Athletic Training ECHO teaches concussion prevention, signs of symptoms
Wednesday, August 16, 2023
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Oklahoma State University’s Human Performance and Nutrition Research Institute is working to tackle one of the biggest topics in sports safety today — concussions.
The recently launched Athletic Training-Sports Management ECHO kicked off its series on concussions Aug. 9 with a session on the assessment and diagnosis of concussions.
The session covered the newest research and publications on diagnosing concussions and the new standard definition of concussions along with a case presentation.
Concussions account for roughly 15% of all reported sport-related trauma at the high school level, said Dr. Aric Warren — Oklahoma State University Center for Health Sciences professor of athletic training.
However, he said the data shows this number is likely a huge underestimation due to the lack of self-reporting by student-athletes of their concussion symptoms or the lack of recognition of the injury by coaches, parents or health care professionals.
The data indicates approximately 55% of pediatric athletes who have sustained a concussion are not seen by a medical professional.
One of the largest pieces of the assessment process is how symptoms present themselves. Some present immediately, but one must be aware they can also evolve over minutes or hours. Undiagnosed concussions elevate the risk of future concussions and additional brain trauma while early recognition reduces the likelihood of developing persistent symptoms.
“Concussions, if underdiagnosed or mismanaged without a removal from play and a proper return to activities, can lead to prolonged recovery, serious long-term disabilities and even death,” Warren said. “Likewise, many individuals who sustain a concussion often experience subsequent mental health concerns. Our ECHO team is dedicated to driving awareness and improving care practices to improve recovery and outcomes in patients who sustain a concussion.”
Most Oklahoma schools do not have access to an athletic trainer or someone skilled and up-to-date with current management practices. The family physician or school nurse is often the front line of assessment and recovery for those who have sustained head trauma.
The resources provided by OSU’s multidisciplinary team through these sessions help develop knowledge and understanding of the latest best practices in the diagnosis and care of concussions.
“If we identify concussion early, it really helps to improve the clinical outcomes, and provides also for a quicker return to activity,” said Lance Walker, HPNRI Rick and Gail Muncrief executive director. “Best practices in management of concussions demands a transdisciplinary evidence-based approach. This ECHO series will further empower the front-line providers on the fields, at the gym, on the mats to provide next-generation care for their athletes at risk for and dealing with this multi-dimensional challenge.”
Dr. Jamie Akin was excited when the Athletic ECHO series was announced, she wanted it to help her find her roots from when she was an athletic trainer at OSU.
“Concussions are not easy to notice for many parents and coaches since they are not physically visible. In the rural community, many fans are sideline spectators and staff are just coaches. If they are lucky, there are family practice or pediatric physicians in attendance,” Akin said. “The recognition, sideline testing and monitoring are changing and this series focusing on these important steps will help greatly in the sideline management and follow-up and treatment plan for these student-athletes.”
As a pediatrician at Texoma Pediatrics, mother of four student-athletes and the wife of a coach, Akin said it is important for athletic trainers, rural physicians and nurses to attend these sessions because a proper treatment plan involves everyone in the athlete's daily routine.
“These people are responsible for following the guidelines and monitoring recovery,” Akin said. “They help make the decisions for when the athlete is ready to return to the field, what to look for in a setback or secondary syndromes. The more people involved, the better the recovery and health of that student-athlete.”
It’s important for clinicians, administrators and coaches to establish a safe space culture for student-athletes to feel comfortable and understand the importance of disclosing when they experience different signs and symptoms. Educating them on what the different signs and symptoms are is just as crucial, Warren said.
“These sessions help keep local physicians and acting team physicians, athletic trainers, coaches and nurses up to date on current guidelines and management of concussions,” Akin said. “This makes treatment, recovery and back to play smoother and safer for athletes, as long as everyone is on the same page.”
Preparation is key to the current best practices in concussion evaluation. It is recommended to obtain sets of objective individual data prior to the start of a sport season that can be used as an accurate comparison to help diagnose the condition, Warren said.
The baseline tests should include various brain functions including cognitive function and abilities, balance, coordinated movements and reaction times.
“The way we are learning to care for and manage concussions has changed drastically in the last few years, so we want to share these new best practices with all our health care colleagues, as well as coaches, administrators, parents and the athletes themselves to better inform them of treatment strategies that are proving to be beneficial,” Warren said.
The ECHO team is focused on sharing strategies and resources to help clinicians in the development of their own preseason testing programs.
“I see many athletes in my practice and many concussion follow-up patients each year,” Akin said “My treatment recommendations will change to reflect any new or changed guidelines being used, to hopefully give maximum benefit for our athletes in the community.”
The Athletic Training-Sports Management ECHO series launched May 24 and is held the second and fourth Wednesday of each month from noon to 1 p.m. The next session of the concussion mini-series on Aug. 23 will dive deeper into return to learn protocols and start conversations about acute care and case management.
Project ECHO supplies access to specialty care for complex health conditions, particularly in rural and underserved communities where specialists are fewer in number and more difficult to access.
This is the first ECHO line focused on athletic training to reach athletic trainers and sports medicine providers at schools across the state.