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.
'Anyone Can Save a Life' Aims to Prepare
July 28, 2015
By Rob Kaminski
MHSAA benchmarks editor
It was 2008 when Jody Redman and staff at the Minnesota State High School League developed an emergency action plan to provide guidance and procedure in the event of sudden cardiac arrest during scholastic athletic competition.
The desired response from schools upon receipt of the plan was, well, less than enthusiastic.
“Only about 40 percent of our schools used the information and implemented the program,” said Redman, associate director for the MSHSL. “Our focus was completely on sudden cardiac arrest, that being the worst-case scenario regarding athletic-related health issues.”
The MSHSL asked the University of Minnesota to survey its member schools, and results showed that the majority of schools not on board simply felt a sudden cardiac arrest “would never happen at their school.” Naive or not on the schools’ parts, that was the reality – so Redman went back to revise the playbook.
“We expanded the plan to deal with all emergencies, rather than specific incidents,” Redman said. “Now it’s evolved so that we are prepared to deal with a variety of situations which put participants at risk. We shifted gears and got more schools to participate.”
Did they ever. And not just in Minnesota.
This summer, the “Anyone Can Save a Life” program, authored by the MSHSL and the Medtronic Foundation, is being disseminated to high schools nationwide with the financial support of the NFHS Foundation. The program will reach schools in time for the 2015-16 school year.
Once received, schools will find that there are two options for implementation, via in-person training or online.
“The in-person method is facilitated by the athletic administrator with the assistance of a training DVD” Redman said. “The important element is the follow through, ensuring coaches return their completed Emergency Action Plan (EAP). With the e-learning module on anyonecansavealife.org, individuals will complete an e-learning module that will walk them through the details of their specific plan, and as they answer questions, the information will automatically generate a PDF of the Emergency Action Plan (EAP) which they can edit at a later date as information changes.”
Schools will find five major components of the program to be received this summer: the first is an implementation checklist for the AD, explaining their role. Next are sections for in-person training, online training and event staff training. The last item contains a variety of resources that will ensure the successful implementation of a comprehensive emergency response to all emergencies.
Generally speaking, the program prompts schools to assemble preparedness teams, broken into four categories: a 911 team, a CPR team, an AED team and a HEAT STROKE team. The groups are made up of coaches and their students who will be in close proximity to all after-school activities.
“The reality about school sports is, at 3:30 every day the office closes and any type of medical support ceases to exist,” Redman said. “We then send thousands of students out to gyms, courts, fields and rinks to participate without systemic support for emergencies. This program puts into place that systemic support.”
Another stark reality is that the majority of schools in any state do not have full-time athletic trainers. Even for those fortunate enough to employ such personnel, it’s most likely the training “staff” consists of one person. That one body can only be in one place at one time, and on widespread school campuses the time it takes to get from one venue to another could be the difference between life and death.
“Athletic trainers can champion the program, but someone needs to oversee that every coach has a completed EAP in place,” Redman said. “For every minute that goes by when a cardiac arrest occurs, chance for survival decreases by 10 percent.”
Thus, it’s imperative to train and grant responsibility to as many people as possible, including student-athletes. In fact, students are a vital component to having a successful EAP. Students will be put in position to call 911, to meet the ambulance at a pre-determined access point, to locate the nearest AED, to make sure emersion tubs are filled for hot-weather practices, and for those who are trained, to assist with CPR. Coaches will identify students at the beginning of the season and prior to an emergency taking place. They will provide them with the details of the job they are assigned so they will be ready to assist in the event of an emergency.
“We have game plans for every sport, and for every opponent on our schedule,” Redman said. “But we don’t have a plan to save the life of a member of our team or someone attending a game at our school.
“This is about developing a quick and coordinated response to every emergency so we give someone in trouble a chance at survival, and then practicing it once or twice a season. We have ‘drop the dummy’ drills where we drop a dummy and evaluate how it went, and how everyone performed. In one scenario, it’s the coach that goes down, and then you have a group of 15- or 16-year-olds standing there. That’s why students have to take ownership of this, too.”
The key to an effective emergency action plan is to utilize and empower students in every sport and at every level to be a part of the response team. Following are brief descriptions of the teams.
The 911 Team
- Two students will call 911 from a pre-determined phone and provide the dispatcher with the location and details of the emergency.
- Two students will meet the ambulance at a pre-determined access point and take them to the victim.
- Two students will call the athletic trainer, if one is available, and the athletic administrator and alert them to the emergency.
The CPR Team
- The coach is the lead responder on this team and is responsible for attending to the victim and administering CPR, if necessary, until trained medical personnel arrive.
- One person is capable of providing effective CPR for approximately two minutes before the quality begins to diminish. Having several students trained and ready to administer CPR will save lives.
The AED Team
- Two students will retrieve the AED and take it to the victim.
- Two students will physically locate the athletic trainer, if one is available, and take him or her to the victim.
The Heat Stroke Team
- Two students identify locations of emersion tub, water source, ice source and ice towels.
- Two students prepare tub daily for practices and events.
For more information, visit anyonecansavealife.org or contact the MSHSL.