Ординатура / Офтальмология / Английские материалы / Sports Vision Vision Care for the Enhancement of Sports Performance_Erickson_2007

4CHAPTER 1 INTRODUCTION TO SPORTS VISION

the AOA Sports Vision Section in their respective regions and have helped facilitate the growth of sports vision globally.

In 1979 Pacific University College of Optometry began providing an elective course on sports and recreational vision in the optometry curriculum. All schools and colleges of optometry in North America now offer some degree of education in sports vision as part of the curriculum. The AOA Sports Vision Section has been supplementing this education with an education program called Sports Vision University. Sports Vision University provides optometry students the opportunity to receive a comprehensive overview of the many aspects of sports vision in one course delivered by two recognized experts in sports vision (one academic practitioner and one private practitioner). The course covers the topics of correcting and protecting athletes, managing sports eye injuries, evaluating visual performance skills in athletes, enhancing visual performance skills in athletes, and marketing and building a sports vision practice. Every 4 years the program will be delivered at each of the schools and colleges of optometry in North America.

OVERVIEW OF A CLINICAL MODEL OF SPORTS VISION

Vision care for athletes should begin with the identification of visual factors that potentially contribute to peak human performance so that these specific functions can be isolated and measured if possible. The visual demands critical to success in sports can vary tremendously. Chapter 2 details an approach to the task analysis process, a process essential to providing appropriate vision care for athletes in any sport or position. Because sports performance generally requires the athlete to process visual information and execute an appropriate motor response, the practitioner should also understand how visual information is processed to understand the exact nature of the processes occurring in skilled motor performance. A model of information processing in skilled motor performance is presented in Chapter 3 to provide a useful approach for understanding the relevant aspects of sports performance.

Once the practitioner has identified the vision factors essential to performance of the visual tasks critical for success in a sport, an evaluation should be created to measure the quality of those skills in the most appropriate, accurate, and repeatable manner. The visual skills that correlate with successful sports performance have not been definitively identified yet, so the practitioner must rely on the available literature and professional judgment to determine the most appropriate evaluation for each athlete. Chapter 4 provides an evidence-based description of each potential vision assessment area and the relative value of each assessment area in an evaluation. Chapter 5 presents recommendations for performing team vision screenings and the unique challenges associated with providing vision care to a team. The results of a screening or evaluation should be summarized for the patient, and a performance profile is recommended in Chapter 5 to highlight areas of strength or weakness and communicate vision recommendations.

A fundamental role of the vision care practitioner is to provide expert consultation services to athletes regarding vision correction and the potential uses and benefits of ophthalmic products. Each athlete has specific variables that will affect ophthalmic recommendations. The gender, age, level of participation, combination of sports activities, and previous history of product use influence the choice of available options. Some athletes seek a single product to meet all visual performance needs, and others seek the optimal products for a variety of highly specific uses. The eye care practitioner should advise athletic patients about the

advantages and disadvantages of spectacles, protective eyewear, sun eyewear, contact lenses, and refractive surgery. Chapter 6 discusses the issues involved in the available modalities for vision correction, eye protection, and vision enhancement. The practitioner should help the athlete make informed decisions about the best options for his or her individual needs.

Participation in sports carries a risk of sustaining an eye injury. The vision care practitioner can perform a crucial role in the prevention of sports-related eye injuries, immediate first aid management if an eye injury occurs, referral of the athlete to an appropriate specialist if necessary, and follow-up care for the athlete who has sustained an eye injury. Chapter 7 provides an overview of assessment and management of sports-related ocular trauma from the perspective of both the athletic trainer and the eye care professional. The chapter concludes with recommendations for effective co-management of ocular injuries in athletes.

As previously mentioned, significant interest exists in determining whether sports performance can be improved by using training procedures to enhance vision. The athlete with identified visual deficiencies is logically expected to achieve improvement in affected aspects of sports performance if those deficient skills are improved to average performance levels. The athlete who possesses average, or even above-average, vision skills presents a more compelling and controversial challenge. Can the vision skills of this athlete be enhanced above the current level, and would this skill enhancement result in demonstrable improvements in sports task performance? A recent review of the literature concluded that most normal visual functions can be improved by specific training paradigms, although thousands of trials may be required to demonstrate enhancement.9 Several studies have reported positive effects of vision training programs on sports-specific tasks,10-13 and some have not found improvement in performance.14-16 Each sports vision practitioner develops an approach to visual performance enhancement that best suits his or her mode of practice; however, useful guidelines should be observed. Chapter 8 provides a sample of visual performance enhancement procedures that have been used by sports vision practitioners, with a rationale and framework for developing effective training programs.

