Ординатура / Офтальмология / Английские материалы / Sports Vision Vision Care for the Enhancement of Sports Performance_Erickson_2007
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SPORTS VISION: VISION CARE FOR THE ENHANCEMENT OF SPORTS |
ISBN: 978-0-7506-7577-2 |
PERFORMANCE |
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Copyright © 2007 by Butterworth-Heinemann, an imprint of Elsevier Inc. |
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Notice
Neither the Publisher nor the Author assume any responsibility for any loss or injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. It is the responsibility of the treating practitioner, relying on independent expertise and knowledge of the patient, to determine the best treatment and method of application for the patient.
The Publisher
ISBN: 978-0-7506-7577-2
Publishing Director: Linda Duncan
Senior Editor: Kathryn Falk
Senior Developmental Editor: Christie M. Hart
Publishing Services Manager: Julie Eddy
Project Manager: Andrea Campbell/Laura Kudowitz
Design Direction: Maggie Reid
Printed in China
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Contributors
Jason Brumitt, MSPT, SCS, ATC, CSCS, OD
Laboratory Instructor
School of Physical Therapy
Pacific University
Forest Grove, Oregon
Peter Shaw-McMinn, OD
Assistant Professor
Southern California College of Optometry
Fullerton, California
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To my wife, Dina, and children, Alexander and Maya, for their enduring love and support,
and to students and practitioners of sports vision for their inspiration
Preface
The role of visual performance in sports has received considerable attention over the years. With the increasing participation rates in sports and recreational activities, interest in vision care services for athletes has intensified among eye care practitioners and sports personnel. Sports vision can be defined as vision care and consultation designed to protect, correct, and enhance vision to make sports and athletic competition safe, enjoyable, and more successful. It encompasses a broad scope of professional skills, including the prevention and management of sports-related eye injuries, the determination and delivery of appropriate refractive correction, the determination of appropriate protective eyewear, the understanding of filters and their potential application in sports, assessment and remediation of functional vision inefficiencies, assessment of sports-specific vision skills, vision training to enhance visual performance, and consultation with athletes and other sports personnel. Vision is the guiding sense for most sports performance, and sports vision is one of many disciplines that can contribute to the achievement of peak performance.
In searching for the role sports vision may play for athletes, previous surveys have suggested that there remains an unmet need in vision care services, with an increasing interest in the sports vision field. As athletes continue to reach new heights, many efforts have been made to enhance performance by optimizing skills in every area pertinent to a given sport. The surveys have shown both an interest by team personnel and optometrists to include vision screenings, proper ocular health care, refractive evaluation and correction, and remedial and/or enhancement vision training to optimize visual performance. However, the available literature in this area is scattered and varies tremendously in quality.
Personally, I have been involved in both the provision of sports vision services in a variety of clinical settings, and the teaching of sports vision to optometry students and practitioners. This combination of experiences obligated me to not only develop the requisite clinical skills, but also to develop an understanding of the relevant professional and research literature. For teaching purposes, I have found that the published texts on sports vision are either very limited in scope, out of date, or out of print. This text reviews the main elements of the vision care services provided to athletes by eye care practitioners, all of which begin with an analysis of the visual demands that are critical to success in sports. I have attempted to build a foundation from vision science research to guide the application of clinical care, an evidence-based approach. I am indebted to the many practitioners and researchers who have shared their ideas and insights on the burgeoning area of sports vision, for the concepts and procedures discussed in this text are the culmination of those collective contributions. Although there are many areas where numerous questions remain unanswered, the combination of careful task analysis, review of related research findings, and logical deduction can guide the practitioner in determining appropriate vision care.
There are several items on the accompanying CD that can help the practitioner to incorporate sports vision services in a variety of clinical settings. Although this text is
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PREFACE ix
primarily addressed to eye care practitioners, other sports personnel may find useful information for assisting athletes with visual performance needs.
The pursuit of sport and recreational activities is a multibillion-dollar-a-year industry that has seen tremendous growth in the past 30 years. As I like to point out to students and practitioners, almost every patient is a sports vision patient. The ability to understand their needs and provide specialty services to meet these individual needs is a fundamental attribute of every successful practice.
