Concussion awareness needed with fall sports
Physical therapists offer ways to diagnose, treat brain injuries
Concussions in sports competitions have been getting a lot more attention in the last four or five years, and area physical therapy clinics are coming up with ways to detect any physical fallout associated with a brain injury and develop a treatment strategy.
“It’s a growing thing, especially as more and more people are concerned about concussions — with the movie ‘Concussion’ coming out last year” it spurred more interest, physical therapist Mike O’Brien said about his Biodex Balance System testing device, which tests balance as one predictor of a concussion. The machine uses sensors to detect the slightest movement while trying to stand still, both with eyes open and closed.
O’Brien, who’s been a physical therapist for 19 years and currently owns Freedom Physical Therapy in Mechanicsville, said performing a pre-concussion “baseline” assessment is important for post-injury evaluation and to provide comparative data during rehabilitation so that athletes aren’t returned to play too soon. “Athletes returning to play prematurely are at a higher risk of injury and a second concussion,” he said.
“It’s looking at your physical ability, your posture and sway, and your balance so we can get a baseline measurement,” O’Brien said. “If you happen to have a concussion, then we have a baseline measurement to look at — we can retest you to see where you’re at and work on getting you back to your baseline. Without the baseline, we’re basically just guessing where you would be if we don’t have that objective information.”
He said cognitive testing, usually done at the school or even right on the sideline, is an important predictor of a concussion and it’s possible severity. But the Biodex test — essentially a physical balance test — helps guide rehabilitation by giving an objective measurement of physical ability. Without a pre-concussion baseline test, the data is compared with hundreds of thousands of Biodex tests in a database to determine where the athlete stands in relation to others in his or her age group.
“It’s nice having the objective measurement with their physical balance” pre-concussion, O’Brien said. “If we do a before, then we can retest. Once they’re back within a safe zone we can get them back [to their sports] and safely say they’re ready to return.”
O’Brien said enrolling in his concussion management program, which centers around the balance testing, usually costs $75, but he’s offering it for $25 through the fall high school sports season.
“It’s a really easy test that’s relatively fun for the athletes to do,” he said. “It’s completely pain free, non-invasive — basically it’s just standing, working on your balance. It’s quick. It’s a great tool for parents to have for their kids. It’s kind of that missing link that a lot of the concussion programs don’t have — they have the cognitive part of it, but they don’t have the physical side of it.”
The 250-pound machine, which can also be used to evaluate physical problems with hips, knees and ankles, is mobile and O’Brien has trailered it to health fairs and nursing homes.
“For older people, we can do a balance screen,” he said. “It’s compared to normative data, so if you’re an 80-year-old it will show you where a normal, male 80-year-old will test. It lets you know if you’re at risk, normal or in the safe zone.”
Gateau Physical Therapy, with offices in California and Lusby, has recently signed on with the BrainyEX therapy program, an eight- to 12-week program that uses aerobic exercise to improve cognitive brain function and help rehabilitation after a concussion.
“It can be for anybody, whether they’re CEOs, it can be for kids, pre-concussion, post-concussion. It can be for any Alzheimer’s or dementia patient. Anybody who wants to increase their cognitive function,” said Keri Ramey, manager and exercise physiologist at the clinic’s Medically Oriented Gym in California. She’s now a “brain coach” in the new BrainyEX program.
The first session is used to assess mental ability and produce a baseline for comparison in future sessions. Each session is 30 minutes on a piece of aerobic exercise equipment, such as a treadmill or stationary cycle.
“During the 30 minutes they have a five minute warm-up when we’re telling them about the education part,” Ramey said. “Then they go into their main exercise part getting their heart rate up — getting anywhere from 56 to 61 percent of their max heart rate where they’re still able to talk to us. The last five minutes are the brainstorms and brain challenges.”
During that last five minutes, the client is asked questions about the educational first five minutes and their ability to recall information and the rate of recall are compared against the baseline drawn from the first session. Ramey said a demonstration with colleagues showed promise for short-term improvements.
“I did a demo with a couple of our employees in the Lusby office and you could see that the oxygen was getting to their brain because they were answering questions a lot quicker,” she said.
She said the program is really meant to promote lifestyle changes — more aerobic exercise, better eating, monitoring stress — to improve or retain cognitive function over the long term.
The benefit is “not long term, like any exercise and any benefit, you’d have to continue doing something,” Ramey said. “You don’t have to keep doing BrainyEX after BrainyEX after BrainyEX, you just have to keep that lifestyle up and continue doing aerobic training. It’s good education for anybody. Not only does it promote brain health, it promotes a healthy lifestyle.” The clinic is charging $105 for every three sessions.
Clinic owner and physical therapist Bonnie Gateau, who started Gateau Physical Therapy in Lusby in 1987, is a believer in bringing brain health into the physical therapy equation for those who’ve suffered concussions, have some form of dementia or just want to improve their cognitive ability.
“I’m going to do the program myself,” she said. “I’m really excited to offer it. It’s a really awesome tool.”
Gateau Physical Therapy owner Bonnie Gateau, left, and manager and exercise physiologist Keri Ramey pose with a BrainyEx sign in the California office’s Medically Oriented Gym. The therapy clinic also has an office in Lusby.
Freedom Physical Therapy owner Mike O’Brien gives a demonstration of the Biodex Balance System that can determine when someone has had a concussion and therapy may be needed.