VOLUME 2 : ISSUE 4

accomplish more with our new web site functions
By Tammy Gardner, Axon Sports Customer Service Manager
We’re always listening to the suggestions and feedback our customers offer and continually take into consideration how we can improve our system’s functionality. We would like to take this opportunity to announce two exciting new features.

Combine Baseline and After Injury Test Credits to Earn Volume Discounts
The purchasing of Baseline and After Injury test credits has now become even more convenient and cost effective.  When taking advantage of our volume pricing you’ll have the ability to combine Baseline and After Injury test credits into one easy purchase.  For example, purchasing 150 Baseline test credits and 100 After Injury test credits will allow you to receive the 250 test credit volume price. Buy Now

New File Types Make It Easier To Manage Baseline Rosters
You can now download your Baseline Rosters into an Excel spreadsheet allowing for the data to be sorted and filtered in a number of different ways.

Watch for additional functionality enhancements coming in the next few months.  If you  have an idea you’d like us to consider, please send an email to customerservice@axonsports.com

THE WINTER SPORTS SEASON IS HERE!
PLAY PREPARED WITH A BASELINE TEST

Axon Sports Ad in Eastbay Catalog
Recent Axon Sports Eastbay Catalog Ad

Preseason Baseline testing is an essential part of a proactive concussion management plan. The Axon Sports online Baseline test captures a snapshot of an Athlete’s brain speed and accuracy. In the event of a concussion, results are used by qualified Medical Providers to help determine when it’s safe for Athletes to return to the classroom, practice, or competitive play.

We encourage all Athletes to create their individual Baseline before the first contact practice of the playing season. The Axon Sports CCAT may be supervised by responsible adults who can help ensure an environment free from distractions and an Athlete’s “best effort.” Test results are available immediately and stored for future use. Preseason Baseline tests: an important step toward keeping our Athletes safe. Register or Log In

Athletes
EASTBAY BLOGGER TALKS WITH NOTRE DAME'S TEAM PHYSICIAN

On behalf of its Athletes, Eastbay recently interviewed Dr. Moriarity, head team physician at the University of Notre Dame, on sports-related concussions. Learn what he’d like Athletes at all levels of play to know.
View new blog posts

Schools, Leagues, and Clubs
Fast, Easy, Online: SportsSignup and Axon Sports Pave the Way for Sports Organizations

SportsSignup and Axon Sports have joined forces to make it easy for sports organizations to integrate Baseline testing for concussion management into their administrative process. The partnership allows organizations to offer Axon Sports cognitive Baseline tests to their members as a complement to SportsSignup’s comprehensive suite of services. SportsSignup’s customer base consists of sports administrators and coaches. The online offering is rounded out with educational materials and templates for the sports organizations and their families. Sports SignUp Logo
SportsSignup, owned and operated by League Sports Services LLC, provides sports organizations and event organizers with easy-to-learn and easy-to-use integrated Software-as-a-Service (SaaS) solutions to facilitate online sports registration, e-commerce fundraising, and coach/volunteer background check management. Since 2003, the company has been dedicated to operating a secure, affordable, and hassle-free online service suite that enables administrators from thousands of soccer, football, baseball, lacrosse, basketball, track & field, and many other sports organizations to easily automate many aspects of their duties. For more information visit sportssignup.com.

Schools, Leagues, and Clubs
How do you prep for the Winter Sports Season?
Check out Axon Sports’ Free Concussion Management Toolkit

Ahead Of The Game Resources
Sample page from Axon Sports online Concussion Management toolkit, Ahead of the Game.
Michigan Neurosport Concussion Poster
Michigan Neurosport Poster –
Click for a poster size copy

 

 

 

 

 

 

 

 

 

 

Check out our Ahead of the Game toolkit to help you implement a concussion management program and communicate it with Parents. Just register for a free account at axonsports.com or axonsports.ca.  The toolkit provides sample documents, presentations, and videos plus access to online safety courses, including those created by the University of Michigan Neurosport program and endorsed by the American Academy of Neurology to help high school and youth coaches recognize the signs and symptoms of concussion.

