UNIVERSITY OF WISCONSIN-STOUT ATHLETIC TRAINING CONCUSSION PROTOCOL & GUIDELINES

Size: px

Start display at page:

Download "UNIVERSITY OF WISCONSIN-STOUT ATHLETIC TRAINING CONCUSSION PROTOCOL & GUIDELINES"

Angelina Dorsey
5 years ago
Views:

1 UNIVERSITY OF WISCONSIN-STOUT ATHLETIC TRAINING CONCUSSION PROTOCOL & GUIDELINES The health and safety of our student-athletes is a high priority. This document establishes (1) the educational procedures for student-athletes, coaches, directors of athletics and medical staff regarding concussions, (2) the diagnosis and medical management plan for concussions, (3) the return to play and return to learn management plans, and (4) the management plan to reduce head trauma exposure. Definition of Concussion A concussion is a disturbance in brain function that occurs from a direct or indirect insult to the brain or a violent shaking of the head. As a result, transient impairment of mental functions such as memory, balance/equilibrium, and vision may occur. It is important to recognize that many sport-related concussions do not result in loss of consciousness and, therefore, all suspected head injuries should be taken seriously. Coaches and fellow teammates can be helpful in identifying those who may potentially have a concussion, because a concussed athlete may not be aware of their condition or potentially be trying to hide the injury to stay in the game or practice. Pre-season Education NCAA requires that all student-athletes, coaches, team physician, athletic trainers, and director of athletics have been provided the NCAA concussion fact sheets and are reviewed annually. Student athletes must sign a statement in which student-athletes accept the responsibility for reporting their injuries and illnesses to the athletic training staff, including signs and symptoms of concussions. Each studentathlete electronically signs this form in their SportsWare account every year before participation. (Appendix A) stating that they understand that they must report a concussion to the athletic training staff and that they understand how they can obtain a concussion and the signs and symptoms of a concussion. Staff, coaches, and director of athletics, will be required to sign an acknowledgement that they have received, read, and understand this educational material including the causes, signs and symptoms, and possible consequences of concussion. This education also outlines their responsibility for reporting any suspected concussions or head injuries directly to the medical staff. Staff will sign electronically on SportsWare. Medical staff will review our concussion management plan annually and stay up to date on all best practices. Baseline Testing All first-year athletes will report any concussion history on our medical clearance form. Baseline testing: ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) baseline assessment will be done every year on freshman, transfer, and junior student athletes in contact and collision sports. Post-Concussion Management When a student-athlete shows any signs, symptoms or behavior indicating a concussion, the athlete shall be removed from practice or competition and evaluated by the UW-Stout Athletic training staff.

2 If a team is at an away event, then the coach and student-athlete must follow instructions of the host athletic trainer. If there is no medical staff on site, the coach will remove athlete and refer if needed. A student-athlete who is evaluated and treated for a concussion shall be withheld from the competition or practice and not return to activity for the remainder of the day. A Sport Concussion Assessment Tool (SCAT 5) (Appendix B) is to be performed to help the athletic trainer assess the student athlete for any signs and/or symptoms of a concussion, the athlete s history, and mechanism. The athletic trainer will also review post- concussion management plan with the student athlete and a parent/friend/roommate to review patient care instruction. (Appendix C) This includes things they should refrain from, and good things to do for their symptoms. Athletic Training Staff will notify the Dean of Students via that the student has obtained a concussion and estimate time needed for recovery. Within hours after the initial injury, the student athlete will take the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) computerized test to determine post injury status and the results compared to their baseline test. In the instance that the athlete does not have a baseline, normative values will be used. They will also take the BESS test to assess balance. Athlete will report daily to the athletic training staff to complete a symptom score. (Appendix D) Athletes will be instructed to not attend classes for 48 hours. After hours the athlete can begin sub-symptomatic aerobic exercise and progress daily as allowed. Note that an athlete may remain on the same level of activity for several days. The Berlin 2016 Return to Play Consensus guidelines will be followed. BERLIN 2016 Return to Play Stage 1- Symptom-limited activity Daily activities that do not provoke symptoms Gradual reintroduction of work/school activities Stage 2- Light aerobic exercise Walking or stationary cycling at slow to medium pace. No resistance training Increase heart rate Stage 3- Sport-specific exercise Running or skating drills. No head impact activities Add movement Stage 4- Non-contact training drills

3 Harder training drills, eg, passing drills. May start progressive resistance training Exercise, coordination, and increased thinking Stage 5 -Full contact practice Following medical clearance, participate in normal training activities Restore confidence and assess functional skills by coaching staff Return to sport Criteria for Return to Play. All criteria must be met: Return to Play model from the University of Pittsburgh Medical Center will also be used. (Appendix E) After completion of stage 4 and before stage 5 they must re-take the IMPACT test and BESS test and have comparable scores to their baseline or normative values. Athlete must complete stage 5 which is a full practice before seeing a physician. Upon completing stage 5, medical clearance for a student-athlete before engaging in (e.g., competition, practice, conditioning sessions) is required as determined by a physician (e.g., team physician) or the physician's designee. Per NCAA Concussion Management Plan. Dr. Rhoades or specified member of UW-Stout s Student Health Center will be used for clearance and referrals for student athletes with prolonged symptoms for further help.

