King‐Devick test normative reference values and internal consistency in youth football and soccer athletes

Abstract

The King-Devick (K-D) test has gained popularity as a sideline concussion assessment tool, comprising of visual tracking and saccadic eye movements. However, limited normative data exist for youth athletes under the age of 13. The purpose of this study was to establish normative reference values and examine the internal consistency of the K-D test in youth athletes. The K-D test was administered to 422 youth football and soccer athletes prior to their respective season. The average K-D score was 54.29 ± 11.5 seconds. Across the two trials, 55% of participants committed at least one error. Overall, the K-D test demonstrated a high internal consistency (Cronbach α = 0.92) when administered at baseline. Inter-item correlations revealed a moderate-to-strong relationship between test cards and trials (r range = 0.71 to 0.95; P < 0.001), along with test cards and baseline K-D time (r range = 0.85 to 0.94; P < 0.001). Although the K-D test was consistent during baseline testing, the high percentage of errors at baseline makes the K-D test questionable for post-concussion comparisons.

Disparities on Baseline Performance Using Neurocognitive and Oculomotor Clinical Measures of Concussion

“…The KD test has demonstrated high internal consistency (Chronbach α = .92) for baseline times in youth populations across 2 trials. 29 For the purpose of this study, the hard-copy test card versions were used.…”

Does Vestibular-Ocular-Motor (VOM) Impairment Affect Time to Return to Play, Symptom Severity, Neurocognition and Academic Ability in Student-Athletes following acute Concussion?

“…This may guide more realistic expectations for the concussed student-athlete and staff in the sporting team. Furthermore, neither the current study nor Whitney et al (17) explored if time to RTP was affected by when in the sporting season the SRC was sustained. Sustaining an SRC in-season versus out of season may affect the urgency of returning the student-athlete to play.…”

“…The Vestibular-Ocular-Motor Screening (VOMS) tool and King-Devick test are reported to assess both the vestibular and ocular components of VOM function (9,15). The King-Devick test has come under scrutiny for high rates of abnormal baseline performance (16,17), false-positive tests post-exercise (18,19), practice effects (18) and low sensitivity (60-62%) and specificity scores (39-84%) (20,21). The VOM Screening (VOMS) tool has shown promise due to high agreement between re-tests (ICC 0.9) (22), good internal consistency (Cronbach α = .97) (23) and low false-positives (2-11%) (19,22,24).…”

Exploring Vestibular/Ocular and Cognitive Dysfunction as Prognostic Factors for Protracted Recovery in Sports-Related Concussion Patients Aged 8 to 12 Years

“…57 A positive screen on the K-D was defined as ≥67.39 seconds (8-11 years) or ≥52.67 seconds (12 years) total time across all 3 test cards based on a normative value of the 75th percentile score for each respective age group. 58…”