Schools, Leagues, and Clubs
Korrio and Axon Sports – Advancing Safety for the Athlete

Korrio Involvement Graphic
Korrio Communication Channels

A new partnership between Korrio and Axon Sports is all about advancing safety with efficient online Athlete-centric solutions. Korrio has a singular focus on kids and sports, having developed the most sophisticated sports automation platform in the market. Kids are the center of its universe–and its top concern is keeping them safe, both on and off the field. To that end, Korrio has posted relevant information on its web site and is using its communication channels to educate Parents, Athletes and Coaches about concussion management, testing and warning signs. For Coaches, it’s crucial to recognize the symptoms of such head injuries in order to remove hurt players from the game. To gain insights, Korrio has created a Youth Soccer Coaches Concussion Awareness Survey. Information gathered through the survey will help shape communication programs.
Korrio Logo

Korrio’s contemporary platform design allows Athletes to easily and safely store their Axon Sports Baseline tests for concussion management in their personal Korrio dashboard*. Having one place to manage your sports life makes it easy for today’s busy families on the go.  Korrio harnesses the power of next-generation web technology to make tasks simpler and more automatic. Visit today at korrio.com

Check out this article by Soccer Nation. Read the full news release.

*Editor’s Note: Full integration with Korrio’s Playflow is expected in January 2012.


NEW RESOURCES FOR COACHES

1. Hockey Canada Launches Web Site Devoted to Head Contact Rules
Here’s a new resource for Coaches: Hockey Canada launches a web site, hockeycanada.ca/HeadContactRule, dedicated to the head contact rule for the 2011-12 season. The rule calls for zero tolerance on any head contact in minor and female hockey in all 13 Hockey Canada branches. As more than 550,000 minor hockey players take to the ice for another hockey season, Hockey Canada’s special web platform will provide numerous resources for minor hockey associations, participants, parents and volunteers to assist with the implementation of the new head contact rule.

Head Contact Rule Ad
Hockey Canada Head Contact Rule Ad

Editor’s Note: When it comes to concussions and head injuries, helping Coaches know what to look for so they can remove a player from practice or play is imperative. Many states and some interscholastic associations are now mandating education for Coaches as part of their concussion management laws/policies. In addition to offering you an online toolkit, we’ve researched several concussion education options for Coaches.

2. New Sports Medicine Guide
Created by the American Orthopaedic Society for Sports Medicine (AOSSM), in partnership with the American Academy of Orthopaedic Surgeons (AAOS), this sports medicine guide is an illustrated resource on the most common injuries and treatments in sports. Concussions are addressed on pages 11 through 13.

3. High School Survey
If you have two minutes and you see/know of high school concussions, please take this online survey.  The Concussion Blog is gathering information on head injuries for data collection only, completely non-identifiable and non-scientific. The questions include gender, age, grade, sport, game/practice, who evaluated, how they evaluated, hospital trip, and return to play. The survey is quick – just 10 questions – and you can use it to report each concussion.

Concussion Blog Logo

Medical Providers
How to Interpret After Injury Tests: The Time-Recovery Curve

By Dr. David Darby, Neurologist, Axon Sports Medical Consultant

After a concussion, there is a typical time-course recovery curve commonly seen in the Axon Sports Computerized Cognitive Assessment Tool (CCAT) After Injury report. The graph below, taken from an Athlete with a concussion, shows all the typical features. This graph is the lower graph on an Axon Sports’ After Injury report, in which the Baseline results have all been plotted at “zero” and the y-axis shows the magnitude of the change from Baseline in standard deviation (sd) units. These are also called “effect sizes” with any change greater than 1.65 sd below the Baseline being flagged as abnormal. Recall that a change of 1.65 sd units is approximately equivalent to a blood alcohol concentration change of 0.08%. Each set of aligned vertical points consists of the task results for a test done on the same day. On the graph are shown the speed measures of the Processing Speed (PS, magenta), Attention (AT, blue) and Working Memory (WM, brown), and accuracy measures of the Working Memory (WM, red) and Learning (LN, green).

