scholarly journals Sport-specific differences in dynamic visual acuity and gaze stabilization in division-I collegiate athletes

2020 ◽  
Vol 30 (4) ◽  
pp. 249-257
Author(s):  
C. Quintana ◽  
N.R. Heebner ◽  
A.D. Olson ◽  
J.P. Abt ◽  
M.C. Hoch
Keyword(s):  
Visual Acuity ◽  
A Priori ◽  
Collegiate Athletes ◽  
Division I ◽  
Normative Values ◽  
Dynamic Visual Acuity ◽  
Gaze Stabilization ◽  
Concussion Management ◽  
Vestibular Ocular Reflex ◽  
Concussion History

BACKGROUND: The vestibular-ocular reflex (VOR) integrates the vestibular and ocular systems to maintain gaze during head motion. This reflex is often negatively affected following sport-related concussion. Objective measures of gaze stability, a function mediated by the VOR, such as the computerized dynamic visual acuity test (DVAT) and gaze stabilization test (GST), may have utility in concussion management. However, normative data specific to sport, sex, or concussion history have not been established in collegiate athletes. OBJECTIVE: The objective of this study was to establish normative values for the DVAT and GST in collegiate athletes and explore the effect of sport, sex, and concussion history on VOR assessments. METHODS: The DVAT and GST were completed by 124 collegiate athletes (72 male, 52 female, mean±SD, age: 19.71±1.74 years, height: 173.99±13.97 cm, weight: 80.06±26.52 kg) recruited from Division-I athletic teams (football, soccer and cheerleading). The DVAT and GST were performed in the rightward and leftward directions during a single session in a standardized environment. Normative values for DVAT and GST measures were expressed as percentiles. Non-parametric statistics were used to compare differences between groups based on sex, sport, and concussion history. Alpha was set a-priori at 0.05. RESULTS: Overall, the median LogMAR unit for 124 athletes completing the DVAT was 0 (IQR = 0.17) for both leftward and rightward. The median velocities achieved on the GST were 145 °/sec and 150 °/sec (IQR = 45 and 40) for the leftward and rightward directions respectively. Significant differences were observed between sports (p = 0.001–0.17) for the GST with cheerleading demonstrating higher velocities than the other sports. However, no significant differences were identified based on sex (p≥0.09) or history of concussion (p≥0.15). CONCLUSIONS: Normative estimates for the DVAT and GST may assist in the clinical interpretation of outcomes when used in post-concussion evaluation for collegiate athletes. Although sex and previous concussion history had no effect on the DVAT or GST, performance on these measures may be influenced by type of sport. Sport-related differences in the GST may reflect VOR adaptations based on individual sport-specific demands.

Correlation of Head Impact Exposures With Vestibulo-Ocular Assessments

2020 ◽  
Vol 29 (3) ◽  
pp. 310-314 ◽  
Author(s):  
Theresa L. Miyashita ◽  
Paul A. Ullucci
Keyword(s):  
Visual Acuity ◽  
Cumulative Effect ◽  
Head Impact ◽  
Division I ◽  
Dynamic Visual Acuity ◽  
Head Impacts ◽  
Ocular Reflex ◽  
Gaze Stability ◽  
Vestibulo Ocular Reflex ◽  
Subconcussive Impacts

