Stanley A. Herring, MD, has served as a Seahawks’ team physicians for over twenty years. He also chairs the NFL Head, Neck and Spine Committee’s Subcommittee on Advocacy and Education. He recently answered questions about concussion management and the introduction of sideline concussion assessment software, accessible via tablet.
What is the process for establishing a baseline score for players?
Attention to concussion takes place not only on the field, but also before an injury ever takes place. Prior to the start of the season, team medical staffs administer baseline neuropsychological tests and a baseline history and physical examination that focus on areas like orientation, memory, concentration & balance. The baseline history and physical examination results are recorded via a sophisticated software program. The baseline history and physical examination test uses a 0-6 scoring system to rate symptoms such as headache, fatigue and dizziness. A total of 22 symptoms are rated. It also includes orientation questions (e.g. “What is today’s date? What day of the week is it?”) short- and long-term memory tests (e.g. recalling a list of words), concentration tests (e.g. reciting a string of numbers backwards). There’s also a part of the test in which the player must perform certain physical tasks, like standing on one leg to assess balance.
Why is baseline testing important? And why is it helpful to have test scores available in tablet form.
The baseline scoring system helps determine if there are large discrepancies between a player’s baseline score and his score if there is a suspected concussion during a practice or game. The tablet software, created by X2 Biosystems, allows medical staff to access any given player’s results on the sideline or locker room and simultaneously compare his baseline scores to practice or game day scores. The software allows for baseline results to be portable, storable and transferrable, which is helpful in concussion diagnosis and management. Previously, team medical staff needed to bring paperwork to the sideline or locker room and consult baseline paperwork if a suspected concussion occurred. In addition, now the baseline data and any data obtained after a possible concussion stays with the player in the event he switches teams.
How did use of the tablet and app come about?
The use of tablets was based on a recommendation from the NFL Head, Neck and Spine Committee. It is an important component of a comprehensive concussion assessment.