Concussion Management and Testing Procedures
What is a Concussion?
A concussion is a type of brain injury caused by a blow to the head or a hit to the body that makes the head and brain move quickly. This can disrupt normal brain function and cause symptoms such as headaches, dizziness, behavior changes, sleep problems, and difficulty thinking or learning. While some people lose consciousness, many concussions occur without it.
Sports-related concussions are among the most common injuries in children and teens who participate in athletics. Each year, millions of sports and recreation-related concussions occur in the United States, and all concussions should be taken seriously.
To support athletes and families, WellSport works with local organizations to promote concussion awareness, early recognition and safe recovery. Our program focuses on the 4 R’s of concussion management:
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Recognize – Know the signs of a concussion.
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Report – Tell a coach, parent or medical provider right away.
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Remove – Stop activity so the athlete can be evaluated.
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Recover – Allow full recovery before returning to activity.
During the sports season, athletes may receive a sideline or in-office concussion evaluation that measures balance, reaction time and cognitive function. Standardized return-to-learn and return-to-play guidelines help ensure a safe and timely return to school and sports.
For athletes who need additional support, services such as physical therapy, balance testing and post-concussion exercise assessments can help guide recovery and a safe return to activity.
Preventing and Managing Concussions
WellSport provides resources and presentations for coaches, parents and athletes about concussion education, prevention, and management.
Preseason Testing Procedures
Before the season starts, WellSport offers baseline testing for balance, reaction time, and the use of a standardized baseline concussion evaluation tool (NFL format).
Education of Program:
A letter will be handed out to all incoming freshman and new students about the concussion program and Axon/CogState testing at start of each sport season. If there is a parent/athlete preseason informational meeting, the following information will be presented:
- Presentation about head injuries and concussions
- CDC’s Heads UP Video
- Explanation about the Axon/CogState testing
- Have Axon/CogState and high school consent form and wavier signed by student athlete and parent or legal guardian.
Preseason Baseline Testing
Preferred testing will include contact/collision sports - football, hockey, boy’s and girl’s soccer, cheer, and wrestling. Optional testing is available for all sports. Testing is preferred for freshmen, juniors, new athletes, and any additional sports added to the program. Baseline testing should be performed BEFORE contact, preferably before any practices. Testing will be completed in a high school computer lab/classroom, training room and gym.
Testing Process:
- Register athletes and make sure all consent forms are signed.
- Testing process will include two components - Axon and NFL Baseline or SCAT 3 with reaction stick.
- Axon/CogState testing will be one at a time. NFL baseline or Scat 3 with Reaction Stick can be done in groups based on the amount of help to administer the tests are available.
- The NFL Baseline SCAT with reaction stick will be performed before or after the Axon/CogState test and will be completed by athletic trainers and athletic training students and any individual trained in the administration of the NFL Baseline, SCAT3 and reaction stick.
- Testing data will be reviewed by the athletic training staff and available for sports medicine physicians.
- Results will be kept in student athlete’s file for reference in case of a head injury.
Post-Injury Testing
When possible, NFL sideline testing or Scat 3 will be performed by the athletic trainer at time of incident. NFL sideline/Scat 3 form filled out, monitor symptoms with concussions symptom score sheet, report to parent filled out and recommendation of seeing physician within 48-72 hours. Test can be done on any computer device at a location that involves little to no distractions for the athlete to complete the test. Ideally, re-testing will be completed in the same environment as the baseline test. Axon/CogState retesting will not be administered until the athlete is asymptomatic. A return to normal Axon/CogState test score will be considered by a qualified physician in order for the athlete to start the return to play protocol. When an athlete is referred to a physician, they will be sent with a copy of the Axon/CogState comparison of baseline and post-injury test results (when available), NFL SCAT Baseline test and the results of the NFL Sideline Concussion Assessment Tool (SCAT)(when available), and any concussion scoring symptom sheets.
Return to Play:
When the athlete has normal post injury Axon/CogState test score, return to play protocol will be followed:
Stage 1 – complete physical and cognitive rest
Stage 2 – Light aerobic exercise
Stage 3 – Sport-specific exercise
Stage 4 – Non-contact training drills
Stage 5 – Full contact practice
Stage 5 – Return to play
Post Season
A re-test may be required for concussed athletes to establish a new baseline for the beginning of next athletic season. A re-test is also recommended for all freshman and those beginning their junior year, as well as for any new incoming athlete.
Continued follow up with the concussed athlete, athletic trainer and physician as needed.
In Office Testing with Axon/CogState
For those schools without an athletic trainer, WellSport will perform Axon/CogState Testing in the office on an individual basis or will go out to sites and test groups of student-athletes in their school’s computer lab.
