Concussions are the most common type of traumatic brain injury, causing a momentary interference with the brain’s ability to function, regardless of their severity. Contrary to popular belief, concussions do not involve a loss of consciousness, but may affect memory, judgment, or coordination. The most frequent concussion symptoms are amnesia—loss of memory of the impact that caused the trauma—and confusion. Although the brain is surrounded by cerebrospinal fluid, which functions to protect it from light trauma, this fluid is not always capable of absorbing more severe impact forces associated with a concussion.
To better understand the impact of concussions on athletes, U of T researchers Dr. Lynda Mainwaring and Dr. Doug Richards of the Faculty of Physical Education and Health, in collaboration with their colleagues from Toronto Rehab, Dr. Comper and Dr. Green, are in the midst of the Varsity Athlete Concussion Research Project. Started in 2000, one of the study’s key research objectives is to empirically validate the existing University of Toronto return-to-play guidelines. According to Michael Hutchison, a graduate student working on the project with Dr. Mainwaring, “there exists over 25 return-to-play guidelines in the world for allowing athletes to get back to the field after injury but none have been validated [experimentally].” Experimental affirmation of return-to-play guidelines consist of balancing the athlete’s desire to return to the field with the possible risk for musculoskeletal injury or another concussion. Essentially, it’s a matter of finding the time that, as Hutchinson puts it, is “just right.”
To achieve this objective the researchers combine science and sports. Their study consists of neuropsychological baseline testing, post-injury neuropsychological follow-ups, and prudent medical management. Athletes who undergo baseline testing are those deemed to be at a high risk for concussion through their involvement in contact sports such as basketball, football, rugby, or hockey. So far, 500 Varsity athletes have undergone a baseline test, 5 to 10 per cent of which have sustained a concussion. Baseline testing not only incorporates computerized neurocognitive measures but also neuropsychological tests, which includes a standardized paper and pencil test known to be sensitive to mild traumatic brain injury.
If an athlete experiences a concussion, they are re-tested immediately and then at regular intervals until recovery is complete or baseline functioning is achieved. After each concussion, every athlete goes to the sports medicine clinic run by Dr. Richards. To assess neurocognitive and emotional functioning, the research team measures indicators like reaction time, information-processing, attention, working memory, visual-spatial processing, and the athletes’ emotional response to injury.
The Varsity Athlete Concussion Research project is a truly multifaceted undertaking. Dr. Mainwaring hopes that this research will reveal better ways to ensure a smooth rehabilitative process for concussed athletes. The study has also allowed numerous students to delve into this field of research and pursue pertinent graduate work. The rehabilitative success of our Varsity athletes can be attributed to a true partnership between the athletes, coaches, and other staff members. The tremendous potential this study could have on research and clinical care can be summed up by Dr. Mainwaring’s remark that, “There will always be another game, but you only have one brain.”
