Page 9 - COM Outlook - Winter 2013

9 COM Outlook . Winter 2013
Johnny is racing to meet the opposing
running back at the line of scrimmage. The
players collide, helmet-to-helmet, as John-
ny makes the tackle. When Johnny gets up,
he is clearly not himself. He’s confused and
dizzy. His head is pounding and he’s not
quite sure where to go or what to do. He
stumbles as he returns to the huddle and
attempts to gather himself as he prepares
for the next play.
Although the scenario is as old as foot-
ball itself, many now recognize that Johnny
has suffered an injury to his brain—an
increasingly more common occurrence in
today’s world of athletics.
Based on the data available, it’s estimat-
ed that close to four million sport-related
concussions occur each year in the United
States.1 As staggering as that statistic is, per-
haps of more concern is the report that ap-
proximately 50 percent of all head injuries
in football go unreported.2 Sport-related
concussion is perhaps the most publicized
issue in the field of sports medicine over
the past five years, with many national,
state, and county initiatives establishing
ways to increase care for the athletes that
suffer this unique sports injury.
In Broward County, two NSU-COM fac-
ulty members have been leading the battle
to have athletes take brain injury more seri-
ously—Drs. Andrew Kusienski and Stephen
Russo—who established a sport-related
concussion clinic in 2009. Since then, the
pair has worked with county and statewide
efforts to promote better awareness and
treatment of concussions.
In conjunction with the Broward County
Athletic Association (BCAA), Broward
Health, the Memorial Healthcare System,
and the School Board of Broward County,
Drs. Kusienski and Russo have been provid-
ing cutting-edge clinical care for high school
athletes in Broward County that suffer
sport-related concussions. As a result, they
have helped to shape recent changes for
concussion management in the county.
In March 2012, the School Board of
Broward County enacted a resolution
requiring baseline neuro-cognitive testing
for all athletes in BCAA schools. The board
also promoted NSU’s role in educating
physicians, coaches, parents, school ad-
ministrators, and certified athletic trainers
in Broward County about current concus-
sion management protocols. This mandate
coincides with a new law in the state of
Florida that requires physician clearance
prior to returning to practice or play fol-
lowing a concussion.
Since 2009, NSU-COM has been lead-
ing the way in concussion management in
South Florida. Housed within the Don Taft
University Center’s Sports Medicine Clinic
on NSU’s Davie campus, Drs. Kusienski
and Russo have worked tirelessly in the
concussion clinic over the past four years to
train medical students, graduate psychol-
ogy students, residents, and fellows in their
multi-disciplined approach to the manage-
ment of concussive injuries.
Along with their clinical acumen and
skills, they utilize formal balance test-
ing and the ImPACT (Immediate Post-
Concussion Assessment and Cognitive
Testing) neuropsychological test to assess
the athlete’s stage of recovery. The clinical
team then makes management decisions
ranging from excusing kids from school to
withholding them temporarily from their
athletic activities. Reducing cognitive activ-
ity such as prohibiting student athletes
from reading, studying, or playing video
games is often recommended in an effort
to give the brain a better chance to recover,
while allowing kids to develop a successful
transition back to school before returning
to their athletic pursuits.
In addition, Drs. Kusienski and Russo
will medically intervene with medication
and/or use treatment modalities ranging
from psychological counseling to osteo-
pathic manipulation when cases call for
more comprehensive care. However, this
unique sports medicine team is not just
concentrating on treatment. Team mem-
bers are also actively exploring avenues
of research and are engaged in a study
measuring the body’s psychophysiologi-
cal response and recovery from sport-
related concussions.
Through the collaborative efforts of Drs.
Kusienski and Russo, the concussion clinic
has experienced unprecedented growth
over the past four years. Both on campus
and throughout the Broward County com-
munity, word has spread regarding NSU’s
clinical initiatives on concussion. Starting
with only a handful of cases in 2009, refer-
rals in the community have increased since
its inception, with over 100 concussion-
related cases being seen in the NSU Sports
Medicine Clinic last year.
Having already managed close to 70 cas-
es during the first four months of the 2012-
13 academic year, it’s clear that NSU-COM
has firmly established itself as a leading
health care provider for concussive injuries.
The collective efforts of these two NSU-
COM faculty members are having a positive
impact on the lives and health of the ath-
letes that live in Broward County by helping
to avoid the short-term consequences and
potential long-term aftereffects associated
with sport-related brain injury.
References
1. Langlois J, Rutland-Brown W, Wald M. The epide-
miology and impact of traumatic brain injury: a brief
overview. J Head Trauma Rehab. 2006;21: 375–378.
2. McCrea M, Hammeke T, Olsen G, et al. Unreported
concussion in high school football players: implica-
tions for prevention. Clin J Sport Med. 2004;14:13–17.
Prevention and Treatment of Concussions for Local Athletes
By Andrew Kusienski, D.O., Assistant Professor and Chair of the Department of Sports Medicine
Stephen A. Russo, Ph.D., Assistant Professor at the Center for Psychological Studies and NSU-COM Director of Sport Psychology