1. Lake Park Athletic Trainers Sean Hopkins ATC Ned Kenter MS, ATC Jenna Nagle, ATC

2. ImPact Testing Immediate Post Concussion Assessment and Cognitive Testing Utilized in many professional, collegiate, and high school sports programs across the country This non-invasive test is set up in “video-game” type format and takes about 15- 20 minutes to complete

3. ImPact Baseline Testing Exam is given to athletes before beginning contact sport practice or competition The ImPACT test is a preseason physical of the brain Tracks information such as memory, reaction time, speed, and concentration

4. ImPact Testing If a concussion is suspected, the athlete will be required to re-take the test Same testing format, different questions Preseason and post-injury test data is given to the treating physician to help evaluate the injury. The test data will enable health professionals to determine when return-to-play is appropriate and safe

5. What is a Concussion? “A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth.” (Center for Disease Control)traumatic brain injury Trauma creates a metabolic energy crisis at the cellular level Na + -K + pump requires increased ATP = Hyper-metabolism Hyper-metabolism + decreased blood flow = Energy Crisis Creates vulnerability to second injury and longer lasting deficits

6. Signs and Symptoms Headache Nausea and/or vomiting Dizziness Blurred vision Double vision Spots before eyes Sleepiness and/or grogginess Temporary loss of memory Balance Problems Ringing in the ears Sensitivity to Light Feeling in a “Fog” Fatigue Slurred speech Difficulty concentrating Any abnormal behavior Loss of consciousness

7. Concussion Evaluation Self Reported symptoms with GSC(Graded Symptom Checklist) SCAT 2 (Standardized Concussion Assessment Tool) Balance Testing ImPact Test Referral to primary care Physician or Sports Medicine Physician Potential referral to Neurologist

8. Illinois State Law Illinois House Bill 200 (effective July 1, 2011) Schools must adopt a concussion policy in line with IHSA guidelines “A student athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from participation or competition at that time.” (IHSA) “A student athlete who has been removed from an interscholastic contest for a possible concussion or head injury can not return to that contest unless cleared to do so by a physician licensed to practice medicine in all its branches in Illinois or a certified athletic trainer.” (IHSA) “If not cleared to return to that contest, a student athlete can not return to play or practice until the student athlete has provided his or her school with written clearance from a physician licensed to practice medicine in all its branches in Illinois or a certified athletic trainer working in conjunction with a physician licensed to practice medicine in all its branches in Illinois.” (IHSA)

9. Lake Park Return to Play Protocol (RTP) Rehabilitation Stage Functional Exercise at Each Stage of Rehabilitation Success Goal of Each Stage 1. No activityComplete physical and mental restRecovery (symptom free at rest) 2. Biking Stationary cycling keeping intensity <70% maximum predicted heart rate (30 min. max) Increase heart rate without symptoms 3. Running Running while keeping intensity <70% maximum predicted heart rate (30 min. max) Add movement without symptoms 4. Agility Exercises Sport-specific exercises. No head-impact activities. Add coordination and cognition without symptoms 5. Non-contact practice Full practice without contact Increase exercise, coordination, and cognitive load without symptoms May start progressive resistance training 6. Full contact practice Following medical clearance participate in normal training activities Restore confidence and assess functional skills by coaching staff without symptoms 7. Return to play Normal game play Protocol established from: "Consensus statement on concussion in sport – The 3rd International Conference on concussion in sport, held in Zurich, November 2008." Journal of Clinical Neuroscience. (2009) 16:755–763

10. RTP Protocol Must have 24 hours between stages An athlete will not return to participation the same day as a concussive event. Once the athlete has received clearance from a physician licensed in all branches, they may begin the return to play process. If an athlete receives clearance from a physician, the athletic trainer still reserves the right to hold the athlete out of participation. A parent’s consent is not a sufficient means for an athlete to return to participation. If symptoms last longer than normal, we may recommend vestibular therapy provided by Athletico.

11. Contact Information Ned Kenter MS, ATC Lake Park West ekenter@lphs.org (630)295-5305 Sean Hopkins ATC Lake Park East shopkins@lphs.org (630)295-5252 Jenna Nagle, ATC Lake Park West jnagle@lphs.org (630)295-5305