Context: Managing a concussion injury should involve the incorporation of a multifaceted approach, including a vision assessment. The frontoparietal circuits and subcortical nuclei are susceptible to trauma from a concussion injury, leading to dysfunction of the vestibulo-ocular system. Research investigating the effect of cumulative subconcussive impacts on neurological function is still in its infancy, but repetitive head impacts may result in vestibular system dysfunction. This dysfunction could create visual deficits, predisposing the individual to further head trauma. Objective: The purpose of this study was to investigate the cumulative effect of subconcussive impacts on minimum perception time, static visual acuity, gaze stability, and dynamic visual acuity scores. Design: Prospective cohort. Setting: Division I university. Patients: Thirty-three Division I men’s lacrosse players (age = 19.52 [1.20] y). Intervention: Competitive lacrosse season. Main Outcome Measures: At the beginning and end of the season, the players completed a vestibulo-ocular reflex assessment, using the InVision™ system by Neurocom® to assess perception, static acuity, gaze stability, and dynamic visual acuity. Score differentials were correlated with the head impact exposure data collected via instrumented helmets. Results: A significant correlation was found between change in perception scores and total number of head impacts (r = .54), and between changes in dynamic visual acuity loss scores on the rightside and maximum rotational acceleration (r = .36). No statistical differences were found between preseason and postseason vestibulo-ocular reflex variables. Conclusions: Cumulative subconcussive impacts may negatively affect vestibulo-ocular reflex scores, resulting in decreased visual performance. This decrease in vestibulo-ocular function may place the athlete at risk of sustaining additional head impacts or other injuries.

Comparison of the Gaze Stabilization Test and the Dynamic Visual Acuity Test in Unilateral Vestibular Loss Patients and Controls

2015 ◽  
Vol 36 (4) ◽  
pp. 746-753 ◽  
Author(s):  
Courtney C. J. Voelker ◽  
Amelia Lucisano ◽  
Dorina Kallogjeri ◽  
Belinda C. Sinks ◽  
Joel A. Goebel
Keyword(s):  
Visual Acuity ◽  
Dynamic Visual Acuity ◽  
Vestibular Loss ◽  
Gaze Stabilization ◽  
The Gaze ◽  
Visual Acuity Test ◽  
Acuity Test

scholarly journals Residual Deficits in Vestibular Function Exist Following Return to Sports Participation from Concussion

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S21.3-S22
Author(s):  
Carolina Quintana ◽  
Nicholas Heebner ◽  
John ABt ◽  
Matthew Hoch
Keyword(s):  
Visual Acuity ◽  
Ncaa Division I ◽  
A Priori ◽  
Vestibular Function ◽  
Collegiate Athletes ◽  
Balance Test ◽  
Gaze Stability ◽  
History Of ◽  
Visual Acuity Test ◽  
Division I Athletes

ObjectiveDetermine if collegiate athletes exhibit residual deficits in vestibular function at the time of unrestricted return to participation (RTP) following a sports-related concussion (SRC).BackgroundIt has been well documented that afferent vestibular pathways are disrupted after SRC. This includes both the vestibular-ocular and vestibulospinal reflexes which mediate dynamic vision and postural stability. However, few studies have determined if vestibular function is recovered in athletes at the time of RTP from SRC.Design/MethodsTwenty-six NCAA Division-I athletes (1.77 ± 0.14 m, 92.81 ± 31.30 kg, 10 females, 16 males) performed the Concussion Balance Test (COBALT), the Dynamic Visual Acuity Test (DVAT), and Gaze Stability Test (GST). Thirteen athletes were tested within 14 days of RTP following SRC. Thirteen athletes with no history of SRC were matched to the RTP group based on age, sex, and sport to serve as healthy controls (HC). Paired t-tests with corresponding effect sizes compared COBALT, DVAT, and GST scores between groups (SRC, HC). For all tests, the alpha level was set a priori at 0.10.ResultsTwenty-six NCAA Division-I athletes (1.77 ± 0.14 m, 92.81 ± 31.30 kg, 10 females, 16 males) performed the Concussion Balance Test (COBALT), the Dynamic Visual Acuity Test (DVAT), and Gaze Stability Test (GST). Thirteen athletes were tested within 14 days of RTP following SRC. Thirteen athletes with no history of SRC were matched to the RTP group based on age, sex, and sport to serve as healthy controls (HC). Paired t-tests with corresponding effect sizes compared COBALT, DVAT, and GST scores between groups (SRC, HC). For all tests, the alpha level was set a priori at 0.10.ConclusionsOur preliminary findings suggest that collegiate athletes who return to participation from SRC may experience residual deficits in postural control and visual acuity with dynamic head movements that challenge the vestibular system. Therefore, objective measures of vestibular function may be beneficial to ensure postural control and visual acuity are restored at RTP following SRC.

