Concussion management has become big news lately as the professional sporting leagues deal with the issue and its effects on their players. A recent study has found, not surprisingly, that concussions in the National Hockey League may be getting more severe; Major League Baseball has adopted new concussion guidelines; and the National Football League will be requiring sideline concussion tests this fall, assuming there is a 2011 season.
These are all major steps in the right direction - not only for the players themselves, but also for the millions of student athletes across the country who look toward professional players as role models. But more needs to be done to protect our young athletes from the often devastating effects of head injuries, and the state of Iowa recently made one giant leap toward making athletic activity safer for our children.
A new groundbreaking law permits student athletes in Iowa to be evaluated by physical therapists to determine when it is safe to 'return to play' following a hit, fall, or other incident in order to reduce the risk of a concussion or other brain injuries. Signed April 7 by Gov Terry Branstad, SF 367 requires that a student be immediately removed from participation in an activity when a concussion is suspected, and must be evaluated by a physical therapist or other licensed health care provider trained in the evaluation and management of concussions and other brain injuries. The health care provider must provide written clearance for the student to return to activity.
Kudos to Iowa Physical Therapy Association (IPTA) President Blake A. Hardy, PT, DPT, OCS, and IPTA members whose grassroots lobbying efforts helped ensure that student athletes with head injuries will continue to have access to physical therapists. So far, similar legislation has been introduced in more than 35 states and enacted in 15 in an effort to reduce the risk of concussions or other brain injuries sustained in community and school sports or other extracurricular interscholastic activities. The Iowa law is the first to specifically allow student athletes to receive clearance to return to activity from a licensed physical therapist. Legislation in Vermont also includes physical therapists as health care providers who can make similar decisions, but the bill is awaiting passage. As we know, physical therapists are well trained in evaluation and treatment of balance and vestibular disorders and are appropriate participants in return-to-play decisions.
APTA is working to make certain that physical therapists and other qualified health care providers are included in similar legislation in other states to ensure that there is access and collaboration across a broad range of providers on this important public safety issue.
What are your thoughts on this issue? How might physical therapists best help ameliorate this public health concern? How is this issue being addressed in your state?
Physical therapists are inn a unique position to potentially contribute to the overall management and rehabilitation of concussions, not only in athletics but from all causes. Rehabilitation considerations for concussions is an emerging area of interest among both clinicians and researchers. To the extent that PT's want to be listed on state and/or Federal concussion legislation I belive misses the more important issue: how can we (as a community of healthcare profesisonals) provide the best care for the individual who has sustained a concussion. I don't believe this should be a political issue which forces changes in existing or propsed legislation simply to add "Physical therapists" to the list of healthcare professionals (MDs, PAs, and ATCs) who can effectively evaluate, treat, and make return-to-play decisions -specifically as it pertains to the concussed athlete. As a PT for more than 23 years, I would not have the background and training necessary to evaluate and make RTP decisions if not for my dual credentialling as an ATC and my sports specialty certification from ABPTS. If our profession moves in a direction of including on-field examination and management of concussion and RTP decision making into our entry-level programs, this would provide a more substantial rationale for listing PT's on concussion legislation. Otherwise, entry-level phsyical therapists are not trained in the prevention, acute management, or complex return-to-play decision making process that a team physicain and ATC are. I woul much rather see the APTA engage in conversation about how we as a profession can collaborate with other healthcare professions to provide the optimal care for patients with concussion.
Scott Livingston, PT, PhD, ATC, SCS
University of Kentucky
Posted by Scott Livingston -> ENQZ
on 6/17/2011 11:06 AM