Mar 26, 2010 8:43:12 AM

The NCAA's effort to improve understanding of and response to concussions in all sports continues, highlighted by the scheduling of a summit that will seek a consensus on best practices for medically managing such injuries.

The April 9 meeting in Indianapolis will involve invited subject experts in neurology, neuropsychology and sports medicine, and an array of team physicians and athletic trainers representing NCAA Divisions I, II and III institutions.

The summit is one of several policy-related and educational activities that were recommended last December by the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports. The "Concussion in Sport Collegiate Medical Summit" is timed to permit various NCAA committees and affiliated sports-medicine organizations to consider any resulting recommendations during spring and summer meetings.

Other current activities include a survey of head athletic trainers about concussion-management practices and the development of educational materials for coaches and student-athletes that will be delivered to NCAA member institutions during the coming month.

These activities are the most recent developments in efforts that also have included actions by NCAA sport rules committees to manage concussion issues more effectively.

The NCAA Playing Rules Oversight Panel instructed playing-rules committees to review policies for stopping play for injuries and to consider rules that may further prevent head injuries.

In response, the NCAA Football Rules Committee modified that sport's rules to require removing from play student-athletes suffering any injury (including exhibiting signs of concussion) until cleared to return by appropriate medical professionals, and the Men's and Women's Soccer Rules Committee modified rules to stop the clock and summon medical personnel onto the field in response to signs of concussion.

The effort to address concussion-management policies more broadly began in December with the competitive-safeguard committee's revision of an NCAA Sports Medicine Handbook guideline advising member institutions on appropriate response to concussions and procedures for returning student-athletes to competition or practice.

That effort is continuing with next month's summit, the survey of head athletic trainers, and development and distribution of educational materials.

The summit's primary goal is to explore emerging trends in medical management of concussions and to develop a consensus on best practices for responding to such injuries. The meeting may produce recommendations that ultimately could be implemented through the NCAA legislative process or as policy, making the scheduling of the event timely.

"The best practices discussion could lead us into a direction for other policies," said Debra Runkle, competitive-safeguards committee chair and Dubuque assistant director of athletics/head athletic trainer. "In the end, we want to ensure institutions can continue to provide the appropriate care that is consistent with sound principles of sports medicine and that protect student-athletes and their return to play."

Results of the survey of head athletic trainers will be among information reviewed by summit participants. The survey asks about institutions' concussion-management plans, return-to-play guidelines and the access they provide to appropriate healthcare providers.

The survey also seeks insight into how well institutions and medical staffs are prepared to implement any concussion-management plan that might be legislated or implemented as policy by the NCAA.

Any best practices, legislative concepts or policy recommendations resulting from the April summit would be reviewed later this spring by the competitive-safeguards committee, which then could forward recommendations to appropriate Association-wide and divisional governance groups for consideration of implementation.

While those discussions proceed, the NCAA actively is pursuing new educational initiatives recommended by the competitive-safeguards committee.

Those efforts are rooted in the committee's revision of the Sports Medicine Handbook, which emphasizes athletes "exhibiting an injury that involves significant symptoms, long duration of symptoms or difficulty with memory function should not be allowed to return to play during the same day of competition."

The statement goes on to recommend that athletes suffering loss of consciousness or exhibiting amnesia or persistent confusion should not return to practice or competition until cleared by a physician, and states "it is essential that no athlete be allowed to return to participation when any symptoms persist, either at rest or exertion."

The NCAA, in collaboration with the Centers for Disease Control, has developed posters to educate student-athletes on symptoms of concussion as well as a series of posters aimed at specific high-risk sports. Those materials, along with fact sheets for coaches and for student-athletes, will be distributed in the next few weeks.

"Every preseason game plan should include these free concussion educational materials," said Richard C. Hunt, director of the CDC's Injury Center Division of Injury Response. "We encourage coaches, before the first practice, to talk with their athletes and parents about the dangers and long-term consequences of concussion. Let's take concussion out of the game, just like we take a fracture out of the game."

Information also will be inserted into appendices of NCAA playing-rules books to provide more information to game officials and coaches about concussion.

Other materials currently being developed include a video to educate student-athletes about the dangers of concussions and to further improve awareness of the issues among game officials and coaches, and online continuing-education courses aimed at medical staffs and coaches.

RECENT BACKGROUND

February 23
New data suggest shift in football concussions rate
Injury data influencing sport-safety discussions

January 13
Rules panel supports concussion concepts

December 10
NCAA panel to review concussion issues
Q&A with NCAA competitive-safeguards committee chair
NCAA changes to minimize risk of injury
NCAA-related concussion studies and articles