Concussion Management Program for Red Bank Catholic High School Athletic Department

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1 Concussion Management Program for Red Bank Catholic High School Athletic Department *This document should be used as a framework for a successful concussion management program but is not intended to replace clinical assessment by a physician or qualified healthcare professional trained in concussion management.

2 Table of Contents 1. Overview of program a. Graded Concussion Symptom Scale Checklist 2. Algorithm for concussion management 3. Baseline Concussion testing program a. Link for registration b. Frequently asked questions 4. Post-concussion instructions/plan 5. Resources Concussion Management Team Red Bank Catholic High School Concussion Management Program Page 2

3 Overview of the Concussion Management Program Concussion or mild traumatic brain injury (TBI) continues to plague our athletes across many age groups and we thought it was time to put a comprehensive plan in place so that parents, teachers, coaches and students have a resource available on how to handle each stage of the process. By definition, developed by the Centers for Disease Control, concussion is a complex pathophysiologic process induced by traumatic forces secondary to direct or indirect forces to the head that disrupts the function of the brain. Confusion often occurs at two stages of the process following a head injury to the athlete. First is what to do immediately after the injury and second where to turn for guidance when symptoms continue to linger. While your pediatrician or primary care physician is a valuable resource to rule out severity, they often do not have the experience in properly managing post-concussion symptoms and return to school and sports protocols. This document along with a continual educational process should provide the guidance necessary to hopefully help your child return to their prior level of function. Concussion, unlike other sports related injuries, does not usually involve an injury that can be easily visualized and measured but can only be described subjectively by the student. Therefore it is critical to establish a measurable subjective score of the most common post-concussion symptoms after injury occurs. The Graded Symptoms Scale Checklist is attached on the next page. This should be administered after removal from play or when he/she gets home following a medical evaluation. This post injury score will then be used by the Concussion management team to track progress and should be re-administered every day for 5 days and then periodically after that point if some symptoms linger. Another critical component of any concussion management program is a well-established objective baseline testing program to measure balance and cognitive function before a head injury occurs. These results will be critical in determining which path an athlete takes in regard to the Post Concussion Algorithm developed on the subsequent pages. Every student-athlete in the following sports is encouraged to participate in the Baseline testing program: football, soccer, hockey, basketball, lacrosse, field hockey, wrestling, baseball and softball. The other sports can also participate but are at a lower risk in general for sports related concussions. Red Bank Catholic High School Concussion Management Program Page 3

4 Red Bank Catholic High School Concussion Management Program Page 4

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6 Red Bank Catholic High School Concussion Management Program Page 6

7 Baseline testing program It is recommended that every athlete at risk for a concussion, 10 years of age and older, participates in a baseline concussion testing program every year to establish an objective baseline of their balance and cognitive functions before a head injury occurs. The program utilized at ConcussionRXcare incorporates the Clinical Test of the Sensory Integration of Balance (CTSIB) and the Computerized Cognitive Assessment Tool (CCAT). The balance component measures the body s response to 4 different balance tests and takes approximately 5 minutes to complete. The cognitive component is completed at home on your own computer and is supervised by the parent. The access codes and instructions for the at home portion is ed to you after completion of the balance portion. CLICK HERE TO REGISTER FOR TESTING Group testing dates will be scheduled prior to each sports season FAQ s of Baseline Concussion Testing program 1. What is the cost? The cost is $24.95 for groups of 5 or more. It includes balance and cognitive testing, unlimited post injury retesting, test results interpretation and report to your physician of choice for 1 year from date of test. 2. How often should this test be repeated? We recommend a new baseline gets established every year. This is because the athlete s physical size changes rapidly and their balance control improves. In addition, their brain processes faster and cognitive processing speeds will improve. It is important to maintain accurate baseline data. 3. What if my child already had an ImPACT baseline test? ImPACT is one form of a cognitive test and only tells half the story. Balance testing is another essential component to establish baseline function of the brain and vestibular system. We recommend that your child still completes our program even if they have already had an IMPACC test in high school this year. The Computerized Cognitive Assessment Tool (CCAT) will also be completed and used as an additional cognitive assessment tool for comparison. 4. Will this test diagnose if my child sustained a concussion? NO. Baseline testing is done to objectively document brain function that controls memory, speed of processing and balance control pre and post injury. This test is mainly used to determine readiness for return to play determination. 5. What happens if my child sustains a concussion after completing both parts of the baseline testing program? The first step is to get the appropriate medical attention. Quite often the last place you should go is the Emergency room unless your child demonstrates the following symptoms worsening headache, dizziness, blurred vision or nausea, loss of consciousness; neurological changes like slurred speech, difficulty walking, motor weakness; neck pain. The best thing to do is get quiet rest and allow them to sleep at the appropriate time. It is not recommended to wake them every few hours. You can gently listen and observe them while sleeping. Within hrs. after the suspected head injury, call my office at to report the injury and to schedule a balance retest. A cognitive retest will also be performed at home. Both tests will be analyzed and interpreted with a report and recommendation sent to your physician. This process will be repeated as often as necessary until the results return close to the baseline levels. 6. Where can I look for more information? Red Bank Catholic High School Concussion Management Program Page 7

