UF and FSU researchers collaborate to tackle youth concussions

By Claire Baralt
Dr. Russell Bauer administers a balance exam as part of a baseline screening at the North Florida Sports Concussion Workshop at Raines High School in Jacksonville. Photo by Maria Belen Farias.

Dr. Russell Bauer administers a balance exam as part of a baseline screening at the North Florida Sports Concussion Workshop at Raines High School in Jacksonville. Photo by Maria Belen Farias.

It’s a dreaded moment in any sport, one that brings play to a halt as a hush washes over the crowd — those potentially life-changing seconds when a player’s head collides with something it shouldn’t.

For a long time, conventional wisdom suggested it was okay, and even admirable, to “shake off” a potential head injury and get back in the game. But more than a decade of research has yielded a better understanding of the dangers of concussions, particularly for young, developing brains.

Perhaps the greatest sign of change is the legislative movement that has been sweeping the country. In February 2011, fewer than a dozen states had student-athlete concussion laws. Two years later, 42 states have adopted concussion awareness and prevention legislation, including Florida.

In Florida, as in most states, the new laws mandate three things: educating coaches, parents and athletes about concussions; immediately removing any athlete suspected of sustaining a concussion from play; and allowing an athlete to return to play only after receiving written medical clearance.

But lost in the good intentions of the legislation is an often unrecognized need for training and resources for the health professionals tasked with evaluating whether children are ready to return to play, said Russell Bauer, Ph.D., a professor in PHHP’s department of clinical and health psychology.

That’s where Health IMPACTS for Florida, a statewide community-based research collaboration between the University of Florida and Florida State University, is stepping in to help. The Health IMPACTS network is supported by the FSU College of Medicine and the UF Clinical and Translational Science Institute, which helps speed scientific discoveries to Floridians.

Bauer and collaborators at UF and FSU are training primary care teams at about 20 practices in four cities — Gainesville, Jacksonville, Orlando and Tallahassee — on how to assess and manage possible concussion cases.

Nurse practitioner Susan LaJoie is one of the clinicians participating in the concussion study. An FSU College of Medicine faculty member, LaJoie runs a health clinic at James A. Shanks Middle School in Quincy. Because sports are a healthy outlet, she wants to encourage her young patients to play while keeping them safe and opening a dialogue about risky behaviors. The Health IMPACTS study is helping her do both.

The screening tool used by Health IMPACTS — the Sports Concussion Assessment Tool, or SCAT-2 — can be used on the sidelines to assess an injury immediately after it happens. Comparing a patient’s pre- and post-injury responses to the same set of questions allows health professionals to more readily assess whether the patient sustained a concussion.

“A lot of times a head injury is difficult to diagnose,” LaJoie said. “Typically adolescents are not forthcoming in sharing a whole bunch of symptoms, particularly boys. So having a discrete set of questions they answer and being able to compare that to a baseline — it’s reassuring as a mom and a clinician.”

Health IMPACTS provides the SCAT-2 to participating practices pre-loaded as an application on iPads. Health professionals and patients complete the assessment on the iPads, which then feed the data securely back to the practices for their patients’ medical records as well as to the research team for analysis.

The Health IMPACTS network will collect and analyze data from a thousand screenings and will follow the screened kids for at least a year. The research team members also will study actual injuries among participating students, which they hope will lead to a better understanding of factors that make a child more or less likely to recover. The studies are ripe with additional research opportunities, investigators say.

“With head injuries, it’s a problem that’s widespread, poorly understood and an enormous public health risk — and you can do meaningful research across the translational research spectrum,” Bauer said. “From basic knowledge of how neuronal aspects affect long-term recovery, all the way to helmet redesign and safety guidelines for how to tackle.”

Reprinted from UF Explore research magazine.