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Local schools look to soften impact of concussions

New ImPACT test another tool for physicians

POSTED: August 20, 2011 6:59 p.m.
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Local administrators are looking into a new test which will help trainers and physicians determine when it is safe for a player with a head injury to return to the field.

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It’s a weekly occurrence on the football field.

The running back takes the handoff and sprints upfield, hitting a hole between his offensive linemen. As the crowd stands and cheers in excitement, the hole suddenly disappears. And then you hear it — the crack of helmet striking helmet like two battering rams.

The runner or the defender — or maybe both — falls to the ground for a moment, shaken by the collision, and is then taken off the field for evaluation by a trainer.

In the past, the trainer and, later, a physician would be forced to make decisions about the player’s health based largely on subjective observation.

Is the player confused or disoriented? Is he or she responding regularly? Is it a concussion that requires further attention?

Local schools, however, are moving to give team trainers and physicians another tool to help them decide when it is safe for the individual to return to play.

It is called Immediate Post-Concussion Assessment and Cognitive Testing, a computerized test that establishes a baseline which physicians can compare observations to on an individual basis.

Gordon Higgins, the director for community relations and athletics for Hall County Schools, is spearheading this effort within the area.

He became aware of the program after Cobb County schools looked into it and he brought it up at a board meeting on Aug. 8. The program has received immediate support from both parents and administrators, and Higgins will provide a follow-up with further information at another meeting Monday. He hopes to receive a direction to move forward with the program at that time.

“The main thing I think needs to be conveyed is that ImPACT is not a tool to determine a concussion or other head injury,” he said. “It is a tool to give additional information in an evaluation, which helps physicians to make more informed decisions about the player’s health.”

This is increasingly important in the world of contact sports.

Dr. John Vachtsevanos, an orthopedic surgeon in Gainesville and a team physician for the Atlanta Falcons, helped Higgins introduce ImPACT to county administrators and stressed the difficulty in giving an accurate evaluation of a player’s health after a head injury.

“It’s always been a challenge diagnosing and managing concussions or other head injuries,” Vachtsevanos said. “A lot of times, it’s just sort of fly-by-the-seat-of-your-pants management. It’s subjective.”

The goal of ImPACT is to erase that subjectivity, he said.

The way the program works, Vachtsevanos said, is the player will take an evaluation as part of their physical before the season. It will be administered online and with athletes required to answer a number of questions to establish a baseline of cognitive functioning. Results would be stored on a secure server and never viewed again unless the player encountered a head injury.

If such an injury occurred, the student-athlete would be asked to take the same evaluation again. Then, results would be compared to the individual’s baseline.

Vachtsevanos said that many professional teams, like the Falcons, are using it and that, in his professional experience, no test has better informed doctors of an athlete’s recovery progress.

“It’s definitely the best,” he said. “If it wasn’t, our major sports wouldn’t be using it.”

He added that it would be used, at first, only in the main “contact” sports (football, basketball, soccer and wrestling), and that his group, Specialty Clinics of Georgia-Orthopaedics, PC, would cover the cost for all Hall County schools except Chestatee. Chestatee, he said, would be covered by another group.

School superintendents Will Schofield of Hall County and Marianne Dyer of Gainesville City Schools expressed their interest in moving forward with the program.

Schofield said that, as a former football and wrestling coach, he has long been invested in protecting student-athletes from dangerous head injuries. Upon learning of ImPACT, it seemed like a no-brainer.

“It was so common sense,” he said. “It was one of those ‘a-ha’ moments to have data beforehand to compare post-concussion data with.”

As administrators, Schofield stressed, it is their responsibility to move forward with any program that is going to protect their students.

“One of the jobs we have is to teach these kids as if they were our own,” he said. “So when something comes across our desk that we think can help protect them, it’s our job to move forward with great haste.”

Dyer echoed his sentiments.

“We need to do everything we can to help protect these kids from concussions or any other head injuries,” she said.

While coaches love to have their players on the field trying to win games, Gainesville coach Bruce Miller said that safety is the ultimate goal.

“I just think it’s another safety precaution for the kids,” he said. “And it’s all about the kids. Yeah, we want to win, but their health has to come first.”

And a program like ImPACT, Vachtsevanos said, will go a long way to ensuring athletes' long-term health.

“A lot of times, it’s not the first concussion that gets you,” he said. “It’s the second or third that can have long-term effects on your health.”



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