Heading off big problems

Mental-agility tests help ID possible concussions in S.W. Colo. athletes

A computer program tests athletes’ cognizance levels. A “normal” baseline is set for each athlete, and another test after a possible head injury can show if there is a concussion. Portia Kamps, athletic trainer at Bayfield High School, demonstrates the test. Enlarge photo

JERRY McBRIDE/Herald

A computer program tests athletes’ cognizance levels. A “normal” baseline is set for each athlete, and another test after a possible head injury can show if there is a concussion. Portia Kamps, athletic trainer at Bayfield High School, demonstrates the test.

The local effort to monitor athletic head injuries apparently is ahead of the curve.

Two Mercy Regional Medical Center efforts to protect student-athletes and others from head injuries predate a recently signed state law addressing the same issue.

Since the start of the 2010 school year, certified athletic trainers – employees of Mercy assigned to the three area public high schools – began testing athletes to establish individual baselines of cognitive ability.

They use a computerized program developed in the 1990s called ImPACT, Immediate Post-Concussion Assessment and Cognitive Testing.

Among the exercises are tests for attention span, reaction time, word memory, design recognition, color matching and symbol matching.

An example: An athlete watches 12 words flashed on a computer screen for three-quarters of a second each. The words are repeated, then mixed with 12 new words. The athlete must indicate which words belong to the original list.

Then, if an athlete – including cheerleaders and members of dance squads – suffers what appears to be a concussion, the athletic trainer puts the youngster through the same type of cognitive tests to compare post-injury performance with his/her baseline.

“Our role is to recognize a serious injury, manage the treatment and communicate with the athlete’s physician and family,” Portia Kamps, who is in her fourth year as athletic trainer at Bayfield High School, said last week.

The trainers are present at practices and home games.

The cognitive tests are repeated (there are various versions to minimize memorization) until a health-care professional decides the athlete can return to the field, court, pitch or track.

Before ImPACT was introduced, Kamps and fellow athletic trainers – Alyssa Fredericks at Durango High School and Kolin Tomlinson at Ignacio High School – judged an athlete’s state of mind on the basis of concussion symptoms such as nausea or vomiting, blurry vision, balance problems, confusion, ringing in the ears and sensitivity to light

“But we didn’t have an in-depth cognitive test,” Kamps said.

Mounting concern nationally about the consequences of head injuries led to legislation in Colorado that Gov. John Hickenlooper signed March 29.

Under the new law, which takes effect in January 2012, coaches must bench athletes as young as 11 who appear to have suffered a head injury. The athlete can’t return to play until cleared by a professional health-care practitioner.

The new law also requires coaches in public and private schools and volunteer coaches in youth leagues to annually take online training in recognizing symptoms of a concussion.

The Colorado High School Activities Association, or CHSAA, in 2010 instituted the same policy that Hickenlooper made law.

“The CHSAA policy came out of reaction to several deaths from second impacts,” said Dr. Joe Murphy, team physician for the Fort Lewis College athletic department and medical director of the campus health center. “There’s huge interest in concussion prevention and management,”

Second-impact syndrome, the effects of a concussion received before an earlier one heals, presents a rare but lethal danger for people younger than 20, Murphy said.

The Centers for Disease Control and Prevention estimates that about 135,000 youngsters ages 5 to 18 are treated in emergency rooms annually in the United States for concussions resulting from organized sports.

Gray Matters

A second effort to prevent concussions involves helmets.

Gray Matters – a deft play on words – was initiated in February 2009. Volunteers led by Mercy personnel educate the public about the importance of using a protective helmet while biking, skiing, snowboarding or skateboarding.

The program supplies free helmets when possible. It is sponsored by Mercy Trauma Services and funded by the Mercy Health Foundation.

Amy Allen, a registered nurse and trauma services coordinator at the hospital, directs the effort.

Allen and volunteers visit ski resorts, skate parks and schools to educate adults and children about the use of helmets. Free helmets are available at some events.

“Helmets prevent injury if used properly,” Allen said. “The importance of education is that it creates a culture.”

Allen said she sees more skiers at Durango Mountain Resort wearing helmets since Gray Matters was initiated two years ago.

The program has distributed 500 helmets so far, Allen said.

daler@durangoherald.com

Portia Kamps, athletic trainer at Bayfield High School, also uses tried-and-true tests to see if a student-athlete might have a head injury. Student Kylie Kolz, 18 follows Kamps’ finger. Enlarge photo

JERRY McBRIDE/Herald

Portia Kamps, athletic trainer at Bayfield High School, also uses tried-and-true tests to see if a student-athlete might have a head injury. Student Kylie Kolz, 18 follows Kamps’ finger.

Bayfield High School student Kylie Kolz, 18, demonstrates a running pattern that athletic trainer Portia Kamps, left, has athletes perform when testing them for a concussion. Enlarge photo

JERRY McBRIDE/Herald

Bayfield High School student Kylie Kolz, 18, demonstrates a running pattern that athletic trainer Portia Kamps, left, has athletes perform when testing them for a concussion.

Portia Kamps, athletic trainer at Bayfield High School, goes through a computer program called ImPACT, Immediate Post-Concussion Assessment and Cognitive Test, that she uses on athletes when testing for a concussion. Enlarge photo

JERRY McBRIDE/Herald

Portia Kamps, athletic trainer at Bayfield High School, goes through a computer program called ImPACT, Immediate Post-Concussion Assessment and Cognitive Test, that she uses on athletes when testing for a concussion.