Concussions in High School Athletics

Concussions in High School Athletics

Dewey Frame

December 6th, 2013

SPMGT 290.03

Introduction

Concussions in high school sports have become a very controversial issue nationwide. The growing concern for the safety of our youth has prompted schools, scientists, parents, and students to be on high alert when it comes to concussions. Looking into the topic of concussions in high school sport, the main issues are management of a concussion, the safety of the athletes, and the effects of concussions on high school athletes.

Management of a Concussion

• Concussion Tests

• Concussion tests have been implemented across the country in an attempt to eradicate improper diagnosis and prevent early returns to the athletic event. ImPACT consists of six neuropsychological tests; each designed to target different aspects of cognitive functioning including attention, memory, processing Speed, and reaction time. From these six tests, four separate scores are generated: Verbal Memory, Visual Memory, visuomotor speed, and reaction time. (Schatz, Pardini, Lovell Collins, Podell, 2006)
• The Post-Concussion Symptom Scale (PCSS; ) is also utilized in the ImPACT Test. The scale is used by many sports organizations to document and track concussion symptoms (Lovell, 1999; ). The 21-symptom checklist asks the injured athlete to rate each symptom on a seven-point scale, with zero indicating no experience of a symptom and six indicating a severe symptom. (Schatz, Pardini, Lovell Collins, Podell, 2006)

• Education of Concussions

• Eduaction of concussions must be taught in every high school, knowledge is an athletes’ and doctors’ best weapon. The first step in developing a concussion management program involves educating school personnel about concussions and their effects and each professional’s role in management when an injury occurs. (Sady, Vaughan, Gioia2011)
• Participants should also learn about the potential long-term effects of concussion and the dangers of returning to activity too soon. (Sady, Vaughan, Gioia, 2011)
• To aid in information outreach, the Centers for Disease Control (CDC) has published a toolkit of educational materials for school personnel that parallels the materials available in the Physicians’ Toolkit. (Sady, Vaughan, Gioia, 2011)

• Funding

• Funding for the imPACT equipment and proper helmets in football come at a price due to the level of technology involved in the process. Schools being able to afford such expensive equipment will be a significant factor in years to come. (Sady, Vaughan, Gioia, 2011) Funding for the imPACT test is different for each school district. Many districts are able to provide the tests for free to athletic sport participants. Saving each student a 20 to 25 dollar charge for every test. The schools are able to provide testing for free due to the district being able to fund the program for all the schools. (Sady, Vaughan, Gioia, 2011) This funding is usually done through independent sources, such as sports boosters clubs and donations. (Sady, Vaughan, Gioia, 2011)

Safety of the Athletes

• Equipment

• Modern football helmets have drastically increased the safety of football athletes, however new technology must be advanced in order to sustain the game of football and the increase of player attributes and size. (Rowson, Daniel, Duma, 2013)

• Proper Diagnosis

• Returning an athlete to participation should follow a progression that begins once the athlete is completely symptom free. (Guskiewicz, Bruce, Cantu, Ferrara, Kelly, McCrea, Putukian, McLeod, 2004)
• Baseline measurements of neuropsychological and postural stability are strongly recommended for comparing with post injury measurements. (Guskiewicz, Bruce, Cantu, Ferrara, Kelly, McCrea, Putukian, McLeod, 2004)
• If these tests do not produce symptoms, the athlete can then participate in sport skills that allow return to practice but should remain out of any activities that put him or her at risk for recurrent head injury. This means that physical activity should be avoided for another allotted amount of time. (Guskiewicz, Bruce, Cantu, Ferrara, Kelly, McCrea, Putukian, McLeod, 2004)

• Recovery Process

• Students with a concussion must be restricted from physical activity, sports, or playground activity until a health care professional with expertise in concussion evaluation and management provides clearance for the student to return to play. (Sady, Vaughan, Gioia, 2011)
• The return to play plan for sports activity typically begins after complete resolution of symptoms at physical rest and no symptom return with cognitive exertion. It is essential that school and medical personnel communicate with coaches, PE teachers, and athletic trainers about the student’s cognitive progress when planning a return to physical activity. (Sady, Vaughan, Gioia, 2011)

Effects of Concussions

• Football

• Over 62,000 concussions are estimated to occur annually in high school sports in the US and football accounts for 63% of those concussions. (Guilmette, Malia, McGuiggan, 2007)

• Mental Capability

• The physical symptoms of a concussion include: headache, blurry vision, light/noise sensitivity, and fatigue. All these symptoms can greatly affect a student’s ability to function in the classroom. (Sady, Vaughan, Gioia,2011)

• More than One Concussion

Suffering more than one concussion can be detrimental to a person’s health. Collins and colleagues studied 29 high school athletes, 60 of who had no history of concussions and compared them to 38 athletes whose history demonstrated they had suffered at least three concussions. Those athletes who had a previous history of a concussion were 9 times more likely to demonstrate loss of consciousness (LOC) and greater anterograde and retrograde amnesias following a concussion than those without such a history. A second study reported that athletes with a prior history of concussion were 7 times more likely to show drops in memory performance compared to matched cohorts. (Theye, Mueller, 2004)