Doctors urge pre-concussion testing for local students
New medical technology is making it easier for parents and
schools to know when it is safe to allow a teen with a concussion
to return to playing sports.
Utah Valley Regional Medical Center in Provo is working with
professional trainers in all three school districts in Utah Valley
to offer what is called an ImPACT baseline concussion test before a
student ever plays a game. If the student suffers a concussion, the
student takes another test, and the pre- and post-concussion tests
are compared to determine the exact damage from the concussion.
Since January 2010, 2,377 students in high school and Brigham
Young University and Utah Valley University have taken the test.
The hospital has seen 418 concussion victims in the same time
period. ImPACT stands for Immediate Post Acute Concussion
Treatment.
Before ImPACT testing was available, a student’s post-concussion
testing was compared against a database of students of a similar
age from throughout the nation to determine what should be normal.
But ImPACT is a revolution in treating concussions because it
allows doctors and parents to compare a youth’s cognitive ability
against him or herself, rather than a national database, to
determine the extent of both the injury to the brain, and
recovery.
Until recently, coaches and trainers often took the word of
students as to when they were ready to return to play, which is not
a good method.
“Kids in high school say ‘I’m feeling good, coach, put me in,’
but really their girlfriend is watching the game,” said Brent
Edgington, director of sports medicine for UVRMC. “And the biggest
risk these kids have is second impact syndrome, which is one
concussion on top of another, which can lead to death or severe,
severe disability for the rest of their life.”
ImPACT works like this: Youth take a 25-minute computer exam
which shows the student a list of words, one at a time, and then a
different list of words, then asks the student which words on the
second list had been on the first list. Another test does the same
thing, only with a bunch of squiggly line designs, and there are
other similar tests. The exam measures both verbal and visual
memory, motor speed, reaction time and even color blindness.
During the past couple of years, schools and parents have been
paying more attention to the dangers of concussions in high school
sports after national attention in the wake of deaths of several
high school athletes throughout the nation. Alpine School District
is working to finalize its first district-wide concussion policy,
mandated by a new state law. ImPACT testing is not mandatory, and
its use is often a school-by-school decision. Parents can set up
appointments for their children, or trainers can administer the
test at schools.
The test also has a side benefit, said Dr. Brent Rich at
UVRMC.
“It raises awareness with the kid, the parents, the schools,
that concussions are serious,” he said. “It used to be that
concussions were put under the rug. Now it is OK to talk about
them. We used to think all concussions were the same. People need
to recognize that one concussion can be very different from
another.”
The best treatment is individual, not based on comparing a
student’s post-concussion tests on results from a national
database, he said. All parents and schools should strongly consider
having a student take an ImPACT test before playing sports.
“A developing brain is very vulnerable,” said James Snyder, a
brain injury expert at UVRMC.
Even if a student is kept home from school, playing video games
can add further damage to a concussion. And sometimes parents or
coaches require a student to sit out of several games, but expect
the student to continue going to school and testing — but homework
and testing can actually do further damage. Ignoring the symptoms
of a concussion can be dangerous, and having an ImPACT test to
compare to after a concussion helps medical professionals be more
exact in their assessment, Snyder said. And everyone has to pay
attention to changes in a student’s behavior — not just coaches
and trainers. One student with a severe concussion went untreated
for months because the concussion happened in the last game of the
season, and both the coach and the trainer didn’t see the student
again. Parents did not immediately recognize why their child was
suddenly not doing well in school and not acting like himself.
“People still have the perception that if the student is not
knocked out, they are OK,” Rich said. “Some coaches still say if
you have a headache, buck up. Some of the older coaches say we
played through worse. But if the student gets a second concussion,
the results can be devastating.”
For information about ImPACT testing, visit uvsportsmed.com or
call (801) 357-1200.
Concussion symptoms (data from UVRMC):
Headache
Nausea
Vomiting
Balance problems
Dizziness
Visual problems
Fatigue
Sensitivity to light
Sensitivity to noise
Numbness/tingling
Feeling mentally foggy
Feeling slowed down
Difficulty concentrating
Difficulty remembering
Drowsiness
Sleeping less than usual
Sleeping more than usual
Trouble falling asleep
Irritability
Sadness
Nervousness
Feeling more emotional