Category: Prevention

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Air Force Academy takes part in nation-wide concussion study

Hundreds of basic cadets lined up at the Air Force Academy July 13 to help experts learn more about head trauma.

All Academy cadets are taking part in a three-year, $30M collaboration between the Defense Department and the NCAA to study concussions. Eighteen universities in the United States and the military service academies are participating in the research project.

The study coincides with the White House Summit on sports concussions, a presidential commission created in May 2014 to encourage the identification, treatment and prevention of serious head injuries.

Each basic cadet spent about an hour in a Fairchild Hall laboratory completing   concussion history and symptom inventories, and balance, memory and cognitive tests.

“The collected results of these evaluations will be compiled into a database and form a baseline of a cadet’s complete physical assessment,” said Col. Darren Campbell, director of the Academy’s Concussion Center.

“By having a baseline, we then have something to compare when they are injured,” Campbell said. “We know what their ‘norm’ should look like.”

This baseline is collected by computer-based neurocognitive assessments and one-on-one testing of brain and balance performance given when cadets are healthy, and compared to results when a cadet returns to duty or to the athletic field.

Intercollegiate athletes at the Academy account for about 50 percent of concussions reported in the Cadet Wing, said Lt. Cmdr. Brian Johnson, a behavioral science professor at the Academy.

“Regardless of participation in the national research study, all cadets are given the same level of care,” Johnson said. “We treat every cadet the same and we focus on this issue for long-term effect.”

To comply with NCAA standards, the Academy has conducted neurocognitive testing on its athletes for more than 10 years. The Academy began testing all freshmen in 2014 as part of the DOD-NCAA study to collect a larger test group.

“By using the same measures as the other sites, we can (compile) our data to paint a much clearer picture of what concussions and recovery times look like,” said Dr. Chris D’Lauro, a professor in the Academy’s Behavioral Science Department.

Steve Broglio is an associate professor in exercise science at the University of Michigan, and the lead clinical care coordinator for the universities taking part in the study. The information collected by this testing could prove beneficial years in the future, he said.

“The big goal here is to track people,” he said. “We’re trying to track the student. This is incredibly challenging and exciting.”

Campbell said tracking a cadet’s head injury is part of caring for Airmen.

“We want to provide the best medical care possible to our Airmen and cadets,”
Campbell said. “This testing provides a foundation for our research and gives us the data needed to provide the best health care possible.”

The Academy is ahead of the other universities and other military academies involved in the study because it’s conducting this baseline testing for the entire study body, said Dr. Jerry McGinty, director of sports medicine for the Academy’s Athletic Department.

All basic cadets are scheduled to be tested by July 31st.

More than 37,000 intercollegiate athletes and service members will be tested, McGinty said.

Visit www.usafa.af.mil/news/story.asp?id=123420140 for more information on the study.

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ACC to add athletic trainers to press box

So many of the hurried changes to college sports have that barn-door-after-the-horse-is-gone feeling, a desperate attempt to forestall the wave of lawsuits and other athletic activism that has erupted in recent years.

Giving athletes the same cost-of-attendance benefits as students on academic scholarships was as sensible as it was long overdue, even if the athletic community at large had to be dragged kicking and screaming into the 21st Century and is still complaining about having to pay for it.

On Monday, the ACC announced it has adopted one improvement that is neither forced or overdue. It’s actually timely, and perhaps even forward-thinking: The conference’s application of the NCAA’s new medical-observer protocol for football.

The NCAA last week adopted an experimental rule allowing conferences to use a medical observer to monitor for injuries, not specifically but obviously potential concussions, with the power to stop play if necessary.

The SEC will use one athletic trainer to monitor both teams, in communication with the referee. The ACC’s athletic directors voted Sunday night to adopt a different protocol, with one member of the medical staff for each team in the press box, in communication not with the referee but his sideline.

The issue isn’t whether this is a good idea. It is. It’s a no-brainer. The issue is whether what the ACC is doing goes far enough.

The SEC – and presumably Big Ten, which co-sponsored the NCAA legislation – will let its observers halt the game if needed. The ACC decided not to give its observers that ability, which leaves a narrow time frame for an observer to identify a potentially injured player, communicate with the sideline and remove that player from the game.

“We didn’t really see the necessity in that,” ACC commissioner John Swofford said. “The medical observer should be able in talking to the sidelines to have a timeout called or pull a player from the game. But this is all experimental. We’ll see how it actually works in real time. If there needs to be some adjustment to that then we’ll see. This is where we felt was appropriate. It’s a little different than what some other conferences are doing.”

It doesn’t happen often that a clearly staggered player returns to the huddle without the medical staff on the sideline noticing, but it happens often enough that conferences have seen the wisdom of adding an extra set of eyes in the press box. And in those situations, it’s a fair question whether the ACC’s process will work quickly enough to help that player, especially in an era of hurry-up offenses and quick tempo.

In their meeting Sunday night to debate and approve the observer protocol, the ACC’s athletic directors decided not to go as far as the NCAA would allow, focusing on a team-based model instead of a neutral, officiating-based model.

“This seems sufficient,” N.C. State athletic director Debbie Yow said. “It’s a common-sense approach.”

