Signs and Symptoms:
· Appears to be dazed or stunned
· Is confused about assignment
· Forgets plays
· Is unsure of game, score, or opponent
· Moves clumsily
· Answers questions slowly
· Loses consciousness
· Shows behavior or personality change
· Forgets events prior to play (retrograde)
· Forgets events after hit (posttraumatic
What the Patient reports:
· Balance problems or dizziness
· Double or fuzzy/blurry vision
· Sensitivity to light or noise
· Feeling sluggish or slowed down
· Feeling ‘‘foggy’’ or groggy
· Concentration or memory problems
· Change in sleep pattern (appears later)
· Feeling fatigued
Stages of Concussion:
· Grade 1 (mild): no LOC, Post-traumatic amnesia < 30 minutes
· Grade 2 (moderate): LOC < 1 minute, Post-traumatic amnesia > 30 minutes
· Grade 3 (severe): LOC > 1 minute, Post-traumatic amnesia > 24 hours. Post-concussion signs and symptoms lasting longer than 7 days.
Return to Play Protocol: Not just ImPact testing scores- depends on symptoms and exertional testing.
· Phase 1: 30-40% of max HR; 10-15 min cardio in low stimulus environment
· Phase 2: 40-60% of max HR; 20- 30 min cardio in gym areas, light strength training
· Phase 3: 60- 80% of max HR; any environment, 80% max strength training, plyometrics
· Phase 4: 80-90% of max HR; aggressive strength training, sport specific training
· Phase 5: Full exertion; sport specific training; contact activities as appropriate for sport
· Athletes go on a computer and take the test prior to the school year. The test takes about 20 minutes and measures verbal memory, visual memory, visual motor speed, reaction time and impulse control. The athlete’s score in each category is registered and stored. If an athlete suffers a head injury, the preliminary test serves as a baseline score. The athlete is tested again, and if he or she doesn’t meet the preliminary score, they are held out of competition until they complete the test.
· Going to depend on what sport the athlete is returning to and the severity/findings for each patient.
· Examples: Cardio exertion based walking-running-plyometric program, vestibular system training.
**Remember concussions are a metabolic dysfunction. They are typically associated with grossly normal structural neuroimaging studies ie: CT scan, MRI, and X-rays have failed to detect abnormalities. Return to play should be based on the patient’s symptoms and ImPact testing.
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