Browsing by Author "Snegireva, Nadja"

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    Eye tracking as a diagnostic and monitoring tool for sports-related concussion
    (Stellenbosch : Stellenbosch University, 2020-03) Snegireva, Nadja; Welman, Karen; Derman, Wayne; Patricios, Jon; Stellenbosch University. Faculty of Medicine and Health Sciences. Sport Science.
    ENGLISH SUMMARY : Background: Eye movements have become an easy-to-quantify biomarker for a range of disorders; however, the potential for concussion assessment still needs to be validated. The aim of this prospective cohort study was to establish whether eye tracking technology (ETT) would be a clinically useful, reliable, and valid method to diagnose and monitor youth and adult athletes who have sustained a sports-related concussion (SRC). Methods: To investigate the clinical utility of ETT, an online survey amongst sports medicine clinicians (n = 171) was conducted. For determination of reliability and validity, a testing battery with selected eye tracking metrics (n = 47) was implemented three times (3.0 ± 1.4, 26.1 ± 47.2 and 45.8 ± 19.3 days post-injury) on concussed adult and youth athletes (n = 70) and twice on non-concussed age-and-sex matched athletes (n = 92) with 7.0 ± 3.9 days between sessions. Results: There was insufficient awareness among surveyed clinicians that concussion could lead to abnormal eye movements. Thus, with the exception of abnormal pupil light reflex (examined by 68%), eye movement deficits were inspected by less than half of the respondents (46.3 ± 12%). Only 11% clinicians had actually worked with ETT. Self-paced saccade (SPS) count in the adult group, and the blink duration in the memory-guided saccade (MGS) task, proportion of antisaccade errors, and gain of diagonal smooth pursuit (SP) in the youth group indicated good reliability (ICC > 0.75). Concussed youth athletes had a higher blink duration in the fast MGS task (p = 0.001, η2 = 0.17) and a tendency for higher blink duration in the sinusoidal SP task (p = 0.016, η2 = 0.06) compared to non-concussed youths, as well as to their own subsequent post-concussion values (blink duration decreased over time by 24%, p = 0.35, and 18%, p = 0.48, accordingly). Conclusion. Overall, this study was not able to confirm the findings of previous research on eye tracking metrics for SRC assessment, due to insufficient reliability of described protocols when applied to athletes participating in contact sports. Clinicians can make use of the SPS count as indicator of a concussion among adult athletes, while longer blink durations in MGS or sinusoidal SP tasks might indicate a concussion in youth athletes. Increasing educational opportunities and practical experience of clinicians regarding the use of ETT for SRC assessment to encourage its broader use is advocated, since most deficits in saccades or smooth pursuit are missed during un-instrumented examination. Finally, serial comparison within the same individuals over time is more likely to detect the effect of a SRC than comparison to healthy controls.