Mixed Martial Arts

The medical question

How well do quick ringside tests pick out fighters who may have a concussion after a bout?

The Fight Medicine Research Institute uses this evidence to frame questions about which screening tests can be used after a bout, which cut-offs define a positive result, and whether a choke hold affects the tests as head trauma does. The study’s use of match outcome as the comparison standard and its 34 events determine which questions it can inform.

Summary

In 140 MMA athletes tested before and after a match, a positive King-Devick test was uncommon even after a knockout or technical knockout, the SCAT5 was positive after most of them but also in many other athletes, and neither test set apart athletes whose match ended by a choke hold.

What the work reports

• MMA athletes took the King-Devick test, a timed number-reading test, and the Sport Concussion Assessment Tool 5 (SCAT5) before a sanctioned match and again within 15 minutes after it. The authors grouped match outcomes as a traumatic event (knockout or technical knockout), a perfusion event (a choke hold that ended the match) or neither, and set the cut-offs for a positive test before the study began.
• Of the 140 athletes, 19 had a traumatic event and 15 a perfusion event. For detecting a traumatic event, the King-Devick test had a sensitivity of 21.05% (the share of athletes with a traumatic event that it flagged) and a specificity of 93.39% (the share of other athletes that it did not flag). The SCAT5 had a sensitivity of 77.78% and a specificity of 52.99%. King-Devick times improved by a mean of 2.9 seconds in athletes with no event and did not improve in athletes with a traumatic event.
• Neither test differed significantly between athletes with and without a perfusion event. The authors conclude that the King-Devick test offers high specificity and the SCAT5 reasonable sensitivity for a traumatic event, and that the symptom scores may be the most useful part of the SCAT5. They state that the King-Devick test cannot be used on its own to assess for concussion.

Limits to keep in mind

• The tests were judged against how the match ended (knockout or technical knockout), not against a clinical diagnosis of concussion.
• The health care providers who gave the tests knew the match outcomes, and the authors note that the study had no randomization or controlled comparison.
• The authors describe the sample as relatively small, with 34 events. Only 7 of the 140 athletes were women.
• Only one baseline King-Devick test was done, and no full medical history was available to exclude factors such as an earlier concussion.

Publication status and notices

Published in Archives of Rehabilitation Research and Clinical Translation, a peer-reviewed journal. Original research article in Archives of Rehabilitation Research and Clinical Translation.

Form of this work: Version of record. The version of record is the final article as issued by its publisher.

No correction or retraction notice was found in Crossref or Europe PMC when this record was checked.

Fight Medicine Research Institute contribution

Fight Medicine Research Institute selected and catalogued this study, prepared an original research summary, verified its bibliographic details, and maintains the associated citation record.

PDF files

Article details

Relationship

External research catalogued by the Fight Medicine Research Institute. The original authors, journal and DOI are unchanged.

Published online

No online date in the publisher’s Crossref deposit

Issue date

December 2023, volume 5, issue 4

Repository date

4 October 2023 (Europe PMC first-publication date)

Date used here

4 October 2023 (Europe PMC first-publication date)

Rights

CC BY-NC-ND 4.0. Open access under a Creative Commons Attribution-NonCommercial-NoDerivatives licence (CC BY-NC-ND 4.0), as recorded by Europe PMC and the licence link in the source record. The licence does not cover commercial reuse or adapted versions. The summary on this page is Fight Medicine Research Institute’s own wording. No text or figure from the article is reproduced here. Licence terms.

Source check

12 November 2026, against PubMed Central full text, Crossref and Europe PMC. Checked under the direction of Casey C. Sears, Founder. An LLM was utilized as a research tool with direct human oversight.

Appraisal

The check covered bibliographic details, links, licence and notices. It is not a formal critical appraisal of the full paper.

Clinical review

None. This record is a research summary, not clinical education.

Funding and conflicts

The article states that the study was supported by the Mayo Clinic Small Grants Program and that the investigators have no financial or nonfinancial disclosures in relation to the project.

Catalog

FH-046, added 12 November 2026

Cite the original work

These files cite the work by its own authors, journal and DOI. Fight Medicine Research Institute appears only in a note, as curator of this catalog page.

Eric E Twohey, Ike B Hasley, Patrick J Shaeffer, George A Ceremuga, Stephen A Firkins, Gene C Stringer, et al.. Mixed Martial Arts: Comparing the King-Devick and Sport Concussion Assessment Tool 5 in knockouts, technical knockouts and choke holds. Archives of Rehabilitation Research and Clinical Translation. 2023;5(4):100301. https://doi.org/10.1016/j.arrct.2023.100301

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Related on this website

• Research program: Standardized ringside head-trauma assessment
• Research priority: Standardized post-bout head injury assessment
• Fighter Health: Head injury, concussion and post-bout assessment