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. 

Teaching ABC's of Pressure Situations

October 30, 2013

By Eric Martin
MSU Institute for the Study of Youth Sports

Coaches have seen the signs: Athletes having too much or not enough energy prior to a game, quickening breathing, sweating more than usual, being unable to focus on important details, and having their minds wander from the present to “what if” scenarios and past mistakes. 

Athletes deal with pressure in many ways. Although some handle it well, many do not have the tools to perform to their full abilities in these situations. Most athletes place a high importance on succeeding in sport, and when athletes reach regional, district, or state championships, the pressure they feel may become overwhelming.

How athletes handle this increased pressure can often mean the difference between winning and losing. Therefore, helping athletes deal with it is something coaches should consider prior to athletes encountering these high-stakes situations.

Unfortunately, there is no magic elixir for helping your athletes work under pressure. But if these ABC’s of pressure situations are followed, your athletes will be much better equipped to cope, and the chances of their performance levels dropping significantly will be reduced. 

1. Act the Part         

How you as coaches act influences your athletes. For better or worse, athletes notice your emotions in response to these situations and take cues from how you handle pressure.

You are a demand on your players’ attention – you can add or reduce your players’ perceived stress by how you act. Understanding the demand you place on players requires self-awareness. How do you respond when a key call goes against you? Do you have nervous habits that athletes may notice? What messages are you providing to your athletes – both verbally and non-verbally? Athletes pick up on these non-verbal cues, so you must be aware of how you respond to these situations.

It is important to remember emotions are not always negative – rather acting differently than normal can be a signal to your athletes that you are stressed. Strive to be consistent in your actions – whether you are coaching during a preseason match or championship contest. These situations are stressful for you too, but you need to be the constant your athletes look to for stability. 

2. Breathing – Remember to do it

It seems like a simple thing, but when athletes’ emotions are running high, they forget how to breathe – or, at least, forget how to breathe properly. Worse, they often think they are breathing normally but don’t notice breaths are becoming shorter and shallower. Teaching athletes to breathe properly when not in pressure situations will help them have the tools to rely on when they encounter more intense scenarios. 

For proper breathing, athletes need to do so from the belly and not the chest. The pace of this breathing should be 6-2-7; that is, have athletes take a deep breath from the abdomen for six seconds, hold for two seconds, and then finally slowly exhale completely for seven seconds. This breathing strategy is ideal for pregame situations to quiet nerves and help athletes get ready to play, but a condensed version (3-2-3) can also be used for quick breaks in the action like a timeout or court change.

3. Control the controllables

During times of high pressure, athletes sometimes feel they do not have control over their own performances. It is important to help athletes focus on things they can control and not worry about those that cannot be changed or are outside their influence. 

Instead of athletes dwelling on aspects that are out of their control like unusual game times for championship finals or a referee’s bad call, help them focus on completing their warm-up preparations and how they can respond to poor calls. Helping focus athletes’ attention on things they can control will help them better handle pressure situations and leave them feeling less helpless

Athletes’ emotions are typically out of their control, but how they view them and respond to these emotions are under their control. Author and preacher Charles R. Swindoll said, “Life is 10 percent what happens to you and 90 percent how you react to it!” Be sure your athletes know how to respond when difficult situations arise. 

Conclusion: Fearlessness is an assembly

Not all athletes react to pressure situations in the same manner, but all athletes can benefit from these simple suggestions. Remember to ACT THE PART of how you want your athletes to act, teach your athletes proper BREATHING techniques, and help athletes focus on CONTROLLING THE CONTROLLABLES

Good preparation is the key to performance. Increase self-monitoring and give athletes the tools to succeed in pressure situations; they, in turn, can be in a better position to succeed. However, like any skills, they must be practiced accordingly, and one session will not solve all issues. Devote the time to train athletes in these skills, and when the need arises they will have them ready to use. 

Good luck this season!

Martin is a third-year doctoral student in the Institute for the Study of Youth Sports at Michigan State University. His research interests include athlete motivation and development of passion in youth, sport specialization, and coaches’ perspectives on working with the millennial athlete. He has led many sessions of the MHSAA Captains Leadership Clinic and consulted with junior high, high school, and collegiate athletes. If you have questions or comments, contact him at [email protected]