October 29, 2014

LVC And Brain Sentry To Study Head-Impact Frequency In Student-Athletes

Photo Courtesy of Lebanon Valley Sports Information
BETHESDA, Md. - Lebanon Valley College and Brain Sentry, a privately held maker and distributor of head-impact sensors, today announced plans to partner on a study that could have far-reaching effects in the management of sports-related brain injuries. Within LVC, a highly collaborative and innovative partnership between the Physical Therapy Department and the Athletic Department will focus on the College's three helmeted sports-football, ice hockey, and men's lacrosse, beginning with the latter in spring 2015.

It is well understood that frequent head impacts are a risk factor for concussion and may lead to long-term issues including chronic traumatic encephalopathy (CTE). Much of the effort to combat brain injury in football has focused on reduction of head impacts experienced by athletes. One unanswered question is whether sideline medical personnel, or even the players themselves, recognize the actual number of head impacts experienced during an athletic practice or competition.

The investigative team will use Brain Sentry sensors to determine the actual number of at risk head impacts compared to current standardized sideline assessment by medical personnel and player self-report.
The principal LVC investigators for this study are Robin Myers, D.P.T., APTA Neurologic Specialty Council, clinical assistant professor of physical therapy, and Marcia Epler, Ph.D., P.T., ATC; associate professor of physical therapy.

Football, ice hockey, and men's lacrosse study participants will be equipped with helmet-mounted Brain Sentry Impact Counter sensors, which will count the number of head impacts in excess of 20 gravitational forces or 20g's. Before and after each practice and game, each participant's helmet will be monitored for determination of the actual frequency of head impacts, and recorded by a research assistant.

In parallel to this measured frequency, sideline personnel and participating players' complete a simple survey at the end of every practice and game. The objective of the survey is to determine the observed sideline assessment of the number of "significant" head impacts, as well as the participant's estimate of the number of head impacts.

"Athletic trainers have a number of responsibilities related to practice/game coverage, making it unrealistic to monitor each athlete throughout the athletic event. The recognition of more severe and/or symptom-provoking head impacts commonly observed and evaluated, as well as reliance of self- reporting by the athlete, constitute the current sideline approach in determining the likelihood of concussion," said Dr. Epler. "If we find that sideline personnel, including experienced athletic trainers, are unable to accurately estimate the actual frequency of head impacts via sideline assessment, it raises the question as to the ability of these personnel to objectively identify the players who are at risk to being exposed to excessive head impacts."

Dr. Epler added that excessive head impacts are associated with an increased risk for brain injury; therefore, this study could point to the importance of sensors in helping to identify athletes, at all levels of sport, exposed to excessive head impacts. "An anticipated outcome will be to determine the most accurate means of estimated head impact frequency, be it coaches, athletic trainers, ancillary medical personnel, players, or emerging technological advancements."

The following are also collaborating with Dr. Myers and Dr. Epler on the study:
Stan M. Dacko, Associate Professor and Department Chair of Physical Therapy (B.A., Rutgers University; M.S.P.T., Boston University; Ph.D., Hahnemann University)
Matthew Walko, Clinical Assistant Professor of Physical Therapy (B.S., Misericordia University; M.S., Misericordia University; D.P.T., Misericordia University; NSCA Certified Conditioning Specialist; APTA Certified Cardiovascular and Pulmonary Physical Therapy Specialist)
Erin L. Ulrich, Head Athletic Trainer (B.S., Eastern University; M.S., California University of Pennsylvania, Adjunct Instructor in Department of Physical Therapy)
Greg Merril, co-founder and CEO, Brain Sentry, said that he looks forward to the results of the study. "This is the first time that a study like this will be done," said Merril. "Organizations like USA Football are promoting Heads Up tackling in an attempt to reduce head impact frequency, but if no one knows the number of head impacts being experienced, how can a coach know if a player is doing it right? Without objective information how can we expect to manage this key risk factor?"

Lebanon Valley College is particularly excited that the partnership will enhance its already comprehensive concussion protocol, in which every incoming student-athlete is administered ImPACT testing when they arrive on campus to determine their baseline. If an LVC student-athlete experiences a suspected head injury, a standard SCAT 3 evaluation is administered by an athletic trainer on the sideline or in the athletic training room. Once a suspected head injury occurs, LVC's team physician examines all suspected concussions. Student-athletes receive take-home instructions to educate them about how to optimize recovery from a suspected concussion as well as about when to go to the emergency room.

This post-impact analysis is just a part of the evaluation process that occurs before affected student-athletes can return to practice and competition. Once the student-athlete reports being symptom free and their impact test has returned to baseline, they can begin the multi-step process of guided return to participation. These six-tiered steps of increasing intensity/contact (complete rest, exertional activity, sport-specific skill work/non-contact practice, contact practice, collision practice [if applicable], and full go [game]) are separated by 24-hour time periods to ensure that the athlete remains asymptomatic.