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9/21/12: Emerson Hospital Offers Baseline Concussion Testing for Student Athletes

For many people, the fall season means football, soccer and other collision sports. Across the U.S., millions of kids and adults are back on the field and taking hits. Some will pay the price in the form of a concussion, either from a blow to the head or whiplash causing the head to snap backward or forward.

The Emerson Hospital Center for Sports Rehabilitation and Specialty Services at 57 ORNAC in Concord now offers comprehensive baseline concussion testing so athletes’ physicians can compare pre- and post-concussive cognitive and physical performance. This has proven to be valuable since it shows how the brain functions when it is healthy and can then be compared to data gathered after injury. Emerson’s baseline testing includes ImPACt and two measures of balance, Biodex BS and BESS, which provide a comprehensive evaluation of an athlete’s neurocognitive and physical performance.

“Should a concussion be suspected,” said Christine Schuster, president and CEO of Emerson Hospital, “this data comparison provides objective tools for a smooth transition to recovery and safe return to play.”

According to neurosurgeon Robert Cantu, MD, chairman of surgery at Emerson Hospital, a concussion is diagnosed among 26 different symptoms which fall into four categories: cognitive, such as difficulty with memory and attention; sleep problems; emotional change, such as irritability, anxiety or depression; and somatic symptoms, such as headache, balance problems, lightheadedness and visual issues.

While more than 80 percent of people with mild concussions heal within seven to 10 days, Dr. Cantu said it is critical for the brain to get appropriate physical and cognitive rest to do so. A student might be able to stay in school, he notes, but with reduced schoolwork. Other injuries require weeks or months to heal, while some never completely recover.

“The important thing is to do nothing that produces symptoms,” said Dr. Cantu, who wrote the new book Concussions and Our Kids. He notes that children are especially vulnerable to head trauma because their brains are not yet “myelinated” with a protective coating; their weak necks allow their relatively large heads to swivel on impact; most youth coaches are not trained in assessing concussion; and student athletes may not communicate their symptoms.

Even more challenging is the fact that symptoms don’t necessarily occur immediately following a concussion. Cognitive symptoms, for example, may not be revealed until a student attempts intense homework or takes a test.

“It is also true that, if you ask either an adult or a youngster how they feel, they will usually say ‘fine,’” said Dr. Cantu, noting that more than 90 percent of concussions occur without loss of consciousness. “For all those reasons, I feel strongly that kids under age 14 should not play collision sports such as football.”

Naseem Challawala, PT, MS, DPT, a clinical specialist in neurology and pediatrics at the Emerson Hospital Center for Sports Rehabilitation and Specialty Services, said even a mild concussion should not be taken lightly. According to the American Association of Neurological Surgeons, athletes who suffer a concussion are four to six times more likely to suffer a second concussion, with even more potentially serious consequences.

Concussions can affect memory, judgment, reflex, speech, balance and muscle coordination. The cumulative effects of sub-concussive blows over time may result in chronic traumatic encephalopathy (CTE), a neurodegenerative process causing significant and sustained neuropsychological impairments in information-processing speed, problem solving and planning.

Safe play is the best way to prevent concussion, but research has shown that stronger neck muscles can reduce the impact of a blow to the head. Stronger core muscle stability also helps athletes with overall performance. For this reason, the Emerson Hospital Center for Sports Rehabilitation and Specialty Services provides sports-related conditioning programs focusing on neck and core muscle strengthening, along with sports kinematics.

Above all, if a concussion is suspected, the athlete should stay out of the game until all symptoms have gone away completely. At Emerson, patients with post-concussive disorder are evaluated by a multidisciplinary team, with physical therapy addressing vestibular, headache and balance. Speech and cognitive therapists address attention/concentration, memory, complex decision-making and other strategies for the return to school and work environments.

“We don’t want to scare anyone, and we do want kids to be outside and play sports,” Challawala said. “We just want them to do it safely.”

To learn more or register for comprehensive baseline concussion testing, call (978) 287-8200. The fee is $75 per athlete.

Emerson Hospital is a multi-site health system headquartered in Concord, Mass., with additional facilities in Sudbury, Groton and Westford. The 179-bed hospital provides advanced medical services to more than 300,000 individuals in 25 towns. To learn more, visit www.emersonhospital.org.