Jan 29, 2015
Heads Up: Concussion News & Notes

By R.J. Anderson

States across the country are making concussion prevention and assessment standards a top priority, with enhanced focused on establishing mandatory return-to-play guidelines. We examine a few of these new laws and bills and update you on some new technology that may help athletic trainers in their quest to improve concussion management.
In Texas, a new state law requires coaches and athletic trainers to take two hours of training in order to spot the symptoms of a possible concussion. Students and parents are also required to receive materials on how to spot the symptoms and methods for concussion prevention. It also requires districts to appoint a concussion oversight team to keep track of training and establish a return-to-play protocol for athletes who suffer a concussion.

Student-athlete concussion laws in Rhode Island were recently expanded and now mandate that coaches and team volunteers take a concussion safety refresher course each year.

“I think it’s a good thing because the ultimate goal of the (Rhode Island) Interscholastic League and the high schools is the protection of the athlete,” said Narragansett High School Athletic Director Richard Adham. “We want to make sure the kids are fully protected.”

In Colorado, the Jake Snakenburg Youth Concussion Act, was signed into law by Gov. John Hikenlooper. Snakenberg was a high school football player who died in 2004 after he was hit during a game. His family said doctors told him his injury was likely compounded by a concussion he suffered in a previous game that went undiagnosed.

The law takes effect Jan. 1, 2012 and requires removal from play of any athlete suspected of having sustained a concussion. Then before returning to practice or a game, the athlete must have written authorization from a medical professional.

“This is the most far-reaching bill in the country with regard to protecting children,” said Republican state Sen. Nancy Spence, a sponsor of the legislation.

The Arizona Interscholastic Association (AIA), will mandate all male and female athletes undergo concussion education and pass a formal test before play through a new program. Every student in the state must complete and pass the education module called Brainbook, an interactive online site created by Phoenix’s Barrow Neurological Institute at St. Joseph’s Hospital and Medical Center and Arizona State University that is designed to look like a social media site, and includes a series of educational content, activities, and videos.

“There are approximately 3 million sports-related concussions nationally each year,” says Javier Cardenas, MD, neurologist at Barrow. “Players recognizing the signs and symptoms of concussion can prevent death and disability.”

In an attempt to increase the safety for those who take part in sports, the New York state legislature this year passed the Concussion Management Awareness Act. According to New York State Senator James Seward,

“if signed into law by Governor Andrew Cuomo, the measure would direct the state health and education departments to adopt rules and regulations for the treatment and monitoring of students with mild traumatic brain injuries and establish minimum guidelines regarding removal from play, physician clearance, and return-to-play protocols.”

Seward adds that: “the Concussion Management Awareness Act establishes guidelines to protect student-athletes who have sustained a concussion. The key component is the creation of a concussion management team in each school district that would be comprised of health professionals, sports staff, and appropriate personnel. The concussion management team would be responsible for overseeing staff training, educating parents and students about concussions and helping transition students who have sustained a concussion back into school and sports within specified guidelines.”

“Certified athletic trainers have advocated the need for increased safety and awareness of mild traumatic brain injury, and have spent years educating coaches, officials, parents, athletes, and other medical professionals on concussion recognition and management,” said Christopher Hobler, President of the New York State Athletic Trainers’ Association. “The Concussion Management Awareness Act establishes guidelines and requirements for school districts in New York State to develop concussion management teams, and will require that any athlete with signs and symptoms consistent with concussion be removed from participation and cleared by health care providers trained in concussion management prior to their return to participation. With this bill, we are building a safer environment for the athletes in New York to be healthy on and off the field of competition.”

Athletic trainers may soon have a new–and relatively inexpensive–tool to help them assess and monitor concussed athletes. Cleveland Clinic biomedical engineer Jay Alberts is piloting a study to measure the effects of athlete head injuries using an app designed for the iPad 2. The device, which has built-in accelerometer and gyroscope technology to measure post-injury changes in an athlete’s balance, could make it easier for schools to gauge changes in injured players’ brain functions.

According to the Cleveland Plain-Dealer, athletic trainers at John Carroll University and Solon and Brecksville high schools tested the technology earlier this month as part of a baseline assessment of cognitive and neural functions of about 100 athletes. The athletic trainers used iPads to test the athlete’s balance by strapping the devices to each player’s waist, then ran an app that measured changes in postural stability on both soft and hard surfaces.

“I think of it as another tool in the tool belt,” Don McPhillips, Head Athletic Trainer at John Carroll told the Cleveland Plain-Dealer. “Trying to identify concussions is tough. We have 200 athletes and three trainers, so you can’t keep track of everyone on every play.”

The Clinic says it’s too early to say whether it will commercialize the app and that the development team behind the project is currently focused on testing the app on enough athletes so it can be further validated. The goal is to eventually publish an article on the app in a peer-reviewed journal, a Clinic spokeswoman said.

A new text messaging program designed to raise awareness about concussions and other football injuries among young athletes, coaches, and parents is launching in the Chicago area. The ‘be unstoppable football tips campaign” guides subscribers through a mini concussion-training course, with a text message and an educational link delivered weekly. The campaign is a collaborative effort of Chicago-area sports medicine physicians, neurologists, surgeons, and American Orthopedic Society for Sports Medicine’s national STOP Sports Injuries campaign.

“Texting is an effective way to reach teens and adults where they are today, on their mobile phones,” says Dr. Vishal Mehta, an orthopedic surgeon and co-founder of Healthy TXT, the organization behind the venture. “Harvard University and John Hopkins Children’s Center studies show that healthy behaviors can be inspired and sustained using cell phone technology.”

R.J. Anderson is the Online Editor at Training & Conditioning.

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