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Wednesday, April 30
Updated: May 1, 1:36 PM ET
New test helps determine readiness
Concussions are a fact of life in automobile racing, where crashing into a concrete wall at high speed is relatively common.
Until now, one of the most difficult decisions facing doctors who treat race drivers for concussions has been knowing when a driver is well enough to return to a race car.
Now, thanks to Mark Lovell, director of the Center for Sports Medicine Concussion Program at the University of Pittsburgh Medical Center, there is a new, important tool.
It's call ImPACT, which stands for Immediate Post-Concussion Assessment and Cognitive Testing. That's a formal way of describing a computer test devised by Lovell and Pittsburgh Steelers team neurosurgeon Dr. Joseph Maroon, in conjunction with several of Lovell's former colleagues at Henry Ford Health System in Detroit.
"Before we had tests like ImPACT, a lot of it came down to what the athlete told you,'' Lovell said. "You'd ask: "Do you have a headache? Do you feel nauseous? Do you feel dizzy?' They generally say 'no' to all of those.
"One thing we know about athletes is they're very, very competitive. So we weren't absolutely positive we were always being given an accurate picture of how they were feeling. With a test like ImPACT, you can't cheat it."
The test, which takes 22 minutes the first time and a little less in subsequent uses, measures memory, reaction time, mental speed, information processing, anticipation time and other functions of the brain affected by concussions.
The idea is to administer the test while the subject is healthy -- at the start of the season, preferably. That sets a "baseline" with which to measure further tests after a head injury.
"I started doing this stuff with the NFL back in the late '80s, doing concussion management work," Lovell said. "I realized a long time ago, along with several of my colleagues, that the only way we were going to make this type of evaluation practical was to create computer software for it so it could be used not just in professional athletes but also at the college and high school level."
Lovell said the ImPACT test is used by about half the teams in the NFL "and the rest are kind of transitioning to it." He said the NHL has been studying it and is using what Lovell calls a "paper-and-pencil approach" that he developed years ago. ImPACT is already in use in 350 high schools and 100 colleges.
Lovell said nearly 7,000 people have taken the test, including 600 to 700 who have taken it again after having concussions.
In auto racing, CART has been using the test since last year, all the Indy Racing League drivers will take the test as part of their physical for entering the May 25 Indianapolis 500, Formula One has the software and plans to implement the program as soon as possible, and NASCAR is studying it.
Gary Nelson, managing director of competition for NASCAR, said some drivers are using it on a volunteer basis.
"As with everything, we take a look at it and try to understand everything about it and move in a conservative way," said Nelson, who works out of NASCAR's new research and development center. "But it certainly looks promising and, if we feel it will serve a purpose, we will recommend it to our teams."
Other series have not taken such a cautious approach.
"We have a database on our drivers," said Dr. Steve Olvey, director of medical affairs for CART. "The IRL's all in there, and Formula One is going to start that very soon and we'll have that in the database, too."
Olvey said concussions have been a big problem in auto racing for a long time.
"We had no good way of really looking at it and judging who had too many concussions and who was in trouble because of it," Olvey said.
He added that he and IRL director of medical services Dr. Henry Bock have surmised through the years that certain drivers likely had had too many head injuries, "and it explained their deterioration toward the end of their careers and voluntary early retirement."
Bock, who also oversees the medical facility at the Indianapolis Motor Speedway, said ImPACT is a great tool but there is no foolproof test for determining if a driver is ready to get back in the car.
"It's not a perfect test,'' he said. "There's no hard and fast rules. You have to look at the overall situation -- the physical conditions, how they're feeling, the tests, what a scan shows and more.
"If somebody doesn't feel right in their head, they're smart enough to know they shouldn't be out there for their own safety and the safety of others.''
Gil de Ferran, who missed last year's IRL season finale because of a concussion, was injured again last month in Phoenix. This time, he came away with another concussion and fractures to his neck and lower back.
He has been out of the car and recuperating but expects to be cleared to drive in the Indy 500. De Ferran said he's thankful there is now a test such as ImPACT to assure him all is well before he goes back to racing at speeds of more than 200 mph.
"The thing that I like the least about crashing is actually the head injuries,'' he said. "I guess you're still smart enough to realize that you're a bit dim, and that is not a fun sensation. From an emotional standpoint, that's really what I struggle with the most."
Olvey said the test is especially important for people who have had multiple concussions.
Steve Park, who missed the last eight Winston Cup races of 2001 and the first four events of 2002, flew to Pittsburgh in February to take the ImPACT test.
Park said he wishes he had known about the test before a crash, at Darlington in a Busch Series car, that temporarily left him with blurred vision and slurred speech.
"I'm not going to put it on the shoulders of NASCAR to make it mandatory, but racers should understand the importance of (the test),'' Park said. "Once I learned the importance of it after I was hurt, I was so mad that I didn't have this done beforehand.
"I think people who haven't been injured think of it as something that's not that important but, if you're ever hurt, you'll certainly be glad that you have taken the test."Send this story to a friend | Most sent stories