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Sports Neuropsychology
By Ruben Echemendia, Editor ~ 2006
Preface
Interest in sports-related brain injury has increased exponentially over the past 15 years. This increase has been generated by extensive media exposure and the retirement of several prominent professional athletes due to enduring symptoms following cerebral concussions. Concerns about player safety were raised by newspapers, television specials, and sports commentators. Professional leagues like the National Hockey League and the National Football League began to take a serious interest in cerebral concussions and player safety. This interest then cascaded to college programs, high school programs, and recreational athletes. Historically, neuropsychology has not been centrally involved in sports injuries despite the fact that neuropsychology has a long track record of studying mild traumatic brain injury in the general population, with pioneering work conducted by Harvey Levin, Dorothy Gronwall, Sureyya Dikman, and others. Neuropsychology only recently became involved in sports with the seminal work of Jeff Barth and his colleagues at the University of Virginia in the mid-19080s. Within a very short time frame, neuropsychology has become the “cornerstone” for the assessment and management of sports-related concussion (Aubrey et al., 2002).
The primary objective of this book is to provide clinical neuropsychologists and psychologist with an introduction to the rapidly emerging area of sports neuropsychology. The book is designed as a resource for the clinician on the diagnosis and management of concussion, the development of concussion management programs, consultation with sports teams, and interpretation of clinical data. The authors of the chapters were chosen because they are the leading figures in the field, and each bridges the gap between science and practice in his or her daily work. Although each of the chapters integrates the scientific literature with clinical practice, the focus of this book is largely clinical and is not intended to be an exhaustive review of the scientific literature.
The book is divided into five parts. Part I presents a historical context for the development of sports neuropsychology and ends with a discussion of the issues involved in consulting with sports teams. Part II provides an understanding of the pathophysiology of mild traumatic brain injury and the epidemiology of sports-related concussion. While neuropsychologists are largely involved with the evaluation of players days after injury, this section also outlines the process for making the real-time (sideline) decision of whether or not a player has sustained a concussion and whether of not he or she should be removed from play. The last chapter in this section describes the complexities inherent in the return-to-play decision-making process. For neuropsychologists, this is a unique position, since no other practice area of neuropsychology involves the act of deciding when it is safe to return a client to a situation where the risk of sustaining another brain injury is relatively high.
Part III provides the framework for clinicians and researchers who wish to develop concussion management or research programs for a variety of populations ranging form school-age children to professional athletes. The authors of these chapters have experienced the rewards and frustrations of developing programs where none had previously existed. The reader will benefit from a discussion of their successes and challenges when developing their own programs.
One of the exciting and promising developments in sports neuropsychology has been the development of computer platforms that allow for cost effective and efficient methods for assessing athletes. Which computer program should a clinician choose when establishing a new concussion management program? Part IV describes the four major computerized assessment programs. The authors describe their programs, summarize the reliability and validity studies that have been conducted, discuss interpretative strategies and provide case examples.
Sports neuropsychologists work closely with professionals from other disciplines who are involved with athletes on a daily basis. Part V introduces the perspectives of a team physician and a certified athletic trainer, who provide the reader with information regarding the nature of their training and their role in working with injured athletes, and discuss how neuropsychology has been incorporated into their practice.
In closing, I would like to thank the authors who contributed to this book for their scholarship, hard work, and support in the development and completion of this project. I would also like to thank the teams, coaches and players who have trusted us with their care.
Reference
Aubry, M., Cantu, R., Dvorak, J., Johnston, K., Kelly, J., Lovell, M.R., et al. (2002). Summary and agreement statement of the first International Conference on Concussion in Sport. British Journal of Sports Medicine, 36, 6-10.
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