Graham B. Erickson, OD, FAAO, FCOVD
Acknowledgments
I gratefully acknowledge the following individuals for their contributions to the development of this publication: Drs. Bradley Coffey, Alan Reichow, Karl Citek, Stephen Beckerman, Steven Hitzeman, Alan Berman, Lorne Yudcovich, and Dina Erickson. I thank Pacific University for the encouragement and support on this project, and the Vision team at Nike for their conceptual and pragmatic assistance. My students and research assistants have my enduring appreciation for the role each of them plays in my professional growth. I thank Christie Hart and Laura Kudowitz of Elsevier for their assistance and flexibility in development and production.
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1
Introduction to Sports Vision
CHAPTER OUTLINE
Overview of Terminology |
Overview of a Clinical Model of Sports Vision |
Historical Perspective |
The Future of Sports Vision |
Have you ever wished you could improve your batting average, lower your golf score, or just play your favorite sport better? Most people who participate in sporting activities love to win or at least improve their performance. Athletes at all levels of competition spend a substantial amount of money on sports, including equipment and clothing. Yet many performances that fail are not caused by poor equipment or clothing, or even the wrong physical movement, but by the movement being performed at the incorrect time or in the incorrect place.
A significant percentage of the general population in developed nations participate at some level in sporting activities. The National Sporting Goods Association produces yearly estimates of participation by sport and gender for the United States (available at www.nsga.org). The eye care practitioner must recognize that sports participation crosses all lines of age, gender, race, and socioeconomic status; every patient is potentially a sports vision patient. In addition, a significant percentage of the population may not actively participate in sports but are avid spectators.
Considerable debate has taken place concerning the role of vision in sports. Vision is the signal that directs the muscles of the body to respond. The legendary football coach Blanton Collier is credited for developing the concept that “the eyes lead the body.”1 Vision provides the athlete with information regarding where and when to perform. Superior size, strength, speed, and agility cannot completely make up for inefficient processing of visual information. For example, if the eyes do not tell a batter where the ball is, he or she is not going to hit it no matter how perfect the swing. Even for the discriminating spectator, excellent visual function allows improved opportunity to enjoy watching sports. Little debate exists that vision is a critical factor in sports performance; however, conflicting evidence shows that successful athletes possess superior visual function that allows them to see and perform better than novices in sports.
The athletic community should be educated about the aspects of vision that potentially affect sports performance. To clearly communicate these aspects, the following visual elements should be discussed:
●Sight: The clarity of the image on the retina and ocular health
●Motor/sensory: Fixation stability and eye movements, accommodation, vergence, and fusion; visually guided motor performance
●Information processing: Quick and accurate visual processing, interpretation, and decision making
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2CHAPTER 1 INTRODUCTION TO SPORTS VISION
Understanding the relevance of these aspects to performance provides an avenue for effective communication of specific vision care recommendations. A better-informed sports community benefits by improved access to services that potentially make sports and athletic competition safe, enjoyable, and more successful.
OVERVIEW OF TERMINOLOGY
The term sports vision has been used to describe many vision care services provided to athletes. The mission of the American Optometric Association Sports Vision Section is to advance the quality and delivery of optometric sports vision care through education, injury prevention, and enhancement of the visual performance of athletes. Practitioners working in this area usually are involved with one or more of the following professional activities2:
●Prevention and management of sports eye injuries
●Assessment and remediation of functional vision inefficiencies that may negatively impact competitive consistency
●Specialized contact lens services with emphasis on environmental factors in sports, position of gaze factors, emergency care, and attainment of maximal visual acuity
●Performance-based ophthalmic eyewear services that address visual and environmental demands
●Assessment of specific sports-related visual abilities
●Enhancement training of specific visual abilities considered to be essential for competitive consistency for a specific sport activity
●Consultation with athletes, coaches, trainers, and teams regarding visual factors and strategies related to consistent peak athletic performance
Many in the global community are dedicated to the pursuit of athletic excellence. A critical but often neglected aspect of peak human performance is vision. The information presented in this text should help stimulate the inclusion of these specialized services in the care of athletes, no matter what level of sports participation.
