in this issue concussion awareness for
Post on 11-Apr-2022
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Overview of ConcussionsConcussion is Suspected
Concussion Assessment & TreatmentBaseline Testing
Return to PlayReturn to Learn
Contact Information
In this issue
What is a Concussion?A concussion is a disturbance in brain function caused by sheer stress to the brain tissue.
Statistics Rate of head injury at FIS World Cup Level: •reported range between 10%
and 13.4%•concussion the most
common injury reportedSteenstrup et al, Br J Sports
Med, 2014Rate of concussions per year in general population: 6 per 1000 people (1.6%)Many more go unrecognized & unreported.
We Need to Take Concussions Seriously•Some can be fatal (Second
impact syndrome)•Post-concussion syndrome
(persisting headaches, dizziness, forgetfulness and mood changes)
•Permanent brain impairment (e.g. “Punch drunk” boxers; hockey and football players)
Mechanisms of Concussion•Directblow to the head face
or neck•Transmittedforce to the
head from an injury elsewhere in the body
•Twisting or rotational forces •LOSS OF CONSCIOUSNESS
OCCURS INFREQUENTLY
The Brain After a Concussion•Impairmentofneurologicfunctiondue to a cascade of brain neurochemical changes
•The disturbance is functional,notstructural(Xray and brain scans are normal)
•Usually resolvesspontaneously: 80 to 90% are better in 7 to 10 days
Common Symptoms •Headaches•Nausea•Sleep Disturbance•DifficultyConcentrating•Foggy Feeling•Light Sensitivity•Poor Balance•Poor Memory•Slowed Reaction Times•Crying
Concussion Awareness forBaseball Ontario
Risk Factors for Concussion•Previous concussions •Females •Age •Higher risk sports/
activities•Pre-injury learning
disability (ADHD, ADD, dyslexia)
•Mood disorders•Migraines
Proportion of Concussion and Mild Head Injury by Type of Sport and Helmet
Use, 0-19 years old, BC CHIRPP, 2001-2009
How do we know if an injured player has a concussion?•May be unconscious•Call 911 and ski patrol•Do not move or remove helmet•Use basic CPR
If player is conscious and able to get up:•Screen for concussion
symptoms •confused, dazed?•day, date, venue, event??
•unbalanced or unsteady?•behaving inappropriately?• irritable or emotional?•CAN USE IMPACT or
SCAT3 APP
If even mild concussion is suspected:•Player should not continue
playing •Player should be assessed that
day •Emergency Room, or physician’soffice.
•Should not be left alone following the injury
•Should be monitored for deterioration over the initial few hours following injury
Red Flags - Call 911•Severe neck pain •Severe or increasing
headache •Increased confusion or
irritability •Repeated vomiting •Seizure or convulsion •Tingling or burning in
arms/legs •Deteriorating consciousness •Loss of consciousness •Unusual behaviour change •Double vision•Weakness in arms/legs
Preventative Measures •Headgear&helmets:•No evidence of
concussion reduction•They do reduce
biomechanical forces and head and facial injury
•Mouthguards•no evidence of
concussion reduction•prevent oral injury
•Minimizeriskofinjury•Safe course set up and
good snow conditions•Discourage risky
behaviour •Encourage sportsmanship
You Should Know•Concussions are often
NOT managed well.•You CANNOT diagnose a
concussion on x-ray or CT scan, as there is no obvious structural damage ... no visible signs.
•There is still controversy over how to best manage a concussion.
The Brain is Under ConstructionCognitiveRest•no activities that require
concentration. This includes … no smart phones, video games, TV, playing music or reading!
PhysicalRest•no activities that increase
your heart rate or make you break a sweat
EmotionalChanges •are very real after a
concussion•It is normal to be anxious,
angry or depressed after sustaining a concussion
ResearchRecent research indicates that recovery takes more than just sitting in a dark room with no stimulation waiting to feel better.Research has shown that having physiotherapy treatment from a concussion trained therapist increases your chance of returning to activity earlier.
