Concussion Assessment & Management Program: Dr. Michael S. Sefton

Press

Worcester Telegram & Gazette: September 29, 2004

Keeping Concussions Off Ice

by Jacqueline Reis

Dozens of hockey players recently took a break from practice to take a 20-minute assessment that will help screen them for concussions later in the season.

The series of simple computer tests establishes baseline brain functioning. Comparing the data with those taken after a concussion will help show when it is safe for a player to compete again, said Michael S. Sefton, a neuropyschologist at Whittier Rehabilitation Hospital in Westboro. Mr. Sefton is also a Shrewsbury Youth Hockey coach and hopes to test about 250 players.

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US LACROSSE TO PROMOTE NATIONAL CONCUSSION MANAGEMENT PROGRAM

BALTIMORE – US Lacrosse today announced a strategic partnership with ImPACT Applications, Inc. (ImPACT) to launch a formal Concussion Management Program that will promote testing, education, awareness, and state-of-the-art standards of care to the national lacrosse community. Four US Lacrosse National Teams (Men’s National Team, Women’s National Team, Men’s U-19 Team, and Women’s U-19 Team) will also adopt the program.

More than 1.6 million sports-related concussions occur each year according to researchers at the University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program. Concussions have become recognized as one of the leading sports-related injuries. Research also suggests that youth may be at higher risk for neurocognitive decline following concussion than older athletes.

New online resources at uslacrosse.org will provide a wealth of concussion information and access to the ImPACT™ Baseline Testing Program, a computerized series of neurocognitive tests that help determine the extent and severity of concussions. This program will help the doctor of an injured player determine a safe return time following a concussion. The ImPACT™ program, the world’s first and most widely used computerized sports concussion evaluation system, has been utilized throughout professional sports, including numerous teams in the NFL, the past five years and is now available for the first time via the Internet to all levels of lacrosse players through the US Lacrosse Web site.

“ImPACT was designed to provide a comprehensive head injury management system that provides valuable information to players, their parents, and to doctors,” said ImPACT™ developer Mark Lovell, Ph.D., director of the UPMC Sports Medicine Concussion Program, who also directs the neuropsychological testing programs for the National Football League and the National Hockey League.

A concussion is any change in mental status caused by a sudden violent rocking back and forth of the brain inside of the skull due to a blow to head or upper body. Symptoms can include headache, amnesia, dizziness, confusion, lack of hand-eye coordination, and in some cases, loss of consciousness. Generally, an athlete can safely recover from an initial concussion as long as the brain has time to heal. If a second concussion occurs prior to full recovery from the first, an athlete may experience long-term symptoms in the form of chronic headaches, sleep difficulties, personality changes or memory problems. In rare cases, a second concussion may even result in death from ‘second impact syndrome.’

“This type of innovative tool will prove to be extremely beneficial to lacrosse players since it will help primary care physicians and team medical staff to objectively determine when full recovery from concussion has occurred,” says Michael Collins, PhD, Assistant Director of the UPMC program, who also directs the concussion management programs for Major and Minor League Baseball Umpires and several collegiate and high school programs. “Players who have sustained a concussion often return to play prior to complete recovery, resulting in an increased vulnerability to another concussion and potentially more serious brain injury. By utilizing the ImPACT™ Testing Program, a concussion can be more accurately diagnosed and, based on objective data, a proper return time can be determined to reduce the risk of a secondary concussion.”

The ImPACT™ Baseline Testing Program – standing for Immediate Post-concussion Assessment and Cognitive Testing – evaluates and documents multiple aspects of brain functions, including memory, processing speed, reaction time and post-concussive symptoms. Through a 20-minute test, baseline data on an athlete’s neurocognitive functional state is collected and stored. When a concussion is suspected during the season, the athlete is re-tested and the baseline neuropsychological data is compared to post-concussion data to help determine the athlete’s post-concussion neurocognitive status, as well as when it is safe for the player to return to active sports.

“Proper assessment of the injury and the determination of existing symptoms that may indicate incomplete recovery is critical to the safe management of an athlete suffering from a concussion,” said Dr. Vito Perriello, MD, of the US Lacrosse Sports Science and Safety Committee. “Imaging techniques such as CT scans or MRIs identify anatomic changes in the brain but are not helpful in measuring the effects of concussion, which are functional and not anatomic alterations in the brain. A thorough medical examination is vital and use of neurocognitive tests such as ImPACT™ are incredibly useful in assessing brain function. With neurocognitive testing a physician has an objective tool to help determine concussion subtleties, thereby assisting with medical management and return to play decisions.”

