Neurological Risk Assessment
A Richmond Hill hockey team recently underwent a Neurological Risk Assessment at our Thornhill medical clinic. 16 team members were seen by our staff (sports MD, medical doctor, behavioural optometrist, occupational therapist and 3 administrative assistants) over 3 hours. Areas tested in our Neurological Risk Assessment are binocular vision skills (not routinely tested by your family optometrist), neurocognitive ability and dynamic balance function.
Our neurological risk assessment is designed to screen for neuropsychological conditions that are not infrequently present in the general population. For example, convergence insufficiency is felt to be present in 3-5% of general population and carries with it a significant burden for those trying to perform academically.
The results from our Neurological Risk Assessment showed that 2 of the 16 team members had binocular visual conditions that would put them at a higher risk of a prolonged and more severe concussion recovery if they were to sustain concussions. One athlete was identified in having convergence insufficiency and accommodative dysfunction. Treating this would not only mitigate the risk of prolonged/more severe concussion recovery; it would also enhance his academic potential. The second athlete had vergence dysfunction and anisometropia that would similarly put him at a higher risk of a prolonged/more severe concussion recovery. These conditions can be rehabilitated now through vision therapy; rehabilitating them preemptively before they sustain a concussion is much simpler and more efficient.
Hockey is a sport that carries a higher risk of concussion – American football and rugby being to other sports that carry similarly high rates of concussion. Athletes with undiagnosed visual and/or vestibular conditions, whether they are aware of their conditions or not, are at higher risk of a prolonged and more severe concussion recovery. The potential implications on the patients’ lives – in both curricular and extra-curricular activities – are significant. This brings about the need to identify these patients before they are put at risk of concussion.
Many of those afflicted with concussion suffer from visuo-vestibular anomalies. What this means is that a patient gets mixed signals regarding her perception of where her body is relative to where it actually is. That is, her visual system may tell her one thing, her vestibular system may tell her another, her somatosensory system may give her yet another perspective and then her own beliefs of where she is in the room affects all of this too. This seems like a very unintuitive problem to which many of us cannot relate. However, its implications are profound.
It is not difficult for most of us to see that this problem can lead to symptoms of dizziness and imbalance. This in turn can lead to headaches, fatigue and stress which will affect one’s sleep quality, concentration, etc. This problem will also affect one’s visual system, particularly the way visual information is processed in the brain. The visual and vestibular system are intimately connected, they are 2 sides of a coin. The visual system exists in the head, for which the vestibular system is the gyroscope; the visual system operates in the context of the vestibular system. The vestibular system is involved in driving eye motions and in the perception of what is seen. Abnormalities in the central processing of either system has implications on one’s ability to process what one is seeing at school, work, etc. and in turn, will hinder one’s performance.
Please contact us if you are interested in having our team do a Neurological Risk Assessment for your team.