University of Wisconsin-Stout Athletic Training Concussion Information and Acknowledgement Form What is a concussion? A concussion is a brain injury that: Is caused by a blow to the head or body.

4 University of Wisconsin-Stout Athletic Training Concussion Information and Acknowledgement Form What is a concussion? A concussion is a brain injury that: Is caused by a blow to the head or body. From contact with another player, hitting a hard surface such as the ground, ice or floor, or being hit by a piece of equipment such as a bat, lacrosse stick or field hockey ball. Can change the way your brain normally works. Can range from mild to severe. Presents itself differently for each athlete. Can occur during practice or competition in ANY sport. Can happen even if you do not lose consciousness. How can I prevent a concussion? Basic steps you can take to protect yourself from concussion: Do not initiate contact with your head or helmet. You can still get a concussion if you are wearing a helmet. Avoid striking an opponent in the head. Undercutting, flying elbows, stepping on a head, checking an unprotected opponent, and sticks to the head all cause concussions. Follow your athletics department s rules for safety and the rules of the sport. Practice good sportsmanship at all times. Practice and perfect the skills of the sport. What are the symptoms of a concussion? You can t see a concussion, but you might notice some of the symptoms right away. Other symptoms can show up hours or days after the injury. Concussion symptoms include: Amnesia. Confusion. Headache. Loss of consciousness. Balance problems or dizziness. Double or fuzzy vision. Sensitivity to light or noise. Nausea (feeling that you might vomit). Feeling sluggish, foggy or groggy. Feeling unusually irritable. Concentration or memory problems (forgetting game plays, facts, meeting times). Slowed reaction time. Exercise or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games may cause concussion symptoms (such as headache or tiredness) to reappear or get worse. What should I do if I think I have a concussion? Don t hide it. Tell your athletic trainer and coach. Never ignore a blow to the head. Also, tell your athletic trainer and coach if one of your teammates might have a concussion. Sports have injury timeouts and player substitutions so that you can get checked out. Report it. Do not return to participation in a game, practice, or other activity with symptoms. The sooner you get checked out, the sooner you may be able to return to play. Get checked out. Your team physician, athletic trainer, or health care professional can tell you if you have had a concussion and when you are cleared to return to play. A concussion can affect your ability to perform everyday activities, your reaction time, balance, sleep and classroom performance. Take time to recover. If you have had a concussion, your brain needs time to heal. While your brain is still healing, you are much more likely to have a repeat concussion. In rare cases, repeat concussions can cause permanent brain damage, and even death. Severe brain injury can change your whole life. What should I do if i think I have a concussion? Acknowledgement of concussion information: By electronically signing this form through the "Save and Submit" button, you understand and have received information about the signs and symptoms of concussions and acknowledge that you have the responsibility to report concussion related symptoms to one of the licensed UW-Stout Athletic Trainers.

9 UNIVERSITY OF WISCONSIN-STOUT ATHLETIC TRAINING Post-Concussion Management Conditions may change significantly within the first 24 hours. Immediately obtain emergency care for any of the following signs or symptoms. Have a headache that gets worse Are very drowsy or can t be awakened Can t recognize people or places Have repeated vomiting Behave unusually or seem confused; are very irritable Have seizures (arms and legs jerk uncontrollably) Have weak or numb arms or legs Are unsteady on their feet; have slurred speech Do not perform any physical exertion until cleared by a health care provider. Mental exertion (studying, homework, reading, math, computer, work, etc.) should be minimized until asymptomatic at rest minutes of light reading on occasions may be allowed for some if it doesn t exacerbate symptoms. Activities utilizing a screen should be curtailed if not restricted in the first hours. This includes phone, TV, computer, and video games. Do not drive a car or operate machinery. Do not drink alcohol It is OK to rest and sleep. Do not take medication unless instructed to by healthcare provider I, the student athlete understands this checklist and will follow it.

