Monthly Archives: April 2017

New Study Identifies Way to Treat Sports-Related Concussions Using Telemedicine

An estimated 1.6 to 3.8 million traumatic brain injuries occur every year, according to the Centers for Disease Control and Prevention. More than 75 percent of the injuries are sports-related mild traumatic brain injuries or concussions.

While this issue is being recognized at the professional and elite levels, many youth and collegiate athletic programs across the U.S. lack the adequate medical personnel, specifically concussion specialists, to handle these injuries on the sidelines in real time.

Doctors at Mayo Clinic, in collaboration with the Northern Arizona University football team, conducted a study, Feasibility and Accuracy of Teleconcussion for Acute Evaluation of Suspected Concussion, which was recently published in the journal Neurology. The study, funded by Mayo Clinic, focuses on concussion specialists using telemedicine technology to determine if a player needs to be removed from play in real time.

“Telemedicine has been shown to be a safe and effective means to evaluate and treat numerous acute neurologic conditions, including stroke,” says Amaal Starling, M.D., neurologist and concussion expert at Mayo Clinic. “Now, doctors are starting to explore using telemedicine to manage concussions.”

Dr. Starling and Bert Vargas, M.D., director of the concussion program at UT Southwestern Medical Center, evaluated 11 consecutive male collegiate football players who suffered from a suspected concussion over two football seasons. All athletes received face-to-face baseline examination scores, including a symptom severity checklist, Standardized Assessment of Concussion, King-Devick test, and modified Balance Error Scoring System.

In total, 123 athletes were enrolled in the study, 50 of whom participated through two seasons.

During two football seasons, athletes with suspected concussions were evaluated in person by Northern Arizona University medical personnel and certified athletic trainers. Simultaneously, Dr. Vargas or Dr. Starling would perform a concussion examination via a telemedicine robot.

“During the remote examination, we had the ability to ask additional questions and repeat any portion of the physical evaluation,” says Dr. Vargas. “The decision as to whether or not the athlete should be removed from play was made by both the athletic trainer and neurologist.”

Both physicians had high agreement with the evaluation scoring and 100 percent agreement of the most important decision — removal from play. This suggests neurologists may be able to use telemedicine to manage concussions, make removal from play decisions, and close the gaps in medical care by providing all collegiate and youth athletes similar concussion care as professional athletes receive.

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Discussion on NCAA and Concussions Steals the Show at Harvard Law School Symposium

(Editor’s Note: What follows is original reporting in Concussion Litigation Reporter from Eugene Egdorf of Shrader & Associates. To read the full article, please subscribe at https://concussionpolicyandthelaw.com/subscribe/)

On March 7, 2017, Harvard Law School held its annual Sports Symposium. This year’s topic was entitled “Legal & Ethical Issues Affecting NFL Player Safety.” The event included the most well- speakers known on this topic – folks such as Chris Nowinski and Dr. Robert Cantu, co-founders of Concussion Legacy Foundation; Keynote Speaker DeMaurice Smith, Executive Director of the NFLPA, and Michael McCann, University of New Hampshire Law Professor and writer for Sports Illustrated.

While the title of the event emphasized the NFL, the real highlight was the panel discussion pertaining to the NCAA, which included the NCAA’s Executive Vice President of Regulatory Affairs, Oliver Luck.

The discussion of the science on concussions and head trauma was led by Dr. Cantu with additional data provided by Chris Nowinski. Several significant points were brought out:

  1. Contrary to the operating myth from the NCAA and NFL, concerns over head trauma, concussions, and what we now know as CTE did not become known in the late 2000’s, but rather in the 1930’s, with articles and concerns for “punch-drunk football players” – just like boxers.
  2. The CTE problem is far more pervasive and the future far darker than folks want to admit. Boston University researchers have thus far examined 151 brains of former college football players, and have found CTE in 138, or 91 percent. While thus far no longitudinal studies have been done, it appears that if anything CTE and its symptoms are UNDERREPORTED. And every head trauma adds to the risk – as Dr. Cantu said ” the best analogy to CTE is cigarette smoking.”
  3. Science does not yet know what exposure levels are necessary to cause CTE. Onset appears to vary. But it has been found in teens. There seems to be little doubt that CTE can arise in anyone that has head trauma, and more hits makes it more likely CTE will develop.

To read the rest of the points and full article, please subscribe at https://concussionpolicyandthelaw.com/subscribe/

 

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NFHS Committee Addresses Concussion Problem in Cheer with Rules Changes

The National Federation of State High School Associations (NFHS) Spirit Rules Committee revised several rules for the 2017-18 season, including adjustments to release transitions and inversions, in an ongoing effort to minimize risk of injury for participants in high school cheer and dance.

All rules revisions recommended by the committee at its March 4-6 meeting in Indianapolis were subsequently approved by the NFHS Board of Directors.

The term “static” was removed from several places in the rules book and replaced with wording that more clearly defines the intent of the rules. One particular example involves allowing braced extended stunts to transition in such a way as to allow for more creativity and better technique.

Rules 3-3 and 4-3 had extensive revisions to reduce risk of injury for the top person in a stunt in cheer and dance. The rules were reorganized and clarify the requirements that must be followed in order for the top person to be in an inverted position.

Rules 3-3-8 and 4-3-8 were also added to prohibit a swing roll-down stunt because the person in the swing is being moved facedown toward the performing surface. Additionally, in Rule 3-3-3, inverted stunts that go to a non-inverted position may pass through the inversion without having to stop in a stationary position. This change will allow more creativity and proper technique for certain inverted skills.

“The Spirit Rules Committee takes risk minimization very seriously and looks at the rules for cheer and dance to ensure the most amount of success – from beginners to advanced – with minimal risk for all involved,” said James Weaver, NFHS director of performing arts and sports and staff liaison to the Spirit Rules Committee.

Rules 3-2-7 and 4-2-7 in cheer and dance, respectively, allow for stunts that don’t end in an extended position to be performed without a spotter. However, a spotter would still be required for stunts that stop in an extended position.

Rule 3-8-2 in cheer and Rule 4-8-2 in dance now state that props cannot be held in the hands during tumbling skills, where the supporting hands are not on the performing surface. The committee believes props are a safety concern when a tumbler is using her/his hands for support during a cartwheel or round-off.

A new rule (4-10-14) states that when transitioning from a prop to a stunt/lift, the new bases shall be in contact with the top person before he/she leaves the prop. This rule minimizes the risk to participants when transitioning from props as bases to people as bases so that at no time the top person is free of contact from a base.

In addition, the Spirit Rules Committee approved revisions or removal of 11 definitions in Rule 1.

“The revision of definitions is to ensure accurate understanding of rules by clarifying the language and removing repetitive definitions,” Weaver said.

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