FAQ

1. Why should an athlete not continue to play or return to a game after sustaining a concussion?

Athletes continuing to play (exercise) or receiving multiple blows to the head, after suffering a concussion, may take longer to recover. They also may be more at risk for developing post-concussion syndrome.
An immediate evaluation and examination after a concussion is necessary. While it is important to do a neurological exam to rule out a bleed, it is usually normal in the vast majority of patients. Occasional balance problems or nystagmus on lateral gaze may be found and they usually disappear as the patient recovers.
CT scans and MRIs of the head are usually normal and are not necessary unless the patient has increasing symptoms or there is concern that there might be a bleed. (Research indicates that functional MRIs and PET scans can show the area of the brain affected.)

2. Why should an individual cease doing any activity following a concussion?

Due to the metabolic imbalance that occurs following a concussion, it has been shown that increased blood flow to the brain during recovery may impede or slow down the recovery process and worsen the symptoms of concussion. Most patients do not need to be placed on bed rest unless they are having severe symptoms (severe headaches, marked photophobia, disorientation, balance problems, extreme fatigue, etc). They may participate in any activity that doesn't cause increased symptoms (headaches). In some cases, activities such as reading, watching TV, working at the computer, taking hot baths and having heated discussions with others may increase symptoms. If patients develop increased symptoms while doing a specific activity, that activity should be discontinued.

Many concussed individuals may be unable to concentrate (focus). They may not be able to read or absorb material and may develop an increased headache while doing so. When this occurs, they might be able to participate in an activity for only a few minutes before symptoms increase. If a rest break can be interspersed between those few minute intervals, these activities can be done. As the symptoms abate, longer intervals can be spent reading, watching TV and using the computer. Continuing activities, or exercise that increases symptoms, can delay the recovery from the concussion.

3. How should school/work/college attendance and activities be modified after sustaining a concussion?

i) School/college/work:
While some individuals may be able to attend school or work without increasing their symptoms, the majority will probably need some modifications depending on the nature of the symptoms. Trial and error may be needed to discover what they can and cannot do.

If students are unable to attend school for an entire day without symptoms, they may attend for a half day. Some students may only be able to attend for one period, some not at all, due to severe headaches or other symptoms. Frequent breaks with rest periods in the nurse's office may be necessary. Often, alternating a class with a rest period may be helpful. Mathematics has been shown to cause more symptoms in patients than other subject classes. As recovery proceeds, gradually hours spent in school may be increased.
Depending on their symptoms, some students may need to be driven to school to avoid walking. They should not attend gym or exercise classes.
Workload and homework may need to be reduced. Frequent breaks whilst doing homework may be helpful. Tests or exams should be postponed. Pre-printed class notes and tutors may help to relieve the pressure of schoolwork.
If there are concentration and memory problems, quizzes, tests, and final exams should be delayed or postponed. If test results are poor, a note to the school should request that the scores be voided. Extra time (un-timed tests) may be necessary initially when test taking is resumed.

If noise causes increased symptoms, students with concussions should not listen to loud music (especially in cars or on their iPods). They should avoid attending dances, parties, music concerts and sports events until the hyperacusis is gone.
If light causes increased symptoms or students have photophobia they should avoid bright sunlight and exposure to flashing lights (e.g. computer games). Sunglasses may be necessary.

4. What is Post-Concussion Syndrome?

It is usually defined as having concussion symptoms that last for greater than a month after the initial blow. Fortunately, post-concussion syndrome occurs only occasionally but it is devastating to those individuals encountering it. Some athletes may not be able to return to contact sports due to the long term symptoms they have suffered as a result of their concussion.

The problems that can develop are categorized as follows:

SLEEP ISSUES - Initially, most concussed individuals are very fatigued and sleep more than usual. As the concussion persists, they may have difficulty falling asleep and sleep less than usual. Lack of sleep causes major difficulties and should be resolved before treating the next two issues.

CONCENTRATION AND MEMORY ISSUES – An inability to concentrate (focus) and poor memory, are often associated with increased headaches during schoolwork, and may cause poor school attendance and performance. It can take months, or even longer, to recover from this. Full neurocognitive testing and rehabilitation may be indicated in some cases.
DEPRESSION AND OTHER PSYCHIATRIC PROBLEMS - Although depression may be caused by the concussion itself, the persistence of symptoms and being unable to play may also cause depression. Psychotherapy and anti-depressant medication may be warranted.
Individuals with concussions often suffer frustration and anger due to the curtailment of their normal activities. They may not be able to participate in their chosen sport or attend school. Psychotherapy and support groups may help individuals cope with their feelings.

