When playing sports, it can be tempting to brush off an injury so you can get back in the game. But delaying treatment, particularly when you have a concussion, can lead to serious long-term damage that can impair visual function and cognition.
According to the Centers for Disease Control, up to 3.8 million sports-related concussions occur each year in the USA. Detecting these injuries is not always straightforward or based exclusively on objective signs and symptoms. However, this may soon change.
The NFL, which has been the target of harsh criticism and massive litigation for reportedly turning a blind eye to players with concussions, currently relies heavily on the King-Devick Test (K-D Test) — a two-minute eye movement test that requires players to read numbers displayed on cards or on a tablet.
After suspected head trauma, the athlete is given the K-D Test, and that time is compared with his pre-season baseline time. But many argue more options are needed, and Texas-based startup EyeGuide Focus may have one such solution. The company has developed a headset that can detect concussions in just 10 seconds, also by tracking eye movement.
Like the K-D Test, EyeGuide Focus relies on a baseline measurement. The unit’s software runs on an iPad. You simply follow a small white circle with your eyes, watching it as it moves across the screen. In addition to looking at your pre-injury score, the EyeGuide system compares your eye movements with a database of records from other athletes. The company says this makes it particularly difficult for athletes to cheat the system just to get back on the field.
A third concussion test that’s being investigated has been touted as entirely objective and impossible to question or cheat because it’s a blood test. Medical development company Quanterix says it identifies concussions by picking up proteins that result from brain trauma. The ultimate goal is to adapt it in such a way that a single finger prick test on the sideline could be used to determine if an athlete should return to the field.
The South African Rugby Football Union guidelines state; ‘if in doubt sit then out’ a useful adage to follow, but more importantly advises concussed athletes not to return to the field of play on that day. Lovell et al. have shown that the athlete with concussions demonstrated impaired cognitive function for approximately 5 days, further validating the decision to not allow a player to return to the field of play. SA Rugby uses the Maddock’s test.
Maddock’s Questions for sideline assessment of concussion
- What venue are we at?
- Which half is it?
- Who scored last?
- Which team did we play last week?
- Did we win last week?