A multimodal framework to assess differences in dynamic visual acuity between athletes with and without recent sport-related concussion.

Sport-related concussions (SRC) commonly affect vision and cognition, but there is limited understanding of how concurrent balance and exertion demands may affect visual-cognitive performance beyond symptom resolution.Purpose To determine if a dynamic visual acuity (DVA) task performed during standing and walking could differentiate performance between athletes with and without concussion history.Methods Interuniversity athletes (N = 30, age = 20.9 years ± 1.4) with SRC history who were asymptomatic (SRC = 14; females = 6) were compared to athletes without SRC (CONTROL = 16; female = 7). A DVA task was completed while seated, standing, and during low- and moderate-intensity treadmill walking. A Tumbling 'E' target was presented randomly in either random walk (R) or horizontal (H) motion (2.31 m/s), in one of four orientations; responses were selected using a handheld keypad. Performance was characterized as a change in DVA score from Seated (logMAR) and response time (RT, ms). A linear mixed-effects model was fitted for DVA change scores and a generalized mixed effects model for median RT.Results The SRC group exhibited worse DVA change scores during standing and walking compared to CONTROL (p < .05) during R-motion only. Whereas both groups responded faster during treadmill walking for both R- and H-motion (p < .001). Only two athletes (14%) in the SRC group experienced mild symptoms that did not affect performance during the protocol.Conclusion A multimodal DVA assessment, including standing and walking conditions, may be a feasible approach to detect differences in visual-cognitive performance for athletes following clinical recovery of concussion.