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Michigan H.S. Athletic Association Debuts Pilot Concussion-Testing Program

Student-athletes at 70 Michigan high schools will be subject this fall to a pilot initiative that aims to help diagnose concussions via the use of two sideline-testing programs.

The Michigan High School Athletic Association hosted all 70 high schools for training in the two tests—the King-Devick Test and XLNTbrain Sport—earlier this month. Roughly 10,000 student-athletes in the state will be participating in the program this upcoming school year, with each school having committed to involving at least two sports for each gender in the fall, winter, and spring, respectively.

The King-Devick Test tracks subtle vision problems in athletes suspected of having concussions by having them read single digit numbers either on test cards or on an iPad. If they struggle focusing on specifics, there's an increased chance that they're suffering some type of brain impairment. The test, which is associated with the Mayo Clinic, has been the subject of more than 50 peer-reviewed studies over the past few years supporting its use as an indicator of suboptimal brain function, according to its website.

XLNTbrain Sport, meanwhile, establishes a student-athlete's baseline brain function via a preseason neurocognitive test. When a student-athlete is suspected of having sustained a concussion, he or she undergoes a balance test on the sideline using a mobile app, and the results are compared to his or her preseason baseline. Based on the severity of the concussion, the program generates a recovery plan both for the student-athlete's return to sports and to the classroom.

"These pilot programs are intended to not only improve what's actually happening on the sidelines at practices and contests in these communities that are part of the pilot programs, they're intended to spread the word of the need for improved concussion detection across every community," said John E. Roberts, executive director of the state association, in a statement. "We hope these schools involved will become involved in their leagues and conferences and with their peers across the state as we expand the awareness of the need for better sideline detection and provide ways to get it done."

The MHSAA is the first state association to offer a pilot sideline concussion-testing program, according to its statement. It also will become the first state association to mandate schools keep records of "all possible concussion events, from detection to an athlete's return to play," for all athletes from grades 7 through 12. Additionally, all student-athletes at MHSAA high schools and middle schools will receive insurance "intended to pay accident medical expense benefits—covering deductibles and co-pays left unpaid by other policies—resulting from concussions sustained during MHSAA practices or competitions," with no cost to either families or schools.

These new policies only build upon changes the state association adopted in March 2014 with regard to student-athlete safety. In an effort to ease student-athletes' acclimatization back to football, the MHSAA introduced a gradual ramp-up of activity during the first week of practice of the season. During the first two days of practice that week, football players are only allowed to wear helmets, while full pads can't be worn until the fifth day of practice. Additionally, before the first regular-season game, teams can't have more than one "collision" practice—defined as a practice "in which there is live, game-speed, player-vs.-player contact in pads (not walk-throughs) involving any number of players." After the first regular-season game, teams can have no more than two collision practices in a given week.

The association also established time limits on daily practices, prohibiting coaches from holding one practice more than three hours in length or multiple practices per day totaling more than five hours. "Warm-up, stretching, speed and agility drills, and cool down are all considered part of practice," but strength/weight training and video/classroom sessions do not count toward those hour limits. In addition, it recommended at least one hour of break time in which there is no physical activity if teams do hold two-a-days.

Give the MHSAA credit: Rather than waiting on state legislation to force its hand with regard to concussion-policy advancements, it took a proactive approach. Other state associations would be wise to follow suit.

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