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Journal Article

Citation

Breedlove KM, Ortega JD, Kaminski TW, Harmon KG, Schmidt JD, Kontos AP, Clugston JR, Chrisman SP, McCrea M, McAllister TW, Broglio SP, Buckley TA. J. Athl. Train. 2019; ePub(ePub): ePub.

Affiliation

Department of Kinesiology and Applied Physiology, University of Delaware, Newark.

Copyright

(Copyright © 2019, National Athletic Trainers' Association (USA))

DOI

10.4085/1062-6050-219-18

PMID

31618072

Abstract

CONTEXT: The King-Devick (KD) test has received considerable attention in the literature as an emerging concussion assessment. However, important test psychometric properties remain to be addressed in large-scale independent studies.

OBJECTIVE: To assess (1) test-retest reliability between trials, (2) test-retest reliability between years 1 and 2, and (3) reliability of the 2 administration modes.

DESIGN: Cross-sectional study. SETTING: Collegiate athletic training facilities. PATIENTS OR OTHER PARTICIPANTS: A total of 3248 intercollegiate student-athletes participated in year 1 (male = 55.3%, age = 20.2 ± 2.3 years, height = 1.78 ± 0.11 m, weight = 80.7 ± 21.0 kg) and 833 participated in both years. MAIN OUTCOME MEASURE(S): Time, in seconds, to complete the KD error free. The KD test reliability was assessed between trials and between annual tests over 2 years and stratified by test modality (spiral-bound cards [n = 566] and tablet [n = 264]).

RESULTS: The KD test was reliable between trials (trial 1 = 43.2 ± 8.3 seconds, trial 2 = 40.8 ± 7.8 seconds; intraclass correlation coefficient [ICC] (2,1) = 0.888, P <.001), between years (year 1 = 40.8 ± 7.4 seconds, year 2 = 38.7 ± 7.7 seconds; ICC [2,1] = 0.827, P <.001), and for both spiral-bound cards (ICC [2,1] = 0.834, P <.001) and tablets (ICC [2,1] = 0.827, P <.001). The mean change between trials for a single test was -2.4 ± 3.8 seconds. Although most athletes improved from year 1 to year 2, 27.1% (226 of 883) of participants demonstrated worse (slower) KD times (3.2 ± 3.9 seconds) in year 2.

CONCLUSIONS: The KD test was reliable between trials and years and when stratified by modality. A small improvement of 2 seconds was identified with annual retesting, likely due to a practice effect; however, 27% of athletes displayed slowed performance from year 1 to year 2. These results suggest that the KD assessment was a reliable test with modest learning effects over time and that the assessment modality did not adversely affect baseline reliability.


Language: en

Keywords

baseline testing; mild traumatic brain injury; oculomotor; psychometric properties; vision

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