5. How often do you administer the ImPACT test following an athlete's injury?

Athletes should be evaluated within 72 hours of injury and then at weekly intervals, until they are asymptomatic at rest, asymptomatic with exertion, and all normal on ImPACT (return to play criteria). For those who take a long time to recover, this time interval can be extended. If the case is milder, evaluation may take place a few times within the first week, although testing more than twice in a week is not allowed.

6. Do you administer the test when an athlete still has self reported symptoms?

Athletes can be tested when they are symptomatic, to help monitor their progress and to help determine school/work management, return to exertion, etc.

7. Do athletes who perform the test have increased symptoms following the test because of increased cognitive function?

Athletes will and do complain of symptoms when taking ImPACT, and this is very frequently reported.

8. Who can administer the ImPACT test?

All medical personnel (e.g. sports clinician, nurse, first aid personnel etc.) trained in the administration of the ImPACT test must be under the supervision of a registered ImPACT credentialed psychologist.

9. How often should athletes be given a baseline test?

Ideally, due to maturation effects, athletes 18 years and younger should be baselined annually.

10. What if there are no baseline data available for the athlete?

Following a concussion, the ImPACT performance can be compared to our large normative database to assist in determination of recovery.

11. Who should be baselined?

Baseline testing for all athletes is recommended although some schools only test contact sports players. Visit this link to view the American Academy of Pediatrics recomendations:

www.impacttest.com/pdf/
MedicalConditionsAffectingSportsParticipation.pdf

12. Who should interpret the test results?

According to HPCSA recommendations, only registered psychologists my interpret neuropsychological tests in South Africa.

FAQ

1. Why should an athlete not continue to play or return to a game after sustaining a concussion?

2. Why should an individual cease doing any activity following a concussion?

3. How should school/work/college attendance and activities be modified after sustaining a concussion?

i) School/college/work:
While some individuals may be able to attend school or work without increasing their symptoms, the majority will probably need some modifications depending on the nature of the symptoms. Trial and error may be needed to discover what they can and cannot do.

Depending on their symptoms, some students may need to be driven to school to avoid walking. They should not attend gym or exercise classes.

Workload and homework may need to be reduced. Frequent breaks whilst doing homework may be helpful. Tests or exams should be postponed. Pre-printed class notes and tutors may help to relieve the pressure of schoolwork.

If there are concentration and memory problems, quizzes, tests, and final exams should be delayed or postponed. If test results are poor, a note to the school should request that the scores be voided. Extra time (un-timed tests) may be necessary initially when test taking is resumed.

If noise causes increased symptoms, students with concussions should not listen to loud music (especially in cars or on their iPods). They should avoid attending dances, parties, music concerts and sports events until the hyperacusis is gone.

If light causes increased symptoms or students have photophobia they should avoid bright sunlight and exposure to flashing lights (e.g. computer games). Sunglasses may be necessary.

4. What is Post-Concussion Syndrome?

SLEEP ISSUES - Initially, most concussed individuals are very fatigued and sleep more than usual. As the concussion persists, they may have difficulty falling asleep and sleep less than usual. Lack of sleep causes major difficulties and should be resolved before treating the next two issues.

DEPRESSION AND OTHER PSYCHIATRIC PROBLEMS - Although depression may be caused by the concussion itself, the persistence of symptoms and being unable to play may also cause depression. Psychotherapy and anti-depressant medication may be warranted.

Individuals with concussions often suffer frustration and anger due to the curtailment of their normal activities. They may not be able to participate in their chosen sport or attend school. Psychotherapy and support groups may help individuals cope with their feelings.

5. How often do you administer the ImPACT test following an athlete's injury?

6. Do you administer the test when an athlete still has self reported symptoms?

Athletes can be tested when they are symptomatic, to help monitor their progress and to help determine school/work management, return to exertion, etc.

7. Do athletes who perform the test have increased symptoms following the test because of increased cognitive function?

Athletes will and do complain of symptoms when taking ImPACT, and this is very frequently reported.