The final chapter deals with the unique issues pertaining to the development of sports vision services in professional practice. Challenges of internal and external marketing are discussed, and methods for growing this area of practice are highlighted.

THE FUTURE OF SPORTS VISION

During the past 30 years a general increase in the use and provision of sports vision services by optometrists has been observed.17 Eye care practitioners are a common component in the health care service team in professional sports and many collegiate athletic departments in North America. The range of vision care services includes vision screening programs, vision correction with contact lenses, eye protection consultation, eye injury management, and visual performance enhancement training programs. These services are either provided on-site at the athletic facility or in the practitioner’s practice. Great interest in sports vision services exists within the sporting community, and the consensus is that this need is not being adequately met by eye care practitioners.17

The eye care professions have considerable room for growth in the delivery of sports vision services. Many high-level athletes have never received a comprehensive vision examination and are largely unaware of the potential impact of sports vision services on athletic performance. Indeed, the rate of use of protective eyewear in sports demonstrates the limited impact that

6CHAPTER 1 INTRODUCTION TO SPORTS VISION

public education programs have had in the athletic community. Significant growth potential clearly exists in all of the areas of sports vision care listed at the beginning of this chapter.

Continued professional growth requires that the profession address some of the concerns and issues that may prevent fulfillment of the potential inherent in this area. Specifically, clinical evaluation procedures need to be ergonomically appropriate, produce repeatable and reliable results, discriminate performance levels, be readily available and not cost prohibitive, and be practical for implementation in most clinical practice facilities. If such evaluation procedures are produced, these procedures must have sound scientific validity demonstrated by controlled studies. If this can be achieved, sports vision skill assessment may become a common aspect of patient care.

Similarly, visual performance enhancement procedures need a degree of validation to engender broader acceptance. Some of the same desirable characteristics described for evaluation procedures pertain to training procedures as well. Training programs should attempt to demonstrate vision skill improvement with relevant laboratory and clinical research. The improvement of vision skill performance should also be correlated to a concurrent improvement in sports performance, if possible. However, isolating one area of intervention as being solely responsible for changes in performance is incredibly difficult. This is true for any area of sports training, including strength training, conditioning, speed and agility training, nutritional regimens, and sports psychology. If the improvement of obviously critical vision skills is evident from well-controlled research, the transfer to sports performance offers a logical correlation that perhaps would be more readily accepted than anecdotal reports.

Sports vision specialists have tremendous potential to provide consultation services. The vision factors that influence perception are generally not calculated in the development of sports products. The sports vision specialist is in a unique position to facilitate product innovation in a potentially unique direction. The sports vision specialist can provide scientifically supported advice in such areas as the selection of product colors, the optical properties of performance eyewear, the engineering of performance tints, and the desirable properties of contact lenses for athletes. These potential opportunities could yield fulfilling professional experiences for the practitioner.

The authors hope that, in some small way, this text will help increase the provision of sports vision services to athletic patients and stimulate interest in elevating the professional development of sports vision. Eye care practitioners have the potential to contribute to the performance of their athletic patients; ultimately, sports vision care can contribute to elevating human potential.

REFERENCES

1.Collier B: The eyes lead the body, Optom Management 15:73, 1979.

2.Coffey B, Reichow AW: Optometric evaluation of the elite athlete, Prob Optometry 2:32, 1990.

3.Daland J: Eskimo snow blindness and goggles, Optom J Review Optom 39:1334, 1917.

4.Loran DFC: An overview of sport and vision. In Loran DFC, MacEwen CJ, editors: Sports vision, Oxford, 1995, Butterworth-Heinemann.

5.Fullerton HS: Why Babe Ruth is the greatest home run hitter: Popular Science Monthly tests in the laboratory his brain, eye, ear and muscle—and gets his secret, Popular Science Monthly 99:19, 1921.

6.Abel O: Eyes and baseball, Western Opt World 12:401, 1924.

7.Blodi FC: Some famous persons with visual problems as shown on postage stamps, Doc Ophthalmol 77:295, 1991.