Vestibular Rehabilitation Outcomes in Chronic Vertiginous Patients Through Computerized Dynamic Visual Acuity and Gaze Stabilization Test

2007 ◽  
Vol 28 (6) ◽  
pp. 809-813 ◽  
Author(s):  
Carlo Badaracco ◽  
Francesca Sylos Labini ◽  
Annalisa Meli ◽  
Ezio De Angelis ◽  
Davide Tufarelli
Keyword(s):  
Visual Acuity ◽  
Vestibular Rehabilitation ◽  
Dynamic Visual Acuity ◽  
Gaze Stabilization ◽  
Rehabilitation Outcomes

Gaze stability in young adults with previous concussion history

2020 ◽  
Vol 30 (4) ◽  
pp. 259-266
Author(s):  
Linda J. D’Silva ◽  
Catherine F. Siengsukon ◽  
Hannes Devos
Keyword(s):  
Visual Acuity ◽  
Young Adults ◽  
Sleep Quality ◽  
Daytime Sleepiness ◽  
Head Movements ◽  
Control Group ◽  
Dynamic Visual Acuity ◽  
Symptom Scale ◽  
Gaze Stability ◽  
Concussion History

BACKGROUND: Disruption of visual-vestibular interaction after concussion can cause gaze instability with head movements. The long-term impact of concussion on gaze stability is unknown. OBJECTIVE: This cross-sectional comparative pilot study examined gaze stability in the chronic stage after concussion (greater than one year). A secondary objective was to examine the relationship between gaze stability and sleep. METHODS: Outcome measures included: 1. Gaze stability in logMAR (mean loss of dynamic visual acuity (DVA) in the yaw and pitch planes); 2. Pittsburgh Sleep Quality Index (PSQI); 3. Epworth Sleepiness Scale (ESS). Post-Concussion Symptom Scale (PCSS), time since injury, and number of concussions were collected for the people with concussion. RESULTS: The study sample included thirty-four adults (mean age 23.35±1.3 years). Seventeen had a history of 1–9 concussions, with a mean duration of 4.4±1.9 years since last concussion; and 17 were age and sex-matched controls. Mean pitch plane DVA loss was greater in the concussion group compared to the control group (p = 0.04). Participants with previous concussion had lower sleep quality based on the PSQI (p = 0.01) and increased daytime sleepiness based on the ESS (p = 0.01) compared to healthy controls. Mean DVA loss in the pitch plane was significantly correlated with the PSQI (r = 0.43, p = 0.01) and the ESS (r = 0.41, p = 0.02). CONCLUSION: Significant differences in dynamic visual acuity may be found in young adults long after a concussion, compared with those who have no concussion history. Furthermore, loss of dynamic visual acuity was associated with poorer sleep quality and higher daytime sleepiness.

Discriminative Validity of Vestibular Ocular Motor Screening in Identifying Concussion Among Collegiate Athletes: A National Collegiate Athletic Association–Department of Defense Concussion Assessment, Research, and Education Consortium Study

2021 ◽  
pp. 036354652110123
Author(s):  
Anthony P. Kontos ◽  
Shawn R. Eagle ◽  
Gregory Marchetti ◽  
Aaron Sinnott ◽  
Anne Mucha ◽  
...  
Keyword(s):  
Department Of Defense ◽  
National Collegiate Athletic Association ◽  
Collegiate Athletes ◽  
Ocular Motor ◽  
Predictive Utility ◽  
Ocular Reflex ◽  
Vestibular Ocular Reflex ◽  
Concussion History ◽  
Research And Education ◽  
Assessment Research

