Document Type

Poster

Publication Date

4-20-2021

Abstract

Introduction

Female collegiate soccer and lacrosse athletes are subject to repetitive subconcussive head impacts; defined as “cranial impacts that do not result in known or diagnosed concussion on clinical grounds.” These impacts may result in vestibulo-oculomotor (V-O) system dysfunction. Identifying V-O dysfunction is critical in order to better understand the potential consequences of these impacts.

Purposes

Retrospectively examine four years of pilot data to:

  1. Describe the evolution of an assessment battery for cleared to play athletes.
  2. Identify the assessment tools most frequently positive in cleared to play athletes and non-athletes.
  3. Provide direction for clinical practice and future research endeavors.

Participants

  • 60 Division II female soccer and lacrosse players: 35 soccer, 25 lacrosse
  • 21 non-athletes (2 years)

Methods

Each year tests were retained or discontinued depending on their evaluative strength. Alternate tests were added to capture a given or different domain. The following shows the evolution of assessments (additions bolded):

  • Year One: non-instrumental (clinical) Dynamic Visual Acuity (cDVA), Head Impulse Test (HIT), Head Shake Nystagmus Test (HSN), Y-Balance Test, Balance Error Scoring System (BESS)
  • Year Two: cDVA, HIT, HSN, Y-Balance Test, BESS, Near Point Convergence (NPC)
  • Year Three: cDVA, NPC, HIT, HSN, Trail-Making Test (TMT) A and B
  • Year Four: cDVA, NPC, TMT, 40-yard dash with and without head turns, T-agility Test

Results

  • Difference in V-O system function in athletes compared to non-athletes in first two years of data collection: 14/21 athletes had at least one positive test; 1/25 non-athletes had at least one positive test
  • The cDVA and the NPC tests were most frequently positive tests across four years
  • Repeat participants showed signs of V-O system dysfunction based on cDVA an NPC testing
  • No significant results found with cognition, balance, or performance testing

Conclusion

  • Athletes had a much higher incidence of positive V-O tests than non-athletes
  • Over half of cleared to play athletes had a positive V-O test; cDVA and NPC most frequently positive
  • Highly trained athletes may require more challenging and sensitive assessment tools to identify cognitive and performance deficits

Clinical Relevance

  • Many cleared to play female collegiate athletes may be playing in the presence of V-O deficits
  • Using specific V-O assessments may better identify athletes with V-O dysfunction and lead to subsequent treatment intervention
  • Continued research needed to develop an optimal assessment battery to guide baseline, return to play, and intervention decisions

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