In North America, the term sports vision has been associated with vision therapy designed for the enhancement of sports performance. The areas of sports vision defined above clearly demonstrate that many of these services are basic primary vision care services that are modified to address specific task demands. All eye care practitioners should consider visual performance factors when providing vision care services to athletic patients.
HISTORICAL PERSPECTIVE
The use of special eyewear for sports is perhaps the oldest application of vision factors to performance. Daland described the early use of stenopeic slit masks by Eskimos for hunting,3 and many other special-purpose optical appliances have been described in the literature.4 Optical protection from solar radiation and glare have been used to some degree for centuries. The use of optical refractive compensation for sports has not been as frequently used, most likely for a combination of practical and aesthetic reasons. The available eyewear was not typically appropriate for use in sports; contact lens technology did not emerge as a reasonable option for most athletes until the later half of the twentieth century; and refractive surgery options did not become advantageous until the late 1990s. Today the benefits of significant advances in technology and designs for the correction and protection of vision are enjoyed by athletes (see Chapter 6).
CHAPTER 1 |
INTRODUCTION TO SPORTS VISION |
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The evaluation of vision skills in athletes has also been an area of intense interest. The earliest literature citation found is an account of the sensory and motor gifts of the legendary baseball player Babe Ruth in 1921.5 This report was followed later by an article discussing the role of vision in baseball.6 These early articles produced suggestions for procedures to assess performance potential in baseball on the basis of vision skill analysis. Interestingly, debate in the literature exists concerning the actual vision profile of the great Babe Ruth. Despite the early report that Ruth had eyesight that was 12% faster than the average person,5 a 1991 article reported that an ophthalmologic examination revealed amblyopia ex anopsia in his left eye.7 The potential role of depth perception in batting is challenged by these discrepancies in Ruth’s visual status; either he performed so well because he had superior vision skills, or he was successful despite having degraded stereopsis as a result of a congenital amblyopia. Although no definitive resolution can be made from these contradictory reports, some have speculated that the unilateral vision loss was likely the result of a complication of his nasopharyngeal carcinoma rather than an undetected congenital condition.8 The exact role of vision in sports performance is still hotly debated, and many vision evaluation procedures have been suggested over the years in an attempt to discover the nature of this aspect of sports performance.
Because vision skills are generally recognized as a critical element to most sports performance, significant interest has been expressed in improving sports performance by using training procedures to enhance vision. Many of the visual attributes that have been identified as important in sport are amenable to training. The relevant questions are whether sport-specific visual abilities can indeed be trained and whether any improvements in visual skills transfer to improved sports performance by the athlete. Although the literature has few reports supporting sports vision training, and these reports often have significant flaws, enhancement of visual skill performance can be logically predicted to provide the athlete with a potential advantage when preparing for competition.
The increasing interest in sports and the role of vision in sports has produced the impetus for the formation of organizations to facilitate professional communications. The United States was the first to form an entity through the establishment of the Sports Vision Section of the American Optometric Association (AOA) in 1978. Like many similar organizations, the AOA Sports Vision Section affords practitioners a venue for continuing education, updates through an e-newsletter, a referral network through a member directory, and access to professional materials such as the Sports Vision Guidebooks and the Sports Vision Bibliography. The section has also been active in interprofessional relations with other organizations, such as the U.S. Olympic Committee, Special Olympics, Amateur Athletic Union (AAU) Junior Olympics, American College of Sports Medicine, National Athletic Trainers’ Association, and the National Collegiate Athletic Association. The section provides practitioners and students opportunities to participate in sports vision activities, such as the sports vision screening program at the annual AAU Junior Olympic Games. Ultimately the AOA Sports Vision Section offers practitioners an opportunity to collaborate and advance the profession.
Organizations dedicated to sports vision have also been created outside the United States. The Canadian Association of Optometrists formed a Sports Vision Section in 1987, the European Academy of Sports Vision was formed in Italy in 1989, Optometrists Association Australia established its Sports Vision Section in 1992, and the Sports Vision Association was formed in the United Kingdom in 1993.4 These organizations perform similar functions to