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App Tests Players' Balance on the Sidelines

If you watch the NFL, you have probably heard a coach or an analyst speak about a player getting their "bell rung." This phrase has been a euphemism for a player suffering from a concussion, and in the past these players were often sent back into the game. This practice held no malice or willful intent to place these players in danger. There was just little to no knowledge about concussions and the long-term impact they have on the human brain. And no NFL coach wants to play a football game without one of their star players.

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Former New England Patriots linebacker and defensive captain Ted Johnson retired in 2005 after 10 years of playing football. His career troubles started in 2002 after he suffered two concussions in five days. The first one was in a game. The second came a few days later when, as Johnson claims, his coach pressured him into practicing. During this practice session, Johnson suffered his second concussion. It is unknown if these were his only concussions.

In Jackie MacMullan's article for The Boston Globe, Johnson is quoted as saying "I've probably only been listed as having three or four concussions in my career. But the real number is closer to 30, maybe even more. I've been dinged so many times I've lost count." The accumulated effect of multiple head traumas may have contributed to the emotional problems Johnson has been dealing with.

The NFL has instituted the use of doctors on the sidelines who monitor players and make sure they are not returning to the game while feeling the effects of a concussion. The assessment depends partly on doctors asking the players questions, and running simple tests. NFL sidelines are too hectic and restricted an area to house the equipment needed to test individuals for concussions, but an iPhone app may help team trainers make more informed decisions about possible head injuries.

There's an app for that

Chase Curtiss, a graduate of Wichita State University (WSU), may have found a way to put more objective assessment tools in the hands of sideline doctors. While working as a graduate student in the neuropsychology lab at WSU, Curtiss had the idea to start a company. In 2011 Curtis founded Sway Medical, and within two years developed the Sway Balance app for the iOS platform. It already has Food and Drug Administration (FDA) approval.

The Sway Balance app works like this: players are screened at the beginning of the season by holding an iPhone with the app on it to their chest. A doctor or medical trainer runs them through a series of balance tests, and the app gives a score from 0 through 100 for each player. This establishes a baseline score for individual players while they are relatively healthy. The baseline score can be used as a comparison against the score of a player who has taken a big hit, to reveal issues with balance, which can be one of the primary symptoms of a concussion.

Athletic trainer Jennifer Hudson helped test the app in schools. Hudson describes the difficulty of identifying concussions: "A lot of the initial assessment by trainers on the sidelines have had to be much more subjective, much of them based on how the athlete is feeling."

Sideline doctors and athletic trainers can use the Sway Balance app as a first step in helping them assess a head injury. It is not foolproof, and Curtiss is quick to point out that the app is not intended for diagnosing concussions. The goal is "screening balance as a key symptom of a possible head injury." Players still have to be taken to a hospital and fully examined, but this app could help remove some medical uncertainty and potentially lower the chance that players are sent back into a game when they aren't fit to compete.

Where do we go from here?

Helping athletic trainers keep sports players from harm isn't the only medical use for this app, according to The Wichita Eagle. Under a provision in the Affordable Care Act, physical trainers must collect data on elderly patients they treat. Examples of this include the effects of increasing or decreasing medication doses, and the risk these patients have of falling due to balance issues. It's possible that the Sway Balance app could help trainers collect and assess that data faster and more efficiently.

Sway Medical has partnered with ImPACT Applications Inc., which is known for Immediate Post-Concussion Assessment and Cognitive Testing technology. ImPACT plans to place the Sway Balance app in its products, which are used by major sports leagues such as the NFL, MLB and NHL. Clinics, high schools and colleges also use the concussion assessment systems that ImPACT distributes.

A press release from Sway Medical suggests that the app could branch out into different areas in the future, such as physical therapy, orthopedic and primary care physician practices, senior living facilities and worksite medical clinics.

Pre-emptive strike against second-impact syndrome

Jeremy Patterson, a WSU scientist who worked with Curtiss to test the app, says that addressing the first head injury is "very important" because "second-impact syndrome" leads to problems down the road. "You get a second injury, and you are really cooked," he added, explaining that recovery is much more difficult with each successive concussion.

Research on military patients has also explored a link between multiple brain injuries and psychological problems, including suicide risks and depression. Trained professionals such as psychologists and psychiatric nurse practitioners are on the front lines of society battling mental illness and rising suicide rates among Americans.

Ted Johnson learned the hard way about the after-effects of concussions. "Every day there is a new study linking concussions to depression, as well as early onset of Alzheimer's disease," he told The Boston Globe. "It doesn't have to happen. It shouldn't happen. I don't want anyone to end up like me."

Technological advances such as this new app might help change sports, whether in schools or the big leagues, and potentially keep players safer.

About the Author:

Jamar Ramos has been writing poetry and fiction for many years, and earned his bachelor’s degree in Creative Writing from San Francisco State University. For the last three years, Mr. Ramos switched to producing blog posts for CBSSports.com and writing professionally as an independent contributor for a number of Internet sites. His creative works have been featured in The Bohemian and The San Matean. He now contributes articles for OnlineDegrees.com, OnlineColleges.com, and AlliedHealthWorld.com.