dynavision d2 neuro-cognitive evaluation for concussion management

Dynavision D2™ Visual-Motor Training System

Neuro-Cognitive Evaluation for Concussion Management

Suggested Protocols for Baseline Testing and Post-Concussion Examination*

*Developed by Joseph F. Clark, PhD, ATC

Professor of Neurology, University of Cincinnati School of Medicine

Presented at Dynavision ADT Seminar, October 2014

© 2015 Dynavision International, LLC

Dynavision D2™ Neuro-Cognitive Evaluation for Concussion Management

The Dynavision D2™ concussion baseline test consists of 2 tests; Proactive (Mode A), and Reaction Test (Mode D). These programs come standard with Dynavision D2™ software. Proactive (Mode A):

Step 1: Select *Proactive, 1 Min. Step 2: Click Run Program. Data Management:

A quadrant graph will appear at the conclusion of the run. The client’s score (hits per minute) and average reaction time by quadrant are indicated. Click Show Text Report to view light board statistics:

Reaction Times

Quadrants/Rings

Time/Score Breakdown

Click Print, or Done

Data Management: Focus: Average reaction time and clinical observations

Verbal Instructions:

“Hit the red buttons as quickly as you can until time runs out.”

“Do you have any questions?”

Clinical Observations:

Left/right symmetry of the upper extremities

Unsteady balance

Alternating hands instead of using hand that is closest

Intention tremors

Pauses before striking


Reaction Test (Mode D):

Step 1: Select *Reaction Test. Click Run Program. Test 1: Right Hand - 4 Choice

Test 2: Left Hand - 4 Choice


“Press and hold the red button with your right hand. Ignore the green button for now. When a second red light appears, strike it as quickly as you can.”

“Repeat each test 5-7 times with each hand. Do not press the green button until you are ready to move on to the next test.”


Clinical Observations:


Unsteady balance

Intention tremors

Pauses before striking

Data Management: Focus: Average reaction time and clinical observations


Test 3: Right Hand – 8 Choice

Test 4: Left Hand – 8 Choice


Test 5: Right Hand 1 Choice

Test 6: Left Hand 1 Choice


Data Management: A text report will appear at the conclusion of the sixth and final reaction test. Visual, Motor, and Physical reaction times, number of attempts and number of false starts are indicated.

Dynavision D2™ Concussion Exam

The Dynavision D2™ concussion exam consists of 3 memory tests graded in complexity. These programs must be configured by the clinician as they do not come standard with Dynavision D2™ software. Detailed instructions for programming and report management are provided below. Repeat Concussion Baseline Test Protocol

Proactive (Mode A)

Reaction Test (Mode D)

Memory Test 1


Step 1: Select Reactive Mode Step 2: Activate rings 1, 2, and 3

Step 3: Under T-Scope Option, click Change. Step 4: Set flash at 1 digits for 1.00 seconds. Click OK. Step 5: Click Save Program. Name the program. Click OK. Step 6: Click Run Program. Memory Test 2

Step 1: Select Reactive Mode


“Single digit numbers will flash on the screen for one second.”

“Hit the red buttons as quickly as you can. At the same time, call the numbers out.”



“Single digit numbers will flash on the screen for one second.” “Hit the red buttons as quickly as you can. At the same time, call out the first number, remember the second number, and then call out the sum.” “For example, if the first number is 4 and the second number is 3, you would say “4” followed by “7.” “Do you have any questions?”

Clinical Observations: Note the client’s score, ability to call numbers accurately.

Data Management: Focus: All data

Additional Observations:


Unsteady balance


Intention tremors

Pauses before striking or calling/adding numbers


Step 2: Activate rings 1, 2, and 3

Step 3: Under T-Scope Option, click Change. Step 4: Set flash at 1 digits for 1.00 seconds. Click OK. Step 5: Click Save Program. Name the program. Click OK. Step 6: Click Run Program. Memory Test 3

Step 1: Select Reactive Mode


“Single digit numbers will flash on the screen for one second.” “Hit the red buttons as quickly as you can. At the same time, call out the first number, remember the second number, and then call out the sum.”

“This time, some of the red lights will be green. When you see a green light, call green. Do not call red.” “Do you have any questions?”

Clinical Observations: Note the client’s score and ability to call and add numbers.




Unsteady balance


Intention tremors



Step 2: Activate rings 1, 2, and 3

Step 3: Under T-Scope Option click Change. Step 4: Set flash at 1 digits for 1.00 seconds. Click OK.

Step 5: Under Lights/No Green Lights, click Change. Select 20%. Step 6: Click Save Program. Name the program. Click OK. Step 7: Click Run Program. Documenting T-Scope Errors:

Clinical Observations: Note the client’s score, ability to call and add numbers, and ability to call green lights accurately.




Unsteady balance


Intention tremors



1. Click Right or Wrong to record errors during the run.

2. Click Edit T-Scope Scores to record errors after the run.


Interpretation for Return to Play:

A less than 10% reduction in baseline score at retest indicates a passing score.

A 10% reduction in baseline score at retest indicates a failing score.

Please Note: The Dynavision D2™ device can provide clinicians with objective information regarding the user’s neuro-cognitive

condition and this information has shown to be a useful part of a comprehensive neurological examination; however,

performance on the D2™ (or any other single test or evaluation) should not be used as the sole basis for making a clinically

prudent decision regarding a player’s readiness to ‘Return to Play’.

To Calculate Score: 1. Add the total number of hits

and the T-Scope score.

2. Subtract the number of errors.

3. Multiply this number by two to determine the final score.

Example: 38 (Number of hits) + 8 (T-Scope Score) - 2 (Errors) = 44

44 X 2 = 88 Baseline Score = 88

dynavision d2 neuro-cognitive evaluation for concussion management

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