Pre- and post-season visio-vestibular function in healthy adolescent athletes.

Abstract

OBJECTIVE\nTo evaluate pre- to post-season differences in individual subtests of the Visio-Vestibular Examination (VVE) in healthy middle and high school athletes.\n\n\nMETHODS\nThis prospective cohort study recruited participants from a private suburban United States secondary school. Participants completed a demographic questionnaire prior to the start of their season. A proxy for head impact exposure was estimated by incorporating previously published head impact frequencies by team and sport. The VVE was completed pre- and post-season and consisted of 9 subtests: smooth pursuit, horizontal/vertical saccades and gaze stability, binocular convergence, left/right monocular accommodation, and complex tandem gait. Generalized estimating equations were employed to assess the relative risk of an abnormal VVE outcome based on testing session (pre- vs. post-season).\n\n\nRESULTS\nParticipants included middle and high school athletes (n=115; female=59 (51.3%); median age at first assessment=14.9 years, [IQR=13.6, 16.0]) during 2017/18 - 2019/20 school years. During pre-season testing, accommodation (10.0%) and complex tandem gait (9.2%) had the largest proportion of abnormal outcomes, while smooth pursuits (10.6%) and convergence (9.5%) had the largest proportion of abnormal outcomes post-season. When assessing the effect of testing session on the relative risk of any abnormal VVE subtest, there were no significant findings (P≥0.25). Additionally, there were no significant effects of testing session when adjusting for estimated head impact exposure for any VVE subtest (P≥0.25).\n\n\nCONCLUSIONS\nVisio-vestibular function as measured by the VVE does not change from pre- to post-season in otherwise healthy adolescent athletes. Our findings suggest that the VVE may be stable and robust to typical neurodevelopment occurring in this dynamic age group and help inform post-injury interpretation of visio-vestibular impairments.