Concussions in amateur rugby union identified with the use of a rapid visual screening tool

J Neurol Sci. 2013 Mar 15;326(1-2):59-63. doi: 10.1016/j.jns.2013.01.012. Epub 2013 Jan 29.


Aim: To use the King-Devick (KD) test and Sports Concussion Assessment Tool 2 (SCAT2) in amateur rugby union players to identify witnessed and unrecognised episodes of concussion that occurred from match participation.

Methods: A prospective observational cohort study was conducted on a premier club level amateur rugby union team during the 2012 competition in New Zealand. Every player completed a pre-competition questionnaire on concussion history, a baseline PCSS and two trials of the KD before they participated in any match activities.

Results: For players reporting a concussion in the previous three years there was an average of 4.0±2.8 concussions per player. There were 22 concussive incidents recorded over the duration of the competition (46 per 1000 match hours). Five concussive incidents were witnessed (11 per 1000 match hours) and 17 unrecognised concussive incidents were identified with the KD (37 per 1000 match hours). Witnessed concussions recorded, on average, a longer KD on the day of injury (5.5±2.4s) than unrecognised concussions (4.4±0.9s) when compared with their baseline KD.

Discussion: The KD was able to identify players that had not shown, or reported, any signs or symptoms of a concussion but who had meaningful head injury. The current rate of concussion reported was a ten-fold increase in previously reported concussion injury rates. This makes the KD suitable for rapid assessment in a limited time frame on the sideline such as a five-minute window to assess and review suspected concussed players in rugby union.

MeSH terms

  • Adolescent
  • Adult
  • Athletic Injuries / diagnosis
  • Athletic Injuries / epidemiology
  • Brain Concussion / diagnosis*
  • Brain Concussion / epidemiology
  • Brain Concussion / physiopathology*
  • Cohort Studies
  • Diagnostic Techniques, Neurological*
  • Football / injuries*
  • Humans
  • Male
  • New Zealand / epidemiology
  • Photic Stimulation / methods*
  • Prospective Studies
  • Saccades / physiology*
  • Time Factors
  • Young Adult