Concussion Vital Signs

Concussion Vital SignsPeter C. Entwistle Ph.D.Charles Shinaver Ph.D.PearsonWebinarFootball season is almost here and so is baseline testing for your athletes. This webinar willprovide a "how to" of administering baseline testing for student athletes using ConcussionVital Signs online neuro‐cognitive test.In this webinar, we will walk you through the basics of how to administer this online test,including how to:register an organization as an administratorlogin an athlete for testingestablish a good testing environment and administer the testmaneuver within the administrator panellogin and maneuver within the Clinician's Portal.Pragmatic issues such as creating different "teams" or "sports" within an administratorpanel will be covered as well as simple ways to create user names so they are easy to findand then how to search for test results.We will also review the tests in the battery and the Basic Overview of CVSscores that are obtained. We will review how to view reports especially the efficiency withwhich you can identify whether a test is valid or not and which subtest(s) is not valid.If you are interested in online neuro‐cognitive concussion assessments, in particular, theCVStool, this one‐ hour session will help you understand the unique aspects of this concussionmanagement tool.

Contact: Kent Willette Phone: 1 952 2369885 or 1 800 6277271x267147 Email:kent.willette@pearson.comWebinar Meeting Description:This one-hour session will help you understand the unique aspectsof Concussion Vital Signs, an online neuro-cognitive test thatprovides baseline and post-injury assessments for student athletes.This webinar will provide a "how to" of the test, starting with a walkthrough of administering the test and including how to:register an organization as an administrator log in an athlete for testing establish a good testing environment and administer the test maneuver within the administrator panel; and log in and maneuver within the Clinician's Portal Other pragmatic issues will be addressed, including: creating different "teams" or "sports" within an administrator panel simple ways to create user names so they are easy to find searching for test resultsIn addition, we will review the tests in the battery, the scores, andreports, emphasizing the efficiency with which you can identify thevalidity of a test and/or subtest(s).ConcussionWhat is concussion?How do you get one?What are the consequences?How do you assess and monitor concussion?Who should do an evaluation if you think youhad one? Can you get more than one? Is there anyharm?

ConcussionHow do you define it?Definition A concussion is a mild type of traumatic braininjury, (mTBI). It can occur as a result of a fall, a motorvehicle accident, or a blow to the head. A concussion is the brain’s reaction to a jolt orblow or the head. It is caused by the brain moving back andforth or twisting in the skull.Management of ConcussionHow do you manage concussion andreturn to play decisions?

