What does it say about our sport ( Stew, Concussions. )

2/4/2016 5:01pm
" how does this speak for our concussion testing, if he got cleared to go race.. but clearly he can't race... so that's what I wonder, how good is the concussion testing "

- Ricky Carmichael.
hvaughn88
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Conway, AR, USA
2/4/2016 5:03pm
Am I still an asshole for saying the standards need to be better to protect riders or nah?

You're not an asshole for your comments about the standards. You're still an asshole because your still an asshole
2/4/2016 5:16pm
Yeah, listening to DMXS now before bed. I'm not bashing what's in place. Surely it's better than nothing and these guys are doing there best, but we can be better. Learn & grow from every experience. That's all I hope for.

More than anything, it comes down to the riders being honest with themselves, teams & sponsors not pressuring them as well.
motogrady
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2/4/2016 5:46pm
Yeah, listening to DMXS now before bed. I'm not bashing what's in place. Surely it's better than nothing and these guys are doing there best, but...
Yeah, listening to DMXS now before bed. I'm not bashing what's in place. Surely it's better than nothing and these guys are doing there best, but we can be better. Learn & grow from every experience. That's all I hope for.

More than anything, it comes down to the riders being honest with themselves, teams & sponsors not pressuring them as well.
Well, one guys opinion, is leave it as is, if anything drop any outside interference, influence or requirement on the rider himself.

18 and under, sure, he's a minor, he doesn't know the ramifications.
But, as an adult, it's his business.
Stay out of it.

Let the rider make the call.

The Shop

EddieC
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2/4/2016 10:34pm
Am I still an asshole for saying the standards need to be better to protect riders or nah?

Asshole? I prefer uneducated and uniformed in matters of testing and management of sport concussions.
I have included some information for the purpose of informing you and thus upgrading your position to informed.
Uneducated will remain until you can prove you have completed and passed a course in Sport Concussion Management.

Neuropsychological testing has been used extensively in the rehabilitation setting to document and track cognitive recovery. In the area of sports-related concussions, the standard as promulgated by the Zurich statement and other consensus statements has been that recovery can be said to have taken place when symptoms, cognition, and balance have returned to the athlete's baseline (or typical) performance (Halstead et al., 2010; Harmon et al., 2013; McCrory et al., 2013b). Using that as the benchmark, studies have generally found neuropsychological testing to be a useful aid in determining when an athlete has recovered enough to return to competition. Although the methodological rigor of the studies varies (Comper et al., 2010), the ability of neuropsychological tests to detect subtle changes in cognitive function is well established.

Once individuals are symptom-free, it is frequently recommended that they follow a graded return-to-play protocol (see Table 3-8), progression through which is governed in part by recurrence of symptoms (Canadian Academy of Sport Medicine Concussion Committee, 2000; Halstead et al., 2010; Herring et al., 2011; McCrory et al., 2013b). The protocol calls for individuals to proceed to the next level if they remain asymptomatic at the current stage. If concussion symptoms reappear, the athlete should revert back to the previous asymptomatic stage and resume the progression after 24 hours (Canadian Academy of Sport Medicine Concussion Committee, 2000). The Department of Defense is also in the process of developing a gradual return-to-duty guideline (personal communication with Jack W. Tsao, October 8, 2013).

Traditional neuroimaging techniques, such as computerized tomography and magnetic resonance imaging, are of little diagnostic value for concussions per se, because structural imaging results are normal in the case of concussions uncomplicated by skull fracture or hematoma.
http://www.ncbi.nlm.nih.gov/books/NBK185340/

