The use of a visual motor test to identify lingering deficits in concussed collegiate athletes
Background: Emerging evidence suggests neurophysiological deficits, such as visual motor coordination, may persist beyond clinical concussion recovery. Instrumented measurement of upper-limb visual motor coordination is critical for neurological evaluation post-concussion and may identify persistent deficits further elucidating persistent neurophysiological impairments not detected by the current clinical assessment battery.
Aim: To determine if a visual motor coordination test identifies persistent deficits in concussed collegiate student-athletes who have returned to baseline on clinical concussion assessments.
Methods: 13 recently concussed intercollegiate student-athletes (male: 7, 18.9 + 0.7 years, 175.5 + 12.4 cm, 75.5 + 23.2 kg), and 13 matched control student-athletes (male: 7, 19.3 + 1.1 years, 173.5 + 11.9 cm, 75.8 + 19.9 kg) completed two testing sessions (T1: <48 hours after clinical recovery; T2: 30 days post-concussion) on a visual motor exam. The outcome measures were A* Average score (average number of lights hit on A* exam), simple visual reaction time (SVRT-RT), and movement time (SVRT-MT) on the Dynavision D2. The dependent variables were compared with a 2 (Group) x 2 (Time) repeated measures ANOVAs.
Results: There was no group interaction in A* average score (F(1,24)=0.036, p=.849), SVRT-RT (F(1,22)=0.319, p=.575) and SVRT-MT (F(1,22)=1.179, p=.188). There was a main effect for time on A* average score (T1: 76.3 + 10.4 hits; T2: 82.7 + 11.2 hits; F(1,24)=38.1, p<.001) and SVRT-RT (T1: 0.31 + 0.04; T2: 0.29 + 0.04 s; F(1,22)=4.9, p=.039). There was no main effect for SVRT-MT. There were no group differences at either time point.
Conclusions: Among recently concussed collegiate student-athletes, no persistent deficits were identified in visual motor coordination beyond clinical recovery when assessed by Dynavision D2. This visual motor coordination exam may not provide a useful means of tracking recovery following concussion likely due to a substantial practice effect.
Relevance for patients: While post-concussion neurophysiological deficits persist beyond clinical recovery, the laboratory based VMC assessment herein did not identify deficits at critical post-concussion time points. Therefore, other clinically translatable VMC assessments should be further investigated.
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