Oculomotor and Neurocognitive Assessment of Youth Ice Hockey Players: Baseline Associations and Observations After Concussion

Vernau, Brian T.; Grady, Matthew F.; Goodman, Arlene; Wiebe, Douglas J.; Basta, Luke; Park, Yong; Arbogast, Kristy B.; Master, Christina L.

doi:10.1080/87565641.2014.971955

Cited by 39 publications

(15 citation statements)

References 6 publications

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“…Some studies did not include enough detail regarding when the SCAT2/SCAT3 was performed and whether a baseline measure was performed,25 or did not report SCAT2/SCAT3 performance after injury 14…”

Section: Resultsmentioning

confidence: 99%

What tests and measures should be added to the SCAT3 and related tests to improve their reliability, sensitivity and/or specificity in sideline concussion diagnosis? A systematic review

et al. 2017

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Objectives Several iterations of the Sport Concussion Assessment Tool (SCAT) have been published over the past 16 years. Our goal was to systematically review the literature related to the SCAT and provide recommendations for improving the tool. To achieve this goal, five separate but related searches were conducted and presented herein. Design Systematic literature review. Data sources Medline, Embase, PsycINFO, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials, SPORTDiscus and PubMed. Eligibility criteria Original, empirical, peer-reviewed findings published in English and included sports-related concussion (SRC). Review papers, case studies, editorials and conference proceedings/abstracts were excluded. The age range for the ChildSCAT was 5-12 years and for the Adult SCAT was 13 years and above. Results Out of 2961 articles screened, a total of 96 articles were included across the five searches. Searches were not mutually exclusive. The final number of articles included in the qualitative synthesis for each search was 21 on Adult SCAT, 32 on ChildSCAT, 21 on sideline, 8 on video/observation and 14 on oculomotor. Summary/conclusions The SCAT is the most widely accepted and deployable sport concussion assessment and screening tool currently available. There is some degree of support for using the SCAT2/SCAT3 and ChildSCAT3 in the evaluation of SRC, with and without baseline data. The addition of an oculomotor examination seems indicated, although the most valid method for assessing oculomotor function is not clear. Video-observable signs of concussion show promise, but there is insufficient evidence to warrant widespread use at this time. InTRODuCTIOnThe Concussion In Sport Group (CISG) introduced the Sport Concussion Assessment Tool (SCAT) 1 to provide a multifaceted standardised assessment of concussion. The SCAT combined previously separate subcomponents of a clinical evaluation, for example, symptoms (graded symptom checklist), cognitive function (five-word immediate recall/ delayed recall), the modified Maddocks questions 2 and neurological screening, in one tool. The SCAT was revised as an instrument to be used by medical professionals and was renamed to SCAT2. 3 The revision was based on a review of the empirical literature, which added the Glasgow Coma Scale (GCS) )4 , a cognitive test (Standardized Assessment of Concussion, SAC 5 6 ) and a measure of balance (modified Balance Error Scoring System, 7 mBESS). The SCAT2 was revised as the SCAT3 in 2013, 8 and a new tool for children (under 13) was developed, the ChildSCAT3. The SCAT3 included physical or objective signs of concussion in addition to loss of consciousness (LOC) and balance problems, added a foam condition to the BESS, and included a 'concussion injury advice' section. 9This study presents the results of a systematic review of the scientific literature assessing the utility of the SCAT3 and sets forth recommendations for improving the tool. MATERIAlS AnD METhODSThe searc...

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Section: Resultsmentioning

confidence: 99%

What tests and measures should be added to the SCAT3 and related tests to improve their reliability, sensitivity and/or specificity in sideline concussion diagnosis? A systematic review

et al. 2017

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“…Finally, Vernau and colleagues performed near-point of convergence in 108 male hockey players age 6–18, and found 11.5% of subjects had abnormal near-point of convergence. 17 It should be noted that convergence insufficiency (a diagnosis consisting of abnormal near-point of convergence plus other accommodative defects) has been more broadly studied in the pediatric population in the optometry literature, where data has shown between 5% and 17% of children have abnormal exams; 18–20 no such data, however exists for measurements of symptom provocation with saccades or vestibulo-ocular reflex testing. No children exhibited failures on our dysmetria and nystagmus testing, most likely due to the fact that these tests observed purely objective findings rather than some element of symptom provocation.…”

Section: Discussionmentioning

confidence: 99%

Vestibular and oculomotor findings in neurologically-normal, non-concussed children

et al. 2018

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OBJECTIVE To determine the proportion of non-concussed, neurologically normal children with failures on a vestibular and oculomotor examination for concussion performed in an acute setting. DESIGN This was a cross-sectional study of subjects 6–18 years old presenting to a pediatric emergency department with non-neurologic chief complaints. The examination was administered by a pediatric emergency medicine physician, and includes assessments of dysmetria, nystagmus, smooth pursuits, saccades, gaze stability, near-point of convergence, and gait/balance testing. RESULTS Of the 295 subjects enrolled, 24% failed at least one element of testing. 13% had >1 failed element and 5% had >2 failed elements. 29% of females and 19% of males had failed examinations. By age, 15% of subjects 6–8 years old, 32% 9–11 years, 32% 12–14 years, and 26% 15–18 years had failed examinations. Overall, 10% were unable to complete the exam due to developmental age. CONCLUSIONS The provider should be aware that a proportion of non-concussed children may demonstrate failure on a single element of the vestibular and oculomotor exam for. While this testing is of benefit to the acute care provider in diagnosing pediatric concussion, its utility is greatest in the context of an injury history with acute onset of concussion symptoms.

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“…16 This neurological pathway works closely with accommodation to provide concurrent clear focus on near objects and is highly susceptible to damage by concussion. Convergence abnormalities are reported in 14-55% of athletes, [17][18][19] 48-55% of military personnel 11,20 and 14-49% of outpatient groups 11,21,22 previously diagnosed with concussion. Poor convergence will manifest clinically with double vision following near work, and blurred vision or asthenopia with prolonged near tasks such as reading.…”

Section: Convergencementioning

confidence: 99%

Persistent visual disturbances after concussion

Gunasekaran¹,

Hodge²,

Rose³

et al. 2019

Aust J Gen Pract

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Oculomotor and Neurocognitive Assessment of Youth Ice Hockey Players: Baseline Associations and Observations After Concussion

Cited by 39 publications

References 6 publications

What tests and measures should be added to the SCAT3 and related tests to improve their reliability, sensitivity and/or specificity in sideline concussion diagnosis? A systematic review

What tests and measures should be added to the SCAT3 and related tests to improve their reliability, sensitivity and/or specificity in sideline concussion diagnosis? A systematic review

Vestibular and oculomotor findings in neurologically-normal, non-concussed children

Persistent visual disturbances after concussion

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