This work was supported, in part by the NIBIB (EB007954) and a charitable donation from Geraldine Warner.

The protocol described below has components of a vision training program that is a part of the baseline testing performed on all UC athletes. Some of the components have been studied in research trials and in these instances the protocols were approved by the UC Institutional Review Board and the subjects signed informed consent statements.
1. Light Board Vision Training
It takes about 8 min to complete this training.
<ol>
	<li>*A Program8-11
	<ol>
		<li>Direct the subject ...

<ol>
	<li>Vesia, M., Esposito, J., Prime, S. L., Klavora, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Correlations+of+selected+psychomotor+and+visuomotor+tests+with+initial+Dynavision+performance.">Correlations of selected psychomotor and visuomotor tests with initial Dynavision performance.</a> Percept. Mot. Skills. 107 (1), 14-20 (2008).</li><li>Zupan, M., Wile, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Eyes+on+the+prize.">Eyes on the prize.</a> Training and Conditioning. 21 (2), 11-15 (2015).</li><li>Clark, J. F., Ellis, J. K., Bench, J., Khoury, J., Graman, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=High+performance+vision+training+improves+batting+statistics+for+University+of+Cincinnati+baseball+players.">High performance vision training improves batting statistics for University of Cincinnati baseball players.</a> PLoS ONE. 7 (1), e29109 (2012).</li><li>Wilkerson, G. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neurocognitive+reaction+time+predicts+lower+extremity+sprains+and+strains.">Neurocognitive reaction time predicts lower extremity sprains and strains.</a> IJATT. 17 (6), 4-9 (2012).</li><li>Clark, J. F., Graman, P., Ellis, J. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Possible+stereopisis+enhancement+in+collegiate+baseball+players+with+vision+training.">Possible stereopisis enhancement in collegiate baseball players with vision training.</a> Optometry and Visual Performance. 3 (1), (2015).</li><li>Ramsey, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> See the hit, save the brain game plan at cautious UC. , (2014).</li><li>Clark, J. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+exploratory+study+of+the+potential+effects+of+vision+training+on+concussion+incidence+in+football.">An exploratory study of the potential effects of vision training on concussion incidence in football.</a> Optometry and Visual Performance. 3 (1), (2015).</li><li>Thorpe, S., Fize, D., Marlot, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Speed+of+processing+in+the+human+visual+system.">Speed of processing in the human visual system.</a> Nature. 381 (6582), 520-522 (1996).</li><li>Hayes, A., Chen, C. S., Clarke, G., Thompson, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+improvements+following+the+use+of+the+NVT+Vision+Rehabilitation+program+for+patients+with+hemianopia+following+stroke.">Functional improvements following the use of the NVT Vision Rehabilitation program for patients with hemianopia following stroke.</a> NeuroRehabilitation. 31 (1), 19-30 (2012).</li><li>Harmon, K. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=American+Medical+Society+for+Sports+Medicine+position+statement:+concussion+in+sport.">American Medical Society for Sports Medicine position statement: concussion in sport.</a> Br J Sports Med. 47, 15-26 (2013).</li><li>Klavora, P., Gaskovski, P., Forsyth, R. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Test-retest+reliability+of+three+Dynavision+tasks.">Test-retest reliability of three Dynavision tasks.</a> Percept Mot Skills. 80 (2), 607-610 (1995).</li><li>Ghasemi, A., Momeni, M., Jafarzadehpur, E., Rezaee, M., Taheri, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Visual+skills+involved+in+decision+making+by+expert+referees.">Visual skills involved in decision making by expert referees.</a> Percept Mot Skills. 112 (1), 161-171 (2011).</li><li>Klavora, P., Gaskovski, P., Forsyth, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Test-retest+reliability+of+the+Dynavision+apparatus.">Test-retest reliability of the Dynavision apparatus.</a> Percept Mot Skills. 79 ((1 Pt 2)), 448-450 (1994).</li><li>Schwab, S., Memmert, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+impact+of+a+sports+vision+training+program+in+youth+field+hockey+players.">The impact of a sports vision training program in youth field hockey players.</a> J Sports Sci Med. 11, 624-631 (2012).</li><li>Somers, W. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Estimation+of+the+stereoscopic+threshold+utilizing+perceived+depth.">Estimation of the stereoscopic threshold utilizing perceived depth.</a> Ophthal Physiol Opt. 4 (3), 245-250 (1984).</li><li>Bigsby, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+postural+control+manipulation+on+visuomotor+training+performance:+comparative+data+in+healthy+athletes.">Effects of postural control manipulation on visuomotor training performance: comparative data in healthy athletes.</a> Int J Sports Phys Ther. 9 (4), 436-446 (2014).</li><li>Wells, A. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+of+the+Dynavision+D2+for+Assessing+Reaction+Time+Performance.">Reliability of the Dynavision D2 for Assessing Reaction Time Performance.</a> J Sports Sci and Med. 13, 145-150 (2014).</li><li>Guskiewicz, K. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=National+Athletic+Trainers&#8217;+Association+Position+Statement:+Management+of+Sport-Related+Concussion.">National Athletic Trainers&#8217; Association Position Statement: Management of Sport-Related Concussion.</a> J Athletic Training. 39 (3), 280-297 (2004).</li><li>Kuhn, A. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Supervision+and+computerized+neurocognitive+baseline+test+performance+in+high+school+athletes:+an+initial+investigation.">Supervision and computerized neurocognitive baseline test performance in high school athletes: an initial investigation.</a> J Athl Train. 49 (6), 800-805 (2014).</li><li>Reed, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+multi-modal+approach+to+assessing+recovery+in+youth+athletes+following+concussion.">A multi-modal approach to assessing recovery in youth athletes following concussion.</a> J Vis Exp. (91), 51892 (2014).</li><li>Fleisig, G. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Kinetic+comparison+among+the+fastball,+curveball,+change-up,+and+slider+in+collegiate+baseball+pitchers.">Kinetic comparison among the fastball, curveball, change-up, and slider in collegiate baseball pitchers.</a> Am J Sports Med. 34 (3), 423-430 (2006).</li><li>Gray, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+do+batters+use+visual,+auditory,+and+tactile+information+about+the+success+of+a+baseball+swing.">How do batters use visual, auditory, and tactile information about the success of a baseball swing.</a> Res Q Exerc Sport. 80 (3), 491-501 (2009).</li><li>Kato, T., Fukuda, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Visual+search+strategies+of+baseball+batters:+eye+movements+during+the+preparatory+phase+of+batting.">Visual search strategies of baseball batters: eye movements during the preparatory phase of batting.</a> Mot Skills. 94 (2), 380-386 (2002).</li><li>Howard, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Perceiving in Depth. , 978-970 (2012).</li></ol>

