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Concussion Awareness & Baseline Testing


The United States Sports Academy is continuing its concussion awareness efforts by collaborating with the University of South Alabama (USA) on a Concussion Awareness Program, also known as CAP. CAP was developed by Dr. Ashley Marass, an Assistant Professor of Nursing at USA. Also involved in the program are Dr. Anthony Martino, Chair and Associate Professor of Neurosurgery at USA, Mary Wilstrup, a clinical nurse specialist at USA Children’s and Women’s Hospital, Dr. Vincent Ramsey, Chair of Sports & Exercise Science at the Academy, and Dr. Brandon Spradley, the Director of Sports Management at the Academy. The program is a finalist in the NCAA Mind Matters Challenge. The Mind Matters Challenge focuses on two initiatives:

  • A research challenge designed to identify key factors and methodologies to change the culture and behavior of college student-athletes
  • An educational program challenge meant to improve the effectiveness of concussion awareness programs delivered to student-athletes, which may then translate to service members and other at-risk populations.

CAP falls under the educational program challenge and will be implemented in the Mobile County Public School System. Faculty members of the Academy will assist USA with implementing CAP into Mobile County public high schools. Implementing this program will involve concussion education, baseline testing, and concussion treatment and management. Research shows that baseline testing is very important to the overall effectiveness of concussion programs. The same is true with this program as well. Research also indicates that there are many things to consider when baseline testing high schools athletes.

A study by Hunt et al in 2007 found that 11% of high school athletes showed poor effort when performing baseline testing for concussions. Although this was only a sample of high school football players (N = 206 athletes), it is suspected that many athletes intentionally perform poorly on baseline concussion assessments. As the number of people sustaining concussion continues to increase in the United States; there is a need for the implementation of highly researched concussion assessments that have the ability to assess athletes before and after a concussion has been detected. In addition, coaches, parents, and athletic trainers have the responsibility of educating student-athletes about the severity of concussion and motivating student-athletes to give their best performance when undergoing concussion examinations.

Several current concussion management guidelines recommend obtaining a baseline in order to accurately detect when an athlete has been concussed. A concussion is not like any other sport injury. It is a functional injury rather than a structural injury and relies heavily on obtaining an accurate baseline to interpret post-injury performance. Over the years, many health care professionals have questioned whether athletes exert maximum effort during baseline concussion assessments (Hunt et al., 2007). A study by Erdal (2012) assessed the likelihood of athletes “sandbagging” baseline testing by purposely performing bad or giving poor effort.

There is a need for coaches, parents, and athletic trainers to understand how to effectively motivate athletes to give their best performance on concussion testing. Here are a few questions to consider:

  • What’s the real reason athletes perform poorly on concussion assessments, especially baseline testing?
  • Do athletes truly understand the seriousness of concussion?
  • Are athletes more prone to “sandbag” baseline testing because they feel it would affect the amount of time in competition if a concussion is sustained?
  • Do athletes have increased motivation when performing certain types of concussion testing?

These are things to consider when implementing CAP into high schools. Stay tuned for more information about this program. Visit concussionawrenessprogram.org to learn more about CAP.

By: Dr. Brandon Spradley, Director of Sports Management, USSA. Dr. Spradley can be reached at bspradley@ussa.edu 






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