Just in time for the back-to-school season, the CDC is now outlining the first evidence-based recommendations for diagnosing and treating kids with concussions.
“What it does is really clarify a lot of questions about diagnosis, about treatment, about whether or not to scan, so it gives clinicians a best practice guideline,” said Joanna Boyd, public education coordinator at the Brain Injury Alliance of New Jersey.
The report is based on 25 years of research. For starters is using age appropriate symptom scales for diagnosing instead of relying on CT and MRIs as the first line. That’s one key recommendation of the 19 set forth.
“Years ago the only treatment given was cocoon therapy — dark room and no activity until symptoms resolved. Now we know how important active rehabilitation is, but it must be done under the supervision of a concussion expert,” said Danit Macklin, physical therapist at Hackensack University Medical Center.
Active recovery is a huge change in protocol, as is assessing risk factors for prolonged recovery — like previous blows to the head.
“Because there were no guidelines at the time, really coaches and trainers really had no basis to do anything other than send the child back in to play. And only over time did we learn they were actually doing long- and short-term harm to the player because it impacts the player’s ability to think, their cognitive abilities,” said Steven Benvenisti, president of the board of trustees for the Brain Injury Alliance of New Jersey.
“When clinicians are diagnosing what we think of as a concussion, that they should use the term mild traumatic brain injury, and I think this has the potential to help us get some better numbers,” said Boyd.
Another change is to emphasize the severity. It’s estimated about a million kids a year sustain a mild traumatic brain injury, though there’s no real tracking system yet.
“I believe concussions are very important to me because they can happen to anyone. It’s also very preventable, so if people can be educated on that then we’ll have less,” said student athlete Anay Badlani.
Badlani’s brother died of massive head trauma sustained in a car accident seven years ago. Now he’s advocating to keep his brain safe as a soccer player. Rutgers Youth Sports Research Council plans to unveil new, free training for volunteer coaches in November.
“A common theme among parents that are taking their children that have received concussions is — I wish I knew then what I know now. I wish I was educated on concussions, because had I known I would have treated it differently,” said Carol Ann Giardelli, director of Safe Kids New Jersey for the Central Jersey Family Health Consortium.
Here’s the takeaway: Researchers say updates should be continually made as evidence grows because these may be the best practices now, but they may not be in the very near future.