Concussion ManagementToolPre-SeasonBaselineTesting SidelineAssessmentNeurocognitive EvaluationConcussion HistorySymptom ScaleBalance TestingPost-InjuryAssessment Pocket SCAT 2 Emergency Procedures e.g.,Call 911Pocket SCAT2The Pocket SCAT2 is a standardized methodof evaluating injured athletes for concussionand can be used in athletes aged from 10years and older.Key Advantage:Key Advantage:Parents can loginand completeConcussion History“During Play”Mobile AssessmentToolConcussion should be suspected in thepresence of anyone or more of the following:symptoms (such as headache), or physicalsigns (such as unsteadiness), or impairedbrain function (e.g. confusion) or abnormalbehavior. Rest brain‐Monitor recovery withSymptom Scale After symptom free withgraduated exercise then re‐administer the NeurocognitiveTest Update Concussion History Balance TestingAny athlete with a suspected concussionshould be IMMEDIATELY REMOVED FROMPLAY, urgently assessed medically, shouldnot be left alone and should not drive amotor vehicle.iPad, iPhoneXoom, DroidBlackberry EnabledSymptoms and HistoryBrain FunctionComputerized Neuropsychological Testse.g. Concussion Vital SignsPaper and PencilPocket SCAT2The Pocket SCAT2 is a standardized methodof evaluating injured athletes for concussionand can be used in athletes aged from 10years and older.Concussion should be suspected in thepresence of anyone or more of the following:symptoms (such as headache), or physicalsigns (such as unsteadiness), or impairedbrain function (e.g. confusion) or abnormalbehavior.Any athlete with a suspected concussionshould be IMMEDIATELY REMOVED FROMPLAY, urgently assessed medically, shouldnot be left alone and should not drive amotor vehicle.SidelineBaseline /Post‐InjuryBalance TestingBrain imagingLab ValuesStudent-Athlete Concussion ManagementPre‐Participation or Pre‐Season Exam & Activity Policy Plan ProtocolConcussionEducationEvaluation & Management ofConcussed AthletePre-SeasonBaselineTestingSidelineand PostInjuryAssessment Pocket SCAT 2Concussion Symptom ScaleNeurocognitive EvaluationConcussion HistoryBalance Testing Athletic Director Athletic Trainer Coaches School Staff Athletic Trainer School Nurse Coaches Athletic Trainer Coaches School Staff Parent Directed Athletic Trainer Team Physician Coaches Athletes (ObserveTeammate Signs) Team Physician Sports Medicine Neuropsychologist Sports Medicine Neuropsychologist Other Clinicians Hospitals, etc.Team PhysicianSports MedicineNeuropsychologistOther CliniciansCDC ProgramsTeam PhysicianSports MedicineNeuropsychologistOther CliniciansHospitals, etc.AcademicSupportDuringRecovery Parent Teachers School Nurse Athletic Trainer School Psychologist Guidance CounselorReturn toPlayDecision Team Physician Personal Physician Neuropsychologist Sports Medicine Parent Athletic Trainer Coach School NurseSystematic Documentation of Relevant Clinical Endpoints toHelp Make Informed Return-to-Play Decisions

OPTIMIZED for Easier ManagementAdd USERS e.g. One UniversityAccount with Multiple UsersEasy Roster Set-UpEasy to RetireGraduated AthletesEasy to EDIT or UPDATEAccount InformationEasy to VIEW andSEARCH REPORTSEasy to TRACK AccountActivityEasy Roster ReportsInvalid Retest, Baseline, Etc.13 Sideline Assessment mobile enabled for efficiencyPocket Scat 2requires internet connectivityiPad, iPhoneXoom, DroidBlackberry Enablede.g. ListEasy EDIT DemographyFunctionCopyright 2013. All rights reserved.Pocket SCAT2The Pocket SCAT2 is a standardized methodof evaluating injured athletes for concussionand can be used in athletes aged from 10years and older.Concussion should be suspected in thepresence of anyone or more of the following:symptoms (such as headache), or physicalsigns (such as unsteadiness), or impairedbrain function (e.g. confusion) or abnormalbehavior.Any athlete with a suspected concussionshould be IMMEDIATELY REMOVED FROMPLAY, urgently assessed medically, shouldnot be left alone and should not drive amotor vehicle.Collect your sidelineexam information ona handheld device ora clipboard (transferthe data whenconvenient).clipboard14 Copyright 2013. All rights reserved.

Concussion Evaluation:SCAT2 / SACComputerized neuropsychological testing increases the likelihood ofconsistent inter‐rater reliability across sites. It also helps withaccountability/risk management documentation vs. paper‐pencilCVS can assist with your Return‐to‐Play protocol Athletes should not be returned to play the same day of injury. When returningathletes to play, they should follow a stepwise symptom‐limited program, withstages of progression. For example:1.Rest until asymptomatic (physical and mental rest)Document with Concussion Vital Signs Symptom Scale2.Light aerobic exercise (e.g. stationary cycle)Document with Concussion Vital Signs Symptom Scale3.Sport‐specific exerciseDocument with Concussion Vital Signs Symptom Scale4.Non‐contact training drills (start light resistance training)Document with Concussion Vital Signs Symptom Scale5.Full contact training after medical clearanceDocument with Concussion Vital Signs Neurocognitive Testing, Symptom Scale6.Return to competition (game play)There should be approximately 24 hours (or longer) for each stage and theathlete should return to stage 1 if symptoms recur.***Medical clearance necessary before returning to play.**Adapted from the SCAT2 protocol and tools which were developed by a group of international experts at the 3rd International Consensus meeting onConcussion in Sport held in Zurich, Switzerland in November 2008. British Journal of Sports Medicine, 2009, volume 43, supplement 1.18 Copyright 2013. All rights reserved.

