Schools Continue to Manage the Heat

July 16, 2015

By Rob Kaminski
MHSAA benchmarks editor

It certainly was not the MHSAA’s intent to spur the most historically frigid back-to-back winters the state has seen. Nor did the Association wish for one of the mildest summers in recent memory during 2014.

Seemingly, it’s just Mother Nature’s way of reading into MHSAA efforts for managing heat and humidity and acclimatizing student-athletes for warm-weather activities.

Since guidelines were put in place (recommended for regular-season sessions and required for postseason tournaments) before the 2013-14 school year, there have been relatively few days during which psychrometers have had to be implemented.

“The key is, we’ve got plans in place for when the climate returns to normal trends for return-to-school practices and contests in August and September, as well as early June events,” said MHSAA Executive Director Jack Roberts. “It is a bit ironic that there have been relatively few days since the guidelines were established that they’ve actually come into play.”

In a nutshell, the guidelines provide instruction for four ranges of heat index: below 95 degrees; 95-99 degrees; 99-104 degrees, and heat indexes above 104 degrees, with increasing precautions in place as heat indexes rise. An index above 104 calls for all activity to cease.

Certified athletic trainers Gretchen Mohney and James Lioy agree that recent requirements in heat and hydration guidelines are a step in the right direction and encourage that – when possible – an athletic trainer oversee the implementation. Simply taking a reading from just outside the AD’s office or at home does not simulate on-site conditions.

“This doesn’t take into account the radiant heat at the site, which can drastically affect the conditions that athlete plays in. It is essential that all parties involved in making decisions to play collaborate with one another,” Mohney said.

Heat-related deaths in athletics rank only behind cardiac disorders and head and neck injuries, but such fatalities might lead the way in frustration for families and communities of the victims. The reason? Heat-related illness is totally preventable.

Another source of mild frustration is the lack of recording within the state for those practice and game situations which warrant heat protocols.

When the Representative Council was formulating the Heat and Humidity Policy, it was also mindful of ways in which the MHSAA could assist schools in putting the plan into practice. Coaches, athletic directors and trainers needed a method to record information for athletic directors to view and for the MHSAA to track. The MHSAA developed interactive web pages on MHSAA.com which allow registered personnel to record weather conditions as practices and contests are taking place, using psychrometers.

Additionally, discounted Heat and Humidity Monitors and Precision Heat Index Instruments are offered to schools through a partnership between the MHSAA and School Health.

Yet, since the availability of such tools came to fruition two years back, fewer than 1,000 entries have been recorded, and many are multiple entries from the same schools.

Of the 772 entries, only 15 took place when the heat index was in excess of 104, while just 21 indicated an index of greater than 100. Cooler temperatures could be playing a factor in the overall number of participation, particularly in the northern areas of the state.

Nearly all of the responses came during fall practices, with a few isolated cases coming during the spring.

As Mohney pointed out, all resources must be properly used in concert with one another to achieve desired results.

Reminders of the tools available to schools are disseminated throughout the state each summer.

Concussion Testing Pilots Kick Off Fall

August 4, 2015

By Geoff Kimmerly
Second Half editor

The Michigan High School Athletic Association kicked off the 2015-16 school year Monday by hosting 70 member high schools for training in two pilot sideline concussion testing programs aimed at assisting in decision-making regarding the removal of athletes from activity after possible concussion events and record-keeping of those events beginning this fall.

Illinois-based King-Devick Test and Maryland-based XLNTbrain Sport each will be used to monitor approximately 10,000 Michigan high school student-athletes drawn from schools representing all four classes and a variety of regions statewide.

The pilot programs are part of a three-pronged advance by the MHSAA in concussion care this fall. In addition to becoming the first state association to offer pilot sideline concussion testing, the MHSAA will be the first to mandate record-keeping by member schools of all possible concussion events from detection to an athlete’s return to play. The requirement applies to both practices and events, all levels of all sports in grades 7 through 12.

The MHSAA also this fall is the first state association to provide all participants at every MHSAA member high school and junior high/middle school with insurance intended to pay accident medical expense benefits – covering deductibles and co-pays left unpaid by other policies – resulting from concussions sustained during MHSAA practices or competitions. There is no cost to either schools or families.

“These pilot programs are intended to not only improve what’s actually happening on the sidelines at practices and contests in these communities that are part of the pilot programs, they’re intended to spread the word of the need for improved concussion detection across every community,” MHSAA Executive Director John E. “Jack” Roberts said. “We hope these schools involved will become involved in their leagues and conferences and with their peers across the state as we expand the awareness of the need for better sideline detection and provide ways to get it done.”

