Abstract

Context: Vestibular and ocular motor assessment is an emerging clinical assessment for sport-related concussion (SRC). The increased use of these assessments by clinicians calls for examination of outcomes in populations that may impact clinical practice.

Objective: Compare vestibular and ocular motor impairments in high school and collegiate athletes within 72 hours of SRC. Second, examine the distribution of impairments in these populations based upon pre-established clinical cut-off scores.

Design: Cross-sectional study.

Setting: High school (HS) and collegiate athletics (COL).

Patient or Other Participants: Data were collected from 110 athletes (HS: n=47, age=15.40±1.35 years; COL: n=63, age=19.46±1.28 years) within 72 hours of sustained SRC.

Main Outcome Measure(s): Total and change scores were calculated for the Vestibular/Ocular Motor Screening (VOMS) assessment, along with average near point of convergence (NPC) distance. Separate Mann Whitney U tests were used to compare group differences and Chi-square analyses were used to examine athlete distribution above clinical cutoff scores for all VOMS outputs (a priori Alpha level<0.5).

Results: No significant differences were found between high school and collegiate athletes for VOMS total scores, change scores, and NPC distance. A significantly larger proportion of the sample reported scores above the cutoff for all total scores (p<0.001) and change scores in horizontal vestibulo-ocular reflex (VOR; 59.01%, p<0.001), vertical VOR (60.91%, p<0.001), and visual motion sensitivity (60.91%, p<0.001). However, a significantly larger proportion reported smooth pursuit change scores (85.45%, p<0.001) and NPC distance (73.64%, p=0.01) below the cutoff scores.

Conclusions: During the acute phase of SRC, high school and collegiate athletes present with similar vestibular and ocular motor impairments as measured by the VOMS, but vestibular tasks appear to cause greater symptom provocation in concussed athletes. Lastly, VOMS change scores may offer more clinical utility in assessing specific impairments following SRC compared to total scores.

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