Treating concussions: A baseline for success
Editor’s Note: This is the final installment of a four-part series about concussions.
Up, down. Up, down.
But to Dr. Frank Zolli, a professor of clinical sciences, each step is another clue to how well her central nervous system is functioning.
The muscles, the cadence, the foot strikes, it’s all measured with sophisticated equipment to establish a tailored baseline.
Or, in the event of a concussion, to find the deviation from that baseline.
The physical toll of concussions
The University of Bridgeport is studying the physical effects of concussions, not just how they impact cognition. In the video below, Dr. Peter Gorman, an adjunct professor at the school, details some of the research.
Click here: http://bit.ly/1GSkYJO
Concussion Q&A from the CDC
Q: What should you do if you think your child has a concussion?
A: Seek medical attention right away. A health care professional will be able to decide how serious the concussion is and when it is safe for your child to return to regular activities, including sports.
Q: When can your child return to play?
A: Concussions take time to heal. Don’t let your child return to play the day of the injury and until a health care professional says it’s OK. Children who return to play too soon—while the brain is still healing—risk a greater chance of having a repeat concussion. Repeat or later concussions can be very serious. They can cause permanent brain damage, affecting your child for a lifetime.
Q: What should you tell your child’s coach?
A: Tell your child’s coach about any previous concussion(s). Coaches should know if your child had a previous concussion. Your child’s coach may not know about a concussion your child received in another sport or activity unless you tell the coach.
“We’re providing objective data and relating it to performance,” said Zolli, a former St. Peter’s College football player who has spent the last 25 years teaching and conducting research at UB.
“As a result of a concussion or some other injury, we can use the new data to measure it against a baseline, and then measure the progress during the recovery process.
“Once that deviation is corrected, then you can objectively say, ‘This athlete is ready to return to play.’ That’s a big difference from, ‘Well, the symptoms went away — the headaches, the dizziness, the nausea — so this athlete can return to play now.’ This is much more scientific.”
The marching test — once with your eyes open, once with your eyes closed — is among several tests that Zolli and his colleagues use at UB.
There is a treadmill that measures the smallest details of gait, the way a person walks. There is also a room with lights that flash in certain sequences to test reaction time and how that dovetails with cognition, how a person thinks.
“We’ve never had anything like this. We’ve never had access to this kind of objective data before,” Zolli said. “We know it’s absolutely critical to exercise the central nervous system. That’s got to be part of the recovery process, especially with concussions.
“You’ve had a traumatic brain injury. You don’t know what the results have been. We can now translate those results to how the body is functioning or not functioning based on your baseline. It helps us create a strategy for the recovery process.”
For the high school athlete, and even the middle school athlete, recent state legislation has established guidelines to help reduce exposure to concussions.
Concussion data must be tracked and submitted to the state Department of Education. Information about concussions — recognizing the signs and learning about treatment — must be shared with coaches, parents and students.
High schools and middle schools must also have a protocol in place for when a student may return to class, never mind athletic competion.
But what about youth sports? What about their baselines and using sophisticated tools to track their recoveries?
What about the little boy who suffers a head injury playing football? What about the little girl who bumps her head playing soccer?
In Norwalk, social worker and concussions-awareness advocate Katherine Snedaker says the new state law covers just 1-in-11 kids in her city.
A three-year pilot study will now collect data on concussions incurred by Norwalk's children. The city also requires youth sports groups using its fields to follow guidelines similar to the state law.
Anyone using a field in Norwalk needs to follow the city’s guidelines: educate coaches, educate parents, make sure parents are notified about possible concussions, and make sure parents have the information about a particular injury to give to medical providers.
In addition, Snedaker wants to make sure that parents notify schools of any concussions involving their children.
“This fall, we'll have trained almost 1,000 coaches," said Mike Mocciae, Norwalk’s director of recreation and parks, during a recent concussion summit.
"That's non-profit groups that use our field. That's for-profit groups that use our fields. And that's for all programs the recreation department runs, from our playgrounds, to our basketball program, to everything that we offer."
Mocciae said he has worked in parks and recreation for 31 years, and this is among his most important accomplishments.
As part of the "C4 Project" — concussion care connected community — data was collected from school nurses.
For the 2014-15 school year, there were 111 reported concussions in Norwalk: 51 were sports concussions, 60 were non-sports concussions.
Only 27 of the sports concussions were incurred in high school sports, which are covered by the law. Another 24 sports concussions occurred outside of high school, which are not protected under the new state law.
State legislators moved this summer to try and educate families of even younger athletes.
A section was inserted into the legislation that will require youth organizations, as of Jan. 1 2016, to provide parents with either written or online information about concussions that is consistent with recommendations by the U.S. Centers for Disease Control and Prevention.
The provision, however, specifically says that youth sports organizations won't be subject to civil liability if they don't adhere to the new recommendations.
"The worry is, if you think of, say, T-ball, (the coaches) are all volunteers," said state Rep. Diana Urban, a Democrat who represents North Stonington and Stonington. "The worry is that if we ask them to be trained, they're not going to want to volunteer."
But Norwalk hasn't seen that, Urban said.
The bigger issue for youth sports programs is making sure parents get the necessary concussion information.
"It wasn't so bad for the coaches because they're used to having to jump through hoops," said Jack Couch of Norwalk Youth Lacrosse. "Getting paper from parents is like herding cats in a nightmare."
"It's funny. It's cute. It doesn't scare kids," Snedaker said. "It's kind of fun. There's vomit. There's all kinds of things to appeal to kids."
But the concussion video makes clear that it's important to get treatment for an injury that, left untreated, can have long-term detrimental effects on many facets of a child's life.
"The good news is that in a lot of ways, a lot of the coaches, parent organizations, youth programs are somewhat out ahead of where a lot of folks think they are," said state Rep. John Shaban, a Republican from Weston, and the president of Aspetuck Youth Football.
But there's still room for improvement.
"When you think about it, not every kid plays sports,” said Bob Fosina of Norwalk Junior Soccer. “Every kid walks up and down stairs. Every kid gets in a car. Every kid goes on a scooter. I would love to see this be implemented at the (primary) school level."