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Does Visual Performance Influence Head Impact Severity Among High School Football Athletes?

Schmidt, Julianne D. PhD, ATC*; Guskiewicz, Kevin M. PhD, ATC**,†,‡; Mihalik, Jason P. PhD, CAT(C), ATC**,†,‡; Blackburn, J. Troy PhD, ATC‡,§; Siegmund, Gunter P. PhD, PEng¶,‖; Marshall, Stephen W. PhD**,††

Clinical Journal of Sport Medicine: November 2015 - Volume 25 - Issue 6 - p 494–501
doi: 10.1097/JSM.0000000000000143
Original Research

Objective: To compare the odds of sustaining moderate and severe head impacts, rather than mild, between high school football players with high and low visual performance.

Design: Prospective quasi-experimental.

Setting: Clinical Research Center/On-field.

Participants: Thirty-seven high school varsity football players.

Interventions: Athletes completed the Nike SPARQ Sensory Station visual assessment before the season. Head impact biomechanics were captured at all practices and games using the Head Impact Telemetry System.

Main Outcome Measures: Each player was classified as either a high or low performer using a median split for each of the following visual performance measures: visual clarity, contrast sensitivity, depth perception, near–far quickness, target capture, perception span, eye–hand coordination, go/no go, and reaction time. We computed the odds of sustaining moderate and severe head impacts against the reference odds of sustaining mild head impacts across groups of high and low performers for each of the visual performance measures.

Results: Players with better near–far quickness had increased odds of sustaining moderate [odds ratios (ORs), 1.27; 95% confidence intervals (CIs), 1.04-1.56] and severe head impacts (OR, 1.45; 95% CI, 1.05-2.01) as measured by Head Impact Technology severity profile. High and low performers were at equal odds on all other measures.

Conclusions: Better visual performance did not reduce the odds of sustaining higher magnitude head impacts. Visual performance may play less of a role than expected for protecting against higher magnitude head impacts among high school football players. Further research is needed to determine whether visual performance influences concussion risk.

Clinical Relevance: Based on our results, we do not recommend using visual training programs at the high school level for the purpose of reducing the odds of sustaining higher magnitude head impacts.

*Department of Kinesiology, University of Georgia, Athens, Georgia;

Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center, Chapel Hill, North Carolina;

Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;

§Neuromuscular Research Laboratory, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;

MEA Forensic Engineers & Scientists, Richmond, British Canada, Canada;

School of Kinesiology, University of British Columbia, Vancouver, British Canada, Canada;

**Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and

††Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.

Corresponding Author: Julianne D. Schmidt, PhD, ATC, Department of Kinesiology, University of Georgia, 330 River Rd., Athens, GA 30606 (schmidtj@uga.edu).

The authors report no conflicts of interest.

Received November 12, 2013

Accepted June 12, 2014

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.