Reliability of Objective Screening Tools for Concussion in Collegiate Athletes
Alani Jack1, Alyssa Lickfeld2, Micaela Nanni2, Joy Parrish2, Laura Balcer1, Steven Galetta1, John Leddy3, Mohammad Haider4, Haley Chizuk2
1NYU Grossman School of Medicine, 2University of Buffalo, 3UBMD Orthopaedics & Sports Medicine, 4University At Buffalo, SUNY
Objective:

We determined reliability and agreement for the Mobile Universal Lexicon Evaluation System (MULES) and Staggered Uneven Number (SUN) tests over a sports season for a collegiate cohort.  

Background:

Visual as well as cognitive dysfunction are common clinical presentations of concussion.  Formal clinical neuro-ophthalmic examinations and cognitive assessments have long administration times that require a specialist to perform.  The MULES and SUN assess many visual networks and performance requires the integration of saccadic eye movements, color perception, visual memory and object and number identification.  Rapid and reliable tests are important for assessing concussion on the sideline and in the clinic.  MULES and SUN were developed to quickly assess visual function following sports-related concussion both in collegiate and youth athletes.  They have also been studied in patients with multiple sclerosis, mild cognitive impairment and Parkinson’s disease.

Design/Methods:

Healthy collegiate athletes (n=21, mean age 20 years, 57.1% male) completed the MULES and SUN at two baseline visits, approximately two weeks apart, during the pre-season. The tests were administered again immediately at the post-season. The intra-class correlation coefficient (ICC) using a two–way mixed effects model and absolute agreement were calculated as a measure of reliability and agreement between both 1) the two pre-season assessments and 2) the first pre-season assessment and the post-season assessment.  Each side of the MULES and each line of the SUN were analyzed individually. 

Results:

For both MULES and SUN, high levels of reliability were demonstrated between the two pre-season baseline test scores and for pre-season vs. post-season scores (ICCs of 0.76-0.90, p<0.001 for all).  

 

Conclusions:
MULES and the SUN have excellent reliability for capturing the many aspects of visual function and other dimensions related to cognitive and ocular motor function in healthy collegiate athletes.  These freely-accesssible and rapid measures will be useful for further implementation to assess collegiate as well as youth athletes.
10.1212/WNL.0000000000216427
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.