Female student-athletes at Drew Central, Hamburg and Warren high schools, along with student athletes in central Arkansas, recently participated in a federally-funded research study aimed at identifying the best strategies in assessing the effects of concussions in adolescent athletes.

The study was funded through a $50,000 grant from the National Institute of General Medical Sciences’ Institutional Development Award program that was awarded to Dr. Leah Lowe and Dr. Charlotte Yates, two faculty members at the University of Central Arkansas Department of Physical Therapy. Drs. Lowe and Yates contacted Nat Grubbs, a local physical therapist and owner of South Arkansas Rehabilitation in Monticello, to discuss opportunities for collaboration, resulting in the inclusion of area schools and female student-athletes in the study.

“This was a great opportunity to participate in a process aimed at improving the health and the care provided to young people with a concussion injury,” Grubbs said. “Participation in the study not only facilitated the scientific aims of the project, but it also provided valuable baseline neurocognitive data that can specifically benefit each individual participant in the case of a concussion injury in the near future.”

The research study examined a number of assessment strategies related to concussion, including various tests of movement and balance, reaction time testing, and neurocognitive testing.

Grubbs and his colleagues at South Arkansas Rehabilitation in Monticello have extensive experience in baseline neurocognitive testing. They have performed hundreds of baseline tests with students in area schools over the past five years.

“This type of computerized testing is typically performed at the beginning of a school year or prior to a student-athlete’s competitive season, and it establishes a ‘baseline’ or ‘normal’ profile of that individual’s neurocognitive function,”Grubbs said. “Testing can provide composite scores in areas such as verbal memory, visual memory, visual motor speed, reaction time, and impulse control. Having this baseline date is very valuable and helpful to healthcare professionals in providing optimal care following a concussion. Comparing an individual’s post-concussion brain function to baseline data allows the medical team to better determine if and when the concussed brain has returned to normal neurocognitive function for the injured individual.”

One of the questions this research hopes to clarify is the optimal frequency of baseline neurocognitive testing in adolescents.

Current recommendations call for baseline testing with high school student-athletes every other year and once during the athletic career of the college student. However, these recommendations are not necessarily supported by research findings, as there is a void in this aspect of concussion research. This research attempted to address this void by performing a series of baseline tests across the school year, according to Grubbs.

Grubbs used a hypothetical female high school soccer player as an illustration.

A baseline test of a female high school soccer athlete is conducted at the beginning of her ninth grade year. Under current recommendations, another baseline test is not conducted until the beginning of her eleventh grade year. During her tenth grade year, she sustains a concussion. In a clinical effort to determine whether her brain has returned to her normal level of neurocognitive function, she is re-tested and her current results are compared to her baseline test.

“The essential question is: Is the test conducted at the beginning of her ninth grade year a valid representation of her neurocognitive function at this age and stage of her cognitive development, near the end of her tenth grade year, or has her brain developed, matured, and changed over the past 18 months in such a way that her baseline test is no longer really valid, and thus she may have some post-concussion neurocognitive impairments that are not demonstrated under these test conditions?” Grubbs said. “These are very important questions, and it is one of the essential questions being addressed in this research.”

Another important aspect of this research is the inclusion of the female student-athlete, as females tend to be underrepresented in concussion research, which is likely a consequence of the concerns related to concussions and football participation. However, emerging research suggests that concussion injuries may affect the brains of young females differently than that of males. Specifically, young females appear to be at greater risk of sustaining a concussion, and the duration of symptoms and impairments tends to be greater in girls than in boys, according to Grubbs.

“I am so thankful to Drs. Lowe and Yates for the opportunity of including kids, schools, and communities in southeast Arkansas in this project,” Grubbs said. “And I very much appreciate the collaborative and supportive efforts of Michael Goad and Barbie Eubanks at Drew Central schools, Donald Rosen and Cecil Ray Cossey at Hamburg Schools, and Bo Hembree and Heidi Lassiter at Warren schools. We sent out invitations for participation to area schools, and these folks stepped up and showed out in support of this important project.”

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