Concussion

Sport Concussion Knowledge and Clinical Practices

By Frank M. Painter|July 19, 2017|Concussion, Mild Traumatic Brain Injury|

Sport Concussion Knowledge and Clinical Practices: A Survey of Doctors of Chiropractic With Sports Certification

SOURCE: J Chiropractic Medicine 2015 (Sep); 14 (3): 169–175

William J. Moreau, DC, DACBSP, CSCS,
Dustin C. Nabhan, DC, DACBSP, CSCS, RMSK,
Taylor Walden, BA

Managing Director,
United States Olympic Committee,
Colorado Springs, CO

OBJECTIVE: The purpose of this study is to describe the knowledge base and clinical practices regarding concussion by sports-certified doctors of chiropractic.

METHODS: A 21–item survey was distributed to the 312 attendees of the 2014 American Chiropractic Board of Sports Physicians Sports Sciences Symposium. Results were measured by frequency analysis and descriptive statistics for all surveys completed by sports-certified chiropractors.

RESULTS: Seventy-six surveys were returned by sports-certified doctors of chiropractic. All (N = 76) 100% of respondents believe that the evaluation of concussion should be performed by a health care provider with training in concussion. The respondents actively assess and manage concussion in adults (96%), adolescents (95%), and children (75%). A majority (79%) of respondents believe that the Sideline Concussion Assessment Tool–3 represents a current standard of care for the sideline evaluation of the athlete who possibly has sustained a sport concussion. Most respondents agreed or strongly agreed that manual therapies may be appropriate in certain circumstances in adults (80%) and minors (80%).

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Concussion study: UBC’s Thunderbirds use their heads to advance science

By John Wiens DC|November 27, 2015|Concussion|

Source CBC News

Canadian Chiropractic Research Foundation funds concussion study at the University of British Columbia.

UBC football players are helping advance the science around concussions — using their own heads.

When the Thunderbirds take to the field for the national semi-finals today a number of them will be wearing head sensors that take measurements to help researchers unravel the impact of concussions on athletes.

“What we’re trying to do is get a little more info on what’s occurring in head trauma and football,” said Harrison Brown, a PhD candidate at UBC in Kinesiology.

The study is also uncovering patterns or trends, such as, “the differences between positions, practices and games, for example,” Brown said.

More than a dozen players, including the starting quarterback and starting running back, volunteered for the study, funded by the Canadian Chiropractic Research Foundation.

Brown said sensors called “xPatches” — an impact sensing patch — are put behind the players’ ears and worn during practices and games.

Researchers study the number, and the intensity, of hits players take, as well as the effects.

So, while the UBC Thunderbirds take on St. Francis Xavier’s X-men in the hopes of advancing to the Vanier Cup, they will advance science no matter what the final score of the game.

The results of the 2-year study are expected next spring.

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Case Report of a Patient Presenting With Post-concussion Syndrome and Post-traumatic Stress Disorder

By Frank M. Painter|May 22, 2015|Concussion, Post-traumatic Stress Disorder, Upper Cervical Adjusting|

A Case Report on the Management of a Patient Presenting With Post-concussion Syndrome and Post-traumatic Stress Disorder, Using the Upper Cervical Chiropractic Technique

The Chiro.Org Blog

SOURCE: Topics in Integrative Health Care 2015 (Mar 31); 6 (1)

Scott Bales, DC

180 Parsons Rd #11
Alliston, Ontario,
Canada L9R1E8

Introduction: This case report describes the chiropractic management of a patient with a history of multiple mild traumatic brain injuries, using Upper Cervical manipulative technique.

Clinical Features: A 42 year old man presenting with symptoms of post-concussion syndrome, and diagnosed with post-traumatic stress disorder and depression.

Intervention and Outcome: The Kale Upper Cervical Procedure was utilized to assess, monitor, and correct the effects of an upper cervical subluxation in a patient over an 8 week period. The patient reported significant improvement in symptoms of post- concussion syndrome, and small positive improvements in PTSD symptoms. Follow up at 11 months showed continued improvement in most symptoms.

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Nonconcussion Head Impacts in Contact Sports Linked to Brain Changes and Lower Test Scores

By John Wiens DC|December 12, 2013|Concussion|

Source ScienceDaily

Repeated blows to the head during a season of contact sports may cause changes in the brain’s white matter and affect cognitive abilities even if none of the impacts resulted in a concussion, according to a study published today in the journal Neurology.

Using a form of magnetic resonance imaging, or MRI, researchers at the Indiana University School of Medicine and the Geisel School of Medicine at Dartmouth College found significant differences in brain white matter of varsity football and hockey players compared with a group of noncontact-sport athletes following one season of competition. White matter is composed primarily of axons, the long fibers that transmit signals between neurons.

