Head injury testing coming for New Hanover County athletes

Hoggard High School hosts the Greenville Rose football team. Hoggard athletic director and football coach Scott Braswell says, "I think it's probably a very wise policy for us to implement some baseline testing so we can more effectively intervene with head injuries in terms of diagnosis." (Photo by StarNews File photo)

New Hanover County Schools will begin baseline head injury assessment testing for high school student-athletes this summer and fall.

The computerized testing is designed to provide a measure of an athlete's normal brain function and balance. In the event of a concussion, another test is administered to check against the baseline to help determine when an athlete is fit to return to play.

"We're just finding out so much right now about head injuries and the long-term effects and consequences," Hoggard athletic director and football coach Scott Braswell said. "I think it's probably a very wise policy for us to implement some baseline testing so we can more effectively intervene with head injuries in terms of diagnosis."

New Hanover County Schools has yet to decide between providers ImPACT testing and Concussion Vital Services, according to head athletic trainer Matt Triche.

ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) was the first company to provide the testing and lists the entire NFL, all major universities in North Carolina and a large number of high school and club teams in its client list, including Cape Fear Academy in Wilmington. The company offers packages ranging from $350 for 75 tests and 25 follow-up evaluations to $750 for 500 tests and 150 follow-up evaluations.

Concussion Vital Services is newer and slightly more flexible listing a $1.50 cost per athlete for groups of 75 or more.

All four New Hanover County public high schools have student-athlete populations between 400 and 800 students, according to local athletic directors, though many of those are not involved in contact sports.

Based on those numbers, the cost for either program would run approximately $3,700.

"It's going to help," Triche said. "They call it a tool. You can't just give them a test and say, ‘You have a concussion.'"

How it works

Triche said baseline testing is important for dealing with the complex workings of head injuries. He said that, often times, mild head injuries are tougher to identify and more dangerous.

"Just because you don't get knocked out doesn't mean your head injury wasn't that bad," Triche said. "The problem with these small ones is that the athletes don't even know they've had one. They just keep playing and don't give themselves enough time to rest."

If an athlete returns to play too soon, he or she is at risk for second-impact syndrome, a second and possibly fatal injury. The North Carolina Gfeller-Waller Concussion Awareness Act is intended to provide safeguards and education against brain injuries in high school athletes.

Triche said head injuries continue to increase.

"It's been happening more," he said. "They're more aware of what a head injury is, but on the other hand I don't know if it's something else. Five to 10 years ago if you had those symptoms – headaches, dizziness – you'd still tell someone."

Cape Fear Academy started using ImPACT baseline testing this spring for its athletes. Athletic director Chris Meehl said the school chose to start testing after seeing several athletes suffer concussions in the winter.

"We've been talking about it all fall," Meehl said. "And we had a couple concussions in basketball season and we felt like the timing was right to go with it."

Meehl said that CFA has seen "three or four" concussions this spring and has used the test each time to help determine when athletes can return.

"It's been very helpful with getting clearance through the physician or the specialist," Meehl said. "They want to see some of the where your readings are. It's not a main device. We don't make any calls on that stuff using any of the testing. It's just another device to where a specialist can read the results."

Initial tests can be used for the same athlete for two years, and Triche said the 2013-14 school year would be a "trial run" for the testing software.

Hurdles to clear

Forsyth County Schools used ImPACT testing in 2011 and 2012, but discontinued the testing due to its cost, according to Steve Garner, an athletic trainer at Winston-Salem Prep Academy.

Garner said the testing originally was included in a training program that was funded through area hospitals. However, when the program returned to the county school system's payroll, it was considered too expensive. Forsyth County and Winston-Salem has 12 high schools with an enrollment of 15,476 students; New Hanover County has only four high schools and enrolls 7,424 students in ninth through 12th grade.

"We definitely looked at doing it again and implementing it," Garner said. "It was just a matter of the cost of the funding. It was easy to use. When an athlete had a concussion we'd just have them retake the test and send it along with them to a physician. Anything you can have that's any testing or objective numbers, that's invaluable. It's not up to anyone's opinion."

Taking opinion out of the equation is a critical benefit of baseline testing, according to Garner.

The Gfeller-Waller Act requires that any athlete diagnosed with a concussion be cleared to return to play by a doctor trained in concussion management, but leaves that experience up to the doctor's discretion – meaning any doctor can clear an athlete if they feel they've had the requisite experience.

Baseline testing helps reduce the risks of doctors improperly clearing a patient by providing objective numbers to show brain function.

"Some people are experts and can rely on clinical expertise," Garner said. "But since the law allows them to see any physician, here's the evidence and documentation that says they're not right. Especially if the athlete is trying to tell you ‘I don't have a headache.' They can mask those symptoms."

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