When an athlete is involved in a head-on collision on the field, the effects can be immediate and obvious. He may lie motionless, or rise slowly and stagger. On the other hand, he may leap up, appear to be unharmed and continue playing, only to complain of a severe headache, memory loss and dizziness immediately after the game … or days later. After thousands of professional football players sued the National Football League in 2012, alleging that the NFL failed to disclose the neurological damage linked to repeated hits to the head, concussions charged to the front lines of medical research.
Bloomsburg University is becoming a leader in the field.
In partnership with the Geisinger Orthopaedic Institute, Division of Sports Medicine, Bloomsburg University and its team of trainers, coaches and researchers are working to better assess injured athletes, study and protect the brain, and ultimately head off a severe cognitive condition called CTE, or chronic traumatic encephalopathy. Their research is guiding return-to-play calls.
Under a new agreement, Geisinger Sports Medicine physicians “will rely on BU’s Institute for Concussion Research and Service to provide additional assessment results,” says Joseph Hazzard, director of both the institute and BU’s clinical athletic training program. “These results will enhance their clinical decision-making ability, especially as it relates to return-to-play.”
BU’s Institute for Concussion Research and Service is a collaboration between interdisciplinary faculty and students working to better understand concussions. The institute has two main goals: to give medical professionals a better understanding of concussions, symptoms and their outcomes, and to provide a service to the medical community that will assist in making better return-to-play decisions. It works with student-athletes from BU, Susquehanna and Bucknell universities and 20 area high schools.
Roxanna Larsen, program director of Sports and Orthopaedic Medicine at Geisinger’s Woodbine Lane facility near Danville, says, “If a student has suffered a serious concussion or repeated concussions, the partnership with Bloomsburg will allow us to take a deeper look and get more information.
“It’s the individuality of concussions that is hard to explain,” she adds. “Why does one person heal more quickly than others? The testing that BU does will help find more subtle issues.”
Testing may include a symptom checklist and neurocognitive testing, such as computerized quizzes of basic knowledge and memory recall, along with balance testing. The researchers will also search for biomarkers, such as the presence of certain chemicals in saliva, to objectively gauge the presence and extent of brain injury.
“Research indicates that any time a person is injured, there are chemicals in the bloodstream that allow the healing process to begin and show in saliva,” says Hazzard, who served for 15 years as BU’s head athletic trainer before transitioning to full-time teaching in 2004. “We’re looking for a salivary biomarker that would indicate a concussion.”
The latest agreement builds on BU’s longstanding relationship with Geisinger Sports Medicine. Dr. Dan Feldmann, director of sports medicine services, is the head team physician for BU and the medical director for BU’s athletic training program, and sports medicine specialists Dr. Matt McElroy and Dr. Ryan Roza are also BU team physicians.
The partnership also gives students enrolled in BU’s graduate-level clinical athletic training program hands-on experience conducting assessments in the institute’s lab, located in Centennial Hall.
“It gives students the unique opportunity to decide how, in their professional career, they are going to apply the management of concussions from an assessment standpoint,” Hazzard says. “How are you going to make the decision to return a player to the field and what kind of data are you going to use? They have a unique opportunity to understand a broad range of assessment tools.”
Hazzard isn’t aware of any other institution that is doing the same kind of concussion work that BU students are pursuing. “It’s one thing to teach students research methods and another to take them out, do data collection and allow them to understand the difficulties.”
The agreement with Geisinger Sports Medicine reinforces BU’s recent appointment as one of 30 institutions participating in the nation’s largest concussion research project, the NCAA-Department of Defense Concussion Assessment, Research and Education (C.A.R.E.) Consortium, now in its third year.
C.A.R.E. Consortium researchers have collected more than 25 million data points from 16,000 student athletes at the 21 schools already participating, including the University of Pittsburgh, Virginia Tech, Princeton University, University of North Carolina at Chapel Hill and the U.S. military academies. After adding BU and eight additional testing sites — the University of Chicago, University of Miami (Florida), University of North Georgia, University of Pennsylvania, Temple University, Wake Forest University, Wilmington College (Ohio) and Winston-Salem State University — researchers estimate more than 25,000 student athletes will take part.
This research is part of the landmark $30 million NCAA-U.S. Department of Defense Grand Alliance, which is funding the most comprehensive study of concussion and head impact exposure ever conducted. The alliance also supports an educational grand challenge aimed at changing important concussion safety behaviors and the culture of concussion reporting and management. Participating schools receive a portion of that funding to cover the cost of research. •