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New program helps screen young athletes for head injury

WILLMAR -- The player on the Willmar High School girls' soccer team never saw the ball coming.

It hit her hard in the head but she kept on playing.

Jeff Winter, the team's coach, still winces when he describes what happened next, right before halftime at a game last fall.

The girl became disoriented. She didn't know where she was, Winter said.

"She just was swaying and she collapsed in the arms of one of the coaches," he said.

The diagnosis: a severe concussion.

As if this weren't enough, another Willmar girls' soccer player sustained a concussion last year after being hit in the temple during a warm-up.

So when a program was launched in August to help evaluate young athletes who've had a head injury, Winter encouraged his team to participate.

"I know we're going to see the benefits of it," he said.

The program, known as Immediate Post-concussion Assessment and Cognitive Testing, gives local coaches a better, more objective way of determining how soon a head-injured athlete can safely return to the field. It's being offered by Affiliated Community Medical Centers, Alexandria Orthopedic Associates and Rice Memorial Hospital's Rice Rehabilitation Center, with a grant from the Rice Health Foundation.

Around half a dozen young athletes at local high schools sustain a concussion each year, said Chris Heminover, an athletic trainer with the sports medicine program at Affiliated Community Medical Centers.

It's always been a dilemma deciding when it's safe for them to return to play, he said. "Return-to-play guidelines are sketchy. Should they go back? Should they wait? That's my biggest concern -- that it's OK to go back."

As sports injuries go, concussions are especially tricky. Many young players never lose consciousness or show other obvious signs of a head injury, hence a concussion can be easily missed.

High school-aged athletes often are so insistent on returning to the game that they'll downplay a potential head injury, said Lynn Stier, director of the Rice Rehabilitation Center.

"The kids really, really want to play," she said.

There's growing evidence, however, that kids need time to recover before going back on the field.

Some of the latest research has found that when young athletes push themselves too hard after a concussion, they can hinder their recovery, both on the playing field and in the classroom.

A second concussion for these kids can be even more damaging. Among professional athletes, multiple concussions have been found to lead later in life to depression and memory loss.

The new assessment program -- ImPACT for short -- is a 25-minute computerized exam athletes can take to measure their cognitive function and reaction times. Once this baseline is established, kids who sustain a blow to the head during sports can retake the test and compare the results with their pre-injury test.

If the post-injury test results are the same as baseline, it's probably safe for that athlete to return to play, Heminover and Stier said.

If the athlete hasn't returned to baseline, it's an indication that more recovery time is needed. These students can continue to be retested every few days until they're back at baseline -- or be referred for a more extensive medical work-up if they fail to return to normal.

"This really is cognitive-based," Stier said. "It's a physical for the brain. The goal would be hopefully to prevent further brain trauma in the future."

The screening already is used by many college and professional sports teams, but Willmar and New London-Spicer are among only a handful of places in Minnesota that offer it at the high school level.

Jamie Thompson, activities coordinator for the Willmar School District, sees it as "a useful tool."

"Everyone wants to err on the side of caution," he said. "This is a lot more objective. You have data and you have some concrete results. That's what people want. We want to make sure we do everything we can to keep kids safe."

To start with, the program is being offered on a voluntary basis to New London-Spicer football players in grades 9 through 12, and Willmar football, girls' and boys' soccer and girls' and boys' hockey players in grades 9 through 12. Eventually it might be expanded to other contact sports, such as gymnastics, wrestling and diving, as well as to Ridgewater College athletes.

Stier said the grant from the Rice Health Foundation covers 300 baseline tests and 30 post-injury tests for New London-Spicer athletes, and 600 baseline tests and 60 post-injury tests for Willmar athletes.

"This was a service we felt was important to offer," she said. "We're hoping to keep it going after the grant runs out."

So far, nearly 180 athletes have taken the baseline test, she said.

Thompson said coaches have been encouraging their players to be screened.

"I look forward to seeing what the long-range benefits will be," he said. "You hope that none of those kids will ever have to use it."