Head Contact Rule Ad

Figure: Axon Sports CCAT report showing time-recovery curve after a concussion

This Athlete completed an acceptable Baseline test on July 27, 2010, and the results are all plotted at 0. He was injured in early September 2010 followed by a quite severe symptomatic concussion.

Speed Measures
Let’s first examine the speed measures. His first After Injury test done a few days later shows the speed measures (PS, AT and WM) tasks deteriorating from his Baseline levels by 4.0 to 10.0 or more sd units with the PS change the most dramatic. These then bottom out with all beyond 10.0 sd units, prior to returning to Baseline levels in the last two After Injury tests. The PS and AT speed results are then equivalent to his Baseline results, but the WM speed has improved beyond 1.65 sd units in comparison to Baseline WM speed. By doing two After Injury tests, the Physician has confidence this Athlete is now stable and likely to have recovered cognitively.

Working Memory
For WM speed, this Athlete’s final After Injury performance, which is better than the 1.65 standard deviations range of acceptable normal variability, suggests he did not quite perform at his best on the WM test at Baseline. With the Axon Sports CCAT feature of selecting which test to use for future comparisons, either of these last two After Injury tests could be selected for future comparisons. In other words, his enthusiasm to do well post-concussion has allowed achievement of a better Baseline and there’s every reason to use this in future.

Accuracy
The accuracy scores for WM (red) and LN (green) in this Athlete appear less sensitive to the effects of this quite severe concussion. This is typically the case, and relates to a trade-off in speed to preserve accuracy. Sometimes accuracy also drops quite markedly (beyond the 1.0-3.0 sd units seen in this Athlete) suggesting the Athlete is also having trouble maintaining accuracy also due to the cognitive impairment. Speed measures are typically more sensitive to the acute effects of concussion as shown here. Useful indicators of the severity of the concussion include: the magnitude of the maximum deterioration (in sd units), the time after the injury at which this maximum occurs and the time taken to return to Baseline. The latter was about a month which occurs in less than 5 percent of concussions, with about 90 percent recovering within two weeks.

In the situation where an Athlete does not have an optimal Baseline with which to compare After Injury test results, this typical time-course recovery curve can still be seen and testing can be continued until stability occurs in results. At this time, consideration of whether or not the Athlete is likely to be back to their own pre-injury Baseline performance can be made, and may involve other specialized evaluations (including full neuropsychological testing) though of course it’s much simpler to have a Baseline for direct comparison.

Editor’s Note: For additional resources, see Dr. Darby’s pre-recorded webinar on After Injury testing as well as the related Q&A “What am I looking for in the test results” below.

return

Dr. James Moriarity
James Moriarity, M.D.,
Head Team Physician, University of Notre Dame

Ask The Expert
Q: “Can you give me a few tips to bring our supervising Physician up to speed on the Axon Sports Computerized Cognitive Assessment Tool (CCAT)?”

Dr. Jim Moriarity (Head Team Physician at the University of Notre Dame) and Dr. David Darby (Neurologist):
We think the supervising Physician would be interested in these three points: 1) Is it a valid tool for concussion management? 2) What am I looking for in the test results? 3) How does it aid a decision about RTP?

  1. Is it a valid tool for concussion management? The Axon Sports CCAT is designed to measure change from an optimal Baseline in cognitive performance. In this context, there are several types of validity that are important and which research with the Axon Sports CCAT has confirmed. Criterion validity requires abnormal results on the CCAT in brain injury or concussion, Construct validity requires the components of the CCAT to correlate with other tests of similar cognitive constructs (e.g. processing speed, attention, learning and working memory). Reliability, stability and absence of practice effects are essential for valid measurement of subtle changes after concussion. Age-based normative data on single and repeated testing are also essential. Given these basic requirements for a valid test, changes After Injury in the CCAT can be reliably measured to inform the Physician whether a significant change from Baseline has occurred.
    David Darby
    David Darby, MB, BS, PhD FRACP