“The contact sports and noncontact-sports groups differed, and the number of times the contact sports participants were hit, and the magnitude of the hits they sustained, were correlated with changes in the white matter measures,” said Thomas W. McAllister, M.D., chair of the IU Department of Psychiatry.

“In addition, there was a group of contact sports athletes who didn’t do as well as predicted on tests of learning and memory at the end of the season, and we found that the amount of change in the white matter measures was greater in this group,” Dr. McAllister said.

The study was conducted while Dr. McAllister was Millennium Professor of Psychiatry at Dartmouth.

“This study raises the question of whether we should look not only at concussions but also the number of times athletes receive blows to the head and the magnitude of those blows, whether or not they are diagnosed with a concussion,” Dr. McAllister said.

Two groups of Dartmouth athletes were studied: 80 football and ice hockey players in the contact sports group, and 79 athletes drawn from such noncontact sports as track, crew and Nordic skiing. The football and hockey players wore helmets equipped with accelerometers, which enabled the researchers to compile the number and severity of impacts to their heads. Players who sustained a concussion during the season were not included in the analysis.

The athletes were administered a form of MRI test known as diffusion tensor imaging, which is used to measure the integrity of the white matter. They were also given the California Verbal Learning Test II, a measure of verbal learning and memory.

The study did not find “large-scale, systematic differences” in the brain scan measures at the end of the season, which the authors found “somewhat reassuring” and consistent with the fact that thousands of individuals have played contact sports for many years without developing progressive neurodegenerative disorders.

However, the results do suggest that some athletes may be more susceptible to repeated head impacts that do not involve concussions, although much more research would be necessary to determine how to identify those athletes.

More work would also be necessary to determine whether the effects of the head impacts are long-lasting or permanent, and whether they are cumulative.

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Brain Impact: Concussions, Chiropractic and New Laws

By Frank M. Painter|January 3, 2012|Concussion, Education, Traumatic Brain Injury|

Brain Impact: Concussions, Chiropractic and New Laws

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By Robert “Skip” George, DC, CCSP, CSCS

Concussions are (finally) getting the attention of the athletic world, state governments and health care providers of all disciplines.

On Oct. 23, 2011, San Diego Chargers offensive guard Kris Dielman suffered a concussion during a football game against the New York Jets with 12:31 left to play.

He landed hard on the ground after a wicked collision with a Jets linebacker, then got up, wobbled and went back to playing the rest of the game, taking several more hits to the head. Neither the Chargers training staff nor the NFL referees recognized how serious his head injury was as he “waved off” his sideline training staff to return to the huddle. On the flight home to San Diego after the game, Dielman suffered a “grand mal” seizure and will most likely not play for the rest of the season.

Magnitude of the Problem

Concussions are getting much-needed attention in the press, especially given the short- and long-term cognitive loss, early-onset dementia, physical disability and even death resulting from traumatic brain injury (TBI). Chronic traumatic encephalopathy is a chronic, degenerative neurologic disease linked to repetitive head trauma and is known as an invisible killer that can make a 35-year-old brain look more like 80 years old.

There are 250,000 concussions annually in football alone. The prevalence in high-school and college athletics is a major concern, especially considering how big, fast and strong high-school and college athletes have become, and how their play emulates the professionals. This “evolution” is exacting a terrible toll regarding TBI in not only football, but also soccer, hockey, wrestling, water polo and cheerleading.

Three Purdue University professors tracked 21 football players from Lafayette Jefferson High School in Indiana. For two years they kept a record of every hit in practice and during games. They found that half of the players had neurophysiologic changes from contact. They also discovered that the repetitive hits the players were receiving had a cumulative effect on the brain and resulted in brain wave changes that mimicked concussion, even when the contact did not result in a concussion!

Concussion Basics

What is a concussion? It can be defined as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces” or “an immediate and transient loss of neuronal function secondary to trauma.” Signs and symptoms include but are not limited to thinking deficits, lack of sustained attention; amnesia; confused mental status; dazed look / vacant stare; slurred or incoherent speech; vomiting; nausea; emotional liability; slow motor or verbal response; memory deficits; poor coordination; dizziness; headache; restlessness; nervous weakness; exhaustion; and irritability. (more…)

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Sidney Crosby Press Conference with Dr Ted Carrick

By John Wiens DC|September 8, 2011|Concussion, Neurology, Video|

Sidney Crosby, probably the best player in the NHL, and one who is certainly marketed as the face of the NHL along with Alexander Ovechkin, has been unable to play hockey since last year due to a serious concussion. Recently he has been treated by Dr Ted Carrick, a chiropractor and founder of the Carrick Institute for Graduate Studies in Cape Canaveral, Florida. Sid has made dramatic progress since starting treatment with Dr Carrick.

Here is the press conference. Dr Carrick’s remarks start at 7:40 into the clip.

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