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.
Sorting It Out
February 4, 2014
The MHSAA has a good relationship with the high school coaches associations of Michigan in spite of the fact that the MHSAA sometimes befuddles and frustrates some associations’ leaders and members. This occurs, for example, when a coaches association’s board of directors votes unanimously in support of a change in policy or procedure which fails to be adopted by the MHSAA Representative Council. Every so often over the past 25 years, I’ve had to provide reminders of why this occurs – in fact, why it must occur.
First, a coaches association is just that – an association of coaches; and coaches are but one of the many important voices to whom the MHSAA pays regular attention. The MHSAA also must hear the opinions of athletic directors, principals, superintendents, boards of education, contest officials and others. Typically, coaches desire more of everything: contests, classifications, trophies and medals. Just as predictably, most administrators seek reasonable limits on such things and can often be heard to say, “Enough is enough.”
Second, the makeup of many of our state’s high school coaches associations’ boards of directors, and even the associations’ members, do not reflect the MHSAA’s full membership. Understandably, many coaches associations’ board members are disproportionately from large schools in the southern or even southeastern part of Michigan.
And third, by their nature, coaches associations advance proposals for a single sport, which could impact other sports positively or negatively. There is no question that if one sport “gets” something, like another tournament classification or division, other sports will seek the same consideration which may or may not be practical for or beneficial to other sports.
When considering a proposal from a coaches association, MHSAA Representative Council members will almost always ask themselves: “Who’s not in the room? Who are we not hearing from? Is there another side of the issue? How does this play out among small schools, or urban schools, or northern schools? How will this affect other sports?”
We look to coaches associations for sport-specific advice; and we urge them to seek input from a constituency that is as large and diverse as possible. We look to other stakeholders to add their advice and counsel to the process; and we depend on the Representative Council to sort it out and seek the proper balance.