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Concussions on the rise in athletes

One patient’s experience with a new program to treat concussions

 

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Concussions in young athletes are on the rise, especially among those between ages 12 to 15. In fact, one study revealed that 12 percent of emergency room visits involved a concussion. That is the equivalent of one concussion every three minutes.

Logan Kirkpatrick, a 12-year-old from Monroe, North Carolina, and his parents experienced firsthand the challenges associated with managing the symptoms of a concussion.

“It’s very scary to watch your child suffer from a concussion,” said Carrie Kirkpatrick, Logan’s mother. “Logan’s concussion was so severe that he had trouble walking, his peripheral vision became non-existent, and he even had difficulty eating.”

Logan, who was hit in the head while playing basketball, suffered a debilitating concussion in the spring of 2015. His symptoms persisted for almost 80 days – impacting his education and day-to-day life.

“We didn’t initially understand the severity of Logan’s concussion,” his mom said. “He seemed well enough to attend school the day after it occurred but ultimately the stress on his brain caused him to collapse in gym class. When I picked him up from school, he couldn’t walk unassisted and was in a daze. He kept asking me who I was and where we were going. I drove him immediately to the emergency room.”

Logan was referred to Dr. Eric Warren of Novant Health Waxhaw Family & Sports Medicine. He evaluated Logan and performed several tests, including an ImPACT test, a tool that assesses one’s cognitive abilities.

“Logan was a straight A student but he completely bombed the ImPACT test,” Kirkpatrick said.

Warren recommended that Logan’s class schedule be reduced and that he limit his use of electronics and television. He also had to eliminate his involvement in contact sports.

Even after taking those measures, Logan’s symptoms persisted so Warren referred him to Michael Rosenberg, a physical therapist and manager of rehabilitation services with Novant Health.

“After 14 days with standard concussion rehabilitation, Logan showed minimal improvement,” Rosenberg said. “I introduced Dynavision D2, a peripheral-vision training program, into his treatment regimen. Over the course of four months, he received therapy about one to two days a week. He had very advanced symptoms so we had to be conservative with his treatment to ensure he responded appropriately. It took time but in the end his symptoms vastly improved.”

Dynavision D2 is an electronic board with 64 LED green and red lights located in a variety of ring patterns. Similar to the classic electronic game Simon, the lights appear on the board one at a time in a pattern. The patient is asked to touch the illuminated buttons as soon as they appear on the board. This allows the therapist the ability to record the patient’s reaction time.

“Logan showed significant improvement. In fact over the course of several sessions he improved his reaction time by 60 percent,” Rosenberg said. “Dynavision requires quite a bit of concentration so you have to closely observe how a patient responds and adjust the regimen as needed.”

Novant Health is one of the first health care systems in North Carolina to use Dynavision to treat concussions.

“Logan had good days and bad days during treatment, but over time, we definitely saw noticeable improvements,” Kirkpatrick said. “Concussion treatment takes time and it isn’t something to be taken lightly. It flipped our lives upside down.”

New policy adopted to help protect young athletes

With growing concerns about the negative health effects of sports-related concussions, the American Medical Association (AMA) recently adopted new policies aimed at protecting young athletes.

The new policy addresses prompt diagnosis and appropriate concussion management plans. The AMA recommends that any child who is suspected of having sustained a concussion to be removed immediately from the field or court and only allowed to return with a physician’s consent.

The new policy also encourages the adoption of evidence-based, age-specific guidelines for evaluating and managing concussions in all athletes, as well as the development of risk reduction measures to prevent or reduce sports-related injuries and concussions.

“Far too many student athletes continue to remain active and do not call attention to the fact that they may have sustained a concussion,” Rosenberg said. “If not addressed immediately and treated properly, concussions can have long-term effects. Athletes should never return to the field without a physician’s evaluation and written consent.”

Warren also cautions parents and coaches about the signs of a concussion.

“Many people believe that loss of consciousness is the main sign of a concussion. However, most individuals that sustain a concussion never lose consciousness. The two most common concussion symptoms are headaches or dizziness, but even those symptoms aren’t seen in every concussion patient,” Warren said. “If there is ever a question of a possible concussion, an athlete should be removed from play immediately and medically evaluated before they return. I always tell parents and coaches – when in doubt, hold them out!”





Published: 2/2/2016