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):
Sensitivity to light
Sensitivity to noise
Feeling mentally foggy
Feeling slowed down
Sleeping less than usual
Sleeping more than usual
Trouble falling asleep
Feeling more emotional