The majority of patients with sport-related concussion recover within a 7- to 10-day period, although children and adolescents require more time to recover than do collegiate or professional athletes.8,75 Persistence of symptoms beyond the generally accepted time frame for recovery may represent a prolonged concussion or may herald the development of post-concussion syndrome (PCS).117 The accepted time frame for recovery is not scientifically established and is influenced by factors such as age, sex, and history of prior concussions.43,54,74 Approximately 10% of athletes have persistent signs and symptoms of concussion beyond 2 weeks.117 In non-sport–related concussion, most individuals recover completely within the first 3 months68; however, up to 33%12,95 may exhibit symptoms beyond that.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435903/
2/5/2016 1:20am
Are you still a radiologist? You didn't say what kind. Judging by the meltdown I'm going with industrial, that's why you work in a field, and you've been handling the cobalt source too much. So that would make you a radiographer, who doesn't need a degree level to be qualified. Have I been able to see through you?
2/5/2016 1:24am
Keep fighting the good fight Eddie and doing what you do.
DonM
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Fantasy
2/5/2016 4:19am
There are strong rumors that Stewart crashed before A1 and was knocked out....
Roscoe33
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2/5/2016 6:34am
Am I still an asshole for saying the standards need to be better to protect riders or nah?

far worse, your delusional when you believe you know more than the trained, certified and working in the real world doctors when you trained and work as a radiologist.
hillbilly
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Afton, TN, USA
2/5/2016 7:14am
hillbilly wrote:
Protocol should be no protocol, Who would want some suit or a "docter" telling them they can't ride when careers are so short anyway. A rider...
Protocol should be no protocol,

Who would want some suit or a "docter" telling them they can't ride when careers are so short anyway.

A rider with a torn rotator cuff or sliced up hand is just as likely to crash as a dizzy rider.

Stewart made the main and ran up front,didn't crash into anyone.
You do know that people have ridden after a concussion that hasn't improved effectively and then had another crash to the head, resulting in death? I...
You do know that people have ridden after a concussion that hasn't improved effectively and then had another crash to the head, resulting in death?

I won't even mention the issue of CTE's to you either.

The test is garbage, period. A rider can fake the test reactions to have a window in case they're in a position where they'd need to race for points/sponsors. Team sports are less likely to fake the test because one person does not (ultimately) make the team and they have(ing) more emphasis on the severity of head injuries.
Their life their choice.

Where is all the examples of a rider getting back on and causing a crash?

Careers are short,the top guys prepare for the season and one bump to the head sets them out a race and ruins the title
For another year which may not come if they blow a knee outdoors.

hillbilly
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2/5/2016 7:18am
DonM wrote:
There are strong rumors that Stewart crashed before A1 and was knocked out....
And he still raced and did pretty good till stopping so fast,turning a insane tight line that RD5 ,with all his wits about him,got caught by surprise and couldn't avoid hitting stewart.
DonM
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Fantasy
2/5/2016 7:50am
DonM wrote:
There are strong rumors that Stewart crashed before A1 and was knocked out....
hillbilly wrote:
And he still raced and did pretty good till stopping so fast,turning a insane tight line that RD5 ,with all his wits about him,got caught by...
And he still raced and did pretty good till stopping so fast,turning a insane tight line that RD5 ,with all his wits about him,got caught by surprise and couldn't avoid hitting stewart.
Oh no!!!! don't start that debate again! Laughing I'd rather discuss why 4th gear dimmed continues to ignore the real experts when they call him out on his dribble....
2/5/2016 1:48pm
4th gear trimmed after Eddie took to him
2/5/2016 2:50pm Edited Date/Time 2/5/2016 2:54pm
Am I still an asshole for saying the standards need to be better to protect riders or nah?

EddieC wrote:
Asshole? I prefer uneducated and uniformed in matters of testing and management of sport concussions. I have included some information for the purpose of informing you...
Asshole? I prefer uneducated and uniformed in matters of testing and management of sport concussions.
I have included some information for the purpose of informing you and thus upgrading your position to informed.
Uneducated will remain until you can prove you have completed and passed a course in Sport Concussion Management.

Neuropsychological testing has been used extensively in the rehabilitation setting to document and track cognitive recovery. In the area of sports-related concussions, the standard as promulgated by the Zurich statement and other consensus statements has been that recovery can be said to have taken place when symptoms, cognition, and balance have returned to the athlete's baseline (or typical) performance (Halstead et al., 2010; Harmon et al., 2013; McCrory et al., 2013b). Using that as the benchmark, studies have generally found neuropsychological testing to be a useful aid in determining when an athlete has recovered enough to return to competition. Although the methodological rigor of the studies varies (Comper et al., 2010), the ability of neuropsychological tests to detect subtle changes in cognitive function is well established.

