ONU Concussion Policy

July 14, 2014

OHIO NORTHERN UNIVERSITY CONCUSSION MANAGEMENT POLICY

A concussion is a brain injury that is caused by a blow to the head or body that may result in improper brain functioning. A concussion can range from mild to very severe and manifests itself differently in each individual.

Concussions are recognized as being a potentially very serious condition that if managed improperly, can lead to catastrophic consequences. At Ohio Northern
University, we take great pride in providing optimal health care to all student-
athletes. The following policy has been adopted by the Sports Medicine Department
in an effort to provide a consistent management approach to any student athlete that
suffers a concussion, while also recognizing that each concussion, as well as each
athlete, is unique and individualized in nature. By managing concussions individually, and considering the athlete's medical history, it allows the physicians and athletic trainers on staff to ensure the safety for each student athlete.

Ohio Northern University recognizes that concussions may occur outside of participating in a sport. Therefore the acute management of the student-athlete with such a concussion may occur outside the scope of this document. However, return to play decisions for the student athlete that may have suffered a concussion outside of sport participation will be guided by this policy. This policy includes, but is not limited to the management principles mandated by the NCAA.

EDUCATION

Prior to each preseason, student-athletes will be educated on how to recognize signs and symptoms of concussion, the Ohio Northern University Sports Medicine Department Concussion Management Policy, as well as current trends in concussion management.

At the beginning of each academic year, student-athletes will sign a statement acknowledging the receipt of the education, as well as their role in reporting any student-athlete exhibiting signs and symptoms of a concussion to the appropriate member of the Sports Medicine Staff.

SIGNS AND SYMPTOMS OF A CONCUSSION

Signs and symptoms of a concussion may include, but are not limited to the following:

• Nausea/Vomiting

• Tinnitus (ringing in ears)

• Balance problems

• Difficulty concentrating

• Personality changes

• Sensitivity to light and/or noise

• Loss of consciousness

Exercise or activities that require a lot of concentration may cause symptoms to re-appear or worsen, thus increasing the time one needs to recover from a concussion.

BASELINE TESTING

Each athlete (TBD on a sport by sport basis) on an active sport roster, as part of a comprehensive pre-participation physical exam, will be tested with a computerized neuro-psychological exam (ImPACT®). The reason for this is to have "baseline scores" for comparison should a student athlete sustain a concussion throughout their

REPORTING A CONCUSSION

Anyone that suspects a student athlete has a concussion, or notices any athlete suffering from any symptoms of a concussion, must report the concerns to the appropriate member of the Ohio Northern University Sports Medicine Staff.

ACUTE MANAGEMENT OF A CONCUSSION

Any athlete that suffers from symptoms of a concussion shall be removed from participation for evaluation by the Sports Medicine Staff. Following evaluation from the Sports Medicine Staff, decisions will be made whether the athlete should be transported to the local hospital for emergency care and/or further diagnostic testing. Any athlete that is diagnosed with a concussion by a Physician shall not return to participation for the remainder of that day. This is to ensure that the athlete does not negatively influence the nature of the injury by further exerting themselves.

POST-ACUTE CONCUSSION MANAGEMENT

Follow-up Physician care will be determined on an individual basis as directed by the Ohio Northern University Sports Medicine Staff. ImPACT® testing will be performed as determined by the Sports Medicine Staff based on the individual, and their symptoms.

Testing will be performed on a schedule as determined by the sports medicine staff based on the scores of the student-athlete and their symptoms. A "symptom score" shall be taken each day up to, and including the day the student-athlete is completely asymptomatic. Once a student-athlete has been asymptomatic for at least 24 hours and the neuro-psychological test scores have returned to the baseline scores, a gradual return-to-play protocol shall be implemented, unless directed otherwise by a Physician.

• Step 1. Light Aerobic Exercise with Athletic Training Staff

• Step 2. Resistance Training and Sport Specific Exercises with Athletic Training Staff

• Step 3. Non-Contact Practice Participation

• Step 4. Full-Contact Practice Participation

• Step 5. Return to Full-Participation

With the aforementioned progression, an athlete should be allowed to progress, as long as symptoms do not arise at the current level. If symptoms do arise during the progression, the student-athlete will return to the previous asymptomatic level.

FACTORS IN CONCUSSION MANAGEMENT

Ohio Northern University Sports Medicine Department recognizes that there are several factors that influence the concussion management policy. These factors include, but are not limited to:

• Medical History

• Symptoms

• Age

• Medication

• Sport

If it is determined by the sports medicine staff that the athlete should follow an
adapted concussion management protocol, it is in an effort to ensure the safety of the student-athlete during their recovery from a concussion. At any point throughout the recovery of the student athlete, a neurologist, or other specialist specifically trained in concussion management may be consulted as determined by the Physician.

The entire management process from initial evaluation, until eventual return to full participation, including any diagnostic testing, shall be documented in the student athletes medical file.

NCAA “RETURN TO LEARN” GUIDELINES

The foundation of return-to-learn includes:

  • Return-to-learn should be managed in a stepwise program that fits the needs of the individual.
  • Return-to-learn guidelines assume that both physical and cognitive activities require brain energy utilization, and they similarly assume that such brain energy is not available for physical and cognitive exertion because of the concussion-induced brain energy crisis.  Return-to-learn recommendations are based on consensus statements, with a paucity of evidence-based data to correlate with such consensus recommendations.
  • Return-to-learn recommendations should be made within the context of a multi- disciplinary team that includes physicians, athletic trainers, coaches, professors and administrators.
  • Like return-to-play, it is not always easy to provide prescriptive recommendations for return-to-learn because the student-athlete may appear physically normal but is unable to perform at his/her expected baseline due to concussive symptomatology.

The hallmark of return-to-learn is cognitive rest following concussion, just as the hallmark of return-to-play is physical rest.

  • Cognitive rest means avoiding potential cognitive stressors such as:
    • school work, video games, reading, texting and watching television. The rationale for cognitive rest is that the brain is experiencing an energy crisis, and providing both physical and cognitive rest allows the brain to heal more quickly. For the college student-athlete, cognitive rest that is recommended following a concussion means avoiding the classroom for at least one day. The gradual return to cognitive activity is based on the return of concussion symptoms following cognitive exposure.
 

ONU Intercollegiate Concussion Protocol for Student Athletes maybe requested from the ONU AT Staff.