Sports-Related Conference on Concussion and Spine Injury

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1 The 10 th Annual Sports-Related Conference on Concussion and Spine Injury Friday, May 17, 2013 The Joseph B. Martin Conference Center at the Harvard Medical School 77 Avenue Louis Pasteur Boston, MA Directors: Presented by: Boston Children s Hospital Brain Injury Center and Boston Children s Hospital Department of Neurosurgery with support from the Harvard Medical School Department of Continuing Education and the Boston Children s Hospital Department of Psychiatry Register online at cme.hms.harvard.edu/courses/sports

2 Concussion and spine injury: A growing epidemic The past few years have seen major changes in the approach to sports-related head and spinal injuries, in athletes of all ages and levels of competition. Concussion, once worn by athletes like a badge of honor, is now clearly identified as a brain injury that increasingly affects children as early as elementary school. We re learning that head injuries previously identified as minor can have major impacts both short- and long-term and that long-term outcome is difficult to predict, particularly when that patient is under 18, and influenced by many factors. Optimal care for head and spine injuries begins on the field. Long term, many specialties have a role to play pre-hospital transport, nursing, primary care, emergency medicine, sports medicine, neurosurgery, neurology, critical care, radiology, physiatry and neuropsychology. If there is a weak link anywhere along this chain, overall care will suffer, and patients may be left with lasting deficits. About this year s conference The 2013 conference is presented by the Boston Children s Hospital Brain Injury Center and Department of Neurosurgery, with support from the Department of Psychiatry and the Harvard Medical School s Department of Continuing Education. Talks and breakout sessions will share the latest thinking of experts who routinely manage concussion and spinal injuries, from athletic trainers to neurosurgeons. Presenters will discuss the latest strategies for evaluating and treating athletes at all levels, informed by the latest scientific evidence. Special guest speaker Ted Johnson, former player for the New England Patriots, will give his personal perspective on concussion, and the Massachusetts Department of Public Health will review the Massachusetts concussion legislation. Discussion topics will include: Concussion basics, prevention and evaluation Managing symptoms: headache and balance problems Repeat concussion and chronic traumatic encephalopathy Cervical and lumbar spine injuries When to return an athlete to play Considerations for female athletes Additional highlights: In-depth workshops on nursing, on-field management of the injured athlete and neuropsychological testing An interactive case review session (participants are invited to submit cases) Who should attend? This course is for anyone involved in assessing and managing athletes with head or spinal injuries including athletic trainers, coaches, emergency medical technicians, neurologists, neuropsychologists, neurosurgeons, nurses, pediatricians, physical therapists, physician assistants, primary care physicians, psychologists and sports medicine physicians. Learning objectives Upon completion of this activity, participants will be able to: Assess and evaluate sports-related concussion and spine injuries Develop strategies to diagnose and treat them effectively Determine when to safely return an athlete to play in accordance with best practice and legal requirements Recognize when to refer patients to an expert for a higher level of care Work in a multidisciplinary team to provide optimal care for athletic patients Conference schedule and program Friday, May 17, to 8 a.m. Registration Plenary Talks 8 to 8:30 a.m. The Basics of Concussion 8:30 to 9 a.m. Chronic Traumatic Encephalopathy Ann McKee, MD 9 to 9:30 a.m. Neuropsychology and Sports Concussion 9:30 to 10 a.m. Concussion in female athletes: does sex and gender matter? Jill Brooks, PhD 10 to 10:15 a.m. Break 10:15 to 10:45 a.m. Vestibular and Balance Symptoms after Concussion Lenore Herget, PT, DPT, M.Ed 10:45 to 11:15 a.m. Should We Limit Hit Counts in Contact Sports? Chris Nowinski 11:15 to 11:45 a.m. Cervicogenic Headaches 11:45 a.m. to 12:15 p.m. Athletic Spine Injuries 12:15 to 1 p.m. Lunch 1 to 1:15 p.m. Review of the Massachusetts Concussion Legislation Lauren Smith, MD, MPH 1:15 to 2 p.m. Perspectives of a Professional Athlete Ted Johnson, former New England Patriots player 2:15 to 4:15 p.m. Two-Hour Breakout Session How to Set Up a Concussion Practice ; Michael O Brien One-Hour Breakout Sessions (each repeats) Mild Brain Injury Nursing Workshop Regina Laine, MSN, PNP, CNRN; Ariana Moccia, RN, BSN; Alison Oxton, MSN, CPNP-PC; and Michelle Parker, MS, CPNP On-Field Management of the Injured Athlete Pierre D Hemecourt, MD, and Steve Clark, AT Interpretive considerations in the neuropsychological assessment of SRC, and Celiane Rey-Casserly, PhD Interactive Case Review (bring cases or submit in advance) ; Karameh Hawash, MD; Program changes/substitutions may be made without notice.