North Carolina athletic director Bubba Cunningham said there are other benefits to the ACC plan.

“There’s so much chaos on the sidelines that it can be confusing,” Cunningham said. “Someone out of the chaos may have a better perspective, especially if they have a view of a TV.”

The far greater priority was having someone doing the assessments who was aware of each individual player’s medical history, which led them to the two-person, two-team model the Pac-12 used on a limited basis last season and is expanding to all games this season.

“The important thing to us was that our observer was connected to the history of the student-athlete,” Pittsburgh athletic director Scott Barnes said. “We need an observer who’s part of our staff and knows the issues involved. That was our primary concern.”

And while there’s some expense involved in bringing an extra staff member on the road, it’s relatively minor compared to the benefits.

Cunningham said North Carolina typically travels with two or three doctors and may reallocate one to the press box.

“There might be an extra hotel room,” Yow said, “but so what?”

It is a small price to pay for an improved level of player safety and a change that is, for once in college sports, as much proactive as reactive.

Read more here: http://www.charlotteobserver.com/sports/spt-columns-blogs/luke-decock/article27944956.html#storylink=cpy

ORIGINAL ARTICLE:

http://www.charlotteobserver.com/sports/spt-columns-blogs/luke-decock/article27944956.html

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Athletic Trainers are Key to Concussion Management

Athletes under the age of 18 are the most vulnerable when it comes to sustaining concussions. Accurately diagnosing concussions on the field of play is an important way to protect them, according to research published this month in the Journal of Child Neurology.

“The continued play by a child who has sustained a concussion puts them at significant increased risk,” said Jacob Resch, associate professor at the University of Virginia’s Curry School of Education and co-author of the study. “To keep a concussed child from continuing to play requires immediate and accurate diagnosis.”

Every state but one requires youth athletes suspected of having a sport concussion be removed from play and not allowed to return without written clearance from a health care provider. But, according to Resch, many young athletes are playing without the elements in place needed to accurately diagnose a concussion during a game.

The article, “The Acute Management of Sport Concussion in Pediatric Athletes,” provides a clinical framework for the assessment, evaluation and management of pediatric sports concussions.

One key element: the presence of an athletic trainer or trained clinician at sports events.

“Diagnosing sport concussion requires specific training,” Resch said. “Think of it as a medical specialty that not necessarily all general practitioners or pediatricians are well versed in. There is a range of assessments used in diagnosing concussions and each of them requires specific training.

“The best person to have on a sideline is someone who has specific training in this area, most often seen in a certified athletic trainer.”

Young children often play sports in youth leagues, while adolescents often play in club or school sports. Currently, the only data collected on the presence of athletic trainers is on high school sports, where only 46 percent of high schools have a full-time athletic trainer. In many of those cases, a single athletic trainer is responsible for all of the school’s teams.

In other cases, schools or programs may share an athletic trainer or hire an athletic trainer or clinician to temporarily work a tournament or series of events.

“At this point, we just don’t know how many youth sports are being played with a certified athletic trainer or clinician trained in diagnosing concussions on the sidelines,” Resch said.

In the absence of someone specifically trained to diagnose and treat concussions, the role is often filled by an emergency medical technician.

“EMTs are a vital member of the sports medicine team,” Resch said. “However, EMTs may receive limited training in concussion assessment.”

In the article, Resch and co-author Dr. Jeffrey Kutcher of the University of Michigan reviewed the reliability and validity of assessment tools currently used to diagnose concussions. They recommend these tools be used alongside a clinical evaluation.

Another element needed to accurately and immediately diagnose youth sport concussions is a precursor to the first: taking a baseline measurement of the elements assessed to diagnose a concussion before a young athlete is injured. These elements include a balance test and recording the typical number of headaches a child has per month.

“One challenge in diagnosing concussions is that we are often measuring how a concussion manifests itself in other symptoms in the body,” Resch said. “Because no two children are alike and no two concussions are alike, it is difficult to say a particular score on a particular assessment always means a concussion is present or not.”

Knowing how a child scores on a balance test prior to play gives the individual making the diagnosis a sense of how far from that baseline an injured child is currently scoring. To know a child’s baseline often requires parents to seek a supplemental physical with a sports concussion clinician.

“Parents can certainly ask their pediatrician if they have expertise in diagnosing concussions,” Resch said. “If they don’t, they can often recommend someone who does.”

Preseason is a good time for concussion education, the authors suggested. Many states require student-athletes, their parents, coaches and administrators to participate in concussion education before the start of the season. However, those sessions vary significantly across ages, leagues and states.

Resch and Kutcher recommend that whatever the format, the content should include what signs and symptoms of concussion will lead to the player’s immediate removal from the field of play.

Though increased media attention has led to an added emphasis on the response to and management of concussions, the researchers noted that data is significantly lacking on youth sports concussions and called for more research.

“We need to continue to examine the data around concussions in youth sports and use that data to improve our efforts in education and recommendations for keeping young athletes safe,” Resch said.

ORIGINAL ARTICLE:                                                                                                       http://www.healthcanal.com/brain-nerves/65450-study-immediate-diagnosis-of-concussions-better-protects-youth-athletes.html