The Use of a Visual Motor Test to Identify Lingering Deficits in Concussed Collegiate Athletes

Katherine J. Hunzinger; Erik W. Sanders; Horace E. Deal; Jody L. Langdon; Kelsey M. Evans; Brandy A. Clouse; Barry Munkasy; Thomas A Buckley

The Use of a Visual Motor Test to Identify Lingering Deficits in Concussed Collegiate Athletes

Katherine J. Hunzinger, Erik W. Sanders, Horace E. Deal, Jody L. Langdon, Kelsey M. Evans, Brandy A. Clouse, Barry Munkasy, Thomas A Buckley

Health Sciences & Kinesiology

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Abstract

<p> <h3 id="x-x-__sec1title"> Background: </h3> <p id="x-x-__p1"> Emerging evidence suggests neurophysiological deficits, such as visual motor coordination (VMC), may persist beyond clinical concussion recovery. Instrumented measurement of upper-limb VMC 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. <h3 id="x-x-__sec2title"> Aim: </h3> <p id="x-x-__p2"> The aim of the study was to determine if a VMC test identifies persistent deficits in concussed collegiate student-athletes who have returned to baseline on clinical concussion assessments. <h3 id="x-x-__sec3title"> Methods: </h3> <p id="x-x-__p3"> Thirteen 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 h 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) × 2 (time) repeated measures ANOVAs. <h3 id="x-x-__sec4title"> Results: </h3> <p id="x-x-__p4"> There was no group interaction in A* average score ( <em> F </em> (1,24)=0.036, <em> P </em> =0.849), SVRT-RT ( <em> F </em> (1,22)=0.319, <em> P </em> =0.575), and SVRT-MT ( <em> F </em> (1,22)=1.179, <em> P </em> =0.188). There was a main effect for time on A* average score (T1: 76.3±10.4 hits; T2: 82.7±11.2 hits; <em> F </em> (1,24)=38.1, <em> P </em> ≤0.001) and SVRT-RT (T1: 0.31±0.04; T2: 0.29±0.04 s; <em> F </em> (1,22)=4.9, <em> P </em> =0.039). There was no main effect for SVRT-MT. There were no group differences at either time point. <h3 id="x-x-__sec5title"> Conclusions: </h3> <p id="x-x-__p5"> Among recently concussed collegiate student-athletes, no persistent deficits were identified in VMC beyond clinical recovery when assessed by Dynavision D2. This VMC exam may not provide a useful means of tracking recovery following concussion likely due to a substantial practice effect. <h3 id="x-x-__sec6title"> Relevance for patients: </h3> <p id="x-x-__p6"> 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. </p> </p> </p> </p> </p> </p></p>

Original language	American English
Journal	Journal of Clinical and Translational Research
Volume	5
State	Published - Apr 16 2020

Keywords

Dynavision
coordination
mild traumatic brain injury
reaction time

DC Disciplines

Kinesiology
Medicine and Health Sciences

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@article{7fe5360ba4af4968b602246c4c612449,

title = "The Use of a Visual Motor Test to Identify Lingering Deficits in Concussed Collegiate Athletes",

abstract = " Background: Emerging evidence suggests neurophysiological deficits, such as visual motor coordination (VMC), may persist beyond clinical concussion recovery. Instrumented measurement of upper-limb VMC 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: The aim of the study was to determine if a VMC test identifies persistent deficits in concussed collegiate student-athletes who have returned to baseline on clinical concussion assessments. Methods: Thirteen 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 h 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) × 2 (time) repeated measures ANOVAs. Results: There was no group interaction in A* average score ( F (1,24)=0.036, P =0.849), SVRT-RT ( F (1,22)=0.319, P =0.575), and SVRT-MT ( F (1,22)=1.179, P =0.188). 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 ≤0.001) and SVRT-RT (T1: 0.31±0.04; T2: 0.29±0.04 s; F (1,22)=4.9, P =0.039). 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 VMC beyond clinical recovery when assessed by Dynavision D2. This VMC 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. ",

keywords = "Dynavision, coordination, mild traumatic brain injury, reaction time",

author = "Hunzinger, {Katherine J.} and Sanders, {Erik W.} and Deal, {Horace E.} and Langdon, {Jody L.} and Evans, {Kelsey M.} and Clouse, {Brandy A.} and Barry Munkasy and Buckley, {Thomas A}",

year = "2020",

month = apr,

day = "16",

language = "American English",

volume = "5",

journal = "Journal of Clinical and Translational Research",

}

TY - JOUR

T1 - The Use of a Visual Motor Test to Identify Lingering Deficits in Concussed Collegiate Athletes

AU - Hunzinger, Katherine J.

AU - Sanders, Erik W.

AU - Deal, Horace E.

AU - Langdon, Jody L.

AU - Evans, Kelsey M.

AU - Clouse, Brandy A.

AU - Munkasy, Barry

AU - Buckley, Thomas A

PY - 2020/4/16

Y1 - 2020/4/16

N2 - Background: Emerging evidence suggests neurophysiological deficits, such as visual motor coordination (VMC), may persist beyond clinical concussion recovery. Instrumented measurement of upper-limb VMC 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: The aim of the study was to determine if a VMC test identifies persistent deficits in concussed collegiate student-athletes who have returned to baseline on clinical concussion assessments. Methods: Thirteen 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 h 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) × 2 (time) repeated measures ANOVAs. Results: There was no group interaction in A* average score ( F (1,24)=0.036, P =0.849), SVRT-RT ( F (1,22)=0.319, P =0.575), and SVRT-MT ( F (1,22)=1.179, P =0.188). 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 ≤0.001) and SVRT-RT (T1: 0.31±0.04; T2: 0.29±0.04 s; F (1,22)=4.9, P =0.039). 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 VMC beyond clinical recovery when assessed by Dynavision D2. This VMC 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.

AB - Background: Emerging evidence suggests neurophysiological deficits, such as visual motor coordination (VMC), may persist beyond clinical concussion recovery. Instrumented measurement of upper-limb VMC 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: The aim of the study was to determine if a VMC test identifies persistent deficits in concussed collegiate student-athletes who have returned to baseline on clinical concussion assessments. Methods: Thirteen 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 h 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) × 2 (time) repeated measures ANOVAs. Results: There was no group interaction in A* average score ( F (1,24)=0.036, P =0.849), SVRT-RT ( F (1,22)=0.319, P =0.575), and SVRT-MT ( F (1,22)=1.179, P =0.188). 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 ≤0.001) and SVRT-RT (T1: 0.31±0.04; T2: 0.29±0.04 s; F (1,22)=4.9, P =0.039). 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 VMC beyond clinical recovery when assessed by Dynavision D2. This VMC 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.

KW - Dynavision

KW - coordination

KW - mild traumatic brain injury

KW - reaction time

UR - https://digitalcommons.georgiasouthern.edu/health-kinesiology-facpubs/197

M3 - Article

VL - 5

JO - Journal of Clinical and Translational Research

JF - Journal of Clinical and Translational Research

ER -

The Use of a Visual Motor Test to Identify Lingering Deficits in Concussed Collegiate Athletes

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