Is the King-Devick Test a Reliable Tool in Wheelchair Athletes? A Preliminary Prospective Study in Wheelchair Basketball

Sport-Related Concussion in Para Athletes: A Scoping Review of Concussion Incidence, Assessment, and Management

ABSTRACT

Although research on sport-related concussion has grown substantially in the last decade, research on concussion in para sports remains limited. The aim of this scoping review is to synthesize and describe the current literature on the incidence, assessment, and management of sport-related concussion in para athletes. The literature search was conducted in CINAHL, Google Scholar, MEDLINE, SPORTDiscus, and Web of Science databases and identified 22 studies that addressed one of our research questions. A majority of studies addressed concussion in elite athletes; youth and collegiate para athletes were largely underrepresented. Fewer studies addressed concussion assessment and management, in part due to limitations in accessibility of current assessment tools for athletes with varying disabilities. Moving forward, there is a need to capture a larger range of incidence data, create modified assessment tools with para-specific normative data, and develop risk prevention strategies for para athletes.

King-Devick Test in Wheelchair Sports: Identifying Normative Values and Effects of Exertion on Outcomes

OBJECTIVE

To establish normative baseline values on the King-Devick (KD) Test for contact wheelchair sport participants. The secondary purpose was to examine the effect of physical exertion on test score.

DESIGN

Quasiexperimental.

SETTING

Competitive disability sport venues before practices or games.

PARTICIPANTS

One-hundred 43 wheelchair rugby or wheelchair basketball (WBB) players completed the study. Participants were predominantly men (87.5%) and played WBB (84%).

INTERVENTION

30-m wheelchair sprint test to fatigue.

MAIN OUTCOME MEASURE

King-Devick Baseline Score.

RESULTS

Mean KD baseline score was 59.16 ± 15.56 seconds with significant differences ( P < 0.05) identified by sport and impairment type, but not sex. Athletes with spina bifida and cerebral palsy had significantly higher mean baseline KD times than athletes with spinal cord injury. KD scores improved by 3.5% in athletes who reported "light" to "somewhat hard" exertion (RPE = 13). In a subset of athletes who performed sprints until an RPE of 18 was reached, 8 of 12 players (66.7%) demonstrated an improvement in KD score; however, large increases by a few participants caused the noticeable change.

CONCLUSIONS

Normative values for wheelchair contact sport athletes are meaningfully slower than able-bodied sports participants. KD score improved with exertion with the greater improvement after moderate-intensity compared with vigorous-intensity exercise. These findings can be applied clinically to monitor athlete safety.