PLYMOUTH — With the flurry of new research coming out over the past two years on the link between concussions and chronic brain damage, Plymouth High School has decided to take action.
Led by Dr. Tony McPherron, the PHS medical staff implemented a new battery of tests this week to better evaluate the extent of a student athlete’s injuries and determine a length of treatment. Called ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing), it is the first computerized concussion evaluation system.
“It’s pretty sophisticated,” said McPherron. “Between the combination of it and a (physical) evaluation with a kid, now we can tell how bad their concussion is. You get a good idea of how long it’s going to take within a few days. You can tell what part of the brain has been injured.”
Developed in the early 1990s by doctors Mark Lovell and Joseph Maroon, the ImPACT test has since become a standard tool in the treatment of concussions for athletes of all ages and was even given to NFL draft hopefuls during the 2011 scouting combine in February.
The 20-minute exam measures multiple aspects of brain function in athletes, including attention span, working memory, attention time, non-verbal problem-solving and reaction time. The results are used to establish an individualized baseline in healthy athletes’ brain function, which, when compared with a concussed athlete’s post-injury evaluation, can help to objectively evaluate his or her condition and track recovery for safe return to play, preventing the cumulative effects of concussion.
“The ImPACT test’s purpose is going to be give us an objective way to measure when a person is able to return after a concussion,” said PHS Athletic Trainer Ryan Carroll. “It’s going to give us a baseline score, they’re going to take the test again about 48 hours after a concussion and then we’re going to compare the two scores. If they’re equal then, function-wise, they’re able to go back into play. We’d use that along with our physical evaluation to determine if they’re fully ready to go back into athletic participation.”
McPherron took a two-day course in administering the new tests and was credentialed by ImPACT Applications, Inc. during the fall sports season. He and the rest of the PHS medical staff have been trying to implement the testing at the high school for the past two years, but the technology isn’t cheap and only recently became available with a generous donation from LaPorte Hospital, where McPherron works.
Around 200 Plymouth athletes took baseline tests Monday through Wednesday. The results will be compared against any future post-injury tests in the event of a concussion.
“We’ve had three groups in after school,” said PHS Athletic Director Roy Benge. “We could have waited until this summer or next fall, but we wanted to get the underclass kids involved. The seniors, we’re not testing. We’re just testing the underclass kids right now.”
“The test is good for two years,” he continued. “So you can pull up the baseline and compare a future concussion… The doctor doesn’t have to second-guess, and the coach doesn’t have to second-guess. The young man or young lady will have to sit at their computer and take their post test and their comparisons will have to be at the baseline or higher for verification that, yeah, they’re healed. It’s a safety issue, and it doesn’t put coaches at risk to just guess.”
The ImPACT test battery randomly varies questions and problems in a nearly infinite number of alternate forms to help minimize the “practice effects” of more traditional neurocognitive tests. In other words, athletes can’t cheat the test to return to the field or court before they’re ready.
“The biggest danger is really coming back too soon, and that’s when the ImPACT test really comes in handy,” said McPherron. “A kid may be symptom-free — meaning that he doesn’t have a headache any more, he’s not dizzy, he can run, he can exercise — and in the past that’s what we judged it on. But through the research we’ve found sometimes that the brain still hasn’t recovered, and the ImPACT picks that up.”
“Working with Plymouth kids over the years… kids would have an arm broken or not even be able to put weight on a leg and at the same time they’ll look at you and tell you they’re fine and able to play,” he said. “That’s high school kids. They can tell us they’re fine, they can tell us they’re ready to play, but their brain is still not ready until the test says it’s ready. It’s a foolproof way to find out what’s going on with them.”
The technology is still on the cutting edge at the high school level and is only recommended by the IHSAA and National Federation of High School Associations, but it may only be a matter of time before ImPACT becomes mandatory.
“We’re excited that we’re able to get it done now,” said Carroll. “That way we’re kind of ahead of the curve. Everybody’s going to kind of rush in the next couple years trying to get this done, and we’re going to already have it, so that’s going to be a positive for us.”
“We’ve done stuff with our athletic training program here in Plymouth that some of the smaller colleges don’t do,” said McPherron. “We have a phenomenal athletic training program that we’ve really been able to build up… The coaches have been great in all the sports over the past two years about conditioning and getting these kids better and watching out for them and safety. This is kind of the next logical step. We’ve worked on treating the injuries and preventing the injuries. Now we’re working on making it even safer yet, and that’s the most important thing for us.”