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Information For Physicians
Concussion injuries are an expectable medical problem for many of today’s student athletes. More conservative estimates of seasonal rates for high school football have been in the 3-6% range but some player surveys have indicated rates approaching 15% (1,2,3). While rates are also high in other contact sports such as ice hockey, lacrosse, wrestling and rugby, these injuries are seen in the course of intense activity in many other sports. Recent research has shown that rates are much higher for girls than for boys in basketball and soccer (4).
Many student athletes with concussions minimize their symptoms during discussions with their athletic trainers and physicians and are determined to return to their sport as soon as possible. While most concussions heal rather quickly in days or weeks, the medical decision regarding an athlete’s readiness to return safely to a contact sport has received greater scrutiny as it has become clearer that there are significant risks when young athletes are exposed to further trauma before they have completely recovered from an existing concussion (5).
Specialized neuropsychological consultation has become a part of the standard of care in sports concussion management and can provide vital consultation to a physician in his or her medical decision to return an athlete to play.Unlike lengthier test batteries normally used to assess students with learning disabilities, ADHD and other neurological conditions, testing with ImPACT© takes only about 25 minutes. This tool, in the hands of an experienced neuropsychologist, provides valid and reliable information about the effects of concussion on memory, attention, speed of thinking and reaction time as well as quantitative tracking of symptoms (6). This objective information complements a physician’s clinical evaluation and allows the return-to-play decision to be made with greater confidence.
Neal McGrath, Ph.D., New England’s first Credentialed ImPACT© Consultant, provides consultation of this type to team physicians, primary care physicians, family practitioners, neurologists, orthopedists, or any physician caring for a patient with a concussion injury. Patients can be seen in a timely manner for office consultation with ImPACT© testing. Results are available to the doctor within hours by phone, with a detailed written clinical report to follow within 48 hours.
1. Gerberich, S.G., Priest, J.D., Boen, J.R., Straub, C.P. and Maxwell, R.E. Concussion incidences and severity in secondary school varsity football players. American Journal of Public Health. 1983;73:1370-1375.
2. Guskiewicz, K.M., Weaver, N.L., Padua, D.A., and Garrett, W.E., Jr. Epidemiology of concussion in collegiate and high school football players. American Journal of Sports Medicine. 2000; 28(5):643-650.
3. McCrea, M., Hammeke, T., Olsen, G., Leo, P., and Guskiewicz, K.M. Unreported concussion in high school football players: Implications for prevention. Clinical Journal of Sport Medicine. 2004; 14:13-17.
4. Gessel, L., Fields, S., Collins, C., Dick, R. and Comstock, R.D. Concussions among United States high school and collegiate athletes. Journal of Athletic Training. 2007; 42(4): 495-503.
5. Guskiewicz, K.M., Bruce, S.L., Cantu, R.C., Ferrara, M.S., Kelly, J.P., McCrea, M., Putukian, M., and Valovich McLeod, T.C. National Athletic Trainers’ Association position statement: Management of sport-related concussion. Journal of Athletic Training. 2004; 39(3):280-297.
6. Lovell, M.R. The ImPACT© neuropsychological test battery. In R.J. Echemendia (Ed.), Sports Neuropsychology: Assessment and Management of Traumatic Brain Injury, pp. 193-215. New York: Guilford Press; 2006.
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