chicago; and Good Samaritan Hospital (D.D.), Downers Grove, IL.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1212/WNL.0b013e31821184c9

PMID

21288984

PMCID

PMC3087467

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 (r(s) = -0.79, p = 0.0001) and greater worsening of scores (r(s) = 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.

Language: en