Researchers,
supported in part by the National Institutes of Health, determined that the
King-Devick test detected 79 percent of concussions suffered by athletes of the University of Florida men’s football,
women’s soccer and women’s lacrosse teams. The study followed 217 athletes, 30
of whom had a first concussion during the season the testing was taking place.
When
combined with the test results of two other comprehensive concussion tests –
the Standardized Assessment of Concussion and the Balance Error Scoring System
– 100 percent of concussions were identified.
“I
don’t think we’re ever going to have one comprehensive sideline test,” said
study co-author Dr. James Clugston, team physician for the University of
Florida Athletic Department, Gainesville . “But the King-Devick
casts a wider net in diagnosing concussions.”
According
to the Centers for Disease Control and Prevention, up to 3.8 million Americans
sustain sports-related concussions each year. Most of these are not treated in
a hospital or emergency department, according to the CDC, making diagnosis a
challenge.
What
makes the King-Devick test unique is that it is simple and fast, while
increasing the accuracy in diagnosing concussions when used with other tests,
according to the AAN.
“The
King-Devick looks at a different area of brain function that we weren’t really
focusing on,” said Clugston. “It’s really simple to administer and simple to
interpret.”
A
test-taker reads, as quickly and accurately as possible, rows of single-digit
numbers that are unevenly spaced. A baseline test is established to determine
time and accuracy to complete the test with a healthy brain. When an athlete is
deemed to have a potential concussion, the test is administered again.
Irregularities in time or accuracy indicate a concussion. The test takes about
one minute to complete, and can be performed with charts or a tablet.
Current
sideline concussion tests analyze balance and short-term memory, but the
King-Devick test looks for vision-related problems.
“The
visual pathways are commonly affected in concussion,” wrote Dr. Laura Balcer,
author of the King-Devick study and a neurologist at the New York University Langone Medical Center , in a statement issued by
the AAN.
“Adding
a vision-based test to evaluate athletes on the sidelines may allow us to
better detect more athletes with concussion more quickly. This is particularly
important since not all athletes reliably report their symptoms of concussion,
including any vision problems.”
While
the King-Devick should not be the only test administered to diagnose a
concussion, it is effective in diagnosing athletes who hide their symptoms or
aren’t aware they have a concussion, Clugston said. “All of the tests can be
manipulated, and that’s a problem, but I think this may be a little more
objective, and it’s an improvement because it’s testing a whole different
function that we weren’t looking at before.”
Clugston
said the King-Devick test has struggled to gain popularity on athletic
sidelines, possibly because other concussion tests are free, while the
King-Devick, with score sheets and a stopwatch, costs around $45. King-Devick
also offers a test compatible for tablets, which integrates the stopwatch
automatically and keeps records of scores.
“My
ultimate desire would be that we have a truly objective test,” said Clugston.
“And this helps get us there a little more.”
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