Once individuals are symptom-free, it is frequently recommended that they follow a graded return-to-play protocol (see Table 3-8), progression through which is governed in part by recurrence of symptoms (Canadian Academy of Sport Medicine Concussion Committee, 2000; Halstead et al., 2010; Herring et al., 2011; McCrory et al., 2013b). The protocol calls for individuals to proceed to the next level if they remain asymptomatic at the current stage. If concussion symptoms reappear, the athlete should revert back to the previous asymptomatic stage and resume the progression after 24 hours (Canadian Academy of Sport Medicine Concussion Committee, 2000). The Department of Defense is also in the process of developing a gradual return-to-duty guideline (personal communication with Jack W. Tsao, October 8, 2013).

Traditional neuroimaging techniques, such as computerized tomography and magnetic resonance imaging, are of little diagnostic value for concussions per se, because structural imaging results are normal in the case of concussions uncomplicated by skull fracture or hematoma.
http://www.ncbi.nlm.nih.gov/books/NBK185340/

The majority of patients with sport-related concussion recover within a 7- to 10-day period, although children and adolescents require more time to recover than do collegiate or professional athletes.8,75 Persistence of symptoms beyond the generally accepted time frame for recovery may represent a prolonged concussion or may herald the development of post-concussion syndrome (PCS).117 The accepted time frame for recovery is not scientifically established and is influenced by factors such as age, sex, and history of prior concussions.43,54,74 Approximately 10% of athletes have persistent signs and symptoms of concussion beyond 2 weeks.117 In non-sport–related concussion, most individuals recover completely within the first 3 months68; however, up to 33%12,95 may exhibit symptoms beyond that.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435903/
You're going on about the normal symptoms from a single incident, not a person whose experienced 10 + traumas in their lifetime. Especially not a specific individual who experienced one just 10 days before their first race.

When is the first baseline test administered for supercross? The week preceding A1 right?

What happens when the individual takes the test and gives you a false standard? For any number or reasons.

I know it's " Your job and all. " but if even you can't admit that the protocol in place isn't effectively keeping riders out of competition there's nothing I can do to change your mind.

The protocol is perfect.

Every rider should be allowed back on track 7 days after they experience any degree of concussion because " that's the standard. " ..............

You guys gave him the chance to incur a secondary trauma well within the period where, we all know, compounds the effect.

I'm sorry you don't want to admit that, but, I'm not the only one whose calling out your half assed efforts.

It's pretty sad you're unwilling to admin the standards and testing in place, while they may be the best available, do not have the degree of acutely diagnosing any specific individual's status beyond the standards. Not taking their history of brain trauma into factor, or the riders long term well being.
2/5/2016 2:58pm
Am I still an asshole for saying the standards need to be better to protect riders or nah?

Roscoe33 wrote:
far worse, your delusional when you believe you know more than the trained, certified and working in the real world doctors when you trained and work...
far worse, your delusional when you believe you know more than the trained, certified and working in the real world doctors when you trained and work as a radiologist.
I read 10-20 films on any given day. About 20% of what I have seen in my lifetime have been of head traumas from motor accidents, the rest involving the brain are tumor or stroke related. While I do not work directly with patients or have a close follow up with individuals suffering from tbi's. I have enough common sense and information available to me to know the common effects of a concussion, vs the ones people with a history of trauma experience, and I know that you cannot treat each case the same.

That's where the issues are with the standards in testing. No accounting for the individuals history, The standards that apply to everyone are flawed. It's not a wide spread, blanketed type of diagnosis.
ando
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2/5/2016 4:11pm
EddieC wrote:
Asshole? I prefer uneducated and uniformed in matters of testing and management of sport concussions. I have included some information for the purpose of informing you...
Asshole? I prefer uneducated and uniformed in matters of testing and management of sport concussions.
I have included some information for the purpose of informing you and thus upgrading your position to informed.
Uneducated will remain until you can prove you have completed and passed a course in Sport Concussion Management.