Concussion Symptom Scale‐ computerized Used in all Phases Graded (1‐Mild to 6‐ Severe) CSI - ConcussionSymptom Inventory SCAT 2 NeurobehavioralSymptom Inventory19 Copyright 2013. All rights reserved.Concussion History‐ can be obtained from reliable source‐does not have to be from student athleteDemographic and Background Information ‐ Education Years of Education Completed (e.g. high school senior is 11 years): SAT ‐ ACT (total): Received Speech Therapy: Attended Special Education Classes: Repeated One or More Years of School: Diagnosed Attention Deficit Disorder (ADD) or (ADHD): Diagnosed Learning Disability:Demographic and Background Information ‐ Sports Primary Sport: Primary Sport Position: Years you have played this primary sport at current level: Total number of years you have played this primary sport: Secondary Sport: Secondary Sport Position: Years you have played this secondary sport at current level: Total number of years you have played this secondary sport:Concussion & Medical History Number of times diagnosed with a concussion: Injury 1 (Up to 3 Injury’s can be reported) Approximate Date of Injury: Days Lost: Was this concussion sports related? Did this concussion result in a loss of consciousness? Did this concussion result in confusion? Difficulty remembering events immediately before injury? Difficulty remembering events immediately after injury?Indicate whether you have experienced the following: Treatment for Headaches by Physician: Treatment for Migraine Headaches by Physician: Treatment for Epilepsy / Seizures: History of Brain Surgery: History of Meningitis: Treatment for Substance / Alcohol abuse: Treatment for Psychiatric Condition (depression / anxiety etc.): Current Medications:20 Copyright 2013. All rights reserved.User Name:Password:

Concussion Vital SignsConcussionVital SignsImPactDemographicsNeurocognitive tests include:Verbal Memory (Immediate)Visual Memory (Immediate)Finger TappingSymbol Digit CodingStroop TestShifting AttentionContinuous PerformanceVerbal Memory (Delayed)Visual Memory (Delayed)Concussion HistoryConcussion SymptomsTesting Time 25 to 30 MinutesConcussion Symptom Checklist & History are independent from the Neurocognitive testWhat is included? What subtests are there?ConcussionVital SignsVerbalMemoryVisualMemoryFinger Tapping3WidelyRecognizedMeasure ofMotor SpeedSymbol DigitCodingStroop AttentionStrongExecutiveFunctionTestsTesting Tips?What is helpful to know?

Room set up?How do you set the room up toensure test results can be used?Brief introduction tointerpretationWhat do you need to know?When do you repeat baseline testing?When do you do post injury testing?Concussion Vital Signs Test ReportPost‐Concussion Example: First Retest

Concussion Vital Signs Test ReportPost‐Concussion Example:Second Retest28Concussion Vital SignsAdd Administration RightsEasy Roster Set-UpEasy to Retire GraduatedAthletesEasy to EDIT or UPDATEAccount InformationEasy to VIEW and SEARCHREPORTSEasy to TRACK AccountActivityEasy Roster ReportsRetest, Baseline, Etc.e.g. List InvalidEasy EDIT DemographyFunctionContinuity of Care – Clinician Portal

Demo Schools Platform,Assessments, Reports,Data Management Clinician PortalCVS Technical Support: telephone: 1‐ 800 249 0659 #7 Insides sales: Kent Willette Presenters: Peter C. Entwistle & Charles Shinaver

Concussion Vital Signs Test Report Post‐ConcussionExample: SecondRetest 28 Concussion Vital Signs Add Administration Rights Easy to Retire Graduated Athletes Easy Roster Reports e.g. List Invalid Retest, Baseline, Etc. Easy Roster Set-Up Easy to EDIT or UPDATE Account Information Easy to VIEW and SEARCH REPORTS Easy to TRACK Account Activity