UNC prof studies concussions in young athletes

Igor Szczyrba’s world is one of abstract mathematical formulae and complex software, not high school locker rooms and football sidelines. Yet from his research may come one key to keeping young athletes safe.

Szczyrba (pronounced “Sturba”) is a professor of mathematical sciences at the University of Northern Colorado and, for the past 10 years, his research has focused on computer modeling of traumatic brain injuries.

Last week, at a supercomputing conference in New Orleans, Intel, working with football helmet manufacturer Riddell, announced that Szczyrba is among a group of researchers whose modeling will be used to predict what sort of on-field hits are most likely to produce dangerous head injuries, and to suggest in which part of the brain such injuries might occur.

“We want to develop some brain injury criteria,” said Szczyrba, who is collaborating with his son, software engineer Rafal Szczyrba, and Martin Burtscher, an associate professor at Texas State University in San Marcos who received his doctorate in computer science from the University of Colorado in 2000.

A better way to detect concussions

“I’m not a physician but my understanding is that right now, at high school and university football games, if a player takes a blow to the head, the coach asks him some questions, based on a questionnaire,” Szczyrba said. “And based on their answers they decide if there’s a chance there’s a concussion.  But we want to do more.

“If it’s a minor concussion, they might not even know it. The problem with minor brain injuries is that they may not be immediately apparent. A brain hematoma may start very slowly, and even if you do an MRI, it might not show up immediately. You cannot judge immediately whether there’s been a concussion based on the behavior of a football player. That’s why it’s important to help physicians predict the probability of an injury.”

The modeling to be done by Szczyrba and his colleagues will involve data collected from sensors placed inside football helmets. These sensors will measure the acceleration or movement of a player’s head inside the helmet during a hit.

Research indicates that the most dangerous brain injuries appear when the head rotates on the neck. By analyzing the angle and force of each hit, and comparing those hits that cause concussions to those that do not, researchers may be able not only to design helmets that provide better protection, but also imbed chips in those helmets that can alert coaches and physicians when a player has taken a potentially dangerous hit.

“In the past we’ve tried to do similar studies on car accidents,” Szczyrba said. “You can estimate the acceleration of the car, the acceleration of the body, especially the head, but it’s very imprecise because you cannot tell how a body is moving in the car. This is the first time we’re getting the data from football helmets, and data from cars is not as good as data from helmets.”

Szczyrba has just received the first set of data. He hopes that within a year, he and his colleagues will have be able to produce some definitive findings.

Legislation likely to be introduced in Colorado

Meanwhile, expect concussions and how they are treated in school-age athletes to become an increasingly hot topic in Colorado. At least one major conference on the topic is planned for Denver in February, and officials from a number of agencies that deal with brain injuries are working to draft legislation they hope will be introduced in the upcoming Colorado General Assembly.

“Already there are half a dozen states where such legislation has passed or is pending, so it’s not just Colorado,” said Gavin Attwood, executive director of the Brain Injury Association of Colorado. “Part of that wave is because there has been increased research around the effects of concussion on young brains. The brains of high school athletes heal a lot slower than adults. I can’t give you a reason why, but they do.

“The other thing that’s being observed is that if you have several concussions, there can be longterm cognitive issues for the students,” Attwood said. “It could be a lack of concentration, or irritability or depression. So what the country is say is, ‘Hey, we love that our youth play sports and in no way are we trying to put a stop to that, but we’ve got to manage concussions carefully. Otherwise, these kids will potentially have cognitive issues later in life.”

The exact number of sports-related concussions suffered by Colorado students annually isn’t known, but based on extrapolation from national data, officials estimate somewhere between 1,349 and 2,510 such concussions each year that result in emergency room visits.

But the actual number is likely far greater, since many more injured youngsters never make it to the emergency room, and often never receive any sort of treatment at all.

Attwood said the proposed legislation in Colorado will mostly likely address three issues: mandatory education about concussions for all coaches, even volunteer coaches; mandatory removal from the field of play for young athletes suspected of sustaining a concussion; and prohibition from returning to play without the approval of a medical professional with training in treating concussions.

Conference to bring educators, parents, health professionals together

The Brain Injury Association will host a conference, “When Mild Traumatic Brain Injury is Not Really Mild,” on Feb. 4 in Denver. Keynote speaker will be Dr. Ron Savage, chairman and co-founder of the International Pediatric Brain Injury Society and “the guru of all things about disability in the school system,” said Rhonda Rickett, coordinator of the event. “He built the model for brining parents and schools together as very direct partners in educating students with disabilities,” she said.

The REAP Project (Reduce, Educate, Accommodate, Pace) is a community-based model for concussion management developed in Colorado. (Nicholas Garcia)

Also speaking will be Dr. Karen McAvoy, a licensed child psychologist and director of the Center for Concussion at the Rocky Mountain Youth Sports Medicine Institute. From 2004 to 2007, McAvoy was manager of a Centers for Disease Control study on concussion in high school athletes. The researchers followed 92 student athletes with concussions over three years.

Based on that study, McAvoy developed the REAP Project (Reduce, Educate, Accommoate, Pace), a model program for concussion management that health officials hope will be adopted throughout Colorado. During its pilot 2009-10 school year, when it was in place in four Colorado school districts, the REAP project received more than 150 referrals of athletes treated in emergency rooms for concussion. The families of those injured athletes were quickly contacted by REAP so that parents could know what to look for and how to gradually ease the youngsters back into activity without further harm or risk.

For more information

To read more about Szczyrba’s Traumatic Brain Injury research and to see animated computer models, go here and select “animations.”

To see a simulation of a collision between football players and how their heads rotate, see this article in geek.com.

Read the latest recommendations for enhancing athlete safety, released in September by the Colorado Youth Sports Concussions Special Interest Group,