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A quick shake of the head after a heavy blow may indicate a person has a concussion, new Research It is suggested based on the experience of young athletes.
Researchers from Mass General Brigham and the Concussion Legacy Foundation say it's an easy-to-understand activity that, if added to official evaluation guidelines, could help significantly reduce the number of undiagnosed concussions.
“After a blow to the head, we define it as the time when a person shakes their head to the side at a rate between two and eight hertz. But that's complicated medical terminology that we've all seen,” said Dr. Dan Daneshvar, study author and co-chair of sports concussions at Mass General Brigham. .
Cartoons often show a circle of birds that fly away after the character shakes their head, for example.
“There is such a strong lay perception that this is associated with concussions, but it's not included in the guidelines or the medical literature.
To better understand this movement – after the kinematic phenomenon it is named sudden head shaking, or Trembling – and its relationship to stress, the researchers surveyed hundreds of young people who played sports at the high school, college or semi-professional level.
They find that most young athletes are familiar with the symptoms and have experienced them themselves more than once. In nearly three out of four cases, individuals surveyed reported experiencing concussions during SHAAKE.
The confusion reported by the survey participants was often self-diagnosed, but the main causes of anxiety-related symptoms were head shaking, such as restlessness or disorientation, or spatial awareness.
Dr. Julie Stam, a clinical assistant professor at the University of Wisconsin-Madison, who was not involved in the new study, said more formal recognition of this headache and its link to stress is “long overdue.”
“A few decades ago, we thought you had to be unconscious to have a concussion,” she says. Now, science shows that concussions rarely cause such severe symptoms. Instead, more subtle symptoms are known to be more common — and the severity of the pain doesn't always match the severity of the injury, she says.
“People try to uninstall 'Ring the Bell' or 'Stargazing' and restart it,” Stam said. “We used to not consider some of these injuries concussions, and we do now.
Based on the responses to the survey, researchers suggest in the new study that SHAAKE's standard recognition as a sign of concussion can help identify up to a third of undiagnosed concussions.
“Based on our data, SHAKE is a reliable indicator of the possibility of a concussion if an athlete grabs his head after contact, is slow to get up, or loses balance,” said Danshvar, head of brain injury rehabilitation. Spalding Rehabilitation and Harvard Medical School. “Just after these other symptoms of a concussion, athletes should be removed from play and evaluated for possible concussion if they exhibit SHAAKE.”
The National Football League and NFL Players Association have agreed to an update. League concussion protocol In October 2022, Miami Dolphins quarterback Tua Tagovailoa was brought to the turf after intense scrutiny over the decisions made following the hit.
A sideline doctor concluded Tagoviloa's fall was due to an earlier injury to his back and he was cleared to return to the game, but was later hospitalized for depression. The imbalance he was experiencing was later caused by ataxia, which describes a lack of coordination caused by a neurological disorder. Under the new NFL concussion protocols, players cannot compete if they have ataxia.
But the researchers of the new study, published Wednesday in the peer-reviewed scientific journal Diagnostics, suggest that the diagnosis and decisions for Tagovailoa could play out differently if concussions were part of the official concussion protocol.
“In this case, it would be difficult to attribute SHAAKE's findings to a previous back injury,” the researchers wrote. “Any of the doctors who saw Tuan on the field or in the days that followed could have re-evaluated him and decided based on this additional evidence that a concussion diagnosis would properly cover his inconsistencies and his SHAAKE.”
A board of independent and NFL-affiliated physicians and scientists. In 2011, they developed the league's official game-day concussion diagnosis and management protocol, which states: “It is reviewed annually to ensure that players are receiving care that reflects the current medical consensus.” Identification, Diagnosis and Treatment of Panic Symptoms, by N Overview On the NFL website.
“The NFL's medical committee regularly reviews new research, and we have contacted the authors of this study,” NFL chief medical officer Dr. Allen Sills said in a statement about the new study. “As with any new research, we discuss these findings with our experts and look at our own data to see if these findings can be replicated.
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“Our concussion protocol, a conservative process developed from internationally accepted guidelines, is reviewed annually to ensure that players are receiving care that reflects the most current medical consensus on concussion identification, diagnosis and treatment.”
For the new study's researchers and other experts, including SHAKE may be a sign of concussion – widely used in sports protocol and medical guidelines – to provide very little value.
“Our understanding of what earthquakes look like is improving,” Danshvar said. “In my view, this is one of the things where it costs nothing to get an athlete out and evaluated. But the negative consequences of not evaluating an athlete can be devastating to themselves, their career, and their lives.
Concussions are often underreported, and recognizing additional symptoms in an official protocol can help, Stamm said.
“It really empowers the clinicians to say, 'No, this is real,'” she said. “Both give the clinic more reason to take them off the field, and if the athlete has symptoms and realizes they're concussing, they'll probably recognize it as a concussion if they didn't know it before,” he said.