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Hockey Puck Test Helps Detect Concussions

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Hockey Puck Test Helps Detect Concussions


Hockey Puck Test Helps Detect Concussions

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  • <iframe src="" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
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Athletes playing contact sports used to treat injuries from a knock on the head as no big deal, but brain specialists and sports doctors are now expressing more concern about the long-term effects of concussions. That's why some researchers are trying to devise quick and simple ways to help decide if somebody has had a concussion. NPR's Richard Knox reports.

RICHARD KNOX: Megan Garland(ph) knows that a concussion can be serious, that's why she's gone to see Boston neurologist Frances Jensen.

Dr. FRANCES JENSEN (Neurologist): So you're here because of headaches, right?


Dr. JENSEN: So how old are you?

Ms. GARLAND: I'm 17.

Dr. JENSEN: Seventeen? Ok.

KNOX: Back in December, Garland had a nasty fall.

Ms. GARLAND: So I slipped on black ice, fell flat on my head.

Dr. JENSEN: So you had head injury?

Ms. GARLAND: Yeah. And I went to bed, woke up and I just felt like the worst headache I've ever had in my life

Dr. JENSEN: Um-hum.

KNOX: And the headaches didn't stop. Garland's had them for nearly three months now, sometimes accompanied by nausea and vomiting. And her mother says she's also been uncharacteristically irritable. Jensen tests Garland's strength and reflexes.

Dr. JENSEN: Let's just see you straighten your fingers out. Good. Excellent. Okay. Make a muscle, don't let me pull, all right, like this. Very good.

KNOX: Doctors see lots of patients like Megan Garland. Connecticut neurologist Anthony Alessi says it's not at all unusual to see adolescents who've had repeated concussions. That's troubling, because young brains are more susceptible to injury.

Dr. ANTHONY ALESSI (Neurologist): We know that the developing brain really needs time to do just that: develop. So any repeated head injury becomes an issue of concern.

KNOX: It makes it important to figure out just when a kid has suffered a concussion or not. And that's where Dr. James Eckner comes in. He and his colleagues at the University of Michigan have developed a quick test to help diagnose concussions where many of them occur, on the athletic field. They'll present preliminary results on the test this spring at a meeting of the American Academy of Neurology.

Eckner's test measures reaction time, which is often impaired after a concussion. It's really simple. It's just a hockey puck on the end of a stick. The stick has regular markings.

Dr. JAMES ECKNER (Study Author, University of Michigan): The person being tested would be sitting down with their forearm resting on the table. We suspend the device so that their hand is around the hockey puck at the bottom of the device, and without warning we drop it and they just catch it as quickly as they can.

KNOX: The place on the stick where they grabbed it tells the tester how fast they reacted. After a concussion, Eckner says, the reaction time is 15 percent slower, on average, about 30 milliseconds. There are computer programs that test reaction times, but it's not so easy to do that on a playing field. And many school systems are strapped for cash and can't afford the licensing fees.

Eckner says his test has the advantage of being low-tech.

Dr. ECKNER: It's like the stethoscope compared to the echocardiogram. It doesn't give you quite as much information, but it's something you can put in your pocket and carry with you and use very easily.

KNOX: The hockey puck on a stick test needs more work. Even if it holds up, Anthony Alessi, the Connecticut neurologist says it's never going to be a standalone test to rule out a concussion.

Dr. ALESSI: We all want a simple, quick, easy test that's going to tell us exactly what to do, and that's just not the case.

KNOX: Trained personnel will still need to access an athlete's symptoms. But, Alessi says, reaction time tests might help, especially when players hide their symptoms so they can stay in the game.

Once a young athlete's had a concussion, it's important to avoid another, so sometimes it's necessary to make a hard decision. That's the message that neurologist Frances Jensen wants to leave with Megan Garland who's due to start lacrosse practice next month.

Dr. JENSEN: If you're going to be taking a sport that might put you at risk for head injury, that would probably be not a great thing.

KNOX: Women's lacrosse is not exactly a contact sport. Still, Megan seems to agree that maybe it's not such a good idea to risk getting hit in the head with a stick.

Richard Knox, NPR News.

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