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Alpine TD CONFERENCE 2008

Alpine TD CONFERENCE 2008. FIS MEDICAL COMMITTEE CONCUSSION ISS (INJURY SURVALLENCE STUDY). FIS. Medical Committee: Snowboard Alpine Freestyle Cross-country Ski jumping. Medical Committee. Education Sub Committee News Blast FIS Web page Ski Trauma Courses Medical Guide.

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Alpine TD CONFERENCE 2008

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  1. Alpine TD CONFERENCE 2008 • FIS MEDICAL COMMITTEE • CONCUSSION • ISS (INJURY SURVALLENCE STUDY)

  2. FIS Medical Committee: Snowboard Alpine Freestyle Cross-country Ski jumping

  3. Medical Committee • Education Sub Committee • News Blast FIS Web page • Ski Trauma Courses • Medical Guide

  4. FIS NEWS BLAST • Sport nutrition for ski competition • Soft tissue tendon injuries • Research conclusions on pre pubertal strength training • Concussion standards Vienna protocols • Back rehabilitation for ski racers • Future – vision, sport psychology, orthotics in sport • OR????

  5. Snow Sport Trauma course • Provincially • Nationally • Internationally – China, Russia

  6. END

  7. CONCUSSION • Many Alpine athletes KP, CM, MM • Previously under treated • 10% of athletes • Different countries different standards for caring for head injured athletes

  8. CONCUSSION! • Definition Vienna Prague • Disturbance of function of brain after trauma (metabolic not structural) • + or - loss of consciousness • Short lived neurological impairment (24 hours to 10 days) • Resolves spontaneously following a sequential predictable course

  9. Recognition difficult • Subtle symptoms - wide variety of symptoms • Reluctance to report • Normal CT, MRI

  10. SYMPTOMS • HEADACHE • RINGING IN EARS • DIZZY • NAUSIA VISION CHANGE • POOR BALANCE OR COORDINATION • DIFFICULTY OR INACCURATE ANSWEREING OF QUESTIONS .(DATE,TIME, 3 ARTICLE MEMORY) SAC, SCAT. Memory and attention

  11. Signs: • Loss of consciousness • Seizure • Poor coordination • Poor concentration • Inappropriate behavior or emotions • vomiting

  12. If Suspect • Treat as any injury - ABC’s, cervical spine • Don’t leave alone • Monitor - • Not to train or compete in current event • Requires full medical evaluation

  13. ACUTE INJURY MANAGEMENT • Coach or PHSIO or PHYSICIANS WITH THE TEAM –EVALUATES ATHLETE • Signs and Symptoms

  14. TD’s ROLE • Can request independent medical review of a competitors medical condition – see medical guidelines –FIS MEDICAL GUIDE • This can include completion of SCAT and clearance from an independent medical observer.

  15. TD can: • Propose to the jury the exclusion of any competitor – ICR – 601.4.9.4

  16. TD can: • Request the FIS Medical Supervisor to direct a medical examination or request a medical examination of any racer. ICR 221.2

  17. TD can: • Can act where there is no rule by making proposals to Jury – ICR – 601.4.9

  18. Post Injury management • STOP • REST • MENTAL AND PHYSICAL • NO ALCOHOL OR STIMUALANTS • NO MEDICATIONS

  19. PRESEASON PREVENTION ASSESMENTS

  20. Pre Season Assessment Includes: • Concussion history: • Previous head injuries and Symptoms • Loss of consciousness • Cognitive symptoms • Time off from skiing or training • Identify athletes not fully recovered from previous concussion injuries • Baseline-------

  21. Preseason Testing • SAC TEST-1997-Standardized Assessment of Concussion • SCAT TEST – Sport Concussion Assessment Tool – • British Journal Sports Medicine 2005 • Neurosurgery 2005 • Physician and Sports Medicine 2005 • 2nd International Symposium on Concussion in Sport

  22. Pre Season Testing • Impact test - Neurocognitive • Baseline neurocognitive testing using computer • Nast • BC Ski Team • B.C. leads the way in Snow Sports • Ontario – entire jr. hockey

  23. Impact • Identifies athletes at risk! • Used later in year with repeat concussion

  24. IMPACT • ATTENTION • PROCESSING SPEED • REACTION TIME • MEMORY • VISUAL • VERBAL • WORKING

  25. Return to Snow Protocol • Complete physical and mental rest until asymptomatic – then advance along the return to sport protocol with a minimum of 24 hours between advancing steps. Progression only if completely asymptomatic .

  26. PROGRESSIVE RETURN TO SPORT PROTOC0L STEPS: • Complete physical and mental rest until asymptomatic • Low intensity aerobic • Higher intensity aerobic • Easy free ski/ light exercise • Train gates • After medical clearance return to full competition separate all by 24 hours at least! IMPACT TEST BTN STEP 4-5

  27. Role of Impact • Do once athlete is symptom free after step 4. • Prolonged cognitive impairment – prolonged return to sport • Team physician = final clearance before return to sport!

  28. Dr.Karin KauskyCoordinator Impact and concussion management

  29. ISS: • Oslo Sports Trauma Institute (Professor Roald Bahr / Tonje Florenes) • FIFA • ? FIS athletes – competition and training

  30. Objectives • Reliable data on injuries • Predisposing factors • prevention

  31. The Big 5 • Switzerland, Canada, France, Norway, Finland

  32. Data collection • Alpine • Snowboard • Freestyle • Nordic combined • Cross country

  33. Data Collection • TD’s • Team physicians, physios, coaches • Year end interviews

  34. Snowboard • Knee • Head / face • Shoulder • Low back

  35. Reporting • 25% • 25% • 90%

  36. TEAM WORK • SB • ALPINE • NORDIC COMBINED • FREESTYLE • Medical directors have been notified

  37. THANK YOU

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