Special Report: Baseline testing for concussions doesn't - WSFA.com Montgomery Alabama news.

Special Report: Baseline testing for concussions doesn't always work

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Trinity Presbyterian School senior Daniel Phillips has had two concussions. direct-hit put Phillips at risk for Post-concussion syndrome, one of the most dangerous head injuries. Trinity Presbyterian School senior Daniel Phillips has had two concussions. direct-hit put Phillips at risk for Post-concussion syndrome, one of the most dangerous head injuries.
Certified athletic trainer Sarah Beaird said Phillips had been cleared by a physician, but his follow-up baseline test showed something quite different. Certified athletic trainer Sarah Beaird said Phillips had been cleared by a physician, but his follow-up baseline test showed something quite different.
MONTGOMERY, AL (WSFA) -

It's an injury that is single-handedly changing the game of football. Concussions and the damage caused to developing brains are forcing doctors and coaches to make considerations for more than 300,000 high school athletes a year. 

Trinity Presbyterian School senior Daniel Phillips is part of that statistic. "We were down by less than a touchdown, and went for an onside kick in the 4th quarter," Phillips recalled. "A guy came from the back row and clocked me. When I went back to the locker room, I forgot who was beside me."

Phillips had a severe concussion, the second of his high school career. The direct-hit put Phillips at risk for Post-concussion syndrome, one of the most dangerous head injuries. Had it not been for "Baseline Testing", Phillip's brain function could have been in jeopardy.

Certified athletic trainer Sarah Beaird confirms Phillips had been cleared by a physician, but his follow-up baseline test showed something quite different. "Many physicians have been upset that they have cleared them, and I have made them sit out a few more days because they couldn't pass test," Beaird explains.

"It's very frustrating, sitting out all week," Phillips admits, "watching your teammates getting ready for the next week was very hard to do."

While it may have made all the difference in Phillip's future, not everyone isn't ready to implement baseline testing in high school athletics. "We've gotten a lot of resistance," Beaird explains. "There are many physicians in this state that do not support the program, and I understand their concerns. They say since we don't include balance testing, then it's not a full-body testing."

But Beaird says, "Balance is one of the last things that returns. That's why it's a 3-part system for us. They go to a physician, they are cleared by a physician and then they come back to me."    

Beaird was faced with this harsh reality when she moved back to Alabama, solely transitioning to high school athletics. "My first year, I had a guy sitting right there in front of me, you could tell he still had a headache. His eyes were still glassy, he still flinched with lights, sensitive to loud noises and he said he felt just fine. I said you are lying to me. But the note said he could [return to play] and the doctor said he could."

Beaird secured a grant and implemented baseline testing in nearly 10 Montgomery high schools.  Despite the funding, the initiative fell flat. Students didn't take the preseason test to establish a healthy baseline seriously, and some school computers simply wouldn't run the program. 

"They misbehaved a lot in the test," Beaird explains. "They were very loud and didn't pay attention. They had a lot of invalid tests. So, we were looking at having to bus 15-20 from each school back in to retake the test." 

By not concentrating, some students were able to throw the test.  A lower score could expedite their ability to get back in the game after an injury. Beaird says this is the exception, not the rule.

"The approved programs are used from the NFL, the National Hockey League and baseball.  If anyone is going to throw a test, it's going to be those guys up there. They've actually made the programs better because they've thrown more of them, so they are learning how to flag them," Beaird explained.

Even the experts at Children's Hospital's Concussion Clinic are skeptical of independent baseline testing. They encourage a three prong approach like Beaird uses. It includes getting cleared by a doctor, the Sideline Concussion Assessment Tool, or the SCAT2, and a follow up baseline test.

Certified athletic trainer Drew Ferguson warns these measures can't reverse the impact of a life-changing blow. "I've seen athletes in our clinic that were released in various parts of this state by virtue of an impact test. When the truth was, their grades go from As and Bs to Cs and Ds and mentally they were having significant problems."

The desire to protect young, growing brains is increasing across the board as more sobering facts about these gruesome injures are published. But the exact method to prevent and treat those injuries remains unseen, reiterates Dr. Blount, a pediatric neurosurgeon. "I think we are recognizing these injures are serious, they do add up, and the longer and harder players play with the current rules, there's going to be a heavy price to pay."

SYMPTOMS OF A CONCUSSION

Most concussions are associated with symptoms like headaches, confusion, nausea, dizziness, and blurred vision. It is important to remember that fewer than 10% of concussions result in loss of consciousness. When a concussion is suspected, it is most important to immediately remove the athlete from the playing field and have him/her assessed by an experienced athletic trainer or on-field physician. Young athletes who return to play before resolution of their concussion symptoms are at higher risk for significant brain injury.

Return to Play
Athletes should not be returned to play the same day of injury. When returning athletes to play, they should follow a stepwise symptom-limited program, with stages of progression. for example:

1. Rest until asymptomatic (physical and mental rest)
2. Light aerobic exercise (e.g. stationary cycle)
3. Sport-specific exercise
4. Non-contact training drills (start light resistance training)
5. Full contact training after medical clearance
6. Return to competition (game play)
There should be approximately 24 hours (or longer) for each stage and the athlete should return to stage 1 if symptoms recur. Resistance
training should only be added in the later stages. Medical clearance should be given before return to play.

Alabama State Law
The recently passed Alabama state law mandates that all athletes who have suffered concussion must be evaluated by a qualified physician before returning to play.

Click here to download and print the Sports Concussion Assessment Tool (SCAT2)

(Information credited in part to Children's Hospital of Birmingham)

The Alabama High School Athletic Association has taken a very strong role in protecting young athletes from concussions, and ensuring they have adequate time to recover should the athlete suffer a head injury.  The link below has important information concerning symptoms and return to play advice.

http://www.ahsaa.com/Portals/0/pdf/forms/Concussion%20Information%20Form.pdf

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