Page 69 - Journal of Special Operations Medicine - Summer 2015

cognitive factors, to name a few. For humans, vision is Although the Nike STS is no longer being produced,
the most critical factor in sports performance and visual future production from other companies is likely. As
information is the dominant sensory system when per- noted, there are several stations at SOF unit locations
forming practically any perceptual motor task such as throughout USASOC.
those encountered in sports. 32,54,58,60,63,64,72,77,78,89–92 Vision
is the signal that directs the muscles of the body to re- If more comprehensive visual screening is to be per-
spond. Vision provides the information regarding where formed in the military unit setting, the clinical evalu-
and when to perform. Superior size, strength, speed, and ation procedures must have sound scientific validity
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agility cannot completely make up for inefficient pro- demonstrated by controlled studies. Vision care for
cessing of visual information. Therefore, the evaluation athletes should begin with a relevant task analysis to
of vision skills in athletes is an area of intense interest. identify visual skills that potentially contribute to hu-
Definitive answers to global questions are rarely ascer- man performance so that these specific functions can be
tained by isolating factors without consideration of the isolated and measured, if possible. The visual demands
complete process. One could say that we see with our critical to success in sports can vary widely depending
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brains. The visual cortex and its associated connections on the sport in question. It could be argued that the
to other processes interpret information from visible visual demands, and, therefore, prerequisite visual skills
light to build a representation of the world. 30,66,67 How required for mission success for the many SOF mission
an individual perceives and reacts to a set of stimuli is sets, vary widely as well. In other words, our SOF are
crucial to top-level performance in sport and soldiery. multisport athletes.
The ability to perceive and process complex informa-
tion is different from visual function, which does not Domains evaluated by visual sensory training devices
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affect athletic performance. It is the ability to pick up are as follows (Figure 2):
relevant perceptual cues through enhanced search strat- Visual clarity (static visual acuity): 20/20 vision or
egies, increased speed of transmission in visual path- clearer in each eye, with eyes equal to one another,
ways, and effective and efficient transmission of that translates into enhanced depth perception, anticipation,
signal through afferent channels to affected motor neu- quickness, and confidence.
ron pools that defines top-level performers. 64,66,93 This
superior ability has been shown through meta-analysis, Contrast sensitivity: judgment of subtle differences in
in which elite and subelite athletes and professionals contrast between objects and their backgrounds under
of similar visual capabilities were tested and the elite/ varying lighting conditions; recommended for tasks and
expert individuals were found to have greater cognitive sports involving visual discrimination in suboptimal
processing abilities. 56,59,62 Several other studies involving lighting because of environmental variability. For many
other sports and performance milieus have had similar military combat applications, this should be considered
observations. 54,55,57,58,61,93 However, to suggest that su- a top-tier function. Performance enhancement for this
perior visual perceptual skills are of little consequence skill is possible, and deficits can be improved with train-
compared with the cognitive processing of the visual ing. There are several commercially available devices
information overlooks the role that visual information that can evaluate and train contrast sensitivity.
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plays in cognition. Therefore, visual acuity or accuracy
should be assessed as part of the overall process and def- Figure 2 Illustrations of the nine Psycho-Visual-Motor
icits corrected prior to training or rehabilitation. 75,77,78 tasks in the Nike SPARQ Sensory Station reproduced with
permission from Nike Inc. (Nike Inc.; www.nike.com).
Human performance programs within the SOF are still
new and continually developing entities. The overall con-
cept is to emulate the professional and collegiate multi-
disciplinary approach to performance optimization. This
is accomplished by combining strength and conditioning,
rehabilitation, performance nutrition programming, and
sports psychology to adapt this approach to their units.
It enhances physical performance, reduces risk for injury,
and promotes resiliency, wellness, and longevity.

Nike has produced a computer-based evaluation and
training station. It is the only multidomain single station
unit to date that incorporates visual acuity/accuracy,
eye quickness, and visual-motor tasks. Several research
papers have reported on its potential efficacy. 25,41,92

Postconcussion Visual Sensory Screening, Diagnostics, and Training for SOF 59