Kathryn Schneider et at. BJSM June 2014
The LifeMark ModelActive Recovery•Accurately Assess the systems
that are having problems•TreatthedeficitsorRefer
to others for more testing or treatment
•GetActivewith a safe & individualized graduated re-entry strategies for their school, sports & work
•Education throughout the healing process
Autonomic Nervous System
Visual
Vestibular
Neck
Cognitive Function
Psychological & Emotional
Support
Sleep Dysfunction
ASSESSMENT & TREATMENT
Practical Recovery Tips•Power down to speed up
your recovery …•Rest – at night & during day•Don’t drink alcohol or take
recreational drugs•Write things down to help
your memory•Avoid driving for 24 hrs
after injury or longer if needed, as it is cognitively demanding
•Consult with family members or friends if you have to make important decisions
Baseline Testing•A computerized test conducted
pre-season by a trained health care professional to measure an individual athlete’s ‘brain function’
ObjectivelyMeasures,Collects&Records:•Learning and memory skills•Ability to pay attention or concentrate
•Reaction time in problemsolving
•Balancereactions•Visual input and abilities
Supports Safe Return-to-Play Decisions
Coaches and Parents ...•Provide reassurance about
prognosis but stress importance of taking it seriously
•Review what to restrict and what to allow/encourage
•Be alert to new symptoms or deteriorating condition
•Be Patient and Supportive •This is not a “no pain, no gain”
scenario!
Sideline or Coach’s Assessment ToolsMight include …•ImPACT Sideline evaluation app•SCAT 3 and child SCATWhen in doubt … Sit them out!
Why We Use ImPACT•It is the gold standard in
Concussion Management for neurocognitive testing
•Test results are safely stored in central database
•More accurate than paper version (SCAT)
•Used by leagues such as the NFL, MLB, NHL and MLS
SchoolbeforeSport:•Afocusonreturntolearnfirst
has been shown to lead to a quicker return to sport
•This it the only sports injury that DIRECTLY impacts one’s ability to learn
No Activity↓
Light Aerobic Activity↓
Sport-Specific Exercise↓
Non-Contact Training Drills
↓Full-Contact Practice
↓Return to Play
STAGE ACTIVITY SUGGESTIONS
No Activity“Chalk talk” sessions Review signs & plays (Return to Learn)
Light AerobicLight jogging/ stretchingNo throwing or swings Dry fielding drills (no balls)Positional walk through
Sport-SpecificFielding drills (rolled balls)Dry swingsPitch tracking drillsCatch and throw - initiate
Non-Contact Training Drills
Hitting wiffles/Soft TossCatch and throw ball Grounder/fly ball drills(no sliding or diving)
Full Contact Practice Full practice with team
Return to Play Game
Progress to Next Level if No Symptoms
Gradual Return to Activity
Clear & Consistent Communication
AthletesParents
HealthcareCoachesSchools
REPORTWhen in doubt, sit them out. Athletes are not always the best judge of their symptoms.
RECOVERPersistent symptoms need to be assessed and addressed so that you can get active. Doing nothing is no longer good enough.
RETURNA gradual return to school and sports needs to be clearly communicated to minimize the risk of returning too soon.
Online ResourcesParachute – injury prevention•www.parachutecanada.org ImPACT Testing•www.impacttest.com Centre for Disease Control•www.cdc.gov/concussion ONF – mTBI Guidelines•www.concussionsontario.org Concussion Awareness Training Tool•www.cattonline.com CanChild Brain Injury Research•www.canchild.ca
Join us on Social Media ... Help Us Build Awarenesslifemarkconcussion.blogspot.ca/ twitter.com/LMConcussion facebook.com/pages/LifeMark-Concussion/642260432519014?ref=hl
Jessica Mancini, MScPT•Registered Physiotherapist & Vestibular Therapist •Ontario Clinical Leader of Concussion Management for
LifeMark Centric Health•Ontario Softball Team Trainer for the 2013 Summer Games
Joy Brooks-DesBarres, BSc.PT, RPT•Registered Physiotherapist & Clinic Director – LifeMark
Physiotherapy – Oshawa•Team Physiotherapist Canadian’s Men’s Softball 1999 Pan
American Games/ 2000 World Softball Championships•Lead Medical Practitioner Softball 2015 Pan American
Games/ Ajax Pan Am Ballpark
Baseball Ontario Baseline Testing Days
Saturday April 11 - Sunday April 12 (register by April 8)Saturday April 18 - Sunday April 19 (register by April 15)Saturday April 25 (register by April 22)Visit www.lifemark.ca for LifeMark and Centric Health Clinics locations.Register Online at: http://www.centrichealth.ca/healthfairs/Event ID: Concussion2015 (it is not case sensitive)The test takes about 30 minutes$30 + tax per athlete. If tested on one of the dates above; *$5 from every baseline test administered will be given back in support of Baseball Ontario. Please contact cole.rubinoff@lifemark.ca to book additional group testing for your association or team. To book an additional individual baseline test, pleasegotowww.lifemark.catofindtheclinicnearestyou.
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