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. 

4 Thrusts: In Motion, On Track in 2013-14

December 20, 2013

By Jack Roberts
MHSAA Executive Director 

During the fall of 2012 at Update meetings across Michigan, we described “Four Thrusts for Four Years” – four health and safety emphases that would help us keep student-athletes healthier and also get a seat for Michigan’s policies and procedures for school sports on the train of best practices – an express train that is moving faster than we've ever seen it toward more cautious practice and play policies and more educational requirements for coaches.

At this December’s meeting, the MHSAA Representative Council examined a first quarter report card – what’s been accomplished during the first year.

It has been a remarkably strong start, but it’s only a start.

The first thrust, improving management of heat and humidity, received a boost last March when the Representative Council adopted a “Model Policy for Managing Heat and Humidity.” It has been promoted in print, online and at face-to-face meetings; and the response of schools has been nothing short of outstanding. 

This rapid acceptance by school administrators and coaches reflects their appreciation for a clear policy that identifies the precise conditions that call for adjustments in activities, and lists specific actions to be taken when temperature and humidity combine to reach un-safe levels. Gut and guesswork are gone.

The second thrust, raising expectations for coaches’ preparedness, is being advanced in three ways.

In May, the Representative Council adopted the requirement that by the 2014-15 school year, schools must attest that, prior to established deadlines, all assistant and subvarsity coaches at the high school level have completed annually the same MHSAA rules meeting required by all varsity head coaches or, in the alternative, one of the free online sports safety courses posted on or linked to MHSAA.com and designated to fulfill this requirement. This popular change is only the first component of this critically important second thrust.

The second component is this. The Representative Council voted in December to require by 2015-16 that MHSAA member high schools certify that all of their varsity head coaches of high school teams have a valid (current) CPR certification, with AED training as a recommended component.

As this requirement was discussed at constituent meetings, the question was frequently raised: “Why just head coaches?”

“Why indeed,” is our response. If a school has the will and resources, it most certainly should make CPR a requirement of all its coaches, as some school districts have required for many years.

CPR training is conveniently available near almost every MHSAA member school in Michigan. Still, the MHSAA will begin offering CPR certification (with AED training) on an optional basis as an extension of Level 1 of the Coaches Advancement Program (CAP) during 2014-15.

The third component of this thrust is scheduled to go before the Representative Council in March. The proposal is that all individuals hired for the first time as a varsity head coach of a high school team, to begin those coaching duties after July 31, 2016, must have completed the Coaches Advancement Program (CAP) Level 1 or 2.

The MHSAA will track compliance and prohibit varsity head coaches from attending their teams’ MHSAA tournament contests if they fail to complete this requirement, beginning in the 2016-17 school year.

In cases of very late hiring, schools may substitute two online courses of the National Federation of State High School Associations – “Fundamentals of Coaching” and “First Aid, Health and Safety.” However, that coach must complete CAP Level 1 or 2 within six months of the hiring date.

These feel like big steps to some people in MHSAA member schools – “too expensive” or “another obstacle to finding qualified coaches,” some say; but these are baby steps. 

This barely keeps pace with national trends. Michigan’s tradition of local control and its distaste for unfunded mandates has kept Michigan schools in neutral while schools in most other states have made multiple levels of coaching education, and even licensing or certification, standard operating procedure.

The three initiatives to upgrade coaches education in this critical area of health and safety over the next three years only nudges Michigan to a passing grade for what most parents and the public expect of our programs. We will still trail most other states, which continue to advance the grading curve.

And for a state association that is among the national leaders by almost every other measure, it is unacceptable to be below average in what is arguably the most important of all: promoting athlete health and safety by improving the preparation of coaches.

The third health and safety thrust is a focus on practice policies to improve acclimatization and to reduce head trauma; and the fourth thrust is a focus on game rules to reduce head trauma and to identify each sport’s most injurious situations and reduce their frequency.

Because of the critical attention to football on all levels, peewee to pros, our first focus has been to football with the appointment of a football task force which has effectively combined promotion of the sport’s safety record at the school level and its value to students, schools and communities with probing for ways to make the sport still safer.

The task force proposals for practice policies are receiving most attention and will receive Council action in March (and will be published on Second Half over the next few weeks). But the task force also has assisted MHSAA staff in developing promotional materials that are already in use, and the task force pointed MHSAA staff to playing rules that need emphasis or revision to keep school-based football as safe as possible.

During 2013-14, all MHSAA sport committees will be giving unprecedented time to the topics of the third and fourth thrusts and, when necessary, a task force will be appointed to supplement those sport committee efforts.

Frequently Asked Questions About CPR Certification 

Q. Who is authorized to provide CPR certification?
A. The MHSAA does not dictate which organization must provide the CPR education and certification. However, the Michigan Department of Human Services lists the following organizations that are approved to provide CPR training:

  • American CPR Training: www.americancpr.com
  • American Heart Association: www.americanheart.org
  • American Red Cross: www.redcross.org
  • American Safety and Health Institute: www.hsi.com/ashi/about
  • American Trauma Event Management: www.atem.us
  • Cardio Pulmonary Resource Center: 517-543-9180
  • Emergency Care and Safety Institute: www.ecsinstitute.org
  • EMS Safety Services: www.emssafety.com
  • Medic First Aid: www.medicfirstaid.com
  • National Safety Council: www.nsc.org
  • Pro CPR: www.procpr.org


Q.

How expensive is the certification?
A.  $0 to $75.
 
Q. How long does certification take?
A. Two to five hours.
 
Q. How long does the certification last?
A. Generally, two years.
 
Q. Does the MHSAA specify the age level for the CPR training?
A. No. Generally, the course for adults alerts candidates of the necessary modifications for children and infants, and vice versa.