8 Post-Concussion Instructions/Plan Red Bank Catholic High School Concussion Management Program Page 8

9 Red Bank Catholic High School Concussion Management Program Page 9

10 Resources Concussion Management Team David Bertone, PT, DPT, OCS (program coordinator) ConcussionRXcare at db Orthopedic Physical Therapy *Baseline testing and post-concussion rehab Stephen Rice, MD Jersey Shore University Hospital Sports Medicine Center *Physician concussion specialist Joseph E. Conroy, PhD. Coastal Neuropsychology *neuropsychology evaluation, school accommodations University of Pittsburgh Sports Medicine Concussion Program Michael Collins, PhD. Neuropsychology Program Coordinator Red Bank Catholic High School Concussion Management Program Page 10

11 Concussion Baseline Testing. It s a no-brainer! Concussion Facts A concussion is a brain injury, and should never be passed off as just a bump on the head. A person can experience a concussion with a trauma to the head causing the brain to literally shake against the skull. Every person who suffers a concussion will experience its effects differently, some feeling only a few symptoms, and others feeling more. Symptoms can surface within hours, but sometimes it takes days. Concussion Signs & Symptoms Physical effects such as headaches, nausea/vomiting, and loss of balance; Cognitive problems such as grogginess, difficulty concentrating, memory loss, and a slowed ability to process; Emotional problems including irritability, sadness, anxiety and excessive sleepiness. The most important elements in the recovery of a concussion are rest and time. But everyone recovers at different rates, some recovering in two weeks, and others needing more time. If you suffer a concussion and return to activity before you are fully healed, you are at risk for Second Impact Syndrome. Second Impact Syndrome Symptoms: Brain swelling and bleeding in the brain; Long-term neuropsychological impairment; Possible death. Concussion Baseline Testing The only way to determine when it is truly safe to return to physical activity is to test your brain function before you have a concussion. Comprehensive baseline concussion testing provides a pre-injury assessment of both your cognitive ability and physical balance. To get the most accurate result, baseline testing must also include a balance test, a simple sway test on highly specialized equipment. If you have a concussion, you ll repeat the test Our program with Dr. Bertone provides more objective evidence of a student s true readiness to return to play. ~ Jim Anderson, Athletic Trainer, Brookdale College within 72 hours of injury. Post-concussion results will be compared to your baseline to determine whether your brain has completely recovered. Dr. David Bertone, Doctor of Physical Therapy and owner of db Orthopedic Physical Therapy, offers the preferred method of Concussion Baseline Testing that includes both the cognitive and the balance components. The highly specialized equipment Dr. Bertone uses for the balance testing is not often found in physicians offices. Local sports programs, including Brookdale Community College and Marlboro Soccer, have partnered with Dr. Bertone to provide their young athletes the best and only chance to determine safe return-to-play following a concussion. Concussion Education Program Dr. Bertone works with sports leagues, schools and parent groups to teach concussion management, conduct on-site Concussion Baseline Testing, and coordinate on-field assessments. If your group is interested in a partnership with Dr. Bertone, please call About db Orthopedic Physical Therapy db Orthopedic Physical Therapy offers you a unique experience individually suited to the recovery of your specific injuries in a personalized, comfortable environment. Dr. David Bertone, a Doctor of Physical Therapy and a Board Certified Orthopedic Clinical Specialist, has more than 23 years of experience in the field of orthopedic rehabilitation. Using state-of-the-art modalities and equipment, Dr. Bertone applies a highly specialized, evidence-based treatment protocol to help relieve pain, speed recovery and prevent future injury. Schedule Your Concussion Baseline Test Call to schedule your Concussion Baseline Test. $39.95 for the comprehensive Concussion Baseline Test, which includes all post-injury comparative testing for up to one year from the initial date of baseline testing. Discounts are available for group or sports league testing

12 FAQ s of Baseline Concussion Testing program 1. What is the cost? The cost is $39.95 or discounted to $24.95 for groups of 5 or more. It includes balance and cognitive testing, unlimited post injury retesting, test results interpretation and report to your physician of choice for 1 year from date of test. 2. How long does it take? The balance component is completed on-site and takes less then 5min. Once completed, you are ed an access code to complete cognitive test at home on your computer in a quiet environment. That test takes 10 min to complete with a practice test performed first to get use to the format. 3. How old must my child be to participate? It is recommended that they are 10 yrs of age and older based on research. However, your child can be tested at any age, however the test results may be inconsistent based on their level of maturity. 4. How often should this test be repeated? We recommend a new baseline gets established every year. This is because the athlete s physical size changes rapidly and their balance control improves. In addition, their brain processes faster and cognitive processing speeds will improve. It is important to maintain accurate baseline data. 5. What if my child already had an IMPACC baseline test? IMPACC is one form of a cognitive test and only tells half the story. Balance testing is another essential component to establish baseline function of the brain and vestibular system. We recommend that your child still completes our program even if they have already had an IMPACC test in high school this year. 6. Will this test diagnose if my child sustained a concussion? NO. Baseline testing is done to objectively document brain function that controls memory, speed of processing and balance control pre and post injury. This test is mainly used to determine readiness for return to play determination. 7. What happens if my child sustains a concussion after completing both parts of the baseline testing program? The first step is to get the appropriate medical attention. Quite often the last place you should go is the Emergency room unless your child demonstrates the following symptoms worsening headache, dizziness, blurred vision or nausea, loss of consciousness; neurological changes like slurred speech, difficulty walking, motor weakness; neck pain. The best thing to do is get quiet rest and allow them to sleep at the appropriate time. It is not recommended to wake them every few hours. You can gently listen and observe them while sleeping. Within hrs after the suspected head injury, call my office at to report the injury and to schedule a balance retest. A cognitive retest will also be performed at home. Both tests will be analyzed and interpreted with a report and recommendation sent to your physician. This process will be repeated as often as necessary until the results return close to the baseline levels. 8. Who can I contact if I have any questions about the program? David Bertone, PT, DPT, OCS or call Where can I look for more information? 742 Newman Springs Road, Suite 300 Lincroft, NJ 07738

