The University of Pittsburgh Medical Center and the University of Pittsburgh did something that has not been done up to this point; an intensive study on youth football. Using geography as its selector the prestigious group looked into Pop Warner football and concussion rates. The sample size is impressive, over 11,000 athletic exposures over an entire season of play (2011).
However, instead of heralding the work more questions have been raised about the conclusions drawn by lead researcher Micky Collins, PhD. I don’t want to “lead the witness” before you had the chance to hear yourself, watch Dr. Collins below;
Interestingly enough Dr. Collins’ points regarding the depth and breadth of this investigation are spot on, it was both needed and welcome. It is good to have a starting point and something to say “this is where we came from” at all levels of sport – with regards to concussions. After that, I personally Continue reading
The research is starting to come in; the problem is that results and conclusions bring more questions that should be answered. Naturally some will look at early evidence and make a 180 degree change on their attitudes about certain things. We are talking about concussions and the research associated with it. Unfortunately there is plenty of anecdotal and observational cases that sear into our memory, this perhaps shape our thought process. Along with that there is gathering evidence that supports some sort of process change in how we handle this particular injury.
The need to make change is upon us, that cannot be debated; what can be debated is how or what the changes should be. I recently read an article where Micky Collins of UPMC said something to the effect of current concussion concern is like a pendulum that has swung all the way to the other side. Although the changes in sports and activities has certainly not taken that full swing the other way, the pendulum is on the way. His feelings, like mine is that there is no evidence to suggest that a full swing to the other side is warranted, rather there needs to be competent and complete understanding of what we are facing. Rather than making full sweeping changes that would be akin to digging up your backyard to rid your self of a mole; when placing traps and poisons and maybe only having to dig up a small section would fix the problem.
There are definitely things we can do as parents, players, coaches, researchers, doctors and concerned people in general to make a dent in the issue. If we find that the changes are not working then taking another aggressive step may be necessary. I guess the reason for the above rant is to reinforce the need for changes, but the right changes. (As I wrote the last sentence I realized how do we know if the changes are the “right” ones; I guess we don’t but certainly what is happening now needs attention).
One of the small changes that can be made is very obvious to me; Continue reading
On February 29th we posted about the “Cut-Off Indicator” for ImPACT(TM) and recovery periods; in that post I had some open-ended questions regarding this information/press release. Apparently these questions were noticed by UPMC and Chuck Finder, formerly of the Post-Gazette, now part of the media relations of UPMC sent me answers.
The answers were written by Brian Lau, co-investigator of the study/paper, here are my questions and below is the actual response sent to me.
- Why would you neurocognitive test anyone with symptoms, while still recovering?
- Are the numbers based upon the ImPACT “norms” or a baseline calculation?
- Is this experiment repeatable with other measures?
- Where are the control groups?
- Is the accuracy of ImPACT that sensitive (is there even one accurate enough to make this assessment)?
- What did each individual do for management of the concussion in the two days?
Full unedited responses below; Continue reading
The University of Pittsburgh Medical Center and its concussion program have released what they think is a new model to predict how long each individual may take to recover. Lead researcher on this topic is Dr. Micky Collins who stated in a press release that this information is a “game changer”.
The study involves the ImPACT neurocognitive testing platform (developed by UPMC) and its results two days after injury. Although the actual score has not been released publicly; it will appear in the next issue of Neurosurgery. The benefits of such a specific diagnostic indicator would be tremendous for a lot of interested parties.
At the end of the press release/story Dr. Collins indicated something that is similar to what we posted yesterday; “Eighty percent of concussed people recover inside of three weeks.”
This information is all well and good but I would like to speak to some initial “wait a second” thoughts I have regarding this study; Continue reading
As an athletic trainer one of the most difficult tasks is convincing the athlete, parent, and coaches that their son or daughter is hurt. With a concussion everything “looks normal” most times (except for the cases of overt signs). Even with the signs that present most resolve rather quickly and again those affected by the head injury think everything is OK; it’s not like a bone is broken or there is imaging to SHOW an injury/problem.
For a long time researchers have been trying to identify what sign or symptom relates to prolonged recovery. Early on, 80’s and 90’s, the thought was loss of consciousness was the indicator; later to be not the case, and the understanding that one does not have to be KO’ed to get a concussion. Within the community we have used the term feeling “foggy” as a high indicator of prolonged recovery, but that is a very subjective symptom and really unproven, more observational. This might be changing as a very INITIAL study was released by Dr. Brian Lau of the UPMC in the American Journal of Sports Medicine. Continue reading
This is a tried and true quote from Micky Collins of the University of Pittsburgh Medical Center’s Sports Medicine Concussion Program. As I have stated many times the injury itself is more than likely rather benign, IF TREATED CORRECTLY. That is exactly what Collins is preaching; management of the initial injury is of the most importance.
“As we peel the onion on this injury and we started doing more and more research and more and more clinical work, it’s like, wow, this is really something that needs to be dealt with, and you have to do it very carefully,” said Micky Collins…
Researchers and doctors figured out that, despite their serious nature, concussions can be effectively treated. If managed correctly, Collins said, the potential for long-term effects can be mitigated.
Ignoring the signs and symptoms of a concussion is the first step to mistreating the injury, therefore the awareness of what a concussion is and the subsequent treatment will make it easier to handle. Clinicians and “front-line” professionals have been given more technology and research to help with the detection of the concussion. However, the MOST IMPORTANT tool Continue reading