1. The association of the Vestibular/Ocular Motor Screening (VOMS)
and the King-Devick test in youth athletes
Moran, R.1, Elbin, R.2, Covassin, T.3
North Dakota State University, Fargo ND1 , University of Arkansas, Fayetteville AR2, Michigan State University, East Lansing MI3
Methods
Background
Results
The NATA position statement emphasizes the implementation and use of a multi-faceted baseline concussion testing protocol, including vestibular and ocular assessment1
The Vestibular/Ocular Motor Screening (VOMS) is a five-minute assessment measuring symptom provocation that include saccadic eye movements, gaze stability, vestibular-ocular reflex, and near point convergence (NPC) distance and symptoms2
The VOMS has been reported to be a useful tool in identifying patients with concussion and that adolescent athletes experience one or more vestibular/ocular motor impairments or symptoms following sport-related concussion2
The King-Devick test, a number naming ocular motor processing and reaction time test, has gained popularity in it’s use as a concussion screening tool and has had positive relationships with other concussion screening tools3
Slower King-Devick times have been associated with lower SAC and SCAT3 scores post-concussion4 along with higher symptom severity scores4
In concussed adolescent individuals, slower King-Devick times were associated with lower ImPACT composite scores on visual memory, visual processing speed, and reaction time5,6
There remains a lack of research in the association between the King-Devick test and the VOMS assessment at baseline and post-concussion
Study Design: This was a one-time, experimental design
Instrumentation: The Vestibular/Ocular Motor Screening tool and the King-Devick test were utilized during this study
Participants: 468 youth football and soccer athletes aged 8-14 (avg. age = 11.0 ± 1.5 years), from the mid-Michigan area, participated in this study
Procedures: IRB, parental consent, and athlete assent were collected prior to data collection. All athletes were administered the Vestibular/Ocular Motor Screening (VOMS) (Figure 1) and King-Devick (Figure 2) test prior to the start of their respective youth seasons
Data Analysis: To test the association between performance on the VOMS tool symptom provocation and King-Devick performance, a correlation was conducted. The p value set prior at .05
Vestibular subscales of the VOMS produced poor correlations, as well
Horizontal VOR: r= .13; p= .005
Vertical VOR: r= .13; p= .003
VMS: r= .11; p= .011
r=.05; p= .21
r=.04; p= .33
r=.09; p= .04
r=.12; p= .01
Conclusion
Appears that the VOMS ocular motor subscales remain independent from ocular performance on the King-Devick test, due to the nature of symptom provocation and not ocular motor performance, which may further emphasize its implementation
Overall, there is a poor relationship between the ocular motor subscales of the VOMS and King-Devick test, despite both tests utilizing visual tracking, smooth pursuit, and saccadic eye movements
Further investigation is needed on the association between the VOMS and King-Devick post-concussion
Figure 1. VOMS tool grading sheet (Mucha et al., 2013)
Figure 2. King –Devick test card set (Galetta et al., 2011)
Purpose of the Study
References
The purpose of this study was to assess the association between the Vestibular/Ocular Motor Screening (VOMS) and King-Devick test at baseline in youth athletes
1Broglio, S., Cantu, R., Gioia, G., Guskiewicz, K., Kutcher, J., Palm, M., & McLeod, T. (2014). National athletic trainers’ association position statement: management of sport concussion. Journal of Athletic Training, 49(2),
2Mucha, A., Collins, M., Elbin, R., Furman, J., Troutman-Enseki, C., DeWolf, R., Marchetti, G., & Kontos, A. (2014). A brief vestibular/ocular motor screening (VOMS) assessment to evaluate concussions. American Journal of Sports Medicine, 42(10),
3Galetta, K., Morganroth, J., Moehringer, N., Mueller, B., Hasanaj, L., Webb, N., & Civitano, C.
et al., (2015). Adding vision to concussion testing: a prospective study of sideline testing in youth and collegiate athletes. Journal of Neuro-opthalmology, In Press.
4Benedict, P., Baner, N., Harrold, G., Moehringer, N., Hasananj, L, & Serrano, L et al. (2015). Gender and age predcit outcomes of cognition, balance, and vision testing in a multidisciplinary concussion center. Journal of Neurological Sciences, 353,
5Tjarks, B., Dorman, J., Valentine, V., Munce, T., Thomposn, P., & Kindt, S., & Bergeron, M.
(2013). Comparison and utility of King-Devick and ImPACT® composite scores in adolescent concussion patients. Journal of the Neurological Sciences, 334,
6Vernau, B., Grady, M., Goodman, A., Wiebe, D., Basta, L., Park, Y., Arbogast, K., & Master, C.
(2015). Oculomotor and neurocognitive assessment of youth ice hockey players: baseline associations and observations after concussion. Developmental Neuropsychology, 40(1), 7-11.