90 high schools will participate in UNC-CH head injury study

December 02, 1999

CHAPEL HILL - Among the scariest injuries in football and other sports, blows to the head can mean nothing more than a little short-lasting pain or forever change an athlete's life for the worse. For that reason, doctors, athletic trainers and coaches face a daunting task when deciding which injuries to take most seriously.

Now, University of North Carolina at Chapel Hill researchers who are trying to make sports safer soon may be able to take some of the guesswork out of how to handle head trauma. They have received two grants totaling $531,000 to support a two-year investigation of such injuries in games and practices.

The grants will come from the U.S. Centers for Disease Control and Prevention and the National Operating Committee on Standards for Athletic Equipment to fund a project involving 90 high schools in seven East Coast states and the District of Columbia. The seven are Delaware, Maryland, New Jersey, North Carolina, Pennsylvania, South Carolina and Virginia.

"Right now we're recruiting certified athletic trainers at all the schools," said Dr. Kevin M. Guskiewicz, assistant professor of exercise and sport science at UNC-CH and study leader. "In February, we'll begin training the athletic trainers at the various study sites on how to assess concussions using several objective measures, some of which have been developed by members of our research team."

"Some of the assessments involve tests of thinking ability, memory and concentration," Guskiewicz said. "Others involve tests of how well athletes maintain their posture and balance while standing on one foot on a device called a balance box that moves beneath them. During testing, the goal is to keep their bodies and the box as motionless as possible."

All athletes on three of each school's teams will be tested before their season begins and then again immediately after suffering a concussion during any practice or game. Tests will be given again three, 24, 48 and 72 hours after injury and again on days five, seven and 90 post-injury.

"Our recent work suggests that people are returning injured athletes to play way too soon, an average of four days after a concussion," Guskiewicz said. "This new work, in which 45 schools will be the study group and the other 45 will serve as controls, will allow us to see if these assessments are useful. We'll see what kind of decisions are made with and without the tools and what the incidence of re-injury is among players in the two study groups."

UNC-CH's Injury Prevention Research Center, directed by Dr. Carol Runyan, is coordinating the study. Besides principal investigator Guskiewicz, others involved include Drs. Frederick Mueller, professor and chair of exercise and sport science; Steve Marshall, research assistant professor of epidemiology at the School of Public Health; Bryan W. Smith, team physician; and Runyan, all at the university. Dr. Michael McCrea, head of neuropsychology at Waukesha Memorial Hospital in Waukesha, Wis., also will play a major role.

Guskiewicz directs UNC-CH's Sports Medicine Research Laboratory and Undergraduate Athletic Training Education Program. A study he published two years ago attracted national attention after it showed athletes demonstrated thinking and balance deficits up to three days following concussions. His group's recommendation at that time was to institute baseline testing for thinking and balance in high schools and colleges nationwide to prevent concussed athletes returning to compeition prematurely.

Healing continues for more than a week following blows to the head, but the first few days can be critical. Athletes whose more severe injuries could be detected by X-rays or MRI scans, or who were hospitalized more than 48 hours, were excluded from the project since they obviously required and were receiving medical help.

Guskiewicz and McCrea also direct a continuing study of head injuries among football players at 34 randomly selected colleges and universities across the United States. That work is being sponsored by the National Collegiate Athletic Association.

"We are confident that this research is going to produce important information about concussions," the scientist said. "Our goal is to return injured athletes to the playing field in a timely fashion, but more importantly, when we're sure they are safe to play again."
Note: Guskiewicz can be reached at 919-962-5175 or GUS@EMAIL.UNC.EDU.
Contact: David Williamson, 919-962-8596.

University of North Carolina at Chapel Hill

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