New concussion treatment could keep athletes safer

lgierer@ledger-enquirer.comAugust 17, 2013 

As fall sports begin, most area high schools are taking advantage of a new initiative to treat concussions that could help keep athletes safer.

The new Concussion Impact Program initiated by Columbus Regional Healthcare System will be in operation this school year.

A concussion is an injury to the brain which alters the way it functions.

It can be caused by a blow to the head but also when the head is violently shaken.

The effects are usually temporary but long-term damage can occur from repeated instances.

According to the University of Pittsburgh's Brain Trauma Research Center, more than 300,000 sports-related concussions occur annually in the United States.

Athletes playing in any sport at participating high schools will be involved.

Public schools participating include the eight high schools in the Muscogee County School District, Smiths Station High, LaGrange High, Greenville High, Manchester High, Chattahoochee County High, Marion County Middle/High and Central High in Phenix City.

Private schools participating include Calvary Christian, Brookstone, St. Anne-Pacelli and Glenwood. Columbus State University is taking part, too.

ImPACT

ImPACT stands for Immediate Post-Concussion Assessment and Cognitive Testing. It is a computer-based test used to evaluate an athlete's recovery from concussion.

The evaluation is simple to administer by computer with a health care professional assisting and takes approximately 20-25 minutes.

ImPACT is administered over the Internet. In Columbus, the tests will take place at the schools.

ImPact is being used by such organizations as the National Football League, the National Hockey League, Major League Baseball and more than 1,300 colleges and universities.

Prior to the season, parents of athletes will receive an information sheet that they must sign informing them about concussions and head injures.

ImPACT will be administered to athletes during the offseason for a baseline assessment.

The test assesses areas of cognition often impacted including processing speed, attention and short-term memory.

If an athlete shows symptoms of a concussion, he or she will be examined by a health care provider and will not return to playing until cleared.

Before an athlete gets tested, trainers get a concussion history, a history of migraine headache, depression, sleep disorders, learning disabilities and attention-deficit hyperactivity disorder.

In the event the athlete suffers what appears to be a concussion, a reevaluation can be conducted to determine if results have changed from the baseline. The first re-evaluation takes place within 24 hours and another a couple of days later.

This comparison can provide objective data with which to make a determination on an athlete's return. Follow-up tests can be completed over days and weeks with which to compare.

Andy Grubbs is the director of athletic training for the Hughston Foundation, which is overseeing the program.

"An athlete may tell a coach that he or she has not had a headache for days, but it is not because they are healed, but because they have been taking Tylenol."

The ImPACT re-evaluation delivers an accurate observation, he said.

Grubbs said any athlete who gets a concussion must stay out at least seven days. If an athlete is vomiting at the time of the concussion, they will be taken to the hospital.

The damage

Dr. Joseph Zanga, the chief of pediatrics for Columbus Regional, said concussions can affect a student's academic performance by making it more difficult for the person to concentrate.

"More people are now recognizing the fragility of the head and brain," Zanga said.

The physician described the brain as a "gelatin mass of tissue swimming in fluid encased in a very rigid skull."

It is not always easy to tell if there has been damage. Zanga said more people are becoming aware of the neurological damage concussions can cause because of lawsuits being brought by former NFL players and the physical downfall of former heavyweight champion Muhammad Ali.

Hardaway football coach and athletics director Jeff Battles said the program will bring awareness to the community about concussions and their severity.

"We want to make sure we get the diagnosis correct and that we don't send any athlete who has suffered a concussion back into play before being completely healed. That is what this program will help us do," Battles said.

Battles said he has seen athletes get a concussion just from falling with no contact with another person.

"It is usually pretty obvious," Battles said. "The first sign is that the person just is not acting normal. We ask a lot of questions and bench anyone we think might have a concussion. You can't be too careful."

The concern is about more than just football players. Battles said he sees a lot of head injuries among girls playing soccer. The Centers for Disease Control and Prevention confirms that girls soccer ranks second to boys football for number of concussions.

Physical symptoms of a concussion described by Zanga include headache, nausea, vomiting, balance problems, dizziness, visual problems, fatigue, sensitivity to light, sensitivity to noise and numbness.

Other symptoms include difficulty concentrating and remembering, slurred speech or weakness in arms or legs. A person with a concussion may also experience irritability, sadness and nervousness.

"Children feel they are omnipotent and omniscient," Zanga said, explaining why an injured athlete might ignore the problems brought on by a concussion.

Zanga and Battles both said it is important that parents understand how dangerous a concussion can be.

Some parents want to rush their kids back into play for fear their absence may cost the athlete a scholarship.

Each school involved received at no cost a kit that Grubbs said is valued between $500 and $750. A golf tournament raised $21,000 for the program.

Grubbs called the program a tool to communicate post-concussion status to athletes, coaches, parents and clinicians.

It is not a substitute for medical evaluation and treatment.

He said all of the local athletic trainers are well versed in the signs of concussion.

New rules are being introduced to stop spearing with the head in football and helmets are constantly being improved.

Aimee Staley, a psychologist with Columbus Psychological Associates, said those moves are good but will not stop concussions. "We're going to have concussions, and people need to realize the health implications."

She will be providing additional cognitive testing for athletes who are not recovering as well as they should from a concussion and will help gauge long-term risks.

"We've got to make sure the athletes get adequate healing," she said.

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