13 About db Orthopedic Physical Therapy Concussion Recovery When it comes to recovering from a concussion, rest is the most important prescription. Most people who suffer a concussion recover completely within 7-10 days after injury. But in 10% of cases, symptoms linger. That s when a program of supervised rehabilitation is recommended. The 5-step comprehensive post-concussion therapy program at db Orthopedic Physical Therapy aims to improve balance and regain posture control. As progress is made, Dr. Bertone continues the graduated program with more advanced training, all intended to encourage the safe return to physical activity and sports competition. db Orthopedic Physical Therapy offers you a unique experience individually suited to the recovery of your specific injuries. Unlike larger practices, it is owned by the same and only physical therapist who works with you on your recovery, Dr. David Bertone. As a Doctor of Physical Therapy and a Board Certified Orthopedic Clinical Specialist, he offers patients nearly 25 years of experience in orthopedic rehabilitation. Without concussion Using the latest baseline testing, I state-of-the-art would have played methods and too soon after my equipment, injury which might Dr. Bertone offers a have resulted in highly specialized, more damage. evidence-based treatment protocol ~ Devin Hope, soccer athlete to help relieve pain, Brookdale Comm. College speed recovery and prevent future injury. The only way to know when it s truly safe to return to play. One therapist, one goal: transition to better health. Concussion Education Program Dr. Bertone works with sports leagues, schools and parent groups to teach concussion management, conduct on-site Concussion Baseline Testing, and coordinate on-field assessments. If your group is interested in a partnership or would like an educational program, please call Pre-Concussion Testing Baseline Testing Rehabilitation Education 732 Newman Springs Road, Suite 300 Lincroft, NJ

14 Concussion Facts A concussion is a brain injury, and should never be passed off as just a bump on the head. A person can experience a concussion with a trauma to the head causing the brain to literally shake against the skull. The most common cause of concussion is contact sports. Don t be fooled by protective gear like helmets concussions happen even to those wearing helmets. Every person who suffers a concussion will experience its effects differently. Symptoms can occur within hours, or it may take days. If you experience a head injury, here are some clues: Physical effects such as headaches, nausea/vomiting, and loss of balance; Cognitive problems such as grogginess, difficulty concentrating, memory loss, and a slowed ability to process; Emotional problems including irritability, sadness, anxiety and excessive sleepiness. The two most important elements in the recovery of a concussion are rest and time. If you suffer a concussion and return to physical activity too soon, you are at extremely high risk for Second Impact Syndrome which causes: Brain swelling and bleeding in the brain; Long-term neuropsychological impairment; Possible death. Concussion Baseline Testing The only way to determine if you have completely recovered from a concussion is to test your brain function before you have a concussion. Comprehensive baseline concussion testing provides a pre-injury assessment of both your cognitive ability and physical balance. 3.8 million kids ages 5-18 who play organized sports in the U.S. will sustain a sports or recreation-related concussion each year. ~ US Center for Disease Control & Prevention If and when you have a concussion, you ll repeat the test within 72 hours of injury. Your post-concussion results will be compared to your baseline record to help determine whether your brain has recovered so that you can return to play safely. Dr. David Bertone, owner of db Orthopedic Physical Therapy, offers the preferred method of Concussion Baseline Testing that includes both the cognitive and the balance components not often found in physicians offices. Local sports programs work with Dr. Bertone to provide their athletes the best and only chance to determine safe return-to-play following a concussion. Our new program of cognitive and balance testing with Dr. Bertone provides more objective evidence of a student s true readiness to return to play. ~ Jim Anderson, Athletic T rainer Brookdale Comm. College They don t want to take chances you shouldn t either. Schedule Your Concussion Baseline Test Call db Orthopedic Physical Therapy at to schedule your Concussion Baseline Test. Online registration is also available at The cost includes all post-injury comparative testing for up to one year from the initial date of baseline testing. Discounts are available for group or sports league testing. Baseline testing is recommended for athletes 10 years of age or older and should be performed every year to ensure accurate baseline data.

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