Pilot plan on brain trauma tests minor hockey players

JIM KERNAGHAN -- London Free Press

, Last Updated: 8:49 AM ET

Call it heads-up hockey. Tom Janzen used Eric Lindros as one example of why he and other medical professionals will be running a pilot program on brain concussions involving 1,000 local minor hockey players on the weekend.

The oft-concussed New York Rangers star is a one-man statement against the current concussion-testing system.

"We were talking with Eric and his comment was that there are about 10 different (written) tests and he'd ask 'Which one am I getting today?' He'd done them so often he'd memorized them."

By now, most people who follow sports are aware the old views of head injuries no longer cut it.

A guy didn't just "get his bell rung," he sustained some level of brain trauma. He can't necessarily just "shake it off and get back in there" after correctly counting the number of fingers held up.

In what Janzen hopes will lead to mandatory tests across the minor sports of the nation, the estimated 1,000 Great London Hockey Association players will take the 15-minute computerized tests based on reflexes, memory, perception and other brain functions leading to a baseline result. The tests will be administered Saturday and Sunday at St. Thomas Aquinas high school.

If an instance of suspected concussion subsequently crops up, a followup test at the Fowler-Kennedy Sport Medicine Clinic can be compared to the original to help determine if it has, and its severity. Past tests have been pretty basic.

"The old way involved such things as a neuro-cognitive test involving, say, being given five numbers and being asked to repeat them a minute later," said Janzen, whose field is psychiatry. "It was a touchy-feely sort of thing that didn't really determine the level of insult to the brain."

Usually, an athlete is asked how he feels. Almost invariably, competitive people will say they are fine. There is no faking out the computer program.

The program, named ImPACT, was designed by Mark Lovell and his University of Pittsburgh Medical Centre colleagues to measure memory, reaction time, mental speed and information processing and is in use by the National Football League, National Hockey League, NASCAR and some boxing associations.

Lovell will be in London today to help train the testers for the ImPACT program.

The London Knights have been using it three years.

"As soon as I heard Knights trainer Don Brankley talking about it, my thoughts went to minor athletes," said Janzen, who has three sons in minor hockey and has coached it six years himself. "I think it's important we get them before their brains have been scrambled."

Janzen says 15 per cent of hockey players have sustained a concussion before age 14. It's what happens after the concussion that concerns him.

"The concern is that mismanagement of the concussion can lead to long-term cognitive deficits in the kid," he said. "A concussion can be so subtle it never is recognized. They have to be recognized for what they are -- closed head injuries."

Once considered "part of the game," athletes often were thrown back into action, especially key performers in important game situations. Concussions that have meant the end of several major pro athlete careers have led to a more enlightened view.

A concussion sustained during the course of a sporting event is exactly the same as one from an auto crash.

Janzen had some first-hand knowledge that helped spur his desire to make the tests mandatory.

"As a doctor, it's a little embarrassing," he said. "I was coaching my son and it was his first year of contact hockey. He got run over and came to the bench complaining his head hurt. I sat him out a shift or two. He knew the day of the week and the score but when I put him back in, he appeared to be confused."

Concussions can range from complete unconsciousness to the unrecognized subtleties of a Grade 1 concussion. A second and similar hit in that case could lead to serious, even tragic consequences.

These are head games of the most profound kind.


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