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Sports Archives — The Altamont Enterprise, March 17, 2011

ImPACT at Guilderland
Setting a baseline before concussions helps keep athletes safe

By Jordan J. Michael

GUILDERLAND –– Not many years ago, concussions in contact sports went undetected and athletes would often return to the field of play. Concussions in recent years have received national attention, most frequently for professional or college-level athletes.

The Guilderland School District Athletic Department took a huge step forward in concussion awareness when it introduced ImPACT (Immediate Post Concussion Assessment and Cognitive Testing) last spring. Guilderland is currently one of four Section II school districts using the program; Queensbury, Shenendehowa, and Mohonasen are the others.

ImPACT, created by doctors Mark Lovell and Joseph Maroon of the University of Pittsburgh in the early 1990s, is a software program that tests cognitive functioning in athletes. Guilderland’s assistant director for athletics, Regan Johnson, said that the program costs the district $425 per year.

“It’s well worth the cost,” Johnson said. “It’s an unlimited web-based test that is confidential.”

Kate Gawrys, Guilderland’s athletic trainer, said that close to 500 athletes from grades seven to 12 have taken the ImPACT test. Gawrys administers the tests at the high school and Johnson takes care of the kids at the middle school.

“We’re trying to get everyone that is on a team tested,” said Gawrys. “We’re responsible for everyone.”

Every athlete who plays a contact sport for the Dutchmen is required to take the test at least once, so that a baseline can be set for each person. If an athlete is diagnosed with a potential head injury, he or she retakes ImPACT however many times until passing. At that point, the athlete can return to play, unless a doctor says otherwise.

“We won’t put a kid back into play unless he or she is ready,” Johnson said. “ImPACT is there to hold a baseline. Say you get a concussion; take the test again and compare. If you are cleared, OK, you’re free to go back out there if you’re ready.”

Gawrys told The Enterprise that “five or six” athletes have had potential head injuries over the winter season, and “about 20 more” were diagnosed during the fall sports season.

“Bruise on your brain”

Senior Jordan Weeden got a concussion in November when he was struck with an elbow during varsity basketball practice.

“I got hit and dropped. I was all dizzy and stuff,” said Weeden, who took his initial ImPACT test for varsity soccer in the fall. “The lights really bothered me, so I kept my head down. I had headaches all the time and had trouble focusing. I figured that I had a concussion.”

The ImPACT test has six different modules –– attention span, working memory, sustained and selective attention time, response variability, non-verbal problem solving, and reaction time –– and takes about 30 minutes to complete.

Weeden had to take the assessment three different times after Nov. 15 before passing. He was out of basketball for two weeks, but missed only practices because the team hadn’t started games yet.

“The pressure wasn’t too bad because I had time to recover,” Weeden said. “I thought I could pass the test the second time, but I failed again. It was a little frustrating to have to keep taking it over and over.”

Johnson, who took the ImPACT test himself, said that the test, which is administered on a computer, asks personal questions about age, height, and weight. Then, it moves on to things like reaction time, memory, and word discrimination. Finally, the test goes back to the beginning and cycles through everything again.

“It’ll give you a fork or a knife and you have to click on the word,” said Johnson, who has suffered concussions himself. “It could be difficult if you have a concussion because it makes your brain think quickly. It’s supposed to be difficult if you’re concussed. You can tell the difference.”

“It was hard to focus and my reaction time was a lot slower,” Weeden said of taking ImPACT after getting hit in the head. “There are significant memory sections that flash words across the screen and you have to answer ‘yes’ or ‘no.’ You’ll see a shape once, then you’ll have to remember it again.”

Gawrys, who used ImPACT at Springfield College, sees the software program as a memorization test that is designed to figure out how significant a head injury might be. Athletes should be taking the test no more than 42 hours after an injury occurred.

“The numbers and words are scary sometimes because they come to life,” Gawrys said. “The parent and the athlete can see the effects.”

Dustin Weeden, Jordan’s father, said that he didn’t notice anything wrong with his son after he was hit. “Teenagers change all of the time,” he said. “Sometimes, you don’t know what’s going on with your kid, so I didn’t really notice.”

Concussions were something Mr. Weeden dealt with back in the 1970s when he played football for Hoosick Falls. Jordan Weeden told The Enterprise that his father didn’t want him to play football because of the risks of brain damage.

