Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada.
F1000Res. 2019 Jul 9;8:1032. doi: 10.12688/f1000research.19587.5. eCollection 2019.
: Vision tests are used in concussion management and baseline testing. Concussions, however, often occur months after baseline testing and reliability studies generally examine intervals limited to days or one week. Our objective was to determine the one-year test-retest reliability of these tests. : We assessed one-year test-retest reliability of ten vision tests in elite Canadian athletes followed by the Institut National du Sport du Quebec. We included athletes who completed two baseline (preseason) annual evaluations by one clinician within 365±30 days. We excluded athletes with any concussion or vision training in between the annual evaluations or presented with any factor that is believed to affect the tests (e.g. migraines). Data were collected from clinical charts. We evaluated test-retest reliability using Intraclass Correlation Coefficient (ICC) and 95% limits of agreement (LoA). We examined nine female and seven male athletes with a mean age of 22.7 (SD 4.5) years. Among the vision tests, we observed excellent test-retest reliability in Positive Fusional Vergence at 30cm (ICC=0.93) but this dropped to 0.53 when an outlier was excluded in a sensitivity analysis. There was good to moderate reliability in Negative Fusional Vergence at 30cm (ICC=0.78), Phoria at 30cm (ICC=0.68), Near Point of Convergence break (ICC=0.65) and Saccades (ICC=0.61). The ICC for Positive Fusional Vergence at 3m (ICC=0.56) also decreased to 0.45 after removing two outliers. We found poor reliability in Near Point of Convergence (ICC=0.47), Gross Stereoscopic Acuity (ICC=0.03) and Negative Fusional Vergence at 3m (ICC=0.0). ICC for Phoria at 3m was not appropriate because scores were identical in 14/16 athletes. 95% LoA of the majority of tests were ±40% to ±90%. Five tests had good to moderate one-year test-retest reliability. The remaining tests had poor reliability. The tests would therefore be useful only if concussion has a moderate-large effect on scores.
:视觉测试用于脑震荡管理和基线测试。然而,脑震荡通常发生在基线测试后的数月,并且可靠性研究通常检查的间隔限于几天或一周。我们的目的是确定这些测试的一年测试-重测可靠性。:我们评估了加拿大精英运动员在魁北克国家体育研究所进行的为期一年的测试-重测可靠性。我们包括了在 365±30 天内由一名临床医生完成两次基线(季前)年度评估的运动员。我们排除了在年度评估之间有任何脑震荡或视力训练的运动员,或出现任何被认为会影响测试的因素(例如偏头痛)的运动员。数据来自临床图表。我们使用组内相关系数(ICC)和 95%置信区间(LoA)评估测试-重测可靠性。我们评估了九名女性和七名男性运动员,平均年龄为 22.7(SD 4.5)岁。在视觉测试中,我们观察到在 30cm 处正融合性聚散的测试-重测可靠性极好(ICC=0.93),但在敏感性分析中排除一个离群值后,这一数值降至 0.53。在 30cm 处负融合性聚散(ICC=0.78)、30cm 处斜视(ICC=0.68)、近点集合破裂(ICC=0.65)和扫视(ICC=0.61)方面,可靠性较好。在排除两个离群值后,在 3m 处正融合性聚散(ICC=0.56)的 ICC 也降至 0.45。我们发现近点集合(ICC=0.47)、粗立体视力(ICC=0.03)和 3m 处负融合性聚散(ICC=0.0)的可靠性较差。在 3m 处斜视的 ICC 由于 16 名运动员中的 14 名得分相同而不适用。大多数测试的 95%LoA 为±40%至±90%。五项测试具有良好到中等的一年测试-重测可靠性。其余测试的可靠性较差。因此,只有在脑震荡对分数有中等-较大影响的情况下,这些测试才会有用。