Category Archives: Other Sports
From bustling cities to tiny farming communities, the bright lights of the local stadium are common beacons to the Friday night ritual of high school football.
A study from the Peter O’Donnell Jr. Brain Institute and Mayo Clinic shows the technology exists to ease this dilemma: By using a remote-controlled robot, a neurologist sitting hundreds of miles from the field can evaluate athletes for concussion with the same accuracy as on-site physicians.
The study provides preliminary data to support a nascent movement to utilize teleconcussion equipment at all school sporting events where neurologists or other concussion experts aren’t immediately accessible.
“I see teleconcussion being applicable anywhere in the world,” said Dr. Bert Vargas, the study’s lead author, who directs the sports neuroscience and concussion program at the O’Donnell Brain Institute at UT Southwestern Medical Center. “Right now there’s a significant disparity in access to concussion expertise.”
Further, having personnel on hand to quickly identify and remove concussed players from games is an important part of protecting against such long-term injuries, Dr. Vargas said. But across the country – and most notably in rural regions – more than half of public high schools don’t have athletic trainers available to spot such incidents, increasing the chances that a concussion could go unnoticed and perhaps be exacerbated by additional injuries.
“Worst-case scenario, you have nobody at the games who can identify or address potential concussion cases,” said Dr. Vargas, an Associate Professor of Neurology and Neurotherapeutics. “You’re putting the athlete in a position to have a more severe injury with prolonged symptoms and longer recovery time.”
While previous teleconcussion research has focused on diagnosing severe traumatic brain injury (TBI) in the military, Dr. Vargas’ research is the first to measure how accurately telemedicine using standard sideline concussion evaluation tools can help diagnose concussions – a mild form of TBI – at sporting events.
The study, published in Neurology, used a mobile robot that was stationed for two seasons on the sideline and athletic training room of Northern Arizona University’s football games. A neurologist could view the game from the robot’s camera and make evaluations of players who may have been concussed.
Research shows mobile robots controlled by doctors can diagnose sports concussions with the same accuracy as on-site physicians. Researchers say the technology could be a game-changer in rural America, where few doctors or athletic trainers are available to diagnose head injuries during high school athletics.
Using diagnostic tools that measure cognition, balance, and other factors, the remote neurologist made assessments in 11 cases brought to the robot for review. These assessments were later compared with separate face-to-face diagnoses made by sideline medical personnel consisting of Northern Arizona team physicians and athletic trainers. The results matched each time.
The study demonstrates that teleconcussion technology can work, but it doesn’t lessen the need to have trained personnel to help on the sidelines, said Cherisse Kutyreff, Director of Sports Medicine at Northern Arizona, who helped make the on-field assessments during the study.
“If you don’t start with the basics of having an athletic trainer in the schools first, you’re already spinning your wheels,” she said. “Don’t ask the questions if you aren’t prepared to have somebody there to do something with the answers (from the neurologist).”
The findings add scientific backing for the few entities that have already used teleconcussion robots at sporting events. Dr. Vargas sees only a limited future for the technology in college athletics and even less in the professional ranks, where qualified doctors and athletic trainers are already accessible.
His major goal is getting teleconcussion into high school athletics, including soccer, basketball, baseball, and cheerleading. He envisions a scenario where multiple districts could have one concussion specialist on standby for all their games. This person would be accessible when needed through a robot or less expensive interface.
The strategy could be especially beneficial in states such as Texas, which requires concussed high school players to get a physician’s approval before returning to action. In rural corners of the state, finding a doctor to do so often requires a lengthy trek.
“This is a way of bringing physicians into these outlying areas,” Dr. Vargas said. “One person could cover numerous schools. If you’re on-call virtually, you could be anywhere and available as soon as a consult is needed.”
Dr. Vargas’ research was funded by Mayo Clinic Center for Innovation, where he studied brain injury before moving to UT Southwestern. Drs. George Hershey, Northern Arizona’s team physician, and Amaal J. Starling with Mayo Clinic collaborated on the study.
“Removal from play decisions are of utmost importance in the setting of an acute concussion,” said Dr. Starling, a neurologist and concussion expert. “This teleconcussion study demonstrates that a remote concussion neurologist accessible through telemedicine technology can guide sideline personnel to make those decisions in a meaningful and timely manner.”
