MICK (Mobile Integrated Cognitive Kit) App for Concussion Assessment in a Youth Ice Hockey League

Abstract

Background: Visual symptoms are common after concussion. Rapid automatized naming (RAN) tasks are simple performance measures that demonstrate worse time scores in the setting of acute or more remote injury. Methods: We evaluated the capacity for the Mobile Universal Lexicon Evaluation System (MULES) and Staggered Uneven Number (SUN) testing to be feasibly administered during preseason testing in a cohort of youth ice hockey athletes using a novel computerized app, the Mobile Integrated Cognitive Kit (MICK). Participants from a youth hockey league underwent preseason testing. Results: Among 60 participants, the median age was 13 years (range 6–17). The median best time for the MULES was 49.8 seconds (range = 34.2–141.0) and the median best time for the SUN was 70.1 (range = 36.6–200.0). As is characteristic of timed performance measures, there were learning effects between the first and second trials for both the MULES (median improvement = 10.6 seconds, range = −32.3 to 92.0, P < 0.001, Wilcoxon signed-rank test) and SUN (median improvement = 2.4 seconds, range= −8.0 to 15.1, P = 0.001, Wilcoxon signed-rank test). Age was a predictor of best baseline times, with longer (worse) times for younger participants for MULES (P < 0.001, r s = −0.67) and SUN (P < 0.001, r s = −0.54 Spearman rank correlation). Degrees of learning effect did not vary with age (P > 0.05, r s = −0.2). Conclusions: Vision-based RAN tasks, such as the MULES and SUN, can be feasibly administered using the MICK app during preseason baseline testing in youth sports teams. The results suggest that more frequent baseline tests are necessary for preadolescent athletes because of the relation of RAN task performance to age.