Former Pittsburgh Steelers running back Jerome "the Bus" Bettis, who suffered several serious head injuries during his career, is encouraging student-athletes to undergo concussion tests before starting fall sports.
In a 30-second television spot that began airing today, Bettis never directly mentions sports gear sold by Dick's Sporting Goods, the Pittsburgh-based chain of more than 400 stores. Instead, Bettis picks up a white football helmet inside one of the stores and says, "You wouldn't get on the field without this, and you shouldn't get on the field without a baseline concussion test either."
He closes the spot by saying: "Let's bench concussions with the help of Dick's Sporting Goods."
An estimated 3.8 million youngsters suffer concussions annually while engaging in sports and recreational activities, putting them at risk for neurological damage. Studies have confirmed that these brain injuries eventually can contribute to such disorders as dementia and Parkinson's disease. They've also been associated with a newly identified condition called chronic traumatic encephalopathy, which has led to suicides among some athletes, especially professional football players.
On Aug. 2, Bettis and Dick's launched the Protecting Athletes through Concussion Education (PACE) program. Their goal is to test about 1 million middle-school and high-school athletes at more than 3,300 U.S. schools using a tool called Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), already widely used by pro football, baseball and hockey teams.
The 20-minute computerized quiz asks about a player's health history, symptoms, sleep and medications. Other questions focus on the ability to remember words and images, as well as reaction time. Responses establish a baseline level of brain function. Athletes then can be retested after a concussion and the results compared to determine when they've recovered. Based on those results, "young athletes will know when to sit out," Bettis says in the ad.
ImPACT was developed in the 1990s by Dr. Joseph Maroon, a neurosurgeon at the University of Pittsburgh Medical Center, who appears in the ads with Bettis. The testing subsequently was improved and computerized by Dr. Mark Lovell, founding director of the UPMC Sports Medicine Concussion Program, and Dr. Michael "Micky" Collins, current director of the program, which sees 10,000 athletes a year, the majority of whom are youngsters.
Physicians contacted by the ABC News Medical Unit generally supported baseline testing for youngsters who play sports. The tests provide a more accurate picture of an athlete's neurological function than what might be apparent for athletes who understate their injuries or claim to be symptom-free because they're eager to resume playing. "Some of these athletes may be hiding symptoms and others may truly feel OK, but the test can pick up subtle deficits," said Dr. Ken Mautner of Emory Sports Medicine Center in Atlanta.
"For the past two to three years, we have done baseline testing on several teams and high schools, predominantly in high-risk sports: youth hockey, football, men's and women's soccer; men's and women's basketball and wrestling. We have found this to be very helpful," said Dr. Jon Divine, a primary care sports doctor and team physician for the University of Cincinnati.
Divine said athletes who return to play too soon and become reinjured are "at greater risk of post-concussion syndrome, an indefinite time period of headaches and other symptoms, cognitive dysfunction, problems with emotions, behaviors, sleep and many other normal day-to-day activities."
Dr. Aaron Karlin, director of the pediatric concussion management program at the Ochsner Clinic Foundation in New Orleans, likes the tests because, among other things, the results are "easy to show to parents, athletes, coaches, and trainers alike so there is limited argument/discussion."
He said that when athletes' scores quickly return to their normal levels after a head injury, that can be "extremely reassuring for the patient and parent. ... I always say that my job is not to hold these kids out of athletics but rather to get them back as quickly as possible but as safely as possible."
Dr. James Bray, a family medicine specialist at Scott & White Healthcare in Georgetown, Texas, and Dr. Jacob Resch, director of the Brain Injury Lab at The University of Texas at Arlington, said the test could be particularly helpful for athletes with learning disabilities, who even at their best might not score in the same ranges as their peers.
Dr. Mark Halstead, director of the Sports Concussion Clinic at Washington University Sports Medicine in St. Louis and team physician for professional, college and high school athletes in the area, said the tests must be properly administered and interpreted. "Whomever purchases the test to use must have a physician or neuropsychologist who is trained in the test," he said. "These tests should not be interpreted by coaches, parents, athletes or any other non-medically trained providers."
Halstead also cautioned that he and his colleagues are starting to see athletes who deliberately "try to do poorly on their baseline test so they can have a better showing after an injury." Although this remains uncommon, he said he feared "it may become more commonplace."
Dr. Jim Grisolia, a neurologist with Scripps Health in San Diego, expressed worry that the intense focus on youngsters' neurological functions could contribute to parental anxiety and the creeping "medicalization" of daily life.
Dick's will donate $1 for each pair of sport shoes bought by Sept. 12 in its stores or online. It is pledging up to $1 million for the PACE program, according to the ad running on ESPN, the Discovery Channel, Food Network, VH1, TLC, BET, Oxygen and Golf Channel. The new campaign includes four YouTube videos, including one with Bettis.
He also is among several pro athletes, including Ali Krieger, a defender on the U.S. Women's National soccer team; Daryl "Moose" Johnston, a former Dallas Cowboys fullback; Brian Mitchell, a former Philadelphia Eagles running back; and Doug Flutie, former quarterback for the Buffalo Bills, San Diego Chargers and New England Patriots, making in-store appearances and participating in concussion seminars.
The ads began running a day before Dick's was scheduled to issue its second quarter earnings for 2011.