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  • Concussions Less Frequent at Higher Altitudes

    High school athletes at higher elevations experience 31% fewer concussions than athletes closer to sea level, and the difference may have something to do with the "tight fit" created inside the skull when altitude increases intracranial pressure.

    A recent study published in the Orthopaedic Journal of Sports Medicine looked at nearly 6,000 high school athlete concussions from across the US by examining data collected between 2005–2006 and 2011–2012 through the National High School Sports-Related Injury Surveillance System. After dividing incidents by the altitude at which they occurred, researchers found a strong correlation between lower concussion rates and higher elevations, with athletes playing at over 600 feet experiencing fewer concussions in both competition and practice settings.

    Researchers pointed to several factors that could contribute to the differences, but stated that what seems to happen is that higher altitudes reduce intracranial compliance—essentially, the amount of give that allows the slosh effect associated with concussions—and create a situation "similar to having an airbag deploy or 'bubble wrap' inflate and thus prevent damage to structures within a container."

    The study's authors call for more research in the relationship between altitude, intracranial pressure, and concussion, and point to recent studies that reduced brain injury in rats by as much as 83% through altering brain fluid dynamics. They wrote that "future research is warranted to test the hypothesis that mitigating slosh in the human cranium via mild jugular vein compression will reduce or diminish severity of concussion."

    APTA believes that concussion should be managed and evaluated by a multidisciplinary team of licensed health care providers that includes a PT. The association has developed policy resources at both state and federal levels, while practice-focused online concussion resources include a series of podcasts, a PT's guide to concussions, and online learning opportunities on when to return to sport and managing concussions with an interprofessional team. Members can also access evidence-based practice research through the PTNow webpage.

    Latest Thought on Emergency Department Care Available Online

    The past, present, and future of emergency department (ED) care were recently explored in a briefing hosted by Health Affairs, and the entire event and other materials are now available free online.

    The December 4 event brought experts together to focus on ED issues related to integrated networks of care, reinventing emergency care, quality management, access, cost/payment, and disaster preparedness. Among other topics, speakers addressed the increased need for more coordinated care that involves a wider range of health care professionals.

    Health Affairs is a monthly journal focused on health policy.

    Find out more about the integral role of physical therapists in emergency care: check out APTA's webpage devoted to physical therapy practice in EDs.

    Get 'Insider Intel' On Hot Topics in Medicare, Health Reform, and More

    Functional limitation reporting, the therapy cap, 2014 fee schedule payment rates, and the Centers for Medicare and Medicaid's manual changes reflecting the "improvement standard" will take center stage for APTA’s next "Insider Intel" program on December 16.

    The 30-minute call-in program will begin at 1:00 pm, ET. To register for a spot in the session, e-mail advocacy@apta.org with "December 16 Call" in the subject line.

    "Insider Intel" Q&A call-ins are dedicated to specific hot topics in policy and payment, free to APTA members.

    Can't join the live discussion? Recordings of the calls are available on the APTA website afterwards.