Getting the All-Clear on Concussions
It's not so hard to recognize a concussion: It's in the sickening sound of a helmet-to-helmet hit, or the hard check that sends a player head-first into the boards.
Recognizing when an athlete's concussion has cleared and it's okay to return to play isn't clear at all. Too often, athletes who haven't fully recovered – even those whose nausea, dizziness and headaches seem to have vanished – go back to play too soon. That puts their brains at increased risk for even more serious injury.
That's why doctors and athletic trainers at UW Health's Sports Medicine Center have joined the Wisconsin Sports Concussion Collaborative to offer athletes an online test that can objectively determine when an athlete's neurocognitive abilities have returned to normal.
"This is very useful, very objective information for us to have," says Joe Greene, supervisor of athletic training services for UW Health. "It helps us to make return-to-play decisions much better and return these athletes to their activities in a much safer way."
UW Health Sports Medicine began offering the test, call ImPACT, to area athletes last year. But it's only now picking up steam among high schools in the Dane County area, bolstered by a growing awareness of the importance of concussion care – and by incidents like the one that occurred in North Carolina, where a high school football player died on the field a few days after suffering a concussion.
This year, athletic departments at both McFarland and Mount Horeb high schools have partnered with UW Health to baseline test their collision sport athletes (football and hockey, some soccer) before the season's start. Then if an athlete suffers a concussion, the athlete can re-take the test and doctors can see how closely the score compares to the original baseline. Other schools are considering the service as well.
"Comparing the scores gives us more certainty, and it's important to be as certain as possible," notes Greene. The roughly 25 minutes test consists of a series of exercises that measure an athlete's short-term memory and reaction time, two of the abilities than can suffer. For instance, in one part of the test, the athlete is shown a series of words, then asked to recall which words he or she has just seen. Later in the test, athletes must react to information that flashes quickly on the screen.
All the athletic trainers at UW Health Sports Medicine as well as five UW physicians have been trained to interpret the test results: Drs. David Bernhardt, Greg Landry, Kathleen Carr, Allison Brooks and John Wilson.
Greene and his colleagues recommend that an athlete take the ImPACT test twice during his or her high school career – once in ninth grade and again in 11th. Health insurance programs don't cover the baseline test, but for a $10 fee, parents can also pay for their children to take the test at home through a link on the UW Health Sports Medicine Web site. The results are then held within ImPACT's database and are accessible to ImPACT credentialed health care providers should a future concussion occur.
Greene stresses that the ImPACT test is more valuable if there's a baseline test for comparison, but even without a baseline, an athlete's results can still be compared to a large normative database.
"I think as time has gone on we have become consistently more conservative with how we manage any potential head injury," says Green. "With younger athletes, how you handle the initial concussion may not only prevent more concussions from occurring, but also head off more severe ones. This tool helps us do that."
For more information, contact UW Health Sports Medicine at (608) 263-8850.