Concussion Management

athletico.com

Concussion

In a Nutshell

• Prevention• Baseline• Evaluation• Communication• Return to Participation• Vestibular Physical Therapy• Event Coverage

Specifics

• Defining “in Conjunction with”

• SCAT3 vs. SAC vs GSC vs others

• ImPACT (or other testing) Recommendations

Better for every body.

Tools Provided

• SCAT 3• Graded Symptom Checklist• Concussion Information Sheet• Concussion Timeline Checklist• Concussion Physician Letter Template• Physician Update Form

Better for every body.

Return to Participation

• B - Bike• R - Run• A - Agility• I – In Red• N – No Restriction Practice• G – Game Play

Better for every body.

SCAT 3 Scenario

Better for every body.

Concussion Management…It’s A Team thing!

Team Physician

Primary Care Physician

Neuropsychologist

Athletic Trainer

Physical Therapist

Coach

Parents

School Administrators

Educators

Better for every body.

SB 007

• Concussion Oversight Team – Consisting of:• Physician (MD/DO); AND• *Athletic Trainer; AND/OR• *School Nurse; AND/OR• Advanced Practice Nurse; AND/OR• Neuropsychologist; AND/OR• Physician Assistant • Other Licensed Healthcare Providers

Better for every body.

Role of the Concussion Management Oversight Team

• Create a Return to Play Policy that is evidence based

• Create a Return to Learn Policy that is evidence based

Better for every body.

Athlete May Return to Play When:

• Have completed Return to Learn (RTL) and Return to Play(RTP) program

• Written script from a physician stating that the athlete is cleared to return to play

• Signed Parental Consent Form• Informed of returned to participation in accordance to

RTP and RTL policies• Understands the risks of returning to participation• Consents to proper medical disclosures

Better for every body.

Compliance

• Superintendent, or designee, shall be responsible for the compliance of with the RTP and RTL policies

• Designee may not coach any interscholastic sport

Better for every body.

Education

• Coaches and game officials – 2 hour education• Nurse serving on Concussion Oversight Team• Any Game officials• Physician serving on Concussion Oversight Team• ATC serving on Concussion Oversight Team• Any other member of Concussion Oversight team

• Education must be completed by 9/1/2016• Proof of training must be kept by school

Better for every body.

Emergency Action Plan

• School Specific• In Writing • Reviewed by the Concussion Oversight Team• Approved by the Superintendent• Distributed to all personnel• Posted conspicuously at all venues utilized by the

school• Reviewed annually by all ATC’s, coaches, nurses,

first responders, AD’s, volunteers

Better for every body.

Better for every body.

Concussion work at Athletico

• Lectures

• A Step aHead

• BNA

• Many other opportunities to get involved!

BNA Testing

• Brain Network Activity (BNA) Testing is taking Brain wave activity while performing a simple cognitive task

• Computer interprets this into Network activity, which can be used following brain alteration (such as concussion), and compared to either a benchmark test, or to normative data.

Better for every body.

Closing the Gap with BNA™ TechnologyRevealing Brain Networks Activity (BNA™) for Better Clinical Decisions

CT/ MRI DTI PET fMRI FunctionBehavior

Symptoms

BNA™

Structure – Metabolism – Neuronal Function – Function

Demonstration of BNA™ Clinical Utility17 Year Old High School Football Player Case Report

• Head to head collision• Many on field symptoms:

• Disorientation, Headache, Dizziness, Balance problems, Visual Changes, Fatigue, Sensitivity to light/Noise, Migraine

• Diagnosed with concussion

When is it “safe” for him to return to play?

Current Practice Standard Clinical decision is based on subjective measures

CT Scan Normal

Computerized testsnon conclusive

Neuro-Imaging

Resolved within3 weeks

Symptoms Neuropsychology

Based on limited information available through current methods:Physician Decision: Return to Play after 3 weeks

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The BNA Difference

1 Week 2 Weeks 3 Weeks 4 Weeks

BNA demonstrates that, while symptoms are gone, brain recovery is only at 24%. Return to Play in 3 weeks may not be the right decision

24%

Delta (1-4HZ)

Theta (3-8HZ)

Alpha (7-13HZ)

Beta (12-30HZ)

Connectivity

Baseline 1 Week 2 Weeks 3 Weeks 4 Weeks

Thank You!

Better for every body.