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return to play
Return to Play

Two-minute sideline concussion test may solve the sideline dilemma


Prolonged recovery

NFL may test helmet impacts with accelerometers next season

SafeKids USA

Mayo Clinic Hockey Summit recommendations include ban on all hits to the head at all levels

Army identifies blood protein marker which may help identify brain injuries including concussions

What becomes of athletes who suffer concussions when young?

Study suggests athletes may need even more time after concussion to fully heal

NJ female teen athlete suffered 15 concussions now struggles daily

Emergency room visits for kids with head injuries increased 43% in the last five years

High school softball adds concussion rule

Study shows most parents unaware of their local school's concussion policies

Six-yr-old sustains concussion attempting flip off diving board

Quebec bans bodychecking in youth hockey and reduces concussions significantly

Neck muscle strength plays a role in concussion prevention

ESPN's  Preston Plevetes' concussion story, former La Salle football player

Zackery Lystedt inspired WA State's concussion law, the Lystedt Law

Are headguards the answer for soccer players?  Some athletes and coaches in ME believe so


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Neuropsychologist Dr. David Coppel helps determine return-to-play
 


Repeat  3...7...1...12...4...11...backward. On a good day this is difficult for some of us, even adolescents. But one’s ability to successfully recall groups of numbers forward or backward can be greatly hampered by aDr David Coppel concussion, even a slight “sub-concussive” hit. This exercise is one aspect of a post-concussion evaluation that provides David Coppel, Ph.D., some of the clues he needs to accurately assess the extent of an athlete’s injury. As Director of Neuropsychological Services and Research at the Seattle Sports Concussion Program, Dr. Coppel plays a vital role in answering the question, “Has my brain healed, and is it safe for me to return to play?” 

The return-to-play decision after a concussion can be very complex, but remains one of the most important aspects of concussion management. It is a key component in the prevention of more serious injuries as well. Research has shown that many catastrophic injuries are preceded by a perhaps-undiagnosed concussion, and in fact, could have been prevented. This is sad news indeed for the young athletes who endure life-altering surgeries each year as a result of a second injury to an already injured brain.

Computerized testing is a tool

Dr. Coppel has spent the last 14 years evaluating Seattle Seahawks players to ensure they are fit to play after suffering a concussion. The Seahawks are one of the few NFL teams who do not use computerized neuropsychological testing such as ImPACT, Headminders, or CogSport, but opt to take advantage of his expertise instead. “There’s no doubt there is a place for computerized testing,” said Dr. Coppel, “particularly if your goal is to establish a database, or baseline, for all athletes in a school district.” But he voices concern over the administration and interpretation of the results, which are so critical to providing a thorough evaluation. “For example, if an athlete’s ImPACT post-injury test results match their established baseline, that does not necessarily mean they are ready to return to play. For me, it’s a tool, a piece of the puzzle, not the answer.”

An evaluation by Dr. Coppel is challenging. A high school football player who was tested 10-weeks after suffering a significant concussion, found the test quite difficult. Though he believed he was ready to resume activity and thought he had fully recovered, some of his scores were in the 16th percentile, which told Dr. Coppel that his brain still had some healing to do. “I’m able to discern where an individual is struggling by listening to them as they work their way through the evaluation. I also examine factors such as concussion history, classroom performance, and am able to test recall memory, which a computer simply cannot evaluate.”

School districts consider neuropsychological testing for athletesBasket Ball Computer

Many school districts are using computerized testing and Dr. Coppel and the Seattle Sports Concussion Program are working to establish outreach services particularly to those in rural areas that are lacking in interpretive resources. Clinic Manager Patricia O’Leary-Crutcher believes that providing a link utilizing Harborview Medical Center’s telemedicine technology is on the horizon. “We are very excited about the potential for off-site evaluation and consultation. Particularly with the more challenging cases, our staff has had years of experience in making those difficult return-to-play decisions.” She added, “We really implement a team approach to ensure we have enough data to accurately assess each athlete’s injury.”

Perhaps someday there will be a definitive blood test or brain imaging technique that will address the subtleties of concussions. In the meantime, gathering the clues and presenting them to qualified medical personnel who have experience in dealing with these types of brain injuries, is the safest route to healing. The return-to-play decision deserves no less than the most careful consideration.

 

Contact Seattle Sports Concussion Program at (206) 744-0401 or toll free (877) 900-4323


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