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Fairfax Athletes Take Part in Concussion Study

Fairfax County Public Schools athletes have averaged between 200 and 300 concussions per year over the past five years, said Jon Almquist, athletic training program specialist for the school system. These figures are not confined to the usual suspects — football, lacrosse, wrestling — where athletes are expected to take hits or be in close contact with their opponents. They also include what many parents consider the harmless sports, such as swimming, cheerleading and cross country.

Any time a student-athlete takes part in a sport, he runs the risk of receiving a concussion. The trick for the school system's certified athletic trainers is knowing when the athlete has recovered sufficiently to return to competition.

Now the school system will have some high-tech assistance in monitoring student-athlete concussions. Fairfax County is the only school system taking part in a demonstration project testing software, orginally developed by the Department of Defense, to determine the healing rate of student-athletes from concussions.

"The purpose of the study is to develop methods to prevent kids from going back to sports before they recover from concussions," said Dr. Joseph Bleiberg, a neuropsychologist with the National Rehabilitation Hospital and the principal investigator in the study. "One of the other goals is to find out if there are some people who need to be protected in a certain way so we can prevent the first concussion."

A CONCUSSION is a mild traumatic brain injury typically caused by a collision, fall or other form of contact.

"It is not necessary to have a loss of consciousness to have a concussion. That is a major misconception," said Dr. Alison Cernich, also a neuropsychologist with the National Rehabilitation Hospital and the study's coordinator. "That's why athletic trainers are so important. They can pinpoint the symptoms right there at the time of impact."

The study, being conducted on a voluntary basis, will have athletes take a 20-minute computer test, which basically records reaction time. If that athlete should suffer a concussion, as soon as possible he will retake the test several times over the recovery period. The results will then be compared to the pre-injury baseline results in order to gauge the differences in the cognitive responses. The results will not be used, however, to determine if the athlete is healed enough to return to play. Almquist said that decision will still be made by the athletic trainers in conjunction with the athlete's physician and parents. Fairfax County, said Almquist, adheres to strict protocols that include the Standardized Assessment of Concussion along with the Virginia Neurological Index to determine ability to return to play.

"The information from the test can be used as a tool, but not the sole source," Almquist said. "It would be great if in the near future we can use it as regular protocol."

Fairfax County will be taking part in the study for two years, in which time the researchers hope to collect data from at least 1,000 volunteers, especially females.

"Most studies use male athletes. I would like to analyze females," said Bleiberg. "There is reason to believe a child might recover differently from an adult, and females could be different from males."

Bleiberg said on average it takes a "good" seven to eight days for a college-level athlete to recover from a concussion. He said not many studies have focused on the high-school level.

"THE NICE REASON for studying athletes is that they are highly motivated people," Cernich said. "They are people who want to be OK."

Bleiberg said that motivation could also cause the athlete not to be completely honest about how he is feeling because that could keep the athlete from returning to the field. The testing would actually provide data that show how the athlete is progressing in his recovery. However, Bleiberg said, concussions do not only affect the cognitive abilities. Concussions can also affect balance or the inner ear and can cause headaches. "That's why the skilled clinician is very important," Bleiberg said.

Almquist said the school system's certified athletic trainers have gone through training on the system, known as the Automated Neuropsychological Assessment Metrics, and are working with the neuropsychologists.

"In almost every sport there is a possibility of a concussion," Almquist said. "And repeated minor concussions can have a long and devastating impact."

Bleiberg said ultimately he hopes the data will help determine if certain people have a vulnerability or predisposition to suffer from concussions and to eventually develop a test to determine if the athlete falls in that category.

"As physicians, we could say you have this predisposition and should not do contact sports or that you need special equipment," Bleiberg said.

The study is being conducted by the National Rehabilitation Hospital in conjunction with the University of Virginia and is being funded by the National Institutes of Health.