The King–Devick test is not sensitive to self-reported history of concussion but is affected by English language skill

Abstract

ObjectivesHead injuries, including concussion, are a concern in many sports. Current validated concussion assessment protocols such are problematic with suggestions that an oculomotor examination, such as the King–Devick (K–D) test, could be included. This research explores the role of the K–D test in snowsport concussion research. DesignExperienced snowsport participants were recruited through a western Canadian resort (n=75). MethodsParticipants completed a questionnaire that included their history of prior serious head impacts and were assessed via the computer-based K–D test in English. ResultsOf the 75 participants, 23 (69%) reported at least one previous serious head impact. English was the not primary language for seven participants.Independent sample t-tests revealed: significant differences in the K–D average saccade scores for those who had broken their helmets, with or without a serious head injury (̄x¯=171.23, SD=12.9) and those who had not broken a helmet (̄x¯=186.61, SD=20.18; t (70)=−2.53, p=.014, twotailed) and significant differences in the K–D time for those whose native language is English (̄x¯=47.9, SD=6.3) and those where English was not their first language (̄x¯=53.3, SD=7.4; t(73)=.48, p=.04), but no significant difference for their saccade velocities: English (̄x¯=183.64, SD=20.0) versus those where English is a second or third language (̄x¯=188.44, SD=20.1; t(70)=−.56, p=.576). ConclusionsFor subjects whose first language is not English, such as in many snowsport resorts, the K–D test may need to be conducted in a person’s native language to provide a valid assessment based upon the time to complete the task.