NEW ULM - Since the high school sports season opened last month, area students have been busy taking tests.
It's not a test they can study for, there are no right or wrong answers but it just might be the most important test any of them take all year.
This year, six area high schools and Martin Luther College have administered ImPACT [Immediate Post-Concussion Assesment and Cognitive Testing], a baseline cognitive test to evaluate concussions to its student athletes.
Staff photo by Steve Muscatello
Jill Weiss, Sports Medicine Coordinator at the Sister Kenny Rehabilitation Institute gives the ImPACT test to Members of the Cathedral High School Football Team recently.
Coaches at Martin Luther College also took the IMPACT test?because they wanted to see first hand how the program worked.
"It has been coming for a long time," Jill Weiss, Sports MedicineCoordinator at Sister Kenny Rehabilitation Institute said. "It has been trickling down from the professional ranks through college to Division III level which is where MLC is at. There has been strong suggestion that they look into better management and research into head injuries."
Weiss and her fellow trainers that work with the area schools have been giving the computerized test to every athlete, in every fall sport. They started with football players but even athletes in what are considered noncontact sports like cross country and volleyball have also been screened.
"You never know what can happen," Minnesota Valley Lutheran Activities Director Craig Morgan said. "You might think that there isn't contact but what if someone falls down and bumps their head in a cross country meet? Now that we have the pretest, it will be a nice measuring stick."
The goal is to have every athlete in every sport tested across the seasons. The medical staff is starting with the fall sports but will move on to the winter sports like hockey, gymnastics, wrestling and basketball and the spring sports will follow.
"We have a number of multi-sport athletes on campus and it will save time in the winter and spring where this student won't have to be checked again," MLC Athletic Director Jim Unke said. "I think that a blanket coverage is a great way to start. Also, you aren't always sure where the kid is coming from, previous injuries and things like that."
That is Weiss' goal as well, get as many athletes tested now to save time later.
"The implementing year is obviously the most difficult year," Weiss said. "After this year, we will test the athletes every two years. We will test freshmen and juniors, every year from here on out. They determined the baseline is good for two years based on brain function."
MLC was the first of the area schools to go through the testing. Unke said that the NCAA passed a mandate effective this year for each school to have a concussion management program in place.
"We at MLC had to do something because of the mandate from the NCAA and when I spoke with Jill about the ImPACT program, I thought we could kill two birds with one stone," he said. "Not only are we meeting NCAA requirements, but we are taking it a step further to protect our kids."
Unke said that the NCAA requirements were quite basic and ImPACT goes beyond what MLC is required to do.
"It was tracking concussion and tracking the number of concussions and tracking the treatment of concussions," he said. "The ImPACT program is very proactive. They get out and get a baseline for every athlete, if there is an injury you can go back and see where they are in their recovery."
According to the ImPACT web site, St. Scholastica and Bethany Lutheran College are the only other Upper Midwest Athletic Conference schools that uses the program.
A few Minnesota Intercollegiate Athletic Conference schools including St. Olaf and Carleton use the program and most of the Division II?schools in the state like Minnesota State, Winona State and St.?Cloud State are clients of ImPACT.
The site also list a couple dozen high schools in the state that use the program including all three Mankato high schools.
"We all had to report [to the UMAC] how we are going to comply with the NCAA regulations for the concussion management program," Unke said. "And we told them what we were doing through Allina. I have told Jill that we have almost become the pacesetter for what can be done. It's easy to track injuries, symptoms and treatment, but we can get out in front of it and be proactive and create baselines for each and every kid. I think that is really a ground breaking approach to a problem that can really affect kids the rest of their life."
The ImPACT?screeing is a noninvasive cognitive test that can be done in each schools' computer lab. The athletes go through different drills to test for visual and verbal memorization, cognitive processing speed and reaction time.
The end result is the baseline score.
If a concussion does happen, the athlete retakes the test and the trainers or a physician compare the scores.
Since the area athletes have taken the evaluation, Weiss has already used the program to diagnose at least one players ability to return to the playing field.
"We had one area high schooler that took a heavy hit in a scrimmage," Weiss said. "He had symptoms right away, a prolonged headache, we tested him right away and his speed on the test was good. But his memory went from a 90 percentile down to an eight percentile. It was a very big deficit. He didn't realize it. He had no external symptoms any more and his headache was gone but we could tell from the test he wasn't ready. We tested him again a week later and his numbers had rebounded nicely and had comeback to almost baseline."
Concussion are different in everybody. Some bounce back sooner than others and it depends on many different kinds of factors: location of the hit, how hard the hit was, did they have their mouthguard in, did their helmet fit well. Most importantly, if they have had a head injury before.
"Once you sustain a concussion you are much more suseptible to getting another one," Weiss said. "What we are trying to avoid with this test is Second Impact Syndrome."
Second Impact Syndrome is when an athlete experiences a head injury, it could be a mild one - there might not even be any external symptoms - but then if that athlete is allowed back on the field and they experience head trauma again, that is Second Impact Syndrome.
"If we let them return to play when their neuro-cognitive functions aren't back to speed yet, that's when there can really be problems," Weiss said. "Second Impact Syndrome is really scary because it can stay hidden. They may take a second hit and within 24 hours the symptoms can rear their ugly head and be fatal."
ImPACT takes about 20 minutes to complete and is broken into three parts.
Section 1 is background information and health history. Section 2 involves current symptoms and conditions followed by Neuropsychological Tests, which is baseline testing and post injury testing.
The testing is broken down into six modules: Word memory, design memory, X's and O's, symbol matching, color matching and three letter memory.
Weiss is quick to point out that the test has nothing to do with intelligence.
It's really about finding out how their brain works.
"This is not an intelligence test. It has nothing to do with IQ," Weiss said. "It doesn't tell them if they are smart or not. What it tells us is how their brain works, how it functions. So when they do have a disruption, wether it be a mild hit or a severe hit. We have an idea of when they will be back to their normal not everybody elses' normal."
Weiss said that some kids might intentionally try and not do it well, but that is no use.
"I tell them that the computer is smarter than them," she said. "It has flagged a couple of kids. The program told us that something isn't right with this test and you may want to test them again. We instruct them to take the test as fast and as accurate as possible. Don't worry about making mistakes. Do it as fast as you can but do it right."
Unke took the test and said it very nonthreatening.
"I think that I wanted to take it because I wanted to know what it was all about. I was learning right along with them. I just thought, 'if we are going to make our kids do it, I want to see what it's all about,'" he said. "It's pretty nonthreatening. It's testing your memory and reaction time and visual cues and things. It's not a test that is intimidating in any way. I think it's an easy way to reinforce and protect the kids."
For more information on ImPACT go to www.impacttest.com