3 Presenters (alphabetical) Jill Brooks, PhD Clinical Neuropsychologist Head to Head Consultants Jill Brooks is currently in private practice specializing in sports-related concussion. She serves on multiple state-level traumatic brain injury committees and was instrumental in the development of the New Jersey state concussion law. She was formerly an associate professor of Neurology at UMDNJ-Robert Wood Johnson Medical School. Chief of Neurosurgery Service and Chair, Department of Surgery, Emerson Hospital Adjunct Faculty, Department of Neurosurgery and Senior Advisor, Brain Injury Center, Boston Children s Hospital Adjunct Professor of Exercise and Sport Science, University of North Carolina, Chapel Hill A nationally renowned expert in sports-related spine and head injuries and return-to-play criteria, Robert Cantu serves as a neurosurgical consultant to many college and professional teams. He is also vice president for the National Operating Committee on Standards for Athletic Equipment and author of Concussions and Our Kids: America s Leading Expert on How to Protect Young Athletes and Keep Sports Safe. Steve Clark, AT Assistant Athletic Trainer, Northeastern University Steve Clark has been a Certified Athletic Trainer since 1999 and holds a master s degree in Exercise Science/Biomechanics. He is also a Certified Strength and Conditioning Specialist and a clinical instructor for Northeastern University Athletics. Pierre d Hemecourt, MD Director of Primary Care Sports Medicine, Boston Children s Hospital Lecturer in Sports Medicine, Harvard Medical School Pierre d Hemecourt is formally trained in both emergency and sports medicine and has been part of the Sports Medicine staff at Boston Children s since He is also a team physician for Northeastern University, co-medical chair of the Boston Marathon and medical director for the Boston Athletic Association s Half Marathon. Karameh Hawash, MD Attending Neurologist, Brain Injury Clinic, Boston Children s Hospital Director of Neurologic Outcomes, Brain Injury Center, Boston Children s Hospital Instructor in Neurology, Harvard Medical School Karameh Hawash is a board-certified neurologist with special qualification in child neurology. She treats patients in both the Brain Injury Center and the Headache Program at Boston Children s. Lenore Herget, PT, DPT, M.Ed Staff Physical Therapist, Sports Medicine Center, Massachusetts General Hospital Lenore Herget evaluates and treats high school- through professional-level athletes with concussions. Her clinical expertise is in vestibular treatment and progression of exercise through exertional protocols to safely return to play. Her clinical research has focused on management of athletes with post-concussion syndrome and the efficacy of pre- and post-season vestibular testing to aid in return-to-play decision-making. She continues to play year-round soccer in the Eastern Massachusetts Women s Soccer League. Ted Johnson Former New England Patriots Player Ted Curtis Johnson (born December 4, 1972) grew up in Carlsbad, California, where he graduated from Carlsbad High School in From there he attended the University of Colorado and was drafted by the Patriots in the second round of the 1995 NFL Draft with the 57th overall selection. He helped the Patriots reach Super Bowl XXXI and win Super Bowl XXXVI, Super Bowl XXXVIII and Super Bowl XXXIX. In his 10-year professional career, Johnson played in 125 regular season games, recorded 757 tackles, 11.5 