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

<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&plusmn;0.7 years, 175.5&plusmn;12.4 cm, 75.5&plusmn;23.2 kg), and 13 matched control student-athletes (male: 7, 19.3&plusmn;1.1 years, 173.5&plusmn;11.9 cm, 75.8&plusmn;19.9 kg) completed two testing sessions (T1: &lt;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) &times; 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&plusmn;10.4 hits; T2: 82.7&plusmn;11.2 hits; <em> F </em> (1,24)=38.1, <em> P </em> &le;0.001) and SVRT-RT (T1: 0.31&plusmn;0.04; T2: 0.29&plusmn;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>