“I think I had two concussions in one game before,” Mr. Weeden said. “It definitely affected my life. I had a lot of headaches. Still do.”

Sustaining a concussion didn’t change Weeden’s mind about playing sports, but he did say that he felt vulnerable after the injury. “It takes time to heal,” he said. “It’s like having a bruise on your brain.”

Johnson said that a female student last spring had to miss some school due to complications from a concussion. “We’ve had a few former students get sent home from college because they couldn’t focus after a head injury,” he said.

“Some kids will talk about their injuries and some won’t,” Gawrys said. “I’ve seen a few cases of students’ grades going down, but it depends on the student and how they handled the injury.”

“Contact sports versus collision sports”

Gail Hayes of the Centers for Disease Control and Prevention said that the annual estimate for concussions in children ages 5 to 18 is 135,000. The data is collected from the United States Consumer Product Safety Commission, which takes sub-samples from hospitals across the country.

The CDC has said many concussions go unreported. “You can’t see a concussion,” said Hayes. “Symptoms might go unreported.” She went on, “Everyone should work together to help people who are hurt.”

Hayes also said, “Children and teens are more likely to get injured because they’re still growing.”

A concussion is a traumatic brain injury (TBI), Hayes said, and the injury can be diagnosed as anything from a mild traumatic brain injury (MTBI) to severe concussions like brain bleeds.

The CDC joined with the National Football League last fall for a prevention campaign, said Hayes. As the season unfolded, the NFL cracked down on concussions, fining any players who made dangerous hits to the head.

“Everyone looks at football as the big concussion sport, but it’s happening everywhere,” said Johnson, pointing out that half of the concussion cases at Guilderland in the fall were from football. “It’s contact sports versus collision sports.”

Regardless of the sport, or the level, concussions have been put in the spotlight in attempt to make coaches and trainers aware of the slightest symptoms.

“It’s better to miss one game than the entire season,” Hayes said. “If an athlete looks stunned, dazed, confused, or something changes in any way then help should be sought.”

According to Johnson, the New York State motto for concussions is, “When in doubt, sit them out.” A series of numbers, colors, and words allow coaches or trainers to test athletes right on the sidelines during a game.

“We’ve been right on most counts,” Johnson said. “It takes the pressure off because the kids want to play. We save them from themselves. It’s our job to educate and keep them safe. This is not a question of toughness.”

On March 2, Berne-Knox-Westerlo senior Nena Ruiz, 17, sustained her fifth concussion, and second in six months, after falling to the floor during a Class C semi-final basketball game.

The first concussion Ruiz suffered came during a modified basketball game when she was clotheslined by an opposing player. A fall off a bike brought her a second head injury, this one quite serious with a brain bleed. Last year, in a basketball game at Canajoharie, Ruiz was elbowed by a teammate, sustaining her third concussion. In December, she was concussed after both she and an opposing player dove for the ball.

“I don’t really remember what happened,” Ruiz said last week about her latest head injury. “My teammate had to tell me what happened. I have the worst luck. The doctor warned me not to get another one. I’m in trouble this time.”

Ruiz was sidelined for a week after her concussion in December, but the time out is much longer after her latest injury. “I can’t play contact sports for an entire year,” she said.

She took the ImPACT test after her concussion last December upon seeing a concussion specialist. However, Ruiz didn’t have much, if any, of a cognitive baseline because it was her fourth concussion. There was nothing to compare. BKW does not run the test on its athletes.

“The test was really hard,” Ruiz said. “You have to remember everything exactly. Maybe it would have been easier if I hadn’t had four concussions.”

The Friday after her latest head injury, Ruiz went to school, but came home early. “I didn’t remember being at school,” she said. “My memory is not too good. I’ll lose items or not remember where they go.”

Ruiz took another ImPACT test recently, but, after five concussions, she’s scared about her future. “I don’t want to be a 35-year-old woman with dementia,” she said. “If I get hit again, then that tingling in my arms and legs might not go away.”

Ruiz wanted to play basketball in college, or join the Army, but all her head injuries may have put those plans on hold.

“I already filled some paperwork out for the Army,” Ruix said. “But, my brain is busted, so I don’t know if they’ll want me.”

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