sacks, one interception, 16 passes defensed, six forced fumbles, and seven fumble recoveries. Johnson retired before the 2005 NFL season after sustaining many concussions during his career. Currently Johnson co-hosts a sports radio show in Houston, Texas, at KILT AM and co-hosts a nationally syndicated show weekends on CBS Sports Radio. Regina Laine, MSN, PNP, CNRN Regina Laine sees urgent patients in the Neurology clinic and is a member of the Brain Injury Center at Boston Children s. Ann McKee, MD Co-Director, Center for the Study of Traumatic Encephalopathy Director of Neuropathology, New England VA Medical Centers Professor of Neurology and Pathology, Boston University School of Medicine Ann McKee is both a board-certified neurologist and a neuropathologist. For the last 19 years, she has directed the Boston University and VA Brain Banks. Director of the Sports Concussion Clinic in the Division of Sports Medicine, Boston Children s Hospital Director of Research, Brain Injury Center, Boston Children s Hospital Assistant Professor of Pediatrics, Harvard Medical School William Meehan is board-certified in pediatrics, pediatric emergency medicine and sports medicine and author of the book Kids, Sports, and Concussion: A Guide for Coaches and Parents. He has received grants from the National Institutes of Health and the Center for the Integration of Medicine and Innovative Technology to conduct clinical and scientific research on concussive brain injury. Ariana Moccia, RN, BSN Sports Concussion Clinic, Division of Sports Medicine, Boston Children s Hospital Christopher Nowinski Co-Founder and Executive Director, Sports Legacy Institute Co-Director, Boston University Center for the Study of Traumatic Encephalopathy A former Harvard football player and WWE professional wrestler, Christopher Nowinksi is widely credited with bringing the concussion crisis to public attention. He serves on the NFL Players Association Mackey-White Traumatic Brain Injury Research Committee and the Ivy League Concussion Committee, and is the author of the critically acclaimed book Head Games, which inspired an award-winning documentary of the same name. Michael J. O Brien, MD Associate Director, Sports Concussion Clinic, Boston Children s Hospital Instructor in Sports Medicine, Harvard Medical School Michael O Brien is board certified in internal medicine with special qualifications in primary care sports medicine. He has been an attending physician in the Division of Sports Medicine at Boston Children s Hospital since 2004, and is the team physician for The Roxbury Latin School. He is the Associate Director of the Sports Concussion Clinic at Boston Children s Hospital. Alison Oxton, MSN, CPNP-PC Alison Oxton is a nurse practitioner in the Brain Injury Center at Boston Children s Hospital. She specializes in management and treatment of mild traumatic brain injuries. Michelle Parker, MS, CPNP Program Manager, Boston Children s Brain Injury Center Michelle Parker is a nurse practitioner for the Department of Neurosurgery at Boston Children s Hospital. Neurosurgeon and Director of the Brain Injury Center, Boston Children s Hospital Associate Professor of Neurosurgery, Harvard Medical School Mark Proctor has published and lectured locally and nationally regarding sports-related head and spine injuries. He is also the founder and sponsoring surgeon of the Boston chapter of ThinkFirst National Injury Prevention Foundation, as well as the chairman of its board.

