After a concussion, a college athlete’s rush to return to the field raises questions of game-time performance and safety, but the lingering effects might just show up in academics.
Two researchers at Northern Arizona University are improving how injured athletes are evaluated and connecting those who need extra rehabilitation to on-campus resources. Their collaborative project will generate baseline data about NAU football and women’s soccer players that can be used to show when a dip in grades and cognitive function may be traced to residual concussion symptoms.
“We just want to be sure student athletes are going to be successful when they return to academics,” said Emi Isaki, assistant professor in Communication Sciences and Disorders. “Usually there’s a dramatic change in academic performance following a head injury, and that’s what we don’t want to see. We can help the student out before that happens.”
Isaki’s collaborator in the interdisciplinary project is Scot Raab, assistant professor in the Athletic Training program. Both work in the College of Health and Human Services.
While Isaki and Raab said standard evaluations are generally effective, they could still be more thorough, especially considering athletes are highly motivated to return as quickly as possible. Regardless of any pressure they may feel, Raab said, sometimes they truly are not aware of having symptoms.
“Maybe their head doesn’t hurt, the knot is gone and they can see clearly and balance,” Raab said. “They may even have passed the accepted protocols for their return to action. But then they find that after three or four hours of class, they have that ‘mental fogginess’ and fatigue. We need a longer battery of tests to measure them.
In current practice, an NAU athlete suspected of suffering a concussion is assessed immediately by clinical athletic trainers. If a concussion is confirmed, then the athlete is removed from play and referred to a physician. An athlete who reports being symptom-free for 72 hours may be re-evaluated but still cannot return to contact for eight days.
An expanded evaluation would include more balance assessments, visual spatial coordination, cognition, hearing screening, auditory processing, pitch identification and cognitive-communication measures related to academics. Athletes in the research project would be assessed in all these areas in January. That personalized baseline data would be available as a comparison tool when evaluating for a concussion during the season, resulting in more accurate assessments.
Isaki said that while all the tools they plan to use have been shown to be effective, they have not been used together in a study such as this one. And if they show that symptoms are still present after 21 days, resources are readily available at the NAU Speech and Hearing Clinic.
“We’re really fortunate because we have audiology and speech-language pathology right here in the department,” Isaki said. If needed, further referrals could be made to visual therapies, disability services and neuropsychology.
With initial funding from the Technology Initiative Research Fund, via the Arizona Board of Regents, Isaki and Raab plan to use the data they gather in January to apply for a National Institutes of Health grant that would extend the project into a multi-year longitudinal study.
Despite heightened public awareness on the topic, “We are still in the process of collecting data to determine what is going to happen after concussions,” Isaki said. “It is unknown how many concussions result in long-term residual effects.”
As Raab put it, “Part of the fear is that we’re seeing long-term effects and we know the short-term effects. We need to explore that whole middle area from day 21 to year 21. That’s something we’ve never measured before.”