ConcussionsA concussion is a brain injury that can be caused by a blow to the head or body that disrupts normal functioning of the brain. Concussions are a type of Traumatic Brain Injury (TBI), which can range from mild to severe and can disrupt the way the brain normally functions. Concussions can cause significant and sustained neuropsychological impairment affecting problem solving, planning, memory, attention, concentration, and behavior.Recovery from concussion and progression through the Return to Play Protocol is individualized and determined on a case by case basis. Many factors influence the rate of progression and include age, previous concussion history, duration and types of symptoms. Student athletes suspected of having a concussion will start in step 1 and remain in step 1 until symptom free.
IMPACT BASELINE TESTINGAll students participating in interscholastic athletics must complete the ImPACT (Immediate Post Concussion Assessment & Cognitive Testing) baseline test. More information is available on the family id website.All incoming freshmen must complete the test and any student that did not participate in athletics at High School North must complete test.You must receive an instruction sheet from your coach to complete the test, instructions are not available online!The impact test instructions are for baseline tests only. Students with suspected head injuries should not take the baseline test again until the two year mark. Head injuries will be evaluated and the post injury impact test will completed when all symptoms have subsided.Impact is a fee for service program. Please only take the test when you are instructed to do so. Post injury tests are not considered a baseline.
Concussion PolicyNJ State law and Middletown Twp BOE Policy on concussions mandate any student athlete that participates in any sports program, interscholastic, or intramural and is suspected of sustaining a concussion will be immediately removed from competition or practice. The student athlete will not return until he/she has medical clearance from a physician trained in concussion evaluation and management. The medical clearance must be reviewed by the district physician before beginning the return to play protocol. The graduated return to play protocol cannot begin until the student is fully immersed in school activities and asymptomatic at rest. Return to sport requires that the student has returned to his/her impact baseline and completed the district's return to play protocol.Included in Middletown Twp BOE policy: students will be required to visit their physician when a student is suspected of having a concussion. Instructions for returning to learn and returning to play are required from a physician trained in concussion management.
Return to Play ProtocolStudents must be fully immersed in school activity to return to full athletic participation. MD clearance notes must be approved by the district physicianStep 1: Symptom-limited activity. Daily activities that do not provoke symptoms. Gradual reintroduction of work/school activities. Completion of a full day of normal cognitive activities without reemergence of any signs or symptoms. Impact test is at or above baseline results.Step 2: Light aerobic exercise, walking, swimming. Increase heart rate.Step 3: Sport Specific exercise including running/skating. No head impact. Add movement.Step 4: Non contact sport specific training drills, may start resistance training. Exercise, coordination and increased thinking.Step 5: Participation in normal practice activities, including contact after medical clearance. Restore confidence and assess functional skills by coaching staff.Step 6: Return to play involving normal exertion or game activity.Notes:
- An initial period of 24-48 hours of both relative physical rest and cognitive rest is recommended before beginning the RTP progression.
- All steps must are separated by 24 hrs. If any symptoms worsen during exercise, the athlete should go back to the previous step. Resistance training should be added only in the later stages (3 or 4 at the earliest). If symptoms are persistence (e.g. more than 10-14 days in adults and more than 1 month in children) the athlete should be referred to a healthcare professional who is an expert in the management of concussion.
- Return to play can coincide with return to learn, however student athletes must be fulling integrated in their school day to return to full play.
McCrory, P., Meeuwisse, W., Dvorak, J., Aubry, M., Bailes, J., Broglio, S., ... & Davis, G. A. (2017). Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med, bjsports-2017