Concussion testing finds place on playing field

Football players are used to tackling drills and strength conditioning.

But De Soto High School sizes up players for more than their biceps. It also assesses memory, attention span and reaction times.

De Soto began a baseline cognitive test this year to evaluate concussions — and help ensure athletes are healed before they head back to the field. It’s one way De Soto and a handful of other area schools are going beyond state mandates to address concussions and lingering brain injuries.

The test comes as high schools take note of research that shows an alarming increase in the number of adolescents treated in emergency rooms for concussions. High school athletic officials are eager for clear answers to the uncertainty over returning athletes to the field.

Several other districts are eyeing the same approach for next year, but De Soto athletic officials are convinced the test is the right move.

“Why would you not want something there as an extra tool?” said Steve Hawkins, an athletic trainer for Olathe Medical Center assigned to De Soto High School.

“I’ve had kids forget whole periods of the day,” Hawkins said. “They couldn’t remember the last 24 hours.”

The test is in its second year at Independence district high schools, including Truman High School, where cheerleaders, wrestlers and football, basketball, soccer and volleyball players take it.

“It’s a little bit of a security blanket for everybody, for kids, parents and coach,” said Truman High School Activities Director Eric Holm.

The noninvasive cognitive test can be performed in a high school computer lab. Students go through video game-style drills to test for visual and verbal memorization, cognitive processing speed and reaction time.

The end result gives a physician a baseline score.

If a concussion happens, the test is retaken and a physician compares the results. If the results show a marked difference, the student sits out until a physician sees adequate improvement.

Several local physicians said the tests are credible. Many college teams and major league sports, including the NFL, already use them.

“It has revolutionized the way we practice,” said David Dyck Jr., a primary care sports medicine physician. Dyck also is the medical director for the Center for Concussion Management at Midwest Sports Medicine Physicians in Independence.

Dyck said the test helps prevent players from suffering a second blow before a first injury has healed. One concussion can be severe, but a second impact without proper healing can be devastating. Yet determining when a student can return has always been difficult to assess.

Symptoms can be hard to detect and students aren’t always up front about ongoing problems.

The physician still conducts traditional tests that are just as vital to concussion management. Even without the test, Dyck said patients must be symptom-free when they are resting and exercising.

“It was always kind of like a cookbook. We say you got a concussion, sit out a week or sit out two weeks as long as you’re symptom-free,” Dyck said. “Now it’s all very individualized.”

The standard method also relies on athletes being honest and reporting ongoing symptoms. Some athletic officials worry that method puts too much pressure on young athletes who don’t want to let teammates down.

Dyck said he’s aggressive about returning students to the field after they suffer injuries “until it comes to the brain. With the brain I’m ultraconservative. We only get one.”

His practice has deemed the test so important that it conducts the baseline as part of routine annual sports physicals.

“We just think it’s important to have that,” he said. “It’s not worth charging them $2, which is the cost for us to conduct the test.”

Holm said the test means student athletes sometimes sit out longer than they might have in the past. That can be frustrating for players and parents, but ultimately it’s up to the physician, he said.

“It’s too important a thing and you’ve got to keep them out,” Holm said.

A recent study published in the journal Pediatrics showed that the emergency room visits for concussions had more than tripled for children ages 14 to 19 years old. Visits went from about 7,000 in 1997 to almost 23,000 in 2007, researchers said. The study pointed out that participation in team sports decreased during the same time. Yet the increase in ER visits could speak as much to better awareness as it does to injuries, the research team noted.

The Missouri and Kansas high school activities associations have also stepped up their efforts. Athletes who exhibit concussion-like behavior must leave a game and get permission from appropriate medical personnel before returning to play. It’s one of many new safeguards the states deployed to increase awareness.

Coaches also have been asked to take more training and parents are getting more information from school districts.

The studies have not been lost on parents who like the idea of quantifiable data. Football mom Penny Adams worries each time her son steps onto the field at Truman High School.

“That’s a great idea because last weekend he went up against two Coke machines with legs, I’m pretty convinced,” she said.

Her son, Tyler Adams, a senior lineman, told her about the test and it eased her mind, if only for a while.

“I pray every game: Please God just let him get up. Just let him get up,” Adams said.

The test is still relatively new to the high school stage. Several school districts said they’ll implement the test when they can come up with funding and determine a plan for it.

De Soto received free testing courtesy of Overland Park Regional Medical Center. Tests in the Independence school district are paid for by Centerpoint Medical Center as part of a training contract. A Shawnee Mission East booster club was so excited about the possibilities that donors purchased it for the football team this year.

Many area schools use a software program called ImPact for the test, though other versions exist.

For now Blue Valley, Olathe and other districts said they are observing how the tests works at other high schools with the intent of moving forward if it proves successful.

“It’s something that we are definitely looking at doing for our athletes in high-impact sports,” said Lane Green, Olathe Schools Director of Athletics, Activities and Transportation. “I’m going to spend the next school year looking for funding.”

Green said he’d like to see the test implemented at Olathe middle schools in addition to high schools.

De Soto officials also have plans to test more athletes. After 25 years of experience in athletic training, Hawkins said he’s jumping at the chance to improve odds for student athletes.

“Let’s go down the road,” he said. “We’ll see where it goes.”

To reach Dawn Bormann, call 816-234-7704 or send e-mail to dbormann@kcstar.com.

For more information about this article, please visit http://www.kansascity.com/2010/09/04/2200169/more-area-schools-require-student.html#ixzz0ysW4wwLx

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