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    Pennsylvania Concussion Law Includes PTs

    A new law establishing standards for managing concussions and traumatic brain injuries in student athletes specifically includes physical therapists as part of the team of health care providers and officials who are designated to remove students from participation in an activity when a concussion is suspected.

    Publicly signed November 14 at the Lower Dauphin High School in Hummelstown, Pennsylvania, by Gov Tom Corbett, SB 200 also requires that students be evaluated and cleared for participation in writing by an appropriate health care provider trained in the evaluation and management of concussions and other brain injuries. A physical therapist designated by a physician also will be part of the health care team that makes this determination.

    More information on SB 200 is available in APTA's press release.


    Comments

    I feel as though PT's are not as equipped for RTP decisions as other healthcare professionals.
    Posted by James Nelson on 11/16/2011 8:34 AM
    I am confused by the above comment as even an entry level PT should be able to adequately assess for cognitive status, perform appropriate testing and perform follow on care as required in Concussion/ RTP situations.
    Posted by Robert Nosek on 11/16/2011 4:57 PM
    Very true Robert. In fact the PT is better equipped at identifying balance and vestibular deficits that may be found in the post concussion patient. If not recognized, these deficits can increase a player's risk of reinjury and potentially catastrophic results. The physician should include a team to assist in RTP decisions.
    Posted by Sandra Tremblay on 11/18/2011 2:35 PM
    Like anything else the ability to do this well is based on acquired knowledge and skill. Not every PT would be equipped to do this effectively. That's why the law says 'HCP trained in the eval and mngt of concussions and other brain injuries', as it should.
    Posted by Al Bukowski on 11/18/2011 3:05 PM
    Other than physicians, which other "healthcare professionals" are more "equipped"? Especially with the additional requirements for the DPT degree, we are well trained to manage musculoskeletal sport related injuries including concussions.
    Posted by Ken on 11/18/2011 3:11 PM
    Respectfully, all licencsed PT's are trained in neuroanatomy, clinial medicine and neurologic evaluations. Licensed PT's have passed Board PT examinations - written, practical and oral, to demonstrate their competencies. PT's have been evaluating and treating TBI for years. Visting a TBI unit may prove insightful to the expertise of the physical therapist. PT's are able to readily identify neurologic deficits early and recommend sidelining the patient/athlete, appropiately, all in the best interest of the patient/athlete and conversely, when no objective neurologic deficits are found, along with the neurologist evaluation, would be cleared to RTP. A matter of professional ethics and competency. Utilization of the CDP ( computerized dynamic posturography) cannot be overlooked in it's highly sensitive quantitative analysis of movement and balance in the post- concussion population. This test, is conducted by physician technologist and/or physical therapists. A valuable tool in the RTP protocol. This is not a question of territorial boundaries, it is about a team collaborating to provide the best in healthcare for the athlete, for the patient.
    Posted by L. Fong, PT on 11/18/2011 4:02 PM
    I am currently registered with the National Registry for Emergency Medical Technicians and am also a student physical therapist. I strongly feel that PT's are very well equipped for RTP decisions, especially with basic first responder training which can be completed through the SPTS. With the educational background we recieve in neurology, traumatic brain injuries, and vestibular rehabilitation-PT's are a vital component of the continuum of care for a concussed athlete or adolescent. Considering all of the student athletes in the United States who don't currently have access to any healthcare provider on the field-much more obviously needs to be done! Providing this potentially life saving service is a tremendous step forward for our profession, and similar legislation needs to be fought and advocated for in the other 49 states!
    Posted by Daniel Stam on 11/18/2011 4:32 PM
    The key to this is that PTs are part of a team of healthcare, school teachers, coaches and parents who should all be consulted as part of the decision to return an injured athlete to play. For more information see the REAP concusion management program at the Rocky Mountain Youth Sports Medicine Institute.
    Posted by Roger Pomeroy on 11/18/2011 5:48 PM
    As a certified athletic trainer and student physical therapist assistant, I would like to direct your attention directly to SB 200, Section 2. It states "an appropriate medical professional" is (1) a physician trained in evaluation and management of concusssions, (2) a certified athletic trainer, or (3) a licensed psychologist neuropsychologically trained. Later in Section 3 (b) and (c), it states a licensed physical therapist may be involved in the pre-season informational meeeting and removal of play. I agree that it takes a team of experienced medical professionals to make the decision for the athlete to play. For more information, please read the entire bill for yourself.
    Posted by Darin Powell on 11/18/2011 8:21 PM
    Perhaps the SPTS should collaborate with the NATA to devise a protocol and provide a specific course and certification which would represent the PT (and ATC) as a "Healthcare provider who is trained in the evaluation and management of concussions". I am a dual credentialed provider (PT, ATC) and currently work at a high school and along side a physician who is an expert in concussion management (Dr. Kelly of The Orthopedic Institute of NJ). Most of the high schools sports programs refer their mTBIs to Dr. Kelly who does does a very thorough job of concussion management. He currently depends on the ATCs at the high schools to run the athletes through the RTP protocol, then makes the final decision regarding RTP. He has asked the PT department to come up with a concussion management protocol as he feels strongly that PTs should be part of that management team.There should be a credentialing process for those healthcare providers who would participate in the management of athletes who have sustained a concussion to demonstrate proficiency.
    Posted by Brian Karns on 11/18/2011 10:01 PM
    @Darin - you are referencing the version of the bill that was introduced. It was amended and the version signed by the Governor defines "appropriate medical professional" as: 1) A licensed physician who is trained in the evaluation and management of concussions or a licensed OR certified health care professional trained in the evaluation and management of concussions and designated by such licensed physician. (2) A licensed psychologist neuropsychologically trained in the evaluation and management of concussions or who has postdoctoral training in neuropsychology and specific training in the evaluation and management of concussions To read the version of the bill signed by the Governor go to www.legis.state.pa.us, enter in SB 200, and click on 'printer version 1637.'
    Posted by Mark Johnson on 11/20/2011 11:41 PM
    I agree that there should be a credentialing/proficiency regarding RTP. We here in North Carolina had a billed that was past earlier this year that to my knowledge did not include PT's (and yes I contacted my legislators to have us included but to no avail). I feel this is a huge diservice to our profession and to our athletes as there are not that many people that are as qualified as we are to help in this manner. I have been a proud supporter and volunteer for our local high school for the past 10 years where I help with football(4x state champs)and wrestling (1x state champ)and many times am the only qualified health care provider at an event that potentially can be the difference in helping an athlete be the best they can be safely.
    Posted by John Orta on 11/21/2011 10:59 AM
    @Mark, actually Darrin is correct. PT's are not included in the medical professionals allowed to RTP. They can remove a player from competition, but only a physician, ATC or neuropsychologist is allowed to RTP.
    Posted by Jeremy Verrillo on 1/19/2012 4:55 PM
    There has been a lot of discussion about PTs' role in adhering to this new law. Perhaps it would be helpful to take a look at the law's stipulations and medical professionals' responsibilities: http://www.edgarsnyder.com/injury/brain/safety-in-youth-sports-act.html.
    Posted by Edgar Snyder on 8/6/2012 12:59 PM
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