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. 

MHSA(Q&)A: Stevensville-Lakeshore wrestling coach Bruce Bittenbender

February 9, 2012

Bruce Bittenbender grew up in Bethlehem, Pa., in the heart of steel country, and worked part-time in a mill as a young adult. That helped land him in Michigan City, Ind., not long after graduating from Milligan College in Tennessee in 1969.

But Bittenbender wanted to teach and coach.

Bittenbender took a teaching job at South Haven that fall, and as an assistant coach helped that school's wrestling team to the MHSAA Class B championship. A year later the wrestling coaching job opened at Stevensville Lakeshore. He says now that he was too young for the job, but Bittenbender applied and was hired. The program was struggling at that point -- but not for much longer.

According to the National Federation of State High School Associations' record book, Bittenbender trailed only Rex Peckinpaugh of New Castle, Ind., in career dual coaching wins heading into this season (796-780). Bittenbender won his 800th match on Jan. 14 -- and has his team just two more victories from MHSAA Finals weekend Feb. 24-25 in Battle Creek.

Bittenbender retired from teaching two years ago after 35 teaching biology and seven more physical education. At 64, he still gets on the mat with his wrestlers from time to time, although perhaps not as much as he once did. But countless wrestlers -- including those who won a combined 20 individual championships -- have benefited from his instruction.

His coaching tree includes current Rockford coach Brian Richardson and former Lowell coach Dave Strejc, who led teams to MHSAA Division 2 championships in 2002 and 2004. Bittenbender was named National Coach of the Year by the National Federation of State High School Associations in 2002 and again by the National High School Athletic Coaches Association in 2010. He is a member of the Michigan Wrestling Association Hall of Fame, and he will be inducted into the Pennsylvania Wrestling Coaches Association Hall of Fame this spring.

Stevensville Lakeshore is ranked No. 7 in Division 2. His team won its District on Tuesday, downing St. Joseph 35-34 with a decision win in the final match.

What keeps you coming back for another season?

Every year, when you think you've seen it all, something else comes up. When I was in middle school, it was junior high school back then, I was on the edge. The coach (Jim McIntyre, who went on to coach at Kutztown University) grabbed me on the back of the neck and said, "What are you doing?" I was hanging out with kids of questionable character, and he said, "You need to come out for wrestling." I still go back and play golf with that guy once in a while. ... I came from a big family. We didn't have much. I have empathy for the kids that were kicked around, misdirected. Somebody took time out for me. I felt maybe I could kick some of that back.

After so many wins, do you still enjoy all of them the same?

I tell ya, last night I certainly enjoyed the win. It was just like I was 23 again. Yeah, I enjoy it. It's addictive. That's what you're out there for.

The NFHS changed its wrestling weight classes this season, but Michigan chose to stay with its current lineup. What is your thought on that switch?

I think it's going to switch back. It makes no sense to me. The average kid graduating from high school is 5-(foot-)9, 155 pounds. Why add a weight class at the top where you have to compete for kids with football and basketball. … Our sport has prided itself on giving the little guy a chance. ... He can be a state champ in wrestling.

Your teams have finished MHSAA Finals runner-up twice. How much would you like to win that first championship?

I would love to. That's the ultimate goal. We've been so close. We were up three points in '94, and got pinned at heavyweight (to lose 28-25 to Fowlerville). In '86 we broke the record for individual number of points scored, but Eaton Rapids broke it too. We were that close.

I'm assuming you're not going to stop coaching any time soon.

Being around people and the community, and working with kids, it keeps you young. Keeps you in shape, keeps you motivated. I think that's one of the reasons. Now that I'm not teaching, my wife and I are able to travel quite a bit in the fall and summer. I think that's basically a motivator, just being around people.

What do you tell, or would you tell, young coaches who are just getting started in high school wrestling?

I tell them to be careful the first few years. It's different today. … I tell coaches you need to set up standards, discipline, goals and objectives, and go by those. You try to accommodate some of these kids, and this and that, but you can go only so far. You’ve gotta stick to the rules and let the cards fall where they are. If you don't, you'll have problems down the line.

And I think communicating with people, making friends, getting out there and strumming up support for the program is important too. I've had the opportunity to speak to the Lions Club, various civic organizations, at hospitals. You have to try to make yourself available. People have to learn to put their trust in you."