Background: Vestibular and ocular motor screening tools, such as the Vestibular/Ocular Motor Screening (VOMS), are recognized as important components of a multifaceted evaluation of sport-related concussion. Previous research has supported the predictive utility of the VOMS in identifying concussion, but researchers have yet to examine the predictive utility of the VOMS among collegiate athletes in the first few days after injury. Purpose: To determine the discriminative validity of individual VOMS item scores and an overall VOMS score for identifying collegiate athletes with an acute sport-related concussion (≤72 hours) from healthy controls matched by age, sex, and concussion history. Study Design: Case-control study; Level of evidence, 3. Methods: Participants (N = 570) aged 17 to 25 years were included from 8 institutions of the National Collegiate Athletic Association–Department of Defense CARE Consortium (Concussion Assessment, Research, and Education): 285 athletes who were concussed (per current consensus guidelines) and 285 healthy controls matched by age, sex, and concussion history. Participants completed the VOMS within 3 days of injury (concussion) or during preseason (ie, baseline; control). Symptoms are totaled for each VOMS item for an item score (maximum, 40) and totaled across items for an overall score (maximum, 280), and distance (centimeters) for near point of convergence (NPC) is averaged across 3 trials. Receiver operating characteristic analysis of the area under the curve (AUC) was performed on cutoff scores using Youden index ( J) for each VOMS item, overall VOMS score, and NPC distance average. A logistic regression was conducted to identify which VOMS scores identified concussed status. Results: A symptom score ≥1 on each VOMS item and horizontal vestibular/ocular reflex ≥2 significantly discriminated concussion from control (AUC, 0.89-0.90). NPC distance did not significantly identify concussion from control (AUC, 0.51). The VOMS overall score had the highest accuracy (AUC, 0.91) for identifying sport-related concussion from control. Among the individual items, vertical saccades ≥1 and horizontal vestibular/ocular reflex ≥2 best discriminated concussion from control. Conclusion: The findings indicate that individual VOMS items and overall VOMS scores are useful in identifying concussion in collegiate athletes within 3 days of injury. Clinicians can use the cutoffs from this study to help identify concussion in collegiate athletes.

Gaze stabilization and dynamic visual acuity in people with multiple sclerosis

2017 ◽  
Vol 26 (5-6) ◽  
pp. 469-477 ◽  
Author(s):  
Mark M. Mañago ◽  
Margaret Schenkman ◽  
Jean Berliner ◽  
Jeffrey R. Hebert
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Dynamic Visual Acuity ◽  
Gaze Stabilization

Effect of vestibular rehabilitation on passive dynamic visual acuity

2008 ◽  
Vol 18 (2-3) ◽  
pp. 147-157
Author(s):  
Matthew Scherer ◽  
Americo A. Migliaccio ◽  
Michael C. Schubert
Keyword(s):  
Visual Acuity ◽  
Exercise Program ◽  
Home Exercise ◽  
Dynamic Visual Acuity ◽  
Gaze Stabilization ◽  
Ocular Reflex ◽  
Gaze Stability ◽  
Before And After ◽  
Vestibulo Ocular Reflex ◽  
Head Impulses

While active dynamic visual acuity (DVA) has been shown to improve with gaze stabilization exercises, we sought to determine whether DVA during {passive} head impulses (pDVA) would also improve following a rehabilitation course of vestibular physical therapy (VPT) in patients with unilateral and bilateral vestibular hypofunction. VPT consisted of gaze and gait stabilization exercises done as a home exercise program. Scleral search coil was used to characterize the angular vestibulo-ocular reflex (aVOR) during pDVA before and after VPT. Mean duration of VPT was 66 ± 24 days, over a total of 5 ± 1.4 outpatient visits. Two of three subjects showed improvements in pDVA with a mean reduction of 43% (LogMAR 0.58 to 0.398 and 0.92 to 0.40). Our data suggest improvements in pDVA may be due in part to improvements in aVOR velocity and acceleration gains or reduced latency of the aVOR. Each subject demonstrated a reduction in the ratio of compensatory saccades to head impulses after VPT. Preliminary data suggest that active gaze stability exercises may contribute to improvements in pDVA in some individuals.

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