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The Canadian Football League (CFL) and National Football League (NFL) announced last week they are partnering on implementing additional concussion tests during CFL games and practices this season.
In addition to ongoing education, research and medical response protocols already in place in the CFL, medical staff of various CFL teams started using the King-Devick Test (K-D Test) in training camps this summer and will continue throughout the 2015 season. The K-D Test is an objective remove-from-play sideline concussion screening test, based on eye-movement, that is being utilized in addition to the CFL’s established sideline concussion examination. The NFL will contribute funding to help determine whether the K-D Test improves the ability to diagnose concussions.
“Collaborations like this one with the NFL are going to provide some useful data to help assess the ongoing advancement of technology and research in support of player safety,” said CFL Vice President of Football Operations Kevin McDonald. “Working together on initiatives such as this ultimately serves a primary objective which is the health and safety of our players.”
“Advancing the science around concussion diagnosis, prognosis and treatment to improve player health and safety is our priority,” says Dr. Richard Ellenbogen, co-chair of the NFL Head, Neck and Spine Committee. “We engage with the leading international experts and sports leagues to pursue that goal. We are grateful to the CFL, their teams and players for implementing the King-Devick Test this season to determine whether this protocol improves diagnosis and can make football, and all sports, safer.”
The leagues noted in a press release that Concussions are a complex type of brain injury that is not visible on routine scans of the brain, yet are detectable when important aspects of brain function are measured. The K-D Test is a two-minute test that requires an athlete to read single-digit numbers displayed on cards or on a tablet to test eye movement. After suspected head trauma, the athlete is given the test and that time is compared to his preseason baseline time. This information as well as a full medical evaluation will help diagnose a concussion and subsequently remove a player from play.
Presently on NFL sidelines, there are approximately 27 medical staff at a stadium on game day, including an unaffiliated neurological consultant (UNC), who collaborates with team physicians to make in-game neurological assessments and who must independently approve a player returning to play following a suspected head injury. Since 2013, the NFL has required clubs to use electronic tablets with specially designed applications for the diagnosis of concussions. The X2 app, which includes a step-by-step checklist of protocols for assessing players suspected of head injury, as well as all players’ concussion baseline tests, is now an established component of the in-game concussion diagnosis and care. This record travels with a player wherever he goes in the league, so that his medical history is close at hand from game-to-game and team-by-team.
The medical staff at NFL games also includes an expert “eye in the sky”—a certified athletic trainer positioned in a stadium box who scans the field and television replays to help identify players with a potential injury who may require attention. Starting this season, the eye in the sky will be authorized to stop the game and call a medical timeout—which will not count against either team’s limit—if needed to provide a player with immediate attention.
This research collaboration is the latest in a number of research projects underway in Canadian football – both at the professional and collegiate levels. It is the latest step the NFL has taken “to help scientists and doctors find breakthroughs that will benefit all athletees.”
Thomas Jefferson University Hospital, Rothman Institute and Wills Eye Hospital have collaborated to establish the Jefferson Comprehensive Concussion Center (J.C.C.C.) at the Philadelphia Navy Yard.
“The J.C.C.C. will be among the very few concussion centers in the nation to provide clinical care in areas such as neuro-opthalmology, neuroradiology, psychiatry, and complex rehabilitation at one facility,” according to a press release. “In addition to providing clinical care, J.C.C.C. will serve as a center for scientific research into concussion.”
R. Robert Franks, D.O., a pioneer in concussion care at the Rothman Institute; and Mijail Serruya, M.D. Ph.D, a leading cognitive neurologist at Jefferson, will serve as Medical Co-Directors of the new center.
Dr. Franks worked on early plans for J.C.C.C. with Theodore Taraschi, Ph.D., Vice President of Research at Thomas Jefferson University. Said Dr. Franks: “Our vision was to bring together the leaders in sports and non-sports concussion management to treat patients with the best clinical pathways and return to activity protocols to provide for successful patient outcomes in one facility—comprising all of the subspecialties needed to treat concussion. The center’s strength will be the collaboration of our three groups. We will be one of the few centers in the country to have sports medicine, neurology, neuropsychology, neuro-opthalmology, ophthalmology, neuroradiology, physical medicine and rehabilitation, psychiatry, physical, occupational and vestibular therapy in one facility to diagnose and treat mild, moderate or severe concussion with compassion and unparalleled expertise.”
The effects of concussions on the eyes and vision are an important and emerging area of concern in the treatment of these injuries, according to Julia A. Haller, MD, ophthalmologist-in-chief at Wills Eye Hospital. “Concussion and brain injury patients often experience difficulty in tracking and focusing. That can lead to problems reading, driving, concentrating in school and using a computer. These patients need to be diagnosed, evaluated and then receive therapy,” said Haller.
The J.C.C.C. expects to treat a wide range of patients who suffer from traumatic brain injury: accident victims, injured veterans, and athletes.
Dr. Serruya said, “Families will be able to take children, adolescents, and adults to the new Jefferson Concussion Center and get help with every aspect of diagnosis, treatment, and recovery all at one accessible location. This is the same concussion team that treats the Philadelphia Phillies and the Flyers.”