Michigan High Schools Are Participating In A Pilot Baseline Concussion Test, & It Could Be Game-Changing

Where We Are Now: No state law requires baseline testing of high school athletes.

Where We Can Go: Somewhere a lot better than the "now."

Source: Carlos Osorio, Associated Press

Back in 2013, Michigan became the thirty-ninth state to enact legislation governing sports concussions and return to activity. It requires that coaches, employees, and other adults involved in youth sports programs complete online concussion awareness training. It also requires that when an athlete is suspected to have a concussion, that athlete must be removed immediately and can only return with a health professional's written clearance. All states have some form of laws addressing concussions in high school sports, but many are quite feeble because they are reactive rather than proactive. Sports concussion law does improve young athletes' safety, but honestly, more should be done so we can understand brain trauma in sports to better prevent it from happening in the first place.

This is where Michigan may be onto something! 62 high schools in Michigan are participating in a pilot baseline concussion testing program modeled off the testing professional leagues perform. It is designed to be individualized and objective so that everyone across the chain of involvement learns what the signs are and how to detect signs on the sideline. Although it was one of the last states to put into action youth sports concussion laws, Michigan is the first state to implement a baseline testing program that could influence future state concussion law if results are fruitful.

What Is This Test?

Baseline testing is a three-part tool linking "memory, reaction time, attention and stress assessments" to make smarter decisions regarding removing athletes from games and to make concussion diagnoses. Michigan High School Athletics Association (MHSAA) director Jack Roberts said, "The schools that are engaged in the pilot program are learning more about sideline detection and making smarter removal-from-play decisions."

Currently, Michigan is using the King-Devick Test, which is affiliated with the Mayo Clinic, and the XLNTbrain Sport Test. Not only do the tests assist with remove-from-play cases but they also assist with return-to-play cases, for they are both integral to the concussion recovery process. For example, Birmingham Groves administered 30-minute baseline test sessions at the beginning of the season. When an athlete is suspected of having a head injury, the school then administers a five-minute sideline test on an iPhone or tablet app. "It assesses memory by providing words for the athlete to remember. It asks questions that require the athlete to recall the hit. The athletes also hold the phone as they stand tandem for 20 seconds with eyes open and then closed to check balance."

Watch the video below for a demonstration of the minutes-long King-Devick Test on The Today Show to learn more.

Why This Makes Me Really, Really Happy

After this pilot test is complete, the results could affect high school contact sports in a few ways:

1. Hopefully We Will Be Amending/Adding State Laws:

The NCAA backs baseline testing for all college athletes since there is no law mandating it for public schools now. The only other state with anything similar in place is Mississippi, but even that testing program involves much fewer participants and is limited to football.

One justification offered as to why this style of program may not be widely accepted - meaning new legislation would likely be out of the question - is that some school districts may be unwilling or unable to pay money for a detection baseline program, but there is a very reasonable and valid solution available to counter that justification. MHSAA used $10,000, mostly from gate profits, to fund its beginnings this year, and it plans on spending another $20,000 to continue the program in the next school year. Any program has costs, but put it into perspective. The testing company is offering testing for free, at least for the time being, but MHSAA trusts it can fund the program in the long-run with a nominal $3 to $5 fee per student. Additionally, the MHSAA is asking for state grants and state legislative help so that school districts who may not have the means to cough up the funds can access baseline testing.

2. Baseline Testing Could Reveal Relative Risk In Order To Make Rule Changes & Improve Safety:

Baseline testing allows people to see what brain activity looks like at the starting point of a season and compare it to what it looks like after a hard hit resulting in a potential head injury. Moreover, baseline tests at the beginning of each season can show how the memory, reaction time, attention, and stress assessments change for each athlete from year-to-year. Evaluating the relative risks associated with football, soccer, hockey, basketball, lacrosse, rugby, baseball, softball, and other contact activities can influence leagues to alter rules slightly for the safety of the participants. If rules are slightly different at the high school level (e.g., what a legal hit can be) than in college or the professional level, whatever. The majority of high school kids do not go on to higher levels of play, and those who do might not experience overly hard hits or concussions as frequently.

What would be the next best logical step to promote concussion awareness and prevention? Having professional athletic trainers monitor baseline testing and day-to-day safety! Mandatory professional athletic trainers on the sideline for high school teams would be a great step forward for concussion awareness and prevention. Only one-third of high schools nationwide employ a full-time athletic trainer. This basic legal change would take some of the burden off coaches and staff who have taken the required concussion awareness training but who, particularly, have no medical training beyond what current law requires. Again, some schools may say that hiring a professional athletic trainer would be pricey. In all seriousness, if a public school is not willing to find room in its budget to hire a professional on the athletic staff who has the medical training to help keep kids safe, what message does that send to the parents?

3. This Can Provide An Umbrella Baseline For Understanding The Brain Trauma Spectrum From High School To The Professional Level.

Some of the top scientists in the brain trauma arena do not believe high school athletes should be concerned about developing CTE. Nonetheless, one scientific measure we are lacking is a starting point from which athletes participating in contact sports are prone to developing advanced stages of brain trauma. It is a big step in the right direction to measure and evaluate the cognitive function of those athletes who stop playing sports after high school without progressing to the next level. Then we can compare and contrast that to those who stop playing sports after the collegiate or minor level. Finally, we can compare both to those who play professionally and evaluate additional factors such as playing position and frequency on the field.

This could help transition us into a new stage in the constant evolution of contact sports with greater understanding about risk and reward.