In recent years, concussions have become a hot topic both on and off the field. While athletes have always been at risk for concussions, determining the severity and long-term effects of these head injuries has traditionally been difficult.
"Concussions have always been common, but only recently have we begun to realize the magnitude of their potential long-term severity," says R. Robert Franks, Jr., DO, FAOASM, a sports medicine physician with expertise in concussion at the Rothman Institute. "Because of this, we have developed new ways of diagnosing and treating concussions."
In 2010, the Rothman Institute launched a comprehensive concussion program. This program includes the use of a computerized program called ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) to evaluate concussed athletes.
"ImPACT allows us to monitor the cognitive activity of the brain so that athletes are able to get back to playing only when they are ready so as to avoid long-term damage," says Dr. Franks. "ImPACT also provides doctors and certified athletic trainers with a concussion history for patients."
Athletes undergo an initial pre-concussion neurocognitive test that determines their baseline of brain activity. Following a concussion, athletes take an ImPACT post-concussion test that can be compared to the baseline to determine the deviation of the brain's cognitive function from the baseline and help determine the extent of the concussion. Testing takes about 20 to 25 minutes to complete and measures multiple aspects of cognitive functioning, including attention span, verbal memory, visual memory and reaction time.
ImPACT test results are used along with many other factors to develop a plan for return to activity. This occurs when the patient has no symptoms, is not taking any medications to control symptoms, and has returned to baseline on the ImPACT test. Only then can the athlete be deemed safe to start a return to play program.