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Article Title

PROPOSING A NEW METHOD OF ADMINISTERING THE KING-DEVICK TEST FOR CONCUSSION ASSESSMENT

Abstract

Nathan R. D’Amico, Morgan N. Anderson, Melissa N. Anderson, Katie L. Stephenson-Brown, Sam A. Mohler, Mallory K. McElroy, R.J. Elbin Department of Health, Human Performance and Recreation/Office for Sport Concussion Research, University of Arkansas, Fayetteville, Arkansas

The King Devick Test (KD) is a rapid number naming test that is intended to screen for sport-related concussion (SRC). This assessment uses a prospective methodology that compares an athlete’s post-injury scores to their pre-injury (i.e., baseline) scores. Administration guidelines for the KD recommend recording a baseline score from the faster of two error-free trials. However, post-concussion administration guidelines recommend administering the KD only once following a suspected SRC, and if the athlete performs slower than their baseline or makes an error, a concussion should be suspected. It is unclear why post-injury administration of the KD only includes one trial in contrast to the baseline administration. No study to date has investigated the clinical utility of a second post-injury trial on the KD. PURPOSE: To compare changes in the sensitivity of the KD for detecting SRC between one and two post-injury trials. METHODS: Nineteen high school athletes with SRC (13 male, 6 female, age: 15.5 ± 1.1 years) completed two trials of KD (baseline and within 7 days following SRC). Baseline KD scores were compared to two post-injury scores that included the first (i.e., recommended administration) post-injury trial and a second post-injury trial. Percent of athletes scoring above clinical cutoffs for SRC were calculated for each comparison. RESULTS: Comparing baseline (44.30 ± 9.00 secs with 0 errors) to the first post-injury trial (58.15 ± 21.04 secs with 0.21 ± 0.54 errors), 84.2% (n = 16) of athletes were classified as having a SRC. Comparing baseline (44.30 ± 9.00 secs with 0 errors) to the second post-injury trial (53.89 ± 20.33 secs with 0 errors), 63.2% (n = 12) were classified as having a SRC. The same three athletes that scored better than baseline at post-injury trial 1 also scored better than baseline at post-injury trial 2. However, there were an additional four athletes that scored better than baseline on post-injury trial 2, despite scoring worse than baseline on post-injury trial 1. CONCLUSION: Clinicians may want to include a second KD trial following SRC when making clinical decisions regarding concussion. Further research should investigate the utility of two KD trials following SRC.

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