Taking a Hit: No More Baseline Concussion Testing

Photo Courtesy of CQL Football

Aliza Saunders
Editor-in-Chief
March 8, 2018

Every Howard County athlete remembers aimlessly staring at a computer screen trying to remember the last sequence of colorful shapes or obscure words that flashed across their computer screen. Starting in 2012, athletes were required to take this baseline concussion test before trying out for an extracurricular sport. However, beginning in the 2017-2018 school year, baseline concussion tests are no longer required for high school athletes.

“The neuropsychologists determined that there wasn’t significant data to propose baseline [concussion testing] for the individual player,” Athletic and Activities Manager Mr. Senisi said. “They decided to compare the data from a post-concussion test to a typically developing brain function for student athletes of that age.”

According to the NCAA and CDC, a concussion is a “brain injury that is caused by a blow to the head or body” that “can change the way your brain normally works.”

The National Institute of Health estimates that 300,000 athletes suffer from sports-reTaking a Hit: No More Baseline Concussion Testing by Aliza Saunders Editor-in-Chief lated traumatic brain injuries each year in the United States, making sports the second leading cause of traumatic brain injuries for 15 to 24 year olds.

Last July, Dr. Martirano released a statement where he cited several reasons for this change in procedure. According to this post, Dr. Gerry Gioia represented the Howard County Sport Medicine Advisory Committee (SMAC) at an annual conference about sport concussion research in Berlin, Germany. Utilizing the research presented at this conference, Dr. Gioia and SMAC recommended that the baseline concussion testing no longer be required, citing issues with “reliability” and “insufficient evidence of diagnostic value.”

Athletic Coordinator John Davis notified Mr. Senisi and all Howard County Athletics and Activities Managers about this change, providing them notes from the conference, including outcomes and how the change will be implemented in Howard County.

Parents of Howard County athletes are still required to sign the Concussion Information Sheet, which includes a list of symptoms and recommendations if the athlete has suffered from a concussion. Additionally, an optional baseline test will be offered to athletes in late March or April.

While the baseline concussion test is no longer required, the rest of the concussion protocol has remained the same. “If someone is exhibiting typical symptoms of a concussion, such as headaches, dizziness, nausea, visual effects, or any kind of memory effects, I pull them out and do a check,” Athletic Trainer Zach Naelitz said. If Trainer Zach thinks there might have been damage, he removes the athlete from the game and sends them to a doctor for an evaluation.

Moreover, Trainer Zach then administers a computerized concussion test after the injury has occured. “If we suspect a concussion, we do a post-baseline test, and those results are analyzed by Dr. Gerry Gioia, the Division Chief of Neuropsychology at Children’s National Medical Center. He looks at the data and compares it to a typically developing peer. He then works with our trainer one-on-one, and they begin to implement the return-to-play protocol,” Mr. Seinisi said.

Trainer Zach sends Dr. Gioia information about any miscommunication during the test administration, how the injury happened, the athlete’s recovery process, and their medical history.

Once athletes are symptomatic free and cleared by both Dr. Gioia and their doctor, they can begin this return-to-play protocol, which are “steps that the trainer takes to make sure that the student athlete can gradually return to competition,” Mr. Senisi said. Trainer Zach follows this return-to-play policy by “starting at very low exercise all the way up to a full practice. Once they do all that, without a return of symptoms, then they go back into their sport.”

Two years ago, senior Benji Izenberg fell on the soccer field at Atholton while playing with friends after practice, hitting his head on the ground which caused a concussion. He recalls taking the baseline concussion test before the season and the same test again after her got his concussion. Izenberg also remembers receiving a multi-step return-to-play protocol, which “limited how active or physical he was.”

Both Dr. Martirano and Mr. Senisi stress the importance of athlete’s safety and well-being. Dr. Martirano wants “ensure that we provide the best possible care for our students.”

Mr. Senisi said that “the most important part is that we’re using current research and current literature to make the best decisions possible for our student athletes so that we can provide them with the best care necessary.”