Abstract
Vestibular and oculomotor testing is emerging as a valuable assessment in sport-related
concussion (SRC). However, their usefulness for tracking recovery and guiding return-to-play
decisions remains unclear. Therefore the purpose of this study was to evaluate their
clinical usefulness for tracking SRC recovery. Vestibular and oculomotor assessments
were used to measure symptom provocation in an acute group (n=21) concussed≤10 days,
prolonged symptoms group (n=10) concussed ≥16 days (median=84 days), healthy group
(n=58) no concussions in >6 months. Known-groups approach was used with three groups
at three time points (initial, 2-week and 6-week follow-up). Provoked symptoms for
Gaze-Stabilization (GST), Rapid Eye Horizontal (REH), Optokinetic Stimulation (OKS),
Smooth-Pursuit Slow (SPS) and Fast (SPF) tests, total combined symptoms scores and
near point convergence (NPC) distance were significantly greater at initial assessment
in both injury groups compared to controls. Injury groups improved on the King-Devick
test and combined symptom provocation scores across time. The acute group improved
over time on REH and SPF tests, while the prolonged symptoms group improved on OKS.
A regression model (REH, OKS, GST) was 90% accurate discriminating concussed from
healthy. Vestibular and ocular motor tests give valuable insight during recovery.
They can prove beneficial in concussion evaluation given the modest equipment, training
and time requirements. The current study demonstrates that when combined, vestibular
and oculomotor clinical tests aid in the detection of deficits following a SRC. Additionally,
tests such as NPC, GST, REH, SPS, SPF OKS and KD provide valuable information to clinicians
throughout the recovery process and may aid in return to play decisions.
Key words
near point convergence - optokinetic stimulation - concussion - vestibular - balance
