Making (Health) Histories Every Year

July 23, 2015

By Rob Kaminski
MHSAA benchmarks editor

Tom Minter, recently retired from the MHSAA as assistant director, wore many hats while serving the Association and donned official’s gear in numerous sports outside of business hours.

But one of his finest refereeing efforts might have come during the 2009-10 and 2010-11 school years when he guided approximately 60 individuals representing 25 medical and professional organizations through an arduous process to upgrade the antiquated Physical Form to what is the standard today: the Pre-participation Physical Examination/Health History Form.

The form highlighted Stage 1 of the MHSAA’s 4 Hs of Health and Safety – Health Histories – and the current form is much more comprehensive, answering questions previously not asked during the quicker, more brief, evaluations.

Sudden cardiac death claims the lives of more than 300 Michigan children and young adults between the ages of 1-39 years annually. Yet, many of these deaths could be prevented through screening, detection, and treatment. One such way to detect high risk conditions that predispose to SCDY is through pre-participation sports screening of student-athletes, and the current physical form provides a mechanism.

While much more detailed, schools report that parents are more than willing to take the extra time and effort to complete the lengthier version.

“When the expanded form came out, people kiddingly made comments about its length; yet in today's day and age everyone understands we need all the information we can cultivate regarding health histories of our student athletes,” said Mark Mattson, athletic director at Traverse City Central.

Down state, feelings have been similar. “We don’t have a problem at all here,” said Anna Devitt, athletic secretary at Hartland High School. “Our parents take care of it, and haven’t balked at the length at all.”

Both agree, and are joined by many others across the state, that  the next logical step is for the form to be converted to a fillable, online document so that records can be accessed by those in need via mobile, laptop or desktop.

Thus, in the “No H left behind” mantra that the MHSAA has assumed, an electronic option of the Health History form is in the early planning stages.

“As an increasing number of our schools strive to be ‘paper-free,’ or at least as much so as possible, it is time to re-invent the delivery method for perhaps our most downloaded or distributed document,” MHSAA Executive Director Jack Roberts said. “Once again, as we move forward with our ‘Heart’ initiative for the coming school year, we are also intent on bringing other projects up to speed.”

The masses are certainly enthused.

“That would be heavenly. An online version that would prevent people from submitting the forms until all the required information was in place would be fantastic,” said Mattson, who has had to turn back, or hold out students while waiting for completed forms, whether at Marquette, Maple City Glen Lake, or his current post in Traverse City. “It’s always been the same; people move too quickly and overlook required fields. It would prevent two things: one, having to hold kids out while waiting for a signature, and two, prevent parents from having to drive in to the athletic office to sign or fill in that last field. We’d know we were getting a completed form.”

At Hartland, where athletic director Jason Reck created an online emergency contact form, a system is in place which allows coaches, administrators and trainers to share necessary data for all student-athletes in addition to the MHSAA forms.

“Our parents love the online emergency contact form, and we require them to fill it out every season, not just once a year,” Devitt said. “Sometimes an athlete gets injured during one season and the next season's coach wants to know about it.”

The information on the form is populated into an Excel spreadsheet which Reck, Devitt, the school trainer and all coaches can access. They can tailor the data by sport and pull it to their mobile devices.

“We’re trying to go completely paperless, and the MHSAA physical form would be another step,” Devitt said. “Our parents and doctor’s offices would love it.”

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.