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.
Athletes: Prepare to Beat the Heat
August 4, 2014
By Geoff Kimmerly
Second Half editor
Despite unseasonably cool temperatures this summer in Michigan, high school athletes should prepare for the heat that usually accompanies August and the beginning of Michigan High School Athletic Association fall practices as they kick off next week.
Each year, the MHSAA provides information to its member schools to help them prepare for hot weather practice and game conditions in the late summer and early fall. Football practice can begin August 11, followed by first practices for all other fall sports August 13.
The topic of heat-related injuries receives a lot of attention at this time of year, especially when deaths at the professional, collegiate and interscholastic levels of sport occur, and especially since they are preventable in most cases with the proper precautions. In football, data from the National Federation of State High School Associations shows that nationally 41 high school players died from heat stroke between 1995 and 2013.
Many MHSAA schools this fall are expected to again follow the MHSAA’s Model Policy for Managing Heat & Humidity that directs schools to monitor heat index prior to and during activity and recommends actions based on those readings.
Also this school year, for the first time, the MHSAA is requiring all assistant and subvarsity coaches at the high school level to complete the same rules and risk minimization meeting requirement as high school varsity head coaches, or, in the alternative, one of several online courses designated for this purpose on MHSAA.com.
“It’s not an accident that causes severe heat illness and death. It’s a lack of attention to what should’ve been taking place, a lack of preparation,” said John E. “Jack” Roberts, executive director of the MHSAA. “We’re trying to communicate to our constituents that if we make the precautions that we should, plan as we should, we will have none of these tragedies in school sports.”
The MHSAA Representative Council adopted in 2013 the Model Policy for Managing Heat & Humidity that, while not mandated for member schools, has been adopted by many at the local level. The plan directs schools to begin monitoring the heat index at the activity site once the air temperature reaches 80 degrees and provides recommendations when the heat index reaches certain points, including ceasing activities when it rises above 104 degrees.
The model policy is outlined in a number of places, including the publication Heat Ways, which is available for download from the MHSAA Website. Heat Ways not only provides the model policy, but addresses the need for proper acclimatization in hot weather.
Heat, hydration and acclimatization also are again focuses of the MHSAA’s required preseason rules meetings for coaches and officials. The online presentation discusses the need for good hydration in sports, regardless of the activity or time of year.
The Health & Safety Resources page of the MHSAA Website has a number of links to different publications and information and a free online presentation from the National Federation of State High School Associations. Visit MHSAA.com, click on “Schools” and then on “Health & Safety Resources” to find the information.
Roberts said the first days of formal practices in hot weather should be more for heat acclimatization than the conditioning of athletes, and that practices in such conditions need planning to become longer and more strenuous over a gradual progression of time.
He added schools also must consider moving practices to different times of day, different locations, or change practice plans to include different activities depending on the conditions.
“I think all schools need to prepare themselves in these ways,” Roberts said. “They need to educate participants, parents and coaches about proper hydration and the dangers of practicing and competing when the heat and humidity are too high.”