Irv Muchnick writes for BeyondChron and for his website ConcussionInc.net about the concussion issue facing sports today. What began in WWE wrestling for Irv has migrated to the mainstream sports. Below is an excerpt from the introductory article about his new e-book titled “UPMC Concussion Scandal Ground Zero”.
Another major North American sport, hockey, now faces its perfect storm with the second and, for all we know permanent, sidelining of its greatest and most athletically artistic star – Sidney Crosby, his generation’s answer to Wayne Gretzky. Had Gretzky, in the 1980s, been disabled long-term or for good by concussions, then the National Hockey League either would be vastly smaller-time today or would not exist at all. It is impossible to calculate the tens or even hundreds of millions of dollars in ticket sales, rights fees, and merchandise revenue that the loss of Crosby might mean for the contemporary NHL.
During the continentally televised Winter Classic game on January 1, 2011, the Pittsburgh Penguins’ Crosby was concussed by a shoulder to the helmet from an opposing Washington Capitals player. Quickly cleared to return to play, Crosby got slammed into the glass four days later in a game against the Tampa Bay Lightning, which knocked him out of action for more than 10 months. Crosby came back last month but lasted only eight games before having to pull himself again due to lightheadedness, dizziness, and other chronic abnormalities associated with a concussion offshoot known as vestibular disorder.
The medical team that checked out Crosby after January 1 and determined he was good to go on January 5?
All symptoms of a vestibular concussion are descirbed above and can really only be measure with vestibular testing – what testing are they doing to determine RTP for Crosby?
A few takeaways from the article:
1) It is not a long-term longitudinal instrument;
2) 2 year baselining intervals are a problem (my note: true especially for high schools);
3) Impact has issues with concurrent validity; and
4) ImPact has issues with divergent validity.
What is not in the article are representation regarding at home testing and use of ImPact without a baseline which only paints worse picture.
No one should use ImPact on a two year baseline for high school, home baselined or without a baseline regardless of what ImPact states. It makes it an easier sell but undermines its utility.
Passing ImPact or any Neuropsych (NP) test only implies the subject has normal cognitive function not that a concussion has resolved (Crosby and Pronger should never have seen ice time based on these results). Concussion has resolved when a complete work-up is taken and that often involves a complete NP work-up with a licensed NP.
If one is testing the long-term change meaning is one developing a neuro-degenerative disease neither ImPact nor any sports concussion instrument is designed for that purpose.
The issues of concurrent and divergent validity are of even greater concern. Headminder has published extensive validity studies and I believe Cogstate/Axon has done as well. It is a standard process when developing NP instruments. It has long been known ImPact does tend to cut such corners.
Nonetheless, caveat emptor and please follow the proper procedures propagated by reasonable people.
Comment placed on the wrong article. Whoops,