Neuropsychological testing has been used extensively in the rehabilitation setting to document and track cognitive recovery. In the area of sports-related concussions, the standard as promulgated by the Zurich statement and other consensus statements has been that recovery can be said to have taken place when symptoms, cognition, and balance have returned to the athlete's baseline (or typical) performance (Halstead et al., 2010; Harmon et al., 2013; McCrory et al., 2013b). Using that as the benchmark, studies have generally found neuropsychological testing to be a useful aid in determining when an athlete has recovered enough to return to competition. Although the methodological rigor of the studies varies (Comper et al., 2010), the ability of neuropsychological tests to detect subtle changes in cognitive function is well established.

Once individuals are symptom-free, it is frequently recommended that they follow a graded return-to-play protocol (see Table 3-8), progression through which is governed in part by recurrence of symptoms (Canadian Academy of Sport Medicine Concussion Committee, 2000; Halstead et al., 2010; Herring et al., 2011; McCrory et al., 2013b). The protocol calls for individuals to proceed to the next level if they remain asymptomatic at the current stage. If concussion symptoms reappear, the athlete should revert back to the previous asymptomatic stage and resume the progression after 24 hours (Canadian Academy of Sport Medicine Concussion Committee, 2000). The Department of Defense is also in the process of developing a gradual return-to-duty guideline (personal communication with Jack W. Tsao, October 8, 2013).

Traditional neuroimaging techniques, such as computerized tomography and magnetic resonance imaging, are of little diagnostic value for concussions per se, because structural imaging results are normal in the case of concussions uncomplicated by skull fracture or hematoma.
http://www.ncbi.nlm.nih.gov/books/NBK185340/

The majority of patients with sport-related concussion recover within a 7- to 10-day period, although children and adolescents require more time to recover than do collegiate or professional athletes.8,75 Persistence of symptoms beyond the generally accepted time frame for recovery may represent a prolonged concussion or may herald the development of post-concussion syndrome (PCS).117 The accepted time frame for recovery is not scientifically established and is influenced by factors such as age, sex, and history of prior concussions.43,54,74 Approximately 10% of athletes have persistent signs and symptoms of concussion beyond 2 weeks.117 In non-sport–related concussion, most individuals recover completely within the first 3 months68; however, up to 33%12,95 may exhibit symptoms beyond that.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435903/
What is the documented return to play (ride) protocol for supercross and motocross? I can't find it anywhere.
2/5/2016 7:26pm
You're going on about the normal symptoms from a single incident, not a person whose experienced 10 + traumas in their lifetime. Especially not a specific...
You're going on about the normal symptoms from a single incident, not a person whose experienced 10 + traumas in their lifetime. Especially not a specific individual who experienced one just 10 days before their first race.

When is the first baseline test administered for supercross? The week preceding A1 right?

What happens when the individual takes the test and gives you a false standard? For any number or reasons.

I know it's " Your job and all. " but if even you can't admit that the protocol in place isn't effectively keeping riders out of competition there's nothing I can do to change your mind.

The protocol is perfect.

Every rider should be allowed back on track 7 days after they experience any degree of concussion because " that's the standard. " ..............

You guys gave him the chance to incur a secondary trauma well within the period where, we all know, compounds the effect.

I'm sorry you don't want to admit that, but, I'm not the only one whose calling out your half assed efforts.

It's pretty sad you're unwilling to admin the standards and testing in place, while they may be the best available, do not have the degree of acutely diagnosing any specific individual's status beyond the standards. Not taking their history of brain trauma into factor, or the riders long term well being.
"You guys gave him the chance to incur a secondary trauma well within the period where, we all know, compounds the effect.

I'm sorry you don't want to admit that, but, I'm not the only one whose calling out your half assed efforts.



While your intentions may be good, your going about it totally the wrong way. Calling out the efforts of Dr's (yes with an actual degree!!!!) with training and studies on the subject, actual 1st hand experience over may years and occasions and working a 2nd job basically as volunteers to keep the riders safe, as frauds and half assed?

Bout time you stopped drinking so much soap box topped off with ivory tower and realise you only work in a hospital, not in the field.
motogrady
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2/5/2016 7:42pm

What I wanna know is, is where is all this "I just want to help a guy from himself", kum by ah stuff coming from?

