Meanwhile, the big news from the USA is that the Indianapolis Colts are letting their long serving quarterback, Peyton Manning, leave the franchise after reaching the end of his contract & spending last season rehabilitating from neck surgery. Meanwhile, our friends at the Steelers are also courting debate amongst their support base after announcing that they are releasing fans-favourite, Hines Ward, from his contract. I have to say that, despite his fearsome reputation, Hines was a pleasure to work with during the short spell I spent working with the Steelers medical team in pre-season in 2010 & I wish him all the best in his future ventures.
Further word from Pittsburgh comes from my good friend & regular contributor to my blog (generally on the topics of heat illness & concussion), John Geist. John has taken the time to share his notes from a recent meeting led by clinical psychologist & concussion expert, Dr. Michael Collins. Please let me know if you have any questions on the points noted & I can pass these onto John in the hope of getting some more in depth information.
Energy consumption by the brain in order of usage:
1. Vision (70%)
2. Vestibular Function
3. Anxiety
Predicted outcomes for protracted recoveries regarding symptoms of concussion:
Day 1. - dizziness (primary symptom reported)
Day 3 - fogginess (primary symptom reported)
Risk factors for recovery complications:
1. Age
2. Migraine history or symptoms
3. Learning disabilities
4. Repetitive concussions
5. Gender - females (especially in the teenage years)
Best predictors of a protracted recovery:
1. Deficit in reaction time
2. Occular symptoms
3-day post head injury test on ImPACT:
If an athlete exhibits 3 or more RCI changes on the ImPACT composite scores (relative to baseline), there is a 94% chance that recovery will be longer than 10 days in duration
Research demonstrated that an athlete with a prior history of concussions were not statistically more likely to have a "protracted" recovery from concussion
The recommendation from Dr Michael Collins was that better questioning is needed - the usual questions of "do you have a headache?" or "how are you feeling?", should be supplemented by the following:
1. Do you have pressure in your head that increases as the day progresses?
2. Are you more sensitive to light & noises than normal?
3. Do you become dizzy when looking up/down, turning heading or standing quickly?
4. Do you feel more fatigued than normal at the end of the day?
5. Do you have blurred or fuzzy vision whilst reading or have difficulty in reading?
6. Do you feel more distracted in school/work than normal?
7. Do you feel a sense of fogginess during the day?
8. Do you have difficulty falling/staying asleep? (The athlete must be able to sleep to recover!)
9. Have your friends or family noticed that you are more irritable than usual?
John's notes are supported by an article published in the Pittsburgh Tribune Review, written by Rob Rossi, which discusses Dr Michael Collins' work on concussion & is illustrated by a case study concerning a young cheerleader who suffered a concussion when falling during a stunt drill. To read this article, click on the link below:
So thank you, once again, to John for his contributions & I hope you can make some useful enhancements to your concussion recovery monitoring strategies as a result.