  2. What am I looking for in the test results? The reasons for doing Baseline and After Injury tests are different and so are the important things to look for in each. Baseline tests should be administered before the Athlete participates in sports since there’s no going back if they do get injured. The most important result on the Axon Sports CCAT Baseline report is whether they achieved an “acceptable” result which is indicated at top right by a green “√”. This means they understood the test, passed integrity checks and scored within the normal range. If they instead get a red “X” they should repeat the Baseline test again until they do get a green “√” or until they’ve done it three times. If they cannot get an acceptable result, they need medical assessment to determine why they are having trouble before they participate in sport (e.g. ADHD, learning disorders or other causes). Once evaluated fully, the Baseline results can be used for comparisons by their Physician, if needed. After Injury tests are usually done to compare to the Athlete’s own Baseline performance. A “try again” ‘result on an Axon Sports After Injury test (red X) means that either the Athlete is exhibiting cognitive decline or the Athlete is not giving a best effort, is distracted (including by concussion symptoms), or fatigued. True positive cognitive decline due to concussion usually appears on the Axon Sports CCAT Advanced test report as declines in speed measures (especially Processing Speed and Attention) with lesser declines in accuracy measurements. These typically will still be present at least two to three days after symptoms resolve, and show a “recovery curve” on the graphs with a low point and then recovery over days to weeks. Be aware that concussed Athletes can fail integrity checks or perform within the population-based normal range (top graph) yet still show significant injury-related decline (best seen on the bottom graph). Note that the grey area on the bottom graph finishes at 1.65 standard deviations of change units (which is roughly equivalent to 0.08% blood alcohol concentration change). Interpretation of the test results should be within the whole medical context for that Athlete. If there is concern that fatigue or distraction is a possibility, have the Athlete repeat the test when they are rested and in your presence to ensure there are no distractive elements in play. At Notre Dame, the practice is to require all of our Athletes to take an After Injury test in our presence if possible and practical. A parent’s presence would be a good substitute.

  3. How does the Axon Sports CCAT aid a Return-to-Play (RTP) decision? The Axon Sports CCAT is one of many tools a Medical Provider will use in making a decision regarding an Athlete’s readiness to return to the classroom, practice, or competitive play. The CCAT can aid that decision since cognitive changes in comparison to the Athlete’s own Baseline often persist days or weeks longer than symptoms or other abnormalities the Physician can observe and measure. These cognitive changes can only be measured by cognitive testing. In this way, the Axon Sports CCAT helps RTP decisions by measuring otherwise undetectable neurological impairment which suggests recovery has not yet occurred. When an Athlete’s symptoms have recovered and cognition is back to Baseline, the Physician is likely to recommend a gradual increase in exercise to ensure symptoms do not reoccur prior to resuming full sport participation.
Sample After Injury Test Result
Sample After Injury Test Result

Editor’s Note: Baseline testing is a great way for Medical Providers to make a difference in their communities by helping their youth sports associations and schools. Volume pricing is available.


Parents and Athletes

10 THINGS I'D LIKE PARENTS TO KNOW ABOUT CONCUSSIONS
By Jean Rickerson, founder, SportsConcussions.org

  1. A concussion is a brain injury caused by a bump or blow to the head or body.
  2. Seek medical attention if a concussion is suspected.
  3. Most concussions heal within a short period of time, days or weeks.
  4. Concussions can impair thinking and memory, and cause emotional or behavioral changes.
  5. You do not need to lose consciousness to have a concussion.
  6. Amnesia, memory loss, or feeling "dazed" can be important clinical signs of concussion.
  7. Symptoms may not develop until minutes, hours, or days after injury.
  8. Concussions can occur in any sport through contact with players, equipment, or facilities.
  9. Concussion baseline testing from Axon Sports can be an important part of a comprehensive concussion management program.
  10. Avoid self-diagnosis. Return-to-play decisions should be made in consultation with a qualified Medical Provider.

SportsConcussions.org
Sportsconcussions.org
is a leader in the sports concussion education field. Bringing timely, up-to-date information from the best resources available in the country and around the world, as well as from nationally known experts. SportsConcussions.org has information for school districts, teams/leagues, and Parents seeking answers and solutions to their concussion management needs.  