10 Concussion Checklist Name Age Gender Date of assessment Sport Date of Injury Examiner Symptoms (0-6) Date: Headache Pressure in Head Neck Pain Nausea or vomitting Dizziness Vision Problems Balance Problems Sensitivity to Light Sensitivity to noise Feeling slowed down Feeling like in a fog Difficulty concentrating Difficulty remembering Fatigue or low energy Confusion Drowsiness Trouble falling asleep Sleep Quality More emotional Irritable Sadness/Depressed Nervous or Anxious Number of Symptoms Symptom Severity Score Did you attend class today? Did your symptoms increase during or after class? Are you communicating with your piers? Did you take any meds in the last 24 hrs? Do symptoms get worse with mental activity? Notes: Exertional RTP Stages Stage 1:

11 UPMC SPORTS MEDICINE CONCUSSION PROGRAM CONCUSSION REHAB Micky Collins, Ph.D., Sean Learish, PT, Mark Lovell, Ph.D., et al. (updated 3/27//08) GUIDELINES FOR POST- Stage of Rehabilitation Physical Therapy Program Recommended Exercises Stage 1 Target Heart Rate : 30-40% of maximum exertion *(Max HR- Rest. HR X.30)+Rest. HR Recommendations: exercise in quiet area (treatment rooms recommended); no impact activities; balance and vestibular treatment by specialist (prn); limit head movement/ position change; limit concentration activities; minutes of light cardio exercise. Stage 2 Target Heart Rate : 40-60% of maximum exertion * (Max HR- Rest. HR X.40)+Rest. HR Recommendations: exercise in gym areas recommended; use various exercise equipment; allow some positional changes and head movement; low level concentration activities (counting repetitions); minutes of cardio exercise. (stage 1 exercises included, as appropriate) Stage 3 Target Heart Rate: 60-80% of maximum exertion *(Max HR- Rest. HR X.65)+ Rest HR Recommendations: any environment ok for exercise (indoor, outdoor); integrate strength, conditioning, and balance/proprioceptive exercise; can incorporate concentration challenges (counting exercises, MRS equipment/ visual games) (stage 1&2 exercises included, as appropriate) Stage 4 (Sport Performance Training) Target Heart Rate: 80% of maximum exertion *(Max HR- Rest. HR X.80)+ Rest HR Recommendations: continue to avoid contact activity, but resume aggressive training in all environments Stage 5 (Sport Performance Training) Target Heart Rate: Full exertion Recommendations: Initiate contact activities as appropriate to sport activity; full exertion activities for sport activities -Very light aerobic conditioning -Sub-max isometric strengthening and gentle isotonic -ROM/ Stretching - low level balance activities -Light to Moderate aerobic conditioning -Light weight PRE s -stretching (active stretching initiated) -Moderate Balance activities; initiate activities with head position changes -Moderately aggressive aerobic exercise -All forms of strength exercise (80% max) -active stretching exercise -Impact activities running, plyometrics (no contact) -Challenging proprioceptive/ dynamic balance (integrated with strength and conditioning); challenging positional changes. -Non-contact physical training -Aggressive strength exercise -Impact activities/ plyometrics -Sport Specific Performance Training -Resume full physical training activities with contact -Continue Aggressive strength/ conditioning exercise -Sport specific Activities Stationary Bike; Seated Elliptical; UBE; Treadmill walking: (10-15 min) Quad sets; Ham sets; (UE) light hand weights; resistive band rowing; (LE) SLR s, Resistive bands ankle strengthening Cervical ROM exercise, Trap/LS stretching, Pec stretching, Hamstring stretching, Quad stretching, Calf stretching Romberg exercises (feet together, tandem stance, eyes openclosed); single leg balance Treadmill; Stationary Bike; Elliptical (upright or seated); UBE; (20-25 min) Light weight strength exercise (Nautilus style equipment); resistive band exercises (UE/LE); wall squats, lunges, step up/downs Any stage 1 stretching, active stretching as tolerated (Lunge walks, side to side groin stretching, walking hamstring stretch) Romberg exercises, VOR exercise (walking with eyes focused with head turns); Swiss ball exercises; single leg balance exercises Treadmill (jogging); Stationary Bike; Elliptical (upright or seated); UBE (25-30min) Resistive weight training including free weights; MRS/ Functional Squat; Dynamic Strength activities Active stretching (Lunge walks, side to side groin stretching, walking hamstring stretch) Initiate agility drills (zig zag runs, side shuffle, ect ), Jumping on tramp/blocks. Higher level balance activities: ball toss on plyo floor, balance discs, trampoline; squats and lunges on BOSU ball Program to be designed by Sport Performance Trainers Graded Treadmill testing Interval training Sport Specific drills/training Program to be designed by Sport Performance Trainers Practice and game intensity training Sport specific activities * Target Heart Rates calculated by Karvonen s equation: Max HR (220-Age) Resting HR X Target Percentage + Resting HR

INTERCOLLEGIATE ATHLETICS CONCUSSION ACKNOWLEDGEMENT AND STATEMENT

INTERCOLLEGIATE ATHLETICS CONCUSSION ACKNOWLEDGEMENT AND STATEMENT ACKNOWLEDGEMENT AND STATEMENT A FACT SHEET FOR STUDENT-ATHLETES WHAT IS A? A concussion is a brain injury that: Is caused by a blow to the head or body -From contact with another player, hitting a hard