Vision training, when initiated as a team wide exercise, decreases the incidence of concussions in those players when compared to players who do not receive the vision training7. Vision training produces functional and performance changes that can be quantitatively monitored to assess the success of the training and can be initiated as part of a sports medical intervention for concussion prevention. Functional changes are changes in the measurement, for example faster reaction times documented during vision tr...

Vision training, including the use of light board vision systems, has gained popularity as a means to improve sports performance1,2. Light board systems are often used for rehabilitation following brain injury2,3 and for sports performance enhancement as part of a vision training regimen1,4,5. Vision training has also been used as a means of injury prevention6.
The University of Cincinnati (UC) Division of Sports Medicine has used a light board vision tool for concussion management, diagnosis, return to play decision making, injury prevention and rehabilitation of athletes and performance enhancement3,5,7. Each athlete has baseline measurements collected at the beginning of the season and these values are used as a part of the concussion management program and specifically for an athlete&#8217;s post-concussion evaluation and treatment. One of the strengths of the tool is the objective data collected: number of hits per unit time, location within the visual field of each hit, average reaction time per hit, multi-tasking drills and temporal output for observing progress.
The UC sports medicine team has used the *A and Reaction Test as part of concussion baseline assessments. Three additional, purpose built, programs are also used for concussion diagnosis. These are called Concussion 1, Concussion 2 and Concussion 3. The 3 concussion tests do not need to be included among the preseason baseline tests, because their differing levels of complexity allow each test result to serve as a reference for the others in the set.
When the programs are complemented with additional vision training methods the athlete gets a thorough training and the clinician obtains a wealth of baseline data in the event of a concussion. Several additional vision training methods complete the comprehensive program: Brock&#8217;s string, EYEPORT training, accommodative flippers, tachistoscope, pinhole glasses or strobe glasses with pitch and catch, saccadic eye movement training, and near far training. This paper presents vision training methods with and without a light board system, normative data for baseline results for Division 1 college football players, and expectations and protocols concerning the use of the vision training protocol as part of a concussion management program.