8. Who can administer the ImPACT test?

All medical personnel (e.g. sports clinician, nurse, first aid personnel etc.) trained in the administration of the ImPACT test must be under the supervision of a registered ImPACT credentialed psychologist.

9. How often should athletes be given a baseline test?

Ideally, due to maturation effects, athletes 18 years and younger should be baselined annually.

10. What if there are no baseline data available for the athlete?

11. Who should be baselined?

Baseline testing for all athletes is recommended although some schools only test contact sports players. Visit this link to view the American Academy of Pediatrics recomendations:

www.impacttest.com/pdf/
MedicalConditionsAffectingSportsParticipation.pdf

12. Who should interpret the test results?

According to HPCSA recommendations, only registered psychologists my interpret neuropsychological tests in South Africa.

FAQ

1. Why should an athlete not continue to play or return to a game after sustaining a concussion?

2. Why should an individual cease doing any activity following a concussion?

3. How should school/work/college attendance and activities be modified after sustaining a concussion?

i) School/college/work: While some individuals may be able to attend school or work without increasing their symptoms, the majority will probably need some modifications depending on the nature of the symptoms. Trial and error may be needed to discover what they can and cannot do.

Depending on their symptoms, some students may need to be driven to school to avoid walking. They should not attend gym or exercise classes.

Workload and homework may need to be reduced. Frequent breaks whilst doing homework may be helpful. Tests or exams should be postponed. Pre-printed class notes and tutors may help to relieve the pressure of schoolwork.

If there are concentration and memory problems, quizzes, tests, and final exams should be delayed or postponed. If test results are poor, a note to the school should request that the scores be voided. Extra time (un-timed tests) may be necessary initially when test taking is resumed.

If noise causes increased symptoms, students with concussions should not listen to loud music (especially in cars or on their iPods). They should avoid attending dances, parties, music concerts and sports events until the hyperacusis is gone.

If light causes increased symptoms or students have photophobia they should avoid bright sunlight and exposure to flashing lights (e.g. computer games). Sunglasses may be necessary.

4. What is Post-Concussion Syndrome?

SLEEP ISSUES - Initially, most concussed individuals are very fatigued and sleep more than usual. As the concussion persists, they may have difficulty falling asleep and sleep less than usual. Lack of sleep causes major difficulties and should be resolved before treating the next two issues.

DEPRESSION AND OTHER PSYCHIATRIC PROBLEMS - Although depression may be caused by the concussion itself, the persistence of symptoms and being unable to play may also cause depression. Psychotherapy and anti-depressant medication may be warranted.

Individuals with concussions often suffer frustration and anger due to the curtailment of their normal activities. They may not be able to participate in their chosen sport or attend school. Psychotherapy and support groups may help individuals cope with their feelings.

5. How often do you administer the ImPACT test following an athlete's injury?

6. Do you administer the test when an athlete still has self reported symptoms?

Athletes can be tested when they are symptomatic, to help monitor their progress and to help determine school/work management, return to exertion, etc.

7. Do athletes who perform the test have increased symptoms following the test because of increased cognitive function?

Athletes will and do complain of symptoms when taking ImPACT, and this is very frequently reported.

8. Who can administer the ImPACT test?

All medical personnel (e.g. sports clinician, nurse, first aid personnel etc.) trained in the administration of the ImPACT test must be under the supervision of a registered ImPACT credentialed psychologist.

9. How often should athletes be given a baseline test?

Ideally, due to maturation effects, athletes 18 years and younger should be baselined annually.

10. What if there are no baseline data available for the athlete?

11. Who should be baselined?

Baseline testing for all athletes is recommended although some schools only test contact sports players. Visit this link to view the American Academy of Pediatrics recomendations:

www.impacttest.com/pdf/ MedicalConditionsAffectingSportsParticipation.pdf

12. Who should interpret the test results?

According to HPCSA recommendations, only registered psychologists my interpret neuropsychological tests in South Africa.

i) School/college/work:
While some individuals may be able to attend school or work without increasing their symptoms, the majority will probably need some modifications depending on the nature of the symptoms. Trial and error may be needed to discover what they can and cannot do.

www.impacttest.com/pdf/
MedicalConditionsAffectingSportsParticipation.pdf