In addition, the ImPACT™ program provides a user-friendly injury documentation system that facilitates the tracking of the injury from the field through the recovery process. Proper use of data on ImPACT™ testing should provide additional objective data on brain function to help a physician determine when the brain of an athlete has fully recovered from injury, facilitate a safe return-to-play decision, and minimize the chance of follow-up concussions.

The ImPACT™ technology has been widely adopted and used by trainers and athletic therapists in some of the world’s top sports leagues, including the NFL, Major League Soccer, and the NCAA. ImPACT™ has also become the most widely utilized concussion management solution in Canadian amateur and junior hockey circles, as the Ontario Hockey Federation, Ontario Hockey League, Western Hockey League, and Alliance Hockey all strongly recommend the program’s use.

“The US Lacrosse Concussion Management Program seeks to implement a new standard of care in connection with concussions and effectuate meaningful change in how lacrosse players are returned to play following an injury,” says Steve Stenersen, Executive Director of US Lacrosse. “US Lacrosse is proud to be a part of such an innovative and valuable program for our sport. We look forward to working with ImPACT™ and the national lacrosse community as we strive to create a safer environment for lacrosse players of all ages through this robust campaign of education, awareness, and clinical care.”

The US Lacrosse Web Site will be the primary destination for information and educational tools and resources related to concussion management. In addition to providing access to the ImPACT test, the US Lacrosse Web Site will provide access to a full range of concussion-related content, including:

Concussion Education and Awareness Resources for athletes, parents, trainers and coaches
Concussion Training Programs for lacrosse coaches, team doctors, personnel and athletic trainers
Published Research and industry-related articles
Qualified Clinical Locator that provides athletes, parents, coaches, and trainers with access to a National Clinical Network of concussion specialists

“Our ultimate goal is to create a safer environment for lacrosse players of all ages through education, awareness, and clinical care,” said David Hall, Chief Executive Officer of ImPACT. “Now, the national lacrosse community possesses the necessary education and tools to help monitor for concussions throughout the season and make the right decisions around safe return to play. It is our hope that clinicians throughout the country will participate in this program so that local infrastructure and resources are in place for all of the US Lacrosse members.”

About US Lacrosse

US Lacrosse is a 501(c)3 nonprofit organization founded in 1998 as the national governing body of men’s and women’s lacrosse. The organization provides a leadership role in virtually every aspect of the sport throughout the United States, and its operations include numerous initiatives, dozens of nationally-circulated publications, regional and national events, and numerous programs that support the sport’s growth and development.

The US Lacrosse Sports Science & Safety Committee function as an advisory group to the leadership and to the various committees of US Lacrosse, as well as to serve as a source of lacrosse sport safety education for the entire lacrosse community. The goal of this committee is to utilize the existing sports medicine literature and grow the body of lacrosse safety knowledge in order to objectively advise US Lacrosse and the lacrosse community on factors that may enhance the safety and quality of experience in the sport of lacrosse at all levels.

For more information visit the US Lacrosse web site at http://www.uslacrosse.org/

About ImPACT™

ImPACT™ (Immediate Post-concussion Assessment and Cognitive Testing) was developed over the past decade by sports concussion researchers Mark Lovell, Ph.D., Michael Collins, Ph.D., and Joseph Maroon, M.D. at the University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program. It is the first and most widely used computerized evaluation system to objectively assess the effects and severity of concussion and injury recovery progress and help determine when it is safe for the athlete to return to contact sports following a concussion.

Today, ImPACT™ is used by numerous teams in the National Football League, Major League Soccer, and Major League Baseball; all MLB umpires; more than 300 colleges and universities and more than 1,000 high schools nationwide; the USA Olympic Training Center; USA Hockey and the United States Women’s Olympic Ice Hockey team; U.S. Soccer Federation; the U.S. Ski Team; Championship Auto Racing Teams and the Indianapolis Racing League as well as numerous other national and international professional athletic organizations and sports medicine programs.

For more information visit the ImPACT™ web site at http://www.impacttest.com/