The MHSAA asked schools at the end of this spring to volunteer for the pilot programs and then selected participants in order to guarantee a variety of schools based on enrollment and location. Schools are committed to involving at least two sports for each gender each season.

Schools participating in the XLNTbrain Sport pilot program are: Adrian, Adrian Madison, AuGres-Sims, Bay City Central, Bear Lake, Brethren, Belding, Birmingham Groves, Brighton, Chesaning, Corunna, Detroit Collegiate Prep, East Kentwood, Fennville, Fowlerville, Gibraltar Carlson, Grand Rapids Christian, Grandville, Greenville, Grosse Ile, Hamilton, Harrison Township L’Anse Creuse, Hazel Park, Kalamazoo Christian, Lansing Christian, Macomb L’Anse Creuse North, Owosso, Pewamo-Westphalia, Portland, Reese, Rochester Hills Lutheran Northwest, St. Clair Shores Lakeview, St. Johns, Stanton Central Montcalm, Vermontville Maple Valley, West Bloomfield and Wyoming Kelloggsville.

Schools participating in the King-Devick Test pilot are: Bay City Western, Benton Harbor, Buchanan, Calumet, Caro, Caseville, Detroit Cody, Detroit Martin Luther King, Fenton, Flint Kearsley, Frankenmuth, Fruitport, Garden City, Grand Ledge, Grand Rapids Northview, Lake Leelanau St. Mary, Lake Linden-Hubbell, Lincoln Alcona, Midland Bullock Creek, Montague, Muskegon, Niles, Pontiac Notre Dame Prep, Romeo, Saginaw Heritage, Scottville Mason County Central, Shelby, St. Charles, St. Joseph, Tawas, Vicksburg, Whitehall and Yale.

The King-Devick Test is a rapid eye movement screening evaluation that requires athletes to read single-digit numbers displayed on a tablet computer in order to detect impairments of eye movement, attention, language, concentration and other symptoms of abnormal brain function. The test has been validated in more than 50 recent peer reviewed articles published in elite medical journals and is associated with the Mayo Clinic.

The test is administered on the sidelines during evaluations for suspected head injuries, and the post-injury results are then compared to an athlete’s preseason baseline. Any worsening of performance (increased time and/or errors) suggests a concussion has occurred and the athlete should be “removed from play” for further evaluation.

“The first and most critical step in managing concussion in the youth athlete is to recognize when one has occurred – not always a simple task,” said Dr. David Dodick, professor of neurology and director of sports concussion services at the Mayo Clinic. “The King-Devick test helps take the guesswork and subjectivity out of the sideline evaluation in a rapid, accurate, and objective way.”

XLNTbrain Sport includes balance and web-based neuro-cognitive tests also used before the start of a season to create a baseline measurement of reaction time, attention, inhibition, impulsivity, memory, information processing efficiency and executive function. The test also assesses mood, anxiety, stress and emotionality.

After a possible head injury, a sideline assessment is done using a smartphone or tablet with those results then compared with the athlete’s baseline measurements. The program documents the severity of a concussion, provides a guide for on-the-field decision making regarding treatment and recovery time and can report results via email to parents, coaches, training staff and medical professionals.

Dr. Harry Kerasidis, who designed the XLNTbrain Sport software, presented at the Coalition for Concussion Treatment Summit at the United Nations building in 2014.

“We included an objective balance test that relies on smartphone accelerometer technology which is effective in the field during practice and game situations,” Kerasidis said. “Should a concussion injury be suspected, the system automatically generates a notification to parents and medical professionals and creates a recovery protocol and post-injury tracking so the right people can monitor the athlete’s progress. Then, the system assists medical professionals with the all-important return-to-learn and return-to-play clearance.”

Click for information on XLNTbrain Sport. Click for information on the King-Devick Test.

For more on Health & Safety, including preseason physical examination, hydration and cardiovascular resources in addition to concussion information and online training sessions, visit the MHSAA’s redesigned Health & Safety web page.

PHOTOS: (Top) Saginaw Heritage athletic director Peter Ryan (right) is administered the King-Devick baseline test by K-D's Samantha Figueroa. (Middle) XLNTbrain Sport creater Dr. Harry Kerasidis provides insight on his program to those being trained to use it Monday.