MDNews - Long Island

April 2019

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subspecialty trained orthopedic surgeons for all musculoskeletal issues," says Hayley Queller, MD, PC, Medical Co-director of the ThinkSMART! Concussion Management Program and Co-director of the Sports Medicine Program at St. Charles Hospital. "We offer all of the subspecialties required to care for athletes from head to toe, and that allows us to hone in on the intricacies of each athlete's injury." COMPREHENSIVE CONCUSSION MANAGEMENT BEGINS WITH BASELINE TESTING One of St. Charles Sports Medicine's flagship services is comprehensive con- cussion management. The ThinkSMART! Concu s sion Ma n a gement P rog ra m debuted in 2010, at a time when diagnosis and treatment of concussion in Nassau and Suffolk counties was decentralized, according to Dr. Queller. "When I moved to this area, there was no consensus as to how athletes would be eva luated for concussion and who would treat them," she says. "We wanted to centralize where concussion manage- ment would take place. In order to better diagnose concussion, we began offering baseline neurocognitive testing in a few school districts. Within a short period of time, other districts wanted to be included and the service grew organically." The ThinkSMART! team trains school personnel to administer the ImPACT® test. The computer-based assessment helps clinicians get a sense of student athletes' baseline neurocognitive abilities, such as reaction time and information recall — ideally, before a sport season begins. If a concussion is suspected, the student may take the test again. Then the baseline and post-concussion tests are compared to find differences in neu- rocognitive ability. Currently, 44 school distr ict s test st udent at h letes w it h ImPACT through the ThinkSMART! pro- gram. More than 85,000 student athletes have taken the test since the program's inception. The baseline testing service is available free of charge to participating schools, and the results are available to ThinkSMART! physicians. While the results of the ImPACT test are useful, they are just one component of a comprehensive evaluation, which includes a thorough history intake as well as visual, balance, neurocognitive and vestibular assessments. "The ImPACT test should never be used alone to decide whether someone is concussed," says Jennifer Gray, DO, Medical Director of Physical Medicine a n d R e h a b i l i t a t i o n a n d M e d i c a l C o - d i re c t or of t he T hin k S M A RT! Concussion Management Program at St. Charles Hospital. "Sometimes, athletes retake the test and their results are not significantly different from their baseline results, but that doesn't mean their bal- ance, for example, is good. The ImPACT test is one tool we can use that may show an abnormality." INDIVIDUALIZED, MULTIDISCIPLINARY TREATMENT FOR CONCUSSION The ef fects of concussion a re high ly v a r i a ble, wh ich i s why c onc u s sion specia l i s t s w it h St . Cha rles Spor t s Medicine partner with young athletes a nd their pa rents to ta ilor treatment a nd determine return-to-play pla ns. Treatment ty pica lly beg ins with rest and activity modification, according to Dr. Gray. That may include academic accommodations, such as shor tening school days, skipping certain classes or not using a computer. Some individua ls may need medication to relieve pa in, nausea, dizziness or other symptoms. Michael Sileo, MD, Co-director of the Sports Medicine Program at St. Charles Hospital, (left) and Keith Levinson, PT, DPT, SCS, OCS, CSCS, Sports Therapy Clinical Coordinator at St. Charles, use the Crossover Symmetry Thera band system with a baseball pitcher to assess the pitcher's scapular strength, endurance and positioning while he performs a shoulder abduction movement pattern. During St. Charles Sports Medicine's Recovery Clinic, athletes have the opportunity to recover their fatigued muscles using equipment typically found in the training rooms of professional athletes. These include ice baths and compression devices, such as the one being used in the photo, by an athlete with assistance from Levinson. M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 019 0 7

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