Keeping Your Head: The Most Dangerous Games

by Mark Huslage, LCSW-C, CBIST
Coordinator of Brain Injury Programs, LifeBridge Health

As stories like this show us, emergency room visits are rising for concussions among student athletes. While we often focus on the risks of football, that's only one of many sports that place players at risk for significant neurological injury such as mild traumatic brain injury (mTBI) or “concussion.”

Fall sports such as soccer, lacrosse and cheerleading have high rates of concussive injury, especially as the age and athletic abilities of participants increase. Thankfully, with the increasing awareness of parents, players and coaches, along with coordinated medical approaches at places like the Comprehensive Sports Concussion Program at The Sandra and Malcolm Berman Brain & Spine Institute, improved management of mTBI continues to emerge.

“It’s all about concussion awareness and paying attention on everyone’s part," says Kevin Crutchfield, M.D., director of the Comprehensive Sports Concussion Program at the Sandra and Malcolm Berman Brain & Spine Institute. “There are great pressures on athletes and coaches to play through injury to demonstrate dedication and the desire to win. Someone has to be willing to protect the player from further harm.”

A period of rest is needed in all cases of diagnosed concussion, with some requiring weeks or months of layoff from competitive play.

“For those student athletes who experience memory and thinking problems, temporary classroom accommodations may be needed, as well,” adds Brain and Spine Institute neuropsychologist Julie O’Reilly, Psy.D. “Families should feel empowered to make such requests, as needed.”

Despite recent advances in concussion management, there continue to be injuries that cause long-term physical, cognitive and behavioral effects. Mild traumatic brain injury has been increasingly diagnosed in workplace accidents, motor vehicle accidents and on the battlefield. Slips and falls in at-risk populations add to this burgeoning epidemic. With concussions representing 80 percent of all brain injuries in the U.S., the need for specialized care is readily apparent.

“Many of the people we see in the Mild Brain Injury Program here at Sinai received inadequate medical attention at the time of injury,” says MBI Case Manager Linda Hutchinson-Troyer. “Some went undiagnosed, while others were given only minimal care, with little aftercare instruction.” Experts in the field agree that much of the long-term effects of concussion would be diminished if early management was consistently practiced.

Health care professionals are encouraged to learn more at Sinai Rehabilitation Center's one-day conference on the diagnosis and treatment of mTBI, "Not 'Just a Concussion'—Understanding Mild Brain Injury and Its Management. " This presentation will focus on the medical, neuropsychological and clinical interventions that promote a full and speedy recovery. To register or for more information, click here.

Sinai Occupational Therapist Helps Children in Quito

Many LifeBridge Health employees use their hard-earned vacation time to visit different countries to help those in need. Today we're featuring Sinai Hospital occupational therapist Katie Cooper, pictured at left.

Cooper, who works on the inpatient neurological rehabilitation unit at Sinai, was invited on a 3-week trip to Quito, Ecuador with OT students from St. Catherine's University in Minnesota. She supervised two occupational therapists and two certified occupational therapist assistants at Fundacion Reina de Quito. The students, who have Down Syndrome, can attend the school up to the time they are 6 years old. Cooper and the students worked with them on a variety of activities.

"Many of the children lack in sensory integration," Cooper says. "The program for occupational therapy is being developed, and we were there to help them with best practices."

Other projects included building a shower chair for a student who had athetoid cerebral palsy, a vast improvement over the school staff trying to bathe him in a sink. Cooper speaks Spanish, an asset that "definitely helps."

Cooper plans to return to Quito. She says being an occupational therapist and giving back has been a lifelong dream.

"When I was in seventh grade, the Girl Scouts had a Women in the Workplace Day," she says. "An occupational therapist talked about what she did, and I said, 'that's what I want to do.' Occupational therapy is about changing people's lives and allowing them more independence."

Are you interested in being an occupational therapist at LifeBridge Health? Click here to see our openings.

Sinai Hospital Auxiliary Awards Grant to Comprehensive Sports Concussion Program

The Comprehensive Sports Concussion Program (CSCP) at LifeBridge Health has been awarded a $5,800 grant by the Sinai Hospital Auxiliary. Designed to diagnose and treat sports-related concussions with the most optimal treatment, the CSCP is a collaboration between LifeBridge Sports Medicine, the Sandra and Malcolm Berman Brain & Spine Institute, and the Sinai Rehabilitation Center.

The CSCP will use the funds to support the prevention, diagnosis, and treatment of concussions in student-athletes at schools in underserved communities that surround Sinai Hospital.

“We are honored to have received this award. It provides us an exciting opportunity to identify student-athletes in need of intervention, to promote their recovery and to help them keep pace in class while they are recovering from their concussive symptoms,” said Julie O’Reilly, Ph.D., a neuropsychologist at the Berman Brain & Spine Institute. “It will also allow us to further promote concussion awareness and prevention.”

Through the “Keeping Our Most Vulnerable Kids Safe Program,” health professionals at the CSCP will administer Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) to student-athletes. ImPACT is a computer-based self-test that measures brain processing speed, memory and visual motor skills, all of which have been shown to be affected when a person sustains a concussion. In a two-phased model, student-athletes are tested at the beginning of their respective sports seasons to obtain baseline readings of their cognitive abilities. Then, should one of those tested sustain a concussion or suspected concussion during the season, he or she is tested again, and test scores are compared; a decline in scores suggests that the student-athlete has had a concussion and that medical intervention should be sought. Test scores are also used to aid in diagnosis and treatment and to determine the best course of action for the affected child. In addition to testing, grant funds will be used to educate parents and coaches about this very important topic.

“This program is based on realized deficiencies across the country for better education and clinical management of concussions and to accelerate recovery from injury so that children can return to school and to competitive sports quickly in a way that promotes their optimal health,” added Kevin Crutchfield, M.D., director of the Comprehensive Sports Concussion Program.

To learn more about the Comprehensive Sports Concussion Program at LifeBridge Health, call 410-601-WELL or click here.

Physiatry Added to Dictionary

It’s a word that’s been around since the days of the Truman presidency. But a patient
looking up “physiatry” would find nothing in the dictionary.

Until now.

Last week, Merriam-Webster Inc. released its list of the more than 100 entries now included in the latest edition of its Collegiate Dictionary. Physiatry, a synonym for physical medicine and rehabilitation, made the cut, along with locavore, fan fiction and earmark.

The physiatrists at Sinai Hospital couldn’t be happier about the linguistic recognition of their field.

"The addition of physiatry to the dictionary reflects the increased awareness of the medical specialty of physical medicine and rehabilitation,” says Scott Brown, M.D., the chief of the Department of Physical Medicine and Rehabilitation at Sinai Hospital in Baltimore. “The focus is not on treating a single organ system or disease process. The physiatrists in the Sinai Rehabilitation Center are part of a team of clinicians dedicated to reducing pain and restoring function for patients who suffer from a wide variety of conditions including back pain, head injury, trauma, amputation and stroke."

According to the American Academy of Physical Medicine and Rehabilitation, the field of physiatry began in the 1930s, and increased substantially as veterans returned from World War II with serious disabilities. The mission of helping them lead productive lives led to a new direction for the field. The Advisory Board of Medical Specialties granted physical medicine and rehabilitation its approval as a specialty of medicine in 1947.