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King-Devick testing and concussion recovery time in collegiate athletes

Published:August 27, 2022DOI:https://doi.org/10.1016/j.jsams.2022.08.012

      Abstract

      Objectives

      To assess whether the King-Devick (K D) test is useful as a prognostic test for prolonged concussion symptoms by examining the relationship between a) change in performance on K D test from baseline to within two days post-injury and b) the absolute K D time at post-concussion testing, with an outcome of time to return to play (RTP).

      Design

      Prospective Cohort Study.

      Methods

      Collegiate varsity athletes in the Concussion Assessment, Research, and Education (CARE) Consortium completed baseline and post-injury King-Devick tests from 2014 to 2018. Two exposures were evaluated: 1) change in K D score from baseline to within two days post-injury and 2) absolute K D score within two days post-injury, adjusted for baseline K D. We used Cox proportional hazards models to analyze the relationships between these exposures and time to RTP post-concussion.

      Results

      A total of 309 concussion injuries were included. Median baseline K D score was 40.0 s (IQR: 35.8, 45.2). Median post-injury K D score was 45.8 s (IQR: 39.8, 57.1). Median number of days until RTP in this cohort was 11 (IQR: 8, 17). Post-injury K D score adjusted for baseline K D had a stronger association with time to RTP duration (HR: 0.99 (0.98, 1.00), p = 0.03) than the difference in K D score from baseline to post-injury (HR: 0.99 (0.99, 1.00), p = 0.07).

      Conclusions

      Higher post-injury K D scores are associated with longer RTP. The association between K D post-concussion test and longer RTP warrants further investigation to assess the utility of the K D for prognostication in a clinical setting.

      Keywords

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