1.3 Million HS sports concussions per year (4/25/19 newsletter)

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Education

You can learn how to develop a concussion protocol that is tailored to to your specific sports club or organization by taking the University of Calgary MOOC (massive online open course): Concussion: Prevention, Management, and Treatment. The seven-week course is free, and a certificate is available upon completion; registration is open until May 6th.

TeachAids.org has established new partnerships with nonprofits to provide CrashCourse, their new interactive learning experience about concussions. Positive Coaching Alliance will share CrashCourse in their online resource center and disseminate the program across their network of over 1,000 schools and youth sports organizations nationwide.

Culture

Oscar-winner Jennifer Lawrence will play a veteran who suffers a traumatic brain injury while serving in Afghanistan and struggles to recover once she returns home. The as-yet-unnamed film will start production in June and is being produced by Oscar-winner Scott Rudin and Eli Bush, according to the AP.

Sports

Football contributed to more TBI-related emergency department visits for boys than did any other sport, whereas for girls, soccer and playground activities contributed more TBI-related emergency department than any other activity. The study was done by the Centers for Disease Control and Prevention (CDC) and published in the Morbidity and Mortality Weekly Report. Table #3 in the study breaks down the data by age, gender, and sport or recreational activity.

The summary report detailing the 2017-2018 results of the yearly National High School Sports-Related Injury Surveillance Study has estimated that over 1.3 million concussions occur each year as a result of high school sports alone. The data is extrapolated from a yearly-changing sample of 100 schools across the United States, and the summary report was compiled by A. Dawn Comstock et al. and was published through the University of Colorado at Denver College of Public Health.

The new high school hockey rules which apply greater penalties for boarding and checking from behind has resulted in a "49% decrease in the rates of concussions due to being checked.” Lauren Nadkarni, MD presented the research abstract to the American Medical Society for Sports annual meeting. The National Federation of State High School Associations put the new rules into effect in the 2014-15 hockey season. The rate of concussions due to other reasons did not change.

In advance of the 2019 Kentucky Derby, Churchill Downs has formalized concussion protocol for jockeys. This will include “more thorough jockey education, baseline concussion testing, onsite evaluation after a fall, and additional return-to-ride requirements,” according to an article in The Horse.

Rehab

A study of UK military veterans found that vestibular dysfunction was “directly and independently associated with increased postconcussive symptoms” and “singularly predictive of poor long-term mental health.” The study by Emma Denby BSc et al., published in The Journal of Head Trauma Rehabilitation, concludes that vestibular rehabilitation “may provide relief from post-concussive symptoms other than dizziness and imbalance.”

The PoNS device or Portable Neuromodulation Stimulator developed by Helius Medical Technologies has been approved by Health Canada but rejected by the U.S. Food and Drug Administration (FDA). The device is used in conjunction with physical therapy, and the FDA said that the data submitted did not show that patient improvements were due to the "independent effect of the medical advice," according to an article in Verdict Medical Devices. According to an article at CBC.ca, the PoNS device is used during physical therapy to improve walking and balance dysfunction caused by a concussion or TBI. The device is placed on the tongue and delivers mild, high-frequency electrical impulses in order to help develop new neural connections. Helius plans to submit more clinical trials information to the FDA; the device is available in several clinics in Canada.

Diagnostics

In youth concussion patients assessed within the first ten days of injury, a study found that an abnormal performance on the Romberg balance test was independently associated with a longer duration of symptoms. For the Romberg test, the patient stands with their feet together and eyes closed; an abnormal result is if they lose their balance or have exaggerated body movement. The study, by David R. Howell, Ph.D. et al., was published in the Journal Of Neurosurgery, Pediatrics.

A study finds that the speed at which patients turn their head on the horizontal plane accurately differentiates between those with concussions and those without concussions. The study used inertial sensors to measure head velocity and found that concussed patients turned their head more slowly than controls. The study, by Peter C. Fino, Ph.D. et al., was published in The Journal of Head Trauma Rehabilitation, and concludes that “inertial sensors can improve traditional clinical assessments by quantifying subtle, non-observable deficits in people following a sports-related concussion.”

Baseline Testing

Parachute Canada issued a Statement on Concussion Baseline Testing in Canada. The statement says "Baseline testing using any tool or combination of tools is not required to provide post-injury care of those who sustain a suspected or diagnosed concussion, and mandatory pre-season testing is not recommended."  This is because current evidence does not show a "significant added benefit" of testing. Baseline testing may be considered in athletes with pre-existing conditions or for teams that have dedicated physicians.

K-12 Schools

A study of Indiana high school principals and their return-to-learn accommodations for students with concussions found that one-third of the respondents received academic training accommodations for concussed students, and "90% were willing to provide accommodations as long as necessary," but "nearly 40% of responding principals were unlikely or unwilling to implement accommodations for standardized testing." The study by Isaac A. Janson, Ph.D. et al., published in The Journal of Head Trauma Rehabilitation found that 90% of principals underestimated the frequency of student concussions.

College Students

A study found that the Project Career model successfully supported undergraduate students with traumatic brain injuries. The five-year, multi-site project used cognitive support technology (iPads and apps) and vocational rehabilitation to “improve academic and employment outcomes for veteran and civilian students with traumatic brain injury” in two-year and four-year colleges and universities. The study by Anne Leopold et al. was published in the Journal of Vocational Rehabilitation.