Parents
From the Axon Sports Staff:
Top 15 Things we’d like Parents to Know about Baseline Testing and the Axon Sports CCAT

  1. It’s an accepted practice at all levels of play. Baseline testing for concussion management is a recognized best practice by international experts, the NCAA and the AAP.
  2. The Axon Sports CCAT captures a snapshot of an individual’s processing speed, working memory, attention, and accuracy.
  3. Return to Baseline levels on the Axon Sports CCAT can help determine when the concussion has resolved.
  4. The Axon Sports CCAT is not an intelligence test and poses no risk to your Athlete.
  5. Axon Sports test comparisons are to the Athlete’s own performance.
  6. Athletes get better in speed and accuracy as they mature.
  7. Given that Athletes get better as they mature, annual testing helps keep Baselines current for comparisons.
  8. Athletes will feel more confident and familiar with the test after doing a free practice test.
  9. Athletes should do their best so they can get back to play safely and faster if they suffer a head injury.
  10. Athletes who cannot get an acceptable Baseline result after three “best effort” attempts should see their Doctor for a more thorough Baseline assessment.
  11. The scored test only takes eight to 10 minutes.
  12. Athletes may take a Baseline test at home if supervised by a responsible adult.
  13. Testing requires a distraction-free environment for best effort.
  14. The Axon Sports CCAT can detect more subtle effects of concussion than reported symptoms.
  15. The Axon Sports CCAT is affordable. One Baseline test credit is only $7.50.


State Concussion Awareness Acts Roll Through the U.S.
Concussion awareness acts continue to roll through the country. There are now just six states without pending or passed legislation for youth Athletes.

LegislationMap

Axon Potential Looks at What it Takes to be an Athletic Expert

Anders Ericsson
K. Anders Ericsson (photo credit: FSU Photo Lab, Michele Edmunds)

One of the most influential theories in sports performance development is a theory by K. Anders Ericsson, a psychology professor at Florida State University, known as the “10,000 hour rule.”  His research has shown that achieving expert status in a motor skill based domain, such as sports, requires 10,000 hours of deliberate practice.

The rule has been simplified and taken out of context by different proponents but the core of Ericsson’s research still holds true.  It is often caught in the debate of the effects of nature versus nurture in human development and was one of the main tenets of Malcolm Gladwell’s bestseller, Outliers.

Axon Potential’s blog has looked at the 10,000 hour rule from several different angles, including how our own neuroplasticity benefits our athletic brain.  Visit these articles and others at Axon Potential.

Axon Potential is an affiliate of Axon Sports, dedicated to creating cognitive training programs for competitive Athletes. Its initial product development will be a suite of four research-supported software training products: Baseball Pitch Recognition, Football IQ, Football High-Speed Decision Making, and Soccer Anticipation/Situational Assessment.

IN THIS ISSUE:

NEW WEB SITE FUNCTIONALITY
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WINTER SPORTS ARE HERE! PLAY PREPARED WITH A BASELINE TEST
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EASTBAY BLOGGER TALKS WITH DR. MORIARITY
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SPORTSSIGNUP AND AXON SPORTS PAVE THE WAY FOR SPORTS ORGANIZATIONS
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HOW DO YOU PREP FOR THE WINTER SPORTS SEASON? check out AXON SPORTS' FREE KIT
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Korrio and Axon Sports – Advancing Safety for the Athlete
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NEW RESOURCES FOR COACHES divider
How to Interpret After Injury Tests:
The Time-Recovery Curve

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ASK THE EXPERT:
tips for your supervising physician

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10 FACTS PARENTS should KNOW ABOUT CONCUSSIONS
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15 THINGS AXON SPORTS WOULD LIKE PARENTS TO KNOW ABOUT BASELINE TESTING
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STATE CONCUSSION AWARENESS ACTS
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AXON POTENTIAL: WHAT IT TAKES TO BE AN ATHLETIC EXPERT