Northeast Georgia Health System Comprehensive Concussion Management Program

August 30, 2011
GAINESVILLE, Ga.- While stories about professional and college athletes struggling with mental and physical issues caused by concussions make headlines across the nation, Northeast Georgia Health System (NGHS) is offering area athletes advanced treatment of concussions. One component of NGHS’ Comprehensive Concussion Management Program is state-of-the art software called Immediate Post Concussion Assessment and Cognitive Testing, or ImPACT. ImPACT testing provides physicians with data to help determine when an athlete has recovered and is ready to return to play.

 Lexi Doyle, a sophomore at Mountain View High School and current NGHS Concussion Program patient, no longer plays soccer due to three concussions she suffered during play. ImPACT testing was not available when Lexi suffered her first concussion, but she believes it has been instrumental in her recovery.

“I often wonder if I would still be playing soccer if ImPACT had been available to me after my first concussion,” says Lexi. “I may have never returned to play so quickly after the first one, which may have spared me from the second concussion.”

ImPACT is a 25-minute computerized test that measures a patient’s attention span, working memory, reaction time and problem solving skills. An ImPACT test can be taken before or after a concussion. If an athlete takes an ImPACT test before suffering a concussion, the results are used as a baseline – which essentially gives a physician an idea of the patient’s “normal” functioning. The baseline will later be compared to the results of subsequent ImPACT tests, taken after future concussions, to determine the severity and treatment protocol. If an athlete’s first ImPACT test is taken after a concussion, there’s no baseline test, so physicians compare the results to a national database to determine a baseline.

Lexi suffered her first concussion at soccer practice in 2009. ImPACT testing was not offered in the area, so, after visiting a local emergency room, Lexi was told to rest for two days and play again when she felt better. A few days later, her travel team made it to the championship game of a prestigious tournament. Lexi played during that final game, even though she knew she was still having trouble with her balance and coordination.

Lexi suffered a second concussion soon after she entered the game.

“It was so scary,” Lexi said. “The last thing I knew, I was chasing a break away ball and then, all of a sudden, I was on the ground again. I could not see, hear or move. I was completely disoriented.”

“As one would suspect, a competitive athlete may push themselves and convince a coach they are ready to get back in the game prematurely,” says James Mullin, Psy.D., a board certified neuropsychologist with The Rehabilitation Institute of Northeast Georgia Medical Center (NGMC). “ImPACT gives physicians and coaches a tool to make the determination of whether an athlete is ready to play out of the hands of an eager athlete.”

Once it was confirmed that she had suffered a second concussion, Lexi’s mom decided they needed to seek help. They visited John Alsobrook, MD, a sports medicine physician and medical director of Northeast Georgia Physicians Group Sports Medicine. Dr. Alsobrook quickly placed her on brain rest for the next three months and worked with Dr. Mullin to determine Lexi’s treatment regimen.

“I was not allowed to really leave my house much for three months,” Lexi says. “I had to stay in my room and was not supposed to watch TV or use computers or even my cell phone.”

Once Lexi returned to school, she had a modified schedule and was under the close supervision of Dr. Mullin and Dr. Alsobrook. She was also going to The Rehabilitation Institute of NGMC for physical therapy, including vestibular rehab for her balance.

Although Lexi was showing some signs of improvement, headaches, dizziness, nausea and depression persisted. Lexi, her mom, Dr. Alsobrook and Dr. Mullin traveled to Pittsburg, Pa., where ImPACT was developed, for Lexi to take the test. Once ImPACT testing was available at NGHS, Lexi continued to take the test in order to track her recovery. She was cleared to play sports again in November, but unfortunately suffered her final concussion during the last game. She has not played soccer since.

“Lexi has made great progress,” said Dr. Alsobrook. “The first time she took the ImPACT test, she scored in the first percentile and now she is scoring in the eightieth percentile. Two years later, Lexi is almost symptom-free.”

Some student athletes at Jackson County High School and West Hall High School have already undergone baseline ImPACT testing with Northeast Georgia Health System as part of their sports physicals this year.

“ImPACT is a good tool in managing concussions, but there is a lot more that goes into determining if an athlete is ready to return to play,” says Dr. Mullin. “Northeast Georgia Health System offers the community’s only comprehensive concussion management program with a multi-disciplinary approach to concussion management. Our program, in collaboration with local orthopedic surgeons and neurologists, includes sports medicine physicians, athletic trainers, a neuropsychologist, and physical, speech and occupational therapists.”

For more information about the ImPACT Concussion Program call 770-219-3840.