<table border="0" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td>Name of Material/ Equipment</td>
			<td>Company</td>
			<td>Catalog Number</td>
			<td>Comments/Description</td>
		</tr>
		<tr>
			<td>Dynavision D2</td>
			<td>Dynavision International</td>
			<td></td>
			<td><a href="http://dynavisioninternational.com/shop.html">External Link</a></td>
		</tr>
		<tr>
			<td>EYEPORT Vision Training System</td>
			<td>Exercise Your Eyes, Dove Canyon, CA</td>
			<td></td>
			<td><a href="http://www.promolife.com/cart/eyeport-vision-training-system">External Link</a></td>
		</tr>
		<tr>
			<td>accommodative flippers</td>
			<td>Various manufacturers</td>
			<td></td>
			<td><a href="http://www.amconlabs.com/product.asp?pid=4511&amp;categoryname=&amp;prodCatFrom=206">External Link</a></td>
		</tr>
		<tr>
			<td>pinhole glasses</td>
			<td>Various manufacturers</td>
			<td></td>
			<td><a href="http://www.amazon.com/SaveGoodBuy-Exercise-Eyesight-Improving-Glasses/dp/B0090BXVVK/ref=sr_1_1?ie=UTF8&amp;qid=1409165383&amp;sr=8-1&amp;keywords=pinholes+glasses">External Link</a></td>
		</tr>
		<tr>
			<td>strobe glasses - Nike Sparq</td>
			<td>Nike&#160;</td>
			<td></td>
			<td><a href="http://palmensports.com/order-the-nike-sparq-vapor-strobes-eyewear/">External Link </a></td>
		</tr>
	</tbody>
</table>

vision training methods for sports concussion mitigation and management

There is emerging evidence supporting the use vision training, including light board training tools, as a concussion baseline and neuro-diagnostic tool and potentially as a supportive component to concussion prevention strategies. This paper is focused on providing detailed methods for select vision training tools and reporting normative data for comparison when vision training is a part of a sports management program. The overall program includes standard vision training methods including tachistoscope, Brock&#8217;s string, and strobe glasses, as well as specialized light board training algorithms. Stereopsis is measured as a means to monitor vision training affects. In addition, quantitative results for vision training methods as well as baseline and post-testing *A and Reaction Test measures with progressive scores are reported. Collegiate athletes consistently improve after six weeks of training in their stereopsis, *A and Reaction Test scores. When vision training is initiated as a team wide exercise, the incidence of concussion decreases in players who participate in training compared to players who do not receive the vision training. Vision training produces functional and performance changes that, when monitored, can be used to assess the success of the vision training and can be initiated as part of a sports medical intervention for concussion prevention.

Baseball, football and volunteer subjects have participated in the vision training program. All subjects have been college age men or women, between the ages of 18- and 26 years-old.
Football
The average *A score for 101 UC Football players the first time they performed it was 74.2 &#177; 10.3 hits per min (hpm) and the average Reaction Test time for their first time performing it was 0.34 &#177; 0.03 sec (n = 79, note not all 105 players had a chance to complete th...

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Vision Training Methods for Sports Concussion Mitigation and Management

This paper describes a protocol to conduct, quantitatively monitor, and assess the success of vision training initiated as part of a sports medical management program including intervention for concussion prevention and performance enhancement.

There is emerging evidence supporting the use vision training, including light board training tools, as a concussion baseline and neuro-diagnostic tool ...

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17.2K visualizações.  University of Cincinnati. This paper describes a protocol to conduct, quantitatively monitor, and assess the success of vision training initiated as part of a sports medical management program including intervention for concussion prevention and performance enhancement.