4 Presenters (continued) Celiane Rey-Casserly, PhD Director of the Neuropsychology Program, Boston Children s Hospital Assistant Professor of Psychology, Department of Psychiatry, Harvard Medical School Celiane Rey-Casserly is board-certified in clinical neuropsychology and professional psychology. In addition to her leadership role within Boston Children s Neuropsychology Program, she works with patients in the hospital s Brain Injury Center, Pediatric Brain Tumor Program and Trauma Center. Lauren A. Smith, MD, MPH Medical Director and Chief Medical Officer, Massachusetts Department of Public Health Lauren Smith provides senior clinical leadership for programs, planning and policy at the Massachusetts Department of Public Health, where she recently led the development of regulations related to new legislation on sports head injuries. Director of Neuropsychology, Brain Injury Center, Boston Children s Hospital Instructor in Psychology, Department of Psychiatry, Harvard Medical School Alex Taylor specializes in the diagnosis and management of acquired head injury and sportsrelated concussion (SRC). His work includes investigating SRC s impact on neurocognitive and neurobehavioral functioning. Accreditation Physicians The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Harvard Medical School designates this live activity for a maximum of 7 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Athletic Trainers Boston Children s Hospital is recognized by the Board of Certification, Inc., to offer 6.75 continuing education hours for Certified Athletic Trainers. Psychologists The Division of Psychology, Department of Psychiatry at Boston Children s Hospital is approved by the American Psychological Association to sponsor continuing education for psychologists. The Division of Psychology, Department of Psychiatry at Boston Children s Hospital maintains responsibility for this program and its content. This program offers 6 continuing education credits. Nurses Boston Children s Hospital is an approved provider of continuing nursing education by the Massachusetts Association of Registered Nurses and the American Nurses Credentialing Center Commission on Accreditation. Nursing contact hours for this program are pending. ACGME Competencies: This course is designed to meet one or more of the following Accreditation Council of Graduate Medical Education competencies: patient care, medical knowledge, practice-based learning and system-based practice. Disclosure Policy: The Harvard Medical School (HMS) adheres to all ACCME Essential Areas, Standards and Policies. It is HMS s policy that those who have influenced the content of a CME activity (e.g., planners, faculty, authors, reviewers and others) disclose all relevant financial relationships with commercial entities so that HMS may identify and resolve any conflicts of interest prior to the activity. These disclosures will be provided in the activity materials along with disclosure of any commercial support received for the activity. Additionally, faculty members have been instructed to disclose any limitations of data and unlabeled or investigational uses of products during their presentations. For more information about accreditation, contact course administrator Joanna Jenkins at or joanna.jenkins@childrens.harvard.edu. Course location The Joseph B. Martin Conference Center at the Harvard Medical School 77 Avenue Louis Pasteur Boston, MA The Joseph B. Martin Conference Center at the Harvard Medical School is a large glass building located directly across the street from the Boston Latin School. It is accessible both by car and by public transportation (MBTA subway Green lines B or D, or MBTA bus routes 47, CT2 or 8A). Public parking garages are within walking distance. Registration information Registration by credit card (VISA or MasterCard) can be made at cme.hms.harvard.edu/courses/sports. For registration by check (draft on a United States bank), please make payable to the Harvard Medical School and mail with registration form to the Harvard Medical School Department of Continuing Education, P.O. Box , Boston, MA Telephone or fax registration is not accepted. Registration with cash payment is not permitted. Upon receipt of your paid registration, an confirmation from the HMS-DCE office will be sent to you. Be sure to include an address that you check frequently. Your address is used for critical information, including registration confirmation, evaluation and certificate. Online registration To register or view course information, visit cme.hms.harvard.edu/courses/sports. Inquiries Inquiries should be made by to hms-cme@hms.harvard.edu or by phone to (Monday through Friday, between 10 a.m. and 4 p.m. EST). Refund policy A handling fee of $60 is deducted for cancellations. Refund requests must be received by postal mail, , or fax one week prior to the course. No refunds will be made thereafter. The 10 th Annual Sports-Related Conference on Concussion and Spine Injury Friday, May 17, 2013 The Joseph B. Martin Conference Center at the Harvard Medical School All fields required. (Please print clearly.) COURSE # GROUP REGISTRANTS: IF PAYING BY CHECK, please copy this form and submit each registrant s contact information with payment. Tuition fee Physicians $265 (USD) Residents and Fellows $200 (USD) Other professionals $185 (USD) Past attendees (of this course) $165 (USD) Groups of 3 or more (per person) $155 (USD) Full name First Middle initial Last Mailing address Street City State Zip code Daytime phone ( ) Fax number ( ) Please note: Your address is used for critical information about the course, including registration confirmation, evaluation and certificate. Please be sure to include an address you check daily or frequently. c Please check if you wish to be excluded from receiving notices of future the Harvard Medical School Department of Continuing Education programs Profession Degree Primary specialty (Physicians only) Board certified: Yes c Professional school attended (Physicians only) the Harvard Medical School c U.S. medical school c International c Year of graduation No c

5 Physicians Communications 300 Longwood Avenue, BK2, Boston, MA The 10 th Annual Sports-Related Conference on Concussion and Spine Injury Friday, May 17, 2013 The Joseph B. Martin Conference Center at the Harvard Medical School 77 Avenue Louis Pasteur Boston, MA 02115

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