Eye tracking as a diagnostic and monitoring tool for sports-related concussion
| dc.contributor.advisor | Welman, Karen | en_ZA |
| dc.contributor.advisor | Derman, Wayne | en_ZA |
| dc.contributor.advisor | Patricios, Jon | en_ZA |
| dc.contributor.author | Snegireva, Nadja | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Medicine and Health Sciences. Sport Science. | en_ZA |
| dc.date.accessioned | 2020-02-24T09:45:22Z | |
| dc.date.accessioned | 2020-04-28T15:13:49Z | |
| dc.date.available | 2020-02-24T09:45:22Z | |
| dc.date.available | 2020-04-28T15:13:49Z | |
| dc.date.issued | 2020-03 | |
| dc.description | Thesis (PhD Sport Sc))--Stellenbosch University, 2020. | en_ZA |
| dc.description.abstract | 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. | en_ZA |
| dc.description.abstract | AFRIKAANSE OPSOMMING : Agtergrond: Oogbewegings het 'n maklike kwantifiseerbare biomerker geword vir 'n verskeidenheid van siektes; alhoewel die potensiaal vir harsingskudding assessering moet nog bekragtig word. Die doel van hierdie voornemende kohortstudie was om vas te stel of oogvolgingstegnologie (OVT) 'n klinies nuttige, betroubare en geldige metode kan wees om jeug- en volwasse atlete wat 'n sportverwante harsingskudding (SVH) opgedoen het, te diagnoseer en monitor. Metodes: 'n Aanlyn-opname was gedoen onder sportsgeneeskundiges (n = 171) om die kliniese nuttigheid van OVT te ondersoek. Om die betroubaarheid en geldigheid te bepaal, was 'n toetsbattery met geselekteerde oogvolgingsmetings (n = 47) drie keer (3.0 ± 1.4, 26.1 ± 47.2 en 45.8 ± 19.3 dae na besering) uitgevoer op volwasse- en jeugatlete met SVH (n = 70), en twee keer op ouderdoms-en geslagsooreenstemmende atlete sonder harsingskuddings (n = 92) gedoen met 7.0 ± 3.9 dae tussen sessies. Resultate: Volgens die aanlyn-opnames het sportsgeneeskundiges onvoldoende kennis gehad dat harsingskudding kan lei tot abnormale oog bewegings. Minder as die helfte van die respondente (46.3 ± 12%) het oogbewegings-tekortkominge geïnspekteer, met die uitsondering van abnormale pupille-ligrefleks (ondersoek deur 68%). Slegs 11% van die geneeskundiges het al met OVT gewerk. Die teling van self-tempo saccades (STS) in die volwasse groep, asook die oëkniptydsduur in die geheue-geleide saccade-taak (GGS), die hoeveelheid antisaccade-foute en die diagonale gladde agtervolging (GA) wins in die jeuggroep het op goeie betroubaarheid gedui (ICC > 0. 75). Jeugatlete met harsingskudding het 'n langer oëkniptydsduur in die vinnige GGS taak (p = 0.001, η2 = 0.17) en 'n neiging vir langer oëkniptydsduur in die sinusvormige GN taak (p = 0.016, η2 = 0.06) getoon in vergelyking met nie-harsingskuddings jeugatlete, sowel as teenoor hul eie daaropvolgende post-harsingskuddingswaardes (oëkniptydsduur het afgeneem oor tyd met 24%, p = 0.35, en 18%, p = 0.48, dienooreenkomstig). Afsluiting: In die geheel kon hierdie studie nie die bevindinge van vorige navorsing oor oogvolgingsmetings vir SVH- assessering bevestig nie, as gevolg van onvoldoende betroubaarheid van die beskryfde protokolle wat toegepas word op atlete wat aan kontaksport deelneem. Geneeskundiges kan gebruik maak van die SPS-telling as 'n aanduiding van 'n harsingskudding by volwasse atlete; terwyl langer oëkniptydsduur in GGS of sinusvormige GA-take op 'n harsingskudding by jeugatlete kan dui. Die bevordering van opvoedingsgeleenthede en praktiese ervaring van geneeskundiges word voorgestaan ten opsigte van die gebruik van OVT vir SVH-assessering om die breër gebruik daarvan aan te moedig, aangesien die meeste tekorte in saccades of gladde agtervolging tydens ondersoeke sonder instrumentasie gemis word. Laastens is daar ‘n neiging vir agteropvolgende vergelykings binne dieselfde individue om meer die effek van 'n SVH op te spoor as die vergelyking met gesonde kontrole groep. | af_ZA |
| dc.description.version | Doctoral | en_ZA |
| dc.format.extent | xvi, 148 pages ; illustrations, includes annexures | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/108436 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Stellenbosch : Stellenbosch University | en_ZA |
| dc.rights.holder | Stellenbosch University | en_ZA |
| dc.subject | Brain -- Concussion -- Diagnosis | en_ZA |
| dc.subject | Eye tracking | en_ZA |
| dc.subject | Sports injuries -- Diagnosis | en_ZA |
| dc.subject | UCTD | |
| dc.title | Eye tracking as a diagnostic and monitoring tool for sports-related concussion | en_ZA |
| dc.type | Thesis | en_ZA |