April 2017, Vol. 5, No. 10
Timely reporting on developments and legal strategies at the intersection of sports and concussions—articles that benefit practicing attorneys who may be pursuing a claim or defending a client.
New Study Strengthens Calls for Further Investigation into CTE Links with Soccer.
Appeals Court: Use of Oklahoma Drill May Have Been Gross Negligence
Discussion on NCAA and Concussions Steals the Show at Harvard Law School Symposium
Appeals Court: What Coaches Don’t Know About a History of Concussion Cannot Hurt Them
Soccer Goalie Alleges Team Failed to Hold Him out of Practice After Suffering Concussion, Exacerbating Symptoms
BIAPA Executive Talks About Role of Organization and Membership’s Biggest Concerns
Concussion in Sport: Liability of Governing Bodies
Senate Bill 12 – An Analysis
NFLPA Assails Possible Change in Worker’s Comp Law in Illinois
Attorney Weighs in on Change to Workers’ Comp Law for Professional Athletes
TBI in Emergency Departments a Substantial Economic Burden TBI in Emergency Departments a Substantial Economic Burden
A new study that looked at nearly 134,000 emergency department visits for traumatic brain injury, including concussion, during a one year period in Ontario estimated that those visits had a total cost of $945 million over the lifetimes of those patients.
Medical treatments accounted for $292 million (31 per cent) of the estimated lifetime costs, and lost productivity amounted to $653 million (69 per cent), according to the report, published online in the Canadian Journal of Neurological Science.
Policy makers are increasingly using cost-of-illness studies such as this one to guide resource allocation and identify opportunities for improving health-care sustainability, said Dr. Michael Cusimano, a neurosurgeon at St. Michael’s Hospital and a senior author of the study.
“Traumatic brain injuries are occurring at alarmingly high rates and have the potential for long-term disability, so it’s important to understand how best to prevent them using available resources,” he said. “Determining the patterns, causes, effects, and costs of TBI-related emergency department visits is one way to do that.”
Looking at data from 2009, researchers found there were 133,952 TBI-related visits to Ontario EDs that year. They were also able to break these visits down into demographic groups.
Young children and the elderly had the highest rates of TBI-related ED visits compared with those aged five to 65, according to the authors.
The rate of TBI-related ED visits was higher for men than women across all age groups younger than 65, according to the authors. This gender difference was particularly evident within the 15 to 24 and 25 to 34 age categories, in which men were twice as likely as women to go to an ED with a TBI.
Costs were greater for men than women across nearly all age groups, with men incurring double the costs overall. This finding is consistent with the fact that men suffer a higher rate of fatal injury and earn a higher income on average, compared with women, according to the report. One exception was the over 85 years category, in which costs were 56 per cent higher for females than males. Women live longer than men on average; therefore women are more likely to sustain a TBI because they are overrepresented in the over 85 age range, according to the authors.
Falls were the cause of almost half (47 per cent) of TBIs in the year studied. The highest rate of falls occurred among children under four and the elderly (age 75 years and older), who together were six times more likely to sustain a fall-related TBI compared with other age groups.
Other common causes of TBI were struck by/against injuries, in which TBI was sustained when a person was struck by or struck against another person or an object (37 per cent), motor vehicle crashes (10 per cent) and sports- and bicycle-related accidents (combined 12 per cent).
The highest rates of motor vehicle crash-related TBI occurred among adolescents and young adults. Although they accounted for only 10 per cent of TBIs, they accounted for more than 17 per cent of total costs. This disproportionately large cost reflects the long-term disabilities resulting from the original injury resulting from motor vehicle accidents and the increased likelihood of younger age groups being affected by motor vehicle crashes, resulting in high lifetime medical and lost productivity costs, the authors wrote.
The findings underscore the importance of ongoing surveillance and prevention efforts targeted to vulnerable populations, said Terence Fu, a medical student at St. Michael’s and an author on the study.
“An emphasis on efforts such as falls prevention among the elderly, motor vehicle accident prevention among young adults, and sports-related TBI prevention among youth, could help decrease the incidence and economic burden of these injuries,” he said.