Sports Concussion Program

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Randall Benson
5 years ago
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1 Sports Concussion Program Here to get you back in the game

People who experience a concussion often have symptoms such as headaches, dizziness, vomiting, or nausea. Plus, they may have side-effects that affect their behavior, sensations, or brain function.

2 Sports Concussions It s way more than just getting your bell rung A sports concussion is a medical condition that should be taken seriously. This condition most often results from hitting your head on the ground or on a hard object or hitting another player while playing a contact sport. People who experience a concussion often have symptoms such as headaches, dizziness, vomiting, or nausea. Plus, they may have side-effects that affect their behavior, sensations, or brain function. There are two important points to stress about sports concussions: 1. This condition is far more serious than just bumping your head. New research has shown that there may be serious behavioral, physical, and cognitive changes in the future for those who have had multiple concussions, referred to as post-concussive syndrome. 2. You should not return to playing the sport the same day as your suspected concussion. This is especially true for children under the age of 19. There could be serious side-effects, sometimes fatal, if an athlete who has had a concussion ends up playing with symptoms and then has a second concussion. The brain may literally shut down. An athlete should not return to play if he or she is still have symptoms after a hit to the head, such as headaches, dizziness, nausea, or vomiting. For these reasons, a Sports Concussion Program was created at Dartmouth-Hitchcock and the Children's Hospital at Dartmouth-Hitchcock to help assess and manage athletes who have a suspected concussion.

3 About the Program The Sports Concussion Program is designed for athletes who have had a concussion and need to have a return to play program. Most patients we see are young school athletes who participate in contact sports such as football, hockey, skiing, and soccer. However, this program is open to athletes of any age who have had a concussion and want a defined assessment and management plan for return to sports. We are also happy to see athletes who want to have baseline testing completed in case a future concussion occurs. These test results will serve as a benchmark against which to measure the impact of any future concussion. The program is not for someone who has had a serious traumatic brain injury. There are two stages to the services offered through the Concussion Program: baseline testing and post-concussion management. Athletes who regularly participate in contact sports are highly encouraged to have baseline testing done prior to the start of a sports season. Baseline testing needs to be done once every two years. Baseline testing is $15 per athlete. Baseline testing If you would like baseline testing, you will come to Dartmouth-Hitchcock to take an ImPACT test on a computer. This neurocognitive test tracks your normal visual, auditory, and cognitive functions. The appointment for this testing will take about one hour. Within 72 hours, your test results will be read by a neuropsychologist. The results will be saved in a secure database so they are available in the unfortunate event you get a concussion. We are also available to come to schools for consultation or to conduct baseline testing with a group in a computer lab. You also have the option of completing computerized balance testing on the SMART Balance Master Equitest. This test, called platform posturography, measures subtle changes in your balance system by challenging input from your feet, eyes, and vestibular (inner ear) systems. This would require an additional 15 minutes of testing and an additional charge of $50. This fee would have to be paid out-of-pocket. The results from this test will be interpreted by a physical therapist at the time of your evaluation and will be put in your medical record. Experts recommend that you have both neurocognitive and balance testing for baseline results and post-concussion testing.

4 Post-concussion management If you have a suspected concussion, we recommend that you set up an appointment with our program preferably 24 hours following the concussion, or within a week. This extra time will allow your symptoms to subside slightly and perhaps you will regain back some of your functions. Until that appointment, you should rest, physically and mentally. Be sure to write down your symptoms until you see our team. Please note that misconceptions such as staying up all night are untrue and can actually be harmful. Be sure to limit activities that cause symptoms, such as headaches or dizziness. This includes refraining from activities such as video games, computer work, television, or texting if they cause your symptoms to get worse. Try to keep a regular schedule and get a full night of sleep. On your appointment date, you will come in for a physical exam by one of our specialists. He or she will ask you about your concussion history, any changes you ve noticed in your daily functions like sleeping, eating, or your moods, and what symptoms you ve been experiencing. They will also want to know what activities seem to bring on the symptoms. At that time, you will do your neurocognitive and balance testing to see if there is any change from your baseline scores for visual, auditory, cognitive, balance, and behavioral functions. If you do not have baseline testing results in your file, your results will be compared to standard scores for people in your age category. Within no more than 48 hours after your testing, we will call you with the test results. The results of your physical exam and neurocognitive testing will guide our plan. You may also be asked to stop doing physical and mental activities that cause your symptoms to reappear.

5 Returning to the Game Your return to play plan, referred to as a graduated return to play protocol, will be set up by our program. We will help you choose someone in your local community to help manage this return to play program, typically an athletic trainer or a physical therapist. This is a five day program to test your performance at different levels. Your physical and mental symptoms will be tracked at each stage. Day one you will start with a very minor activity related to your sport, such as throwing the ball up in the air and walking. If you do not feel any symptoms, then you will graduate to the next level. Each day will be one notch up in exertion until you are at full throttle for your sport playing at the level you normally would. If you are symptom-free at that point, you will receive your return to play note. If you have symptoms along the way then you will have to start over at the day one activity and move up the ladder until you are symptom-free. Making an Appointment To make an appointment with the Sports Concussion Program for baseline (individual or group testing) or post-concussion management, please call (603) or concussion@hitchcock.org. For those requiring post-concussion management, we would like to see you 24 hours after your injury or within a week. Until that appointment, please get as much mental and physical rest as possible, stay away from activities that cause symptoms like dizziness and headaches, and keep notes of your symptoms each day. Hear from one of our patients, Ben Bates: patients.d-h.org/concussion

6 Concussion Program Team Michael Sparks, MD Program Director Sports Concussion Program Division Leader, Richard "Pete" Peterson ATC, PA-C, MS Kristine Karlson, MD Debra Fournier, APRN, MSN Traumatic Brain Injury Program, Physical Medicine and Rehabilitation Keith Loud, MD, MSc Adolescent Children's Hospital at Dartmouth-Hitchcock Tate Erickson, MS, NHLAT, ATC Cheshire Medical Center Dartmouth-Hitchcock Keene Heather Shafer, MD Cheshire Medical Center Dartmouth-Hitchcock Keene Deborah Wood, MS, ATC William Storo, MD Pediatrics Dartmouth-Hitchcock Concord David Edson, PT Balance Specialist Thomas McAllister, MD Neuropsychiatrist Dawna Pidgeon, PT Balance Specialist Arthur Maerlender, Jr., PhD Neuropsychologist Susanna Gadsby, RN Program Coordinator (603) patients.d-h.org/concussion

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