March 11, 2014
by Hallie Sawyer | Reprinted courtesy of SimplyKC Magazine
ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is making quite the — pardon the pun — impact on the way doctors in the Kansas City area are able to treat patients with concussions, also known as mild traumatic brain injury.
ImPACT is a software program that was developed at the University of Pittsburgh and is the first of its kind in the market. It is one of the mostly widely used programs and is trusted by major sports organizations like the NHL, MLB, and NFL. What makes the software program so effective is that it assesses cognitive functions like memory, focus, concentration, and reaction time.
Dr. Lori Boyajian-O’Neill, DO, is a sports medicine physician with Midwest Sports Medicine Physicians. She has had nine years of experience with diagnosing and treating concussions in our area’s youth. The physicians use ImPACT as part of their concussion management program, making them a vital source to parents and family practitioners for a more thorough diagnosis and treatment.
Dr. Boyajian-O’Neill has been using ImPACT for many years and has seen vast improvements in how doctors are now able to treat their patients. “This is the type of information that is difficult to assess in the clinic through verbal tests,” she says. “ImPACT makes it easier to assess our patients and is a nice tool to have when we are looking at the whole picture of a patient.”
Through ImPACT, they are able to determine their patient’s cognitive deficits and how the patient is truly thinking. “Now we can monitor reaction time, which is a big marker for recovery, as well as the patient’s reading comprehension levels,” Dr. Boyajian-O’Neill says. When compared to the initial baseline test, she can assess the patient’s readiness to get back to the playing field or to school.
As the test is only tool in the concussion diagnosis toolbox — even though a patient may sail through the ImPACT test post-concussion — she looks at all symptoms: headaches, dizziness, and forgetfulness, before giving the “all clear.” Dr. Boyajian-O’Neill stresses there are many factors involved when diagnosing and treating a concussion and that ImPACT should not be seen as the one and only determination of a patient’s health.
“Just like an X-ray can show a fractured bone, an ImPACT test can tell us the workings of the brain,” says Lisa Carpenter, PT, director of rehab and sports medicine at Overland Park Regional, where one of the concussion-management centers is located. “The reason we really stress having a baseline test is because if you do end up suffering a concussion and we choose to do post-injury concussion testing, we can compare your baseline brain functioning to your current brain functioning.”
The hospital’s comprehensive concussion management program includes the baseline testing as well as educating parents and athletes on how to recognize the symptoms of a concussion. “It’s very important to know that even if a child doesn’t have a baseline test on file, we have enough normative data on file to know where the child should be,” she says.
While the child takes his or her baseline test, parents attend a mandatory education session that delves deeper into the prevention and treatment of concussions as well as quick-reference guides for on-the-spot assessments. The hospital has signed partner agreements with many club teams in the area and has gone out to group settings to educate coaches about concussions.
“One thing to understand is that even if a child came in to do baseline testing because they play a certain sport, the post-injury testing is for any type of mild head trauma, whether it is from sports or just falling off a bike,” Carpenter says. Her team works in collaboration with pediatricians and family physicians across the city and the most important thing to them, she stresses, is that the child gets the necessary medical attention. It is then determined if they need to see a concussion specialist, like Dr. Boyajian-O’Neill.
Dr. Boyajian-O’Neill feels the education component of the program is just as important, if not more so, than the baseline scores. “We must educate athletes, coaches, and parents about the the signs and symptoms of a concussion and the consequences of not recognizing that, or if you do, continuing to play, which is very dangerous,” she explains.
You can set up one-on-one sessions or group sessions (with a recommended minimum of 10 kids) by contacting Betsy Kellerman, sports injury and concussion coordinator at Overland Park Regional Medical Center, at 913.541.3365 by going to midwestsportscare.com for programs at Overland Park Regional Medical Center and Centerpoint Medical Center. Overland Park Regional Medical Center is part of HCA Midwest Health System, Kansas City’s largest health care provider.