Although the medical community has been unable to come to a
conclusion about how to deal with concussions, everyone agrees that
brain injuries are a serious problem facing athletes.
The Touchdown Club at Highlands Ranch High School has been aware
of the dangers associated with head injuries, and this year the
club purchased a new tool for the school that could help in
preventing a second head injury.
The tool is a computer software program called ImPact –
Immediate post-concussion assessment and cognitive testing – and it
is up and running on about a dozen computers at the
school.
Developed by Michael (Mickey) Collins, Ph.D., Mark Lovell,
Ph.D., and Joseph Maroon, M.D, at the University of Pittsburgh,
ImPact will give Highlands Ranch High School athletic trainer Tom
Bradley a better way to determine when it is safe to let an athlete
return to competition after a head injury.
A concussion is an alteration in mental status because of the
brain shaking inside the skull, said the American Academy of
Neurology and the Brain Injury Association.
A concussion does not require a direct blow to the head and can
occur with or without loss of consciousness.
Just about every athlete who has ever played a contact sport is
familiar with concussions, which can range in severity.
At grade 1, there is a hit to the head or a “ding,” and no loss
of consciousness. There is brief confusion that follows, and
symptoms generally do not last longer than 15 minutes.
At grade 2, there is still no loss of consciousness, but the
symptoms, which can include headache, dizziness, vertigo, lack of
awareness of surroundings and nausea and vomiting, persist longer
than 15 minutes.
At grade 3, there is a loss of consciousness from the
injury.
While it is obvious that a player who loses consciousness should
not return to the game and will need a significant amount of time
to heal, the questions that have plagued athletic trainers and
doctors alike are, How long does it take for the brain to heal? and
When is it safe for the athlete to return?
Guidelines have varied from resting the player a few days to a
few weeks, but with ImPact, some of those questions could be
answered with hard data.
With ImPact, Bradley can get a better determination of whether a
player has sufficiently recovered from a concussion by comparing
before and after results.
Each athlete is given a six-step test to create a baseline of
his or her normal brain activity.
After plugging in basic information (name, age, sport) ImPact
tests players’ short- and long-term memories and their reaction
times to one-one-hundredth of a second.
ImPact records and stores the data. If a player suffers a
concussion, he or she is retested the day after the injury. The
tests vary, to minimize “practice effects,” but it continues to
measure for the same cognitive functions.
With the baseline results on hand, Bradley and his staff will be
able to take the results of the post-head injury test and compare
them to the results of baseline test, thus providing a conclusive
way to tell if there are any lingering effects from the
injury.
If the player does not measure up to the baseline, he or she
will be tested again in three days and again in five.
ImPact provides help and guidelines for trainers while storing
the data, which will be used for future research into concussions
and brain injuries.
“The software measures the things that we call cognitive
functions,” said Steven Heinz, a doctor who specializes in
emergency medicine and was the first to motion for the purchase of
the software by the club. “One of the things that we know about
concussions is that not only can a person have the usual symptoms,
but there can be a serious impairment of their mental abilities.
The beauty of this test, from my perspective, is that it is hard to
know for sure that an athlete is giving you the straight scoop
about their injury. The purpose of this test is to give a reference
point to compare the injury to and to have data that shows if they
are symptom-free or not.”
For Bradley, who is often left with the final call on whether a
player is healthy enough to compete, ImPact gives him something to
compare the injury to.
“When a player hurts his right knee, I use his left knee as a
comparison,” Bradley said. “With a head injury, I don’t have
another brain to compare it with.”
Although nothing can stop head injuries from occurring, the
software does help with the prevention against “Second-Impact
Syndrome.”
Second-Impact Syndrome has accounted for nine documented deaths,
including that of a Bear Creek High School rugby player who
suffered two concussions in a short time, the first from skiing and
the second from rugby.
“We know that an athlete who sustains an injury from a second
concussion before being fully recovered from a first concussion is
at significant risk for major brain injury and maybe even death,”
Heinz said.
ImPact will give Bradley and Heinz a much better way to learn
whether an athlete is fully recovered from a first concussion and
is therefore safe to return to competition.
For information about ImPact, visit www.impacttest.com.