Vision training methods for sports concussion mitigation and management.

There is emerging evidence supporting the use vision training, including light board training tools, as a concussion baseline and neuro-diagnostic tool and potentially as a supportive component to concussion prevention strategies. This paper is focused on providing detailed methods for select vision training tools and reporting normative data for comparison when vision training is a part of a sports management program. The overall program includes standard vision training methods including tachistoscope, Brock's string, and strobe glasses, as well as specialized light board training algorithms. Stereopsis is measured as a means to monitor vision training affects. In addition, quantitative results for vision training methods as well as baseline and post-testing *A and Reaction Test measures with progressive scores are reported. Collegiate athletes consistently improve after six weeks of training in their stereopsis, *A and Reaction Test scores. When vision training is initiated as a team wide exercise, the incidence of concussion decreases in players who participate in training compared to players who do not receive the vision training. Vision training produces functional and performance changes that, when monitored, can be used to assess the success of the vision training and can be initiated as part of a sports medical intervention for concussion prevention.

Effects of postural control manipulation on visuomotor training performance: comparative data in healthy athletes.

PURPOSE/BACKGROUND: Visuomotor ability is an important parameter for neurologic function and effective sport performance. Adding a balance challenge during a structured eye-hand coordination task, such as hitting lights on a light board (Dynavision™), has not been previously reported. Using Division I football players, the aim of this study was to determine normative data on a dual-task performance regimen combining a visuomotor light board task with a balance task. The intent is to use such normative data and baseline data as part of a concussion management program. METHODS: Division I college football team members, n=105, were consented. Subjects first performed Dynavision™ D2™ Visuomotor Training Device (D2™) eye-hand coordination tasks, the A* and the RT; they then performed the same tasks with an added balance challenge, standing on a BOSU® ball. RESULTS: Ninety-four athletes completed the full testing procedure on the D2™ system. The mean score of the A* test was 93 ± 11.0 hits per minute; and the mean on the A* test with the added BOSU® balance challenge was 83.7 ± 9.2 hits per minute. The mean RT time was 0.33 ± 0.036 seconds. Mean reaction time increased to 0.38 ± 0.063 while the subject stood on the BOSU® ball. Performance on the D2™ A* and RT were both statistically significantly different in the dual task condition (p<0.05). CONCLUSIONS: Results show an approximate 10% decline in D2™ performance when healthy individuals stand on a BOSU® ball. From the data presented here, the authors determined that there is a 10% decrement in performance when one's balance is challenged on the BOSU® ball. A fall in performance of substantially greater than 10% may indicate abnormal vestibulocerebellar regulatory processing of balance and motion. Further research, using these normative data is needed to determine more specific parameters for definitions of impairment and return-to-play and if there is utility for such studies as part of a concussion management program. LEVEL OF EVIDENCE: III.