Making an 'ImPACT': USAFA works to mitigate concussions

  • Published
  • By Amy Gillentine
  • USAFA Research
More than 250,000 student athletes visit the emergency room every year with head injuries, and tens of thousands of service members are coping with brain injuries from concussions suffered in the line of duty.

Both those groups will benefit from a $30 million collaborative study between the NCAA and the Defense Department designed to enhance safety for athletes and military personnel. The study is in line with other Air Force Academy efforts to mitigate head injuries. For the first time, the Academy has provided all incoming freshmen with concussion baseline testing.

As part of the NCAA-DOD effort, the Academy is providing comprehensive baseline concussion - known as ImPACT tests - to every athlete. Eventually, every cadet at the Academy will have a baseline concussion test for comparison if a head injury were to occur. ImPACT tests are a basic computer-based neurocognitive assessment of brain performance. The baseline test - taken when an athlete is healthy - is compared to results when a player is injured. Along with an in-depth clinical assessment, it determines when an athlete can return to the field.

The goal of the NCAA-DOD effort, said Dr. Christopher D'Lauro, an assistant professor in the Behavioral Sciences and Leadership Department, is to study the natural history of concussions among NCAA student athletes. Once the study is complete, universities will agree to treat concussions identically.

That doesn't happen now, researchers say.

"Everyone handles it differently," said Lt. Col. Darren Campbell, a sports medicine physician at the Academy and one of the lead investigators on the study. "One school might have athletes back on the field at 80 percent of baseline, other schools - and USAFA is one of them - only return athletes to play when they're at 100 percent. What's the long-term recovery look like for both of those?"

Campbell is the director of the Concussion Clinic here, which opened two years ago and is a collaboration between several specialties - sports medicine, neurology, physical therapy, optometry, audiology, vestibulotherapy, and ear, nose and throat.

"Every cadet concussion is treated at this clinic," he said. "Last year alone, we treated 196 separate concussion cases."

The Academy is also taking a multidisciplinary approach to the NCAA-DOD study, he said. Dr. Jerry McGinty, the Athletics Department director of sports medicine, is leading the interdisciplinary study team with Campbell.

"For the first time, there is a collaboration to find the right way to treat concussions," Campbell said. "The behavioral science department, sports medicine, the athletic department - we're all working together on this. It's about cross-collaboration. I have to give major kudos to the academic departments for participating."

The Academy is ahead of other schools, he said, because it has been conducting baseline testing already.

"While the tests will be part of the larger NCAA-DOD study, it is separate and would be performed even if we weren't part of the study," Campbell said. "We have been using the ImPACT tests for about 10 years in our athletes. The remarkable thing that happened this year is that we were able to perform this baseline testing on all incoming freshman. We couldn't have done that without widespread cooperation. When all is said and done, we will have completed ImPACT testing on 1,800 cadets in July and August. In time, we will be able to accomplish baseline testing on all the cadets. I don't think that any other university of higher learning has been able to do that."

All universities enrolled in the NCAA-DOD study will agree to assess concussions the same way.

"This will allow researchers to make apples-to-apples comparisons," said Lt. Commander Brian Johnson, a researcher involved in the study.

It's the first study of its kind - dealing with 37,000 college student athletes and military members at USAFA, the U.S. Military Academy, the Naval Academy and the Coast Guard Academy. More than 18 colleges are involved - ranging from Ivy League research schools to the Big 10 football schools. Not only will the NCAA tests involve the ImPACT tests currently underway, but a full battery of testing for the USAFA NCAA athletes. That testing will begin in about two weeks, researchers say.

"It's a large study," D'Lauro said. "And we're planning to take this level of care beyond just the athletes. After the study, we will have a better long-range plan to diagnose, treat and prevent concussions."

Eventually, D'Lauro and Johnson hope to have a fully-equipped EEG lab at the Academy to provide a neuroimaging component to this concussion research. Currently, they're using equipment available in the Academy's Human Performance Laboratory and the Behavioral Sciences Department. The USAFA team will test undergraduate athletes this month.

The Concussion Assessment, Research and Education Consortium will coordinate the research from the University of Michigan. The Academy's information will be used to expand on the NCAA National Sport Concussion Outcomes Study, an existing investigation of repetitive head injuries.

The investigation into head injuries has the support of the White House as well.

"I've seen in my visits to wounded warriors, traumatic brain injury is one of the signature issues of the wars in Iraq and Afghanistan," said President Barack Obama when he announced the initiative. "The thing is, the vast majority of mild traumatic brain injury cases in the military occur outside deployment. So, even though our wars are ending, addressing this issue will continue to be important to our armed forces ... These efforts are going to make a lot of difference for a lot of people - from soldiers on the battlefield to students out on the football field."