Concussion Management Update from Peter Falla, ATCInjury Prevention
With fall sports getting underway, area athletic trainers (ATs) will soon be busy tending to the health care needs of student athletes. In addition to the everyday sports medicine responsibilities of treating injuries and managing rehab, recognition and care of concussions has become an important focus of healthcare professionals on the field. Concussions are mild traumatic brain injuries that are the result of rapid deceleration of the brain within the skull. The injury is characterized by alteration in brain function. It often takes several weeks to recover from a concussion and the process may negatively affect the student athlete both socially and academically. However, the addition of ImPACT testing has taken some of the guesswork out of concussion management.
ImPACT (Immediate Post-concussion Assessment and Cognitive Testing) is a neurocognitive test that is now routinely given to contact-sport athletes during the beginning of the season to establish a baseline. The 25-minute test has been researched extensively and validated for use in high school athletes and is widely used in collegiate and professional sports.
As head athletic trainer for Greenwich High School, I have overseen 1500 baseline tests and seen the benefits of neurocognitive testing first hand. A recent injury of a football player gave me an opportunity to demonstrate why ImPACT is such a useful aid in the neurological evaluation. In this case, despite clearance by the student’s pediatrician and his own insistence that he was feeling “100 percent better,” his post-injury test scores were significantly lower than his baseline, indicating that he was not fully recovered. At a critical point in the season, the pressure to return to the field was immense. I suggested to the family that they hold the player out of sports and serial test him with ImPACT until his numbers improved. Five days later, his scores were almost identical to his baseline and we began a supervised, gradual return-to-play protocol over five days, while closely monitoring his condition. Three weeks passed before healing was complete but he made it back in time to play in the final game of the season.
It is important to remember that ImPACT neurocognitive testing is “one tool in the belt” of those treating concussions and should not alone be used as the deciding factor in return or not-to-return to sports decisions. There is no substitute for a good neurological examination and proper evaluation done by a medical professional who specializes in head injuries.