8.Voisin A, Elliott DB, Regan D: Babe Ruth: with vision like that, how could he hit the ball? Optom Vis Sci 74:144, 1997.

9.Ciuffreda KJ, Wang B: Vision training and sports. In Hung GK, Pallis JM, editors: Biomedical engineering principles in sports, New York, 2004, Kluwer Academic, pp 407-433.

10.West KL, Bressan ES: The effect of a general versus specific visual skills training program on accuracy in judging length-of-ball in cricket, Int J Sport Vis 3:41, 1996.

11.Quevedo-i-Junyent L, Sole-i-Forto J: Visual training program applied to precision shooting,

Ophthalmol Physiol Opt 15:519, 1995.

12.McLeod B: Effects of eyerobics visual skills training on selected performance measures of female varsity soccer players, Percept Mot Skills 72:863, 1991.

13.Kofsky M: Sports vision visual training and experimental program with Australian Institute of Sport Basketball players, Austr J Optom 6:15, 1988.

14.Abernethy B, Wood JM: Do generalized visual training programmes for sport really work? An experimental investigation, J Sports Sci 19:203, 2001.

15.Quevedo L, Sole J, Palmi J, et al: Experimental study of visual training effects in shooting initiation, Clin Exp Optom 82:23, 1999.

16.Wood JM, Abernethy B: An assessment of the efficacy of sports vision training programs, Optom Vis Sci 74:646, 1997.

17.Zieman B, Reichow A, Coffey B: Optometric trends in sports vision: knowledge, utilization, and practitioner role expansion potential, J Am Optom Assoc 64:490, 1993.

Target Size

Significant differences may exist in the size of the visual information that must be discriminated in different sport activities. For example, the visual discrimination task for a hockey puck is much more demanding than for a basketball. For each sport activity, the interaction between the size of the visual target or object and the viewing distances encountered in the sport should be evaluated to determine the visual discrimination demands. Significant interaction may also exist between visual discrimination level and contrast sensitivity demands. Again with the soccer example, the size of the soccer ball is relatively large, but the judgment of ball spin requires an enhanced level of visual discrimination than the ball size would suggest.

Boundaries

Boundaries for the competition area are established in many sports. In some sports, such as table tennis and billiards, the boundaries are relatively small and can easily be seen during competition. In other sports, such as soccer and football, the competitive boundaries are too large to be seen entirely at all times during competition. The extent of the boundaries establishes the peripheral vision demands for the athlete and may also affect selection of refractive correction modality.

Visual Space Ranges

The athlete must attempt to control a range of physical space in many sports by constantly processing the visual information in that physical space. The physical space can be relatively confined, as in wrestling, or it may be much larger, as in sailing competitions. This factor also relates to the peripheral vision demands for the athlete.

Figure/Ground Color, Texture, Shade

An analysis of the figure/ground characteristics encountered in a sport can assist in the selection of filters to enhance performance. For example, a skeet or trap shooter must quickly locate an orange-colored target against the background of the ground (brown dirt, green grass, brown grass, etc.), any foliage (trees, shrubbery, etc.), and the sky (blue sky, partly cloudy sky, heavily overcast sky, etc.). The selection of the optimal filter for the current light levels and backgrounds is an essential aspect of competitive skeet or trap shooting. Filter selection may offer significant benefits in many sports by sharpening contrast and enhancing critical visual information. Filters also offer a potential benefit by muting distracting visual “noise” from the background. Filter selection is discussed in detail in Chapter 6.

Visual Time

Many sport situations have an established time course of action in which visual processing characteristics can be analyzed. The time course of a Major League Baseball pitch is one situation that has been scrutinized by researchers from a variety of backgrounds.3,4 Depending on the speed of the pitch, the Major League batter has approximately 400 ms between the release of the pitch and the time the ball arrives at the plate. Because the swing takes approximately 150 ms to complete, the batter has approximately 250 ms to process the visual information from the pitch and decide on the appropriate response. These time characteristics are discussed in greater detail in Chapter 3. However, many other sport situations have time characteristics that unfold in a relatively predictable manner. The serve in many racquet sports and volleyball, the pitch in cricket, penalty shots on goal in soccer and hockey, the judgment of hurdles in track, the judgment of the approach in the high jump and pole vault in field