Debate over concussions: when to pull victims from class

Some universities remove concussed students from studies, some allow the concussed to decide


Athlete therapists are unanimous in agreeing that rest is a crucial part of recovering from a concussion. But schools are divided on whether they need to force athletes suffering serious symptoms to withdraw from their studies.

"Complete mental and physical rest"

If athlete's symptoms worsen as a result of class or reading, both Saint Mary's and McMaster Universities will remove students from their studies.

Dr. David Robinson, primary care sport medicine physician at McMaster in Hamilton, Ont., says a student can be removed from the classroom and excused from tests if symptoms worsen during school.

"We specifically talk to them about screen time," says Robinson. "We don't want them texting, we don't want them on computers, we don't want them watching television, and we certainly don't want any physical activity. Complete mental and physical rest."

Chad Newhook, an athletic therapist at Saint Mary's, admits that it's rare for a concussed athlete to be removed from their studies, but it does happen.

"If they go to class or they're studying and they get symptoms because of (school)... we pull them from class."

Newhook and Robinson say the universities are fully on board with this policy. Concussed student athletes return to class much like they return to play, one step at a time.

But, not all universities in the Atlantic University Sport conference have this policy.

'Ultimately it's the student's decision'

Robyn Spencer, varsity therapist at Dalhousie University, says it's not the school's policy to remove concussed students from class, even if they are suffering from symptoms.

"In the end it's the student's decision. We just give them as much information as we can and say that your healing depends on you resting as much as possible. But sometimes it's just not possible for the students to miss out on their program."

According to neurologist and concussion specialist Dr. Kevin Gordon, people who are suffering from post-concussion symptoms often do not make decisions in the best interest of their recovery.

Gordon says student athletes with concussions feel isolated due to the complete mental and physical rest required to recover. This isolation, coupled with the intensity of university studies, could force concussed student athletes to return to classes too soon.

Spencer does warn students that returning to studies too quickly can make symptoms worse but says ultimately it's the student's decision.

Addressing the concussion issue

Phil Currie, executive director of Atlantic University Sport, is chairing a committee put in charge of creating a standard protocol for concussion management in the AUS. This includes a policy that would outline when to withdraw a student from their studies.

Currie says pulling a concussed student from their schoolwork when it's necessary should be a policy of all schools in the AUS. He says the committee plans to discuss if this should be made a standard practice. 

He recognizes the complexities facing student athletes who suffer from concussions and understands the importance of proper concussion management.

"We've got to make sure we get this right because we're dealing with students first. They have to be in the classroom more than they have to be (playing)."

The committee includes three physicians and met for the first time on Jan. 17. Currie hopes to have the protocol developed in time for the AUS annual general meeting in May.

The federal government also wants to prevent brain injuries.It announced on Jan. 19 it will spend $1.5 million to help prevent concussions in sports across Canada. Through education and research, the government hopes to keep kids active and safe.

Testing student athletes for concussions

The testing methods used to determine whether a student athlete has suffered from a concussion, or still has symptoms, are generally the same. There are two tests used.

The first is the ImPACT test, a computerized test that measures symptoms, reaction time and memory. The second test is the Sport Concussion Assessment Tool 2 (SCAT 2) which scores symptoms based on severity to determine the mental health of the athlete.

Newhook says all student athletes at Saint Mary's undergo an ImPACT test before they take part in any school sports. This is in order to determine the athlete's normal cognitive state. The SCAT test is used once a student athlete is suspected of sustaining a concussion and to track their recovery.

Dr. Robinson uses the ImPACT and SCAT 2 tests in the same way.


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