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Space-Age Concussion Assessment Tool Has a Long Way to Go

By Colin Nelson | February 2, 2007
  • Inform patients of the risks associated with prematurely returning an athlete to play after a suspected concussion.

  • Understand that tools for the sideline assessment of concussion in athletes continue to evolve and are not proven to prevent serious long-term injury. The recent Sport Concussion Assessment Tool and so-called Prague concussion guidelines provide important guidance for clinicians managing athletes with head injury.

BOSTON, Aug. 2, 2005 -- As NFL training camps opened this weekend, Ted Johnson, the veteran linebacker for Super Bowl champions New England Patriots, announced his retirement at age 32, citing the effects of multiple concussions.

Wide receiver Wayne Chrebet, who has also had several concussions, was mulling over his future with the New York Jets.

The widely publicized fate of both players drew attention to the difficult question of when a player can return to action after a head injury. This holds true for players at any level of football, from junior high school to the pros.

One proposed solution is a sideline assessment tool using a space-age headset and laptop to save athletes from the consequences of a serious head injury. Others, however, suggest that questions typed on an index card and stuffed into a shirt pocket do just as well or better at no cost.

Low-tech assessment tools, though far from perfect, are probably just as good as pricey, high-tech ones -- and likely better, say some experts. But there is little evidence to show that any sideline assessment tool -- including the new interactive helmet -- do what researchers and clinicians wish they did.

"I think they're putting the cart before the horse here," said Robert E. Sallis, M.D., vice president of the American College of Sports Medicine and editor of the journal Current Sports Medicine Reports. "You want to prevent death and disability. But there's no evidence that any of these tools are going to prevent the things they've set out to prevent," he said in an interview.

"The bottom line is: Do you need this tool to make the diagnosis?" said John P. DiFiori, M.D., chief of sports medicine at UCLA. "Probably not in most cases."

The prospect of rare but devastating head injuries colors the entire management of concussion in sports. Researchers from the Georgia Institute of Technology and Emory University recently provided journalists with a preview of an innovative device designed to help identify those athletes who should be withheld from competition in order to minimize such injuries.

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