Why do some find it a mission to enforce the way they want to live, or should live, on others?
EddieC
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2/5/2016 8:33pm
Am I still an asshole for saying the standards need to be better to protect riders or nah?

EddieC wrote:
Asshole? I prefer uneducated and uniformed in matters of testing and management of sport concussions. I have included some information for the purpose of informing you...
Asshole? I prefer uneducated and uniformed in matters of testing and management of sport concussions.
I have included some information for the purpose of informing you and thus upgrading your position to informed.
Uneducated will remain until you can prove you have completed and passed a course in Sport Concussion Management.

Neuropsychological testing has been used extensively in the rehabilitation setting to document and track cognitive recovery. In the area of sports-related concussions, the standard as promulgated by the Zurich statement and other consensus statements has been that recovery can be said to have taken place when symptoms, cognition, and balance have returned to the athlete's baseline (or typical) performance (Halstead et al., 2010; Harmon et al., 2013; McCrory et al., 2013b). Using that as the benchmark, studies have generally found neuropsychological testing to be a useful aid in determining when an athlete has recovered enough to return to competition. Although the methodological rigor of the studies varies (Comper et al., 2010), the ability of neuropsychological tests to detect subtle changes in cognitive function is well established.

Once individuals are symptom-free, it is frequently recommended that they follow a graded return-to-play protocol (see Table 3-8), progression through which is governed in part by recurrence of symptoms (Canadian Academy of Sport Medicine Concussion Committee, 2000; Halstead et al., 2010; Herring et al., 2011; McCrory et al., 2013b). The protocol calls for individuals to proceed to the next level if they remain asymptomatic at the current stage. If concussion symptoms reappear, the athlete should revert back to the previous asymptomatic stage and resume the progression after 24 hours (Canadian Academy of Sport Medicine Concussion Committee, 2000). The Department of Defense is also in the process of developing a gradual return-to-duty guideline (personal communication with Jack W. Tsao, October 8, 2013).

Traditional neuroimaging techniques, such as computerized tomography and magnetic resonance imaging, are of little diagnostic value for concussions per se, because structural imaging results are normal in the case of concussions uncomplicated by skull fracture or hematoma.
http://www.ncbi.nlm.nih.gov/books/NBK185340/

The majority of patients with sport-related concussion recover within a 7- to 10-day period, although children and adolescents require more time to recover than do collegiate or professional athletes.8,75 Persistence of symptoms beyond the generally accepted time frame for recovery may represent a prolonged concussion or may herald the development of post-concussion syndrome (PCS).117 The accepted time frame for recovery is not scientifically established and is influenced by factors such as age, sex, and history of prior concussions.43,54,74 Approximately 10% of athletes have persistent signs and symptoms of concussion beyond 2 weeks.117 In non-sport–related concussion, most individuals recover completely within the first 3 months68; however, up to 33%12,95 may exhibit symptoms beyond that.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435903/
You're going on about the normal symptoms from a single incident, not a person whose experienced 10 + traumas in their lifetime. Especially not a specific...
You're going on about the normal symptoms from a single incident, not a person whose experienced 10 + traumas in their lifetime. Especially not a specific individual who experienced one just 10 days before their first race.

When is the first baseline test administered for supercross? The week preceding A1 right?

What happens when the individual takes the test and gives you a false standard? For any number or reasons.

I know it's " Your job and all. " but if even you can't admit that the protocol in place isn't effectively keeping riders out of competition there's nothing I can do to change your mind.

The protocol is perfect.

Every rider should be allowed back on track 7 days after they experience any degree of concussion because " that's the standard. " ..............

You guys gave him the chance to incur a secondary trauma well within the period where, we all know, compounds the effect.

I'm sorry you don't want to admit that, but, I'm not the only one whose calling out your half assed efforts.

It's pretty sad you're unwilling to admin the standards and testing in place, while they may be the best available, do not have the degree of acutely diagnosing any specific individual's status beyond the standards. Not taking their history of brain trauma into factor, or the riders long term well being.
Whether a person has 1 or 10 concussions the protocol is the same. We do take into consideration a riders history but the thing that you don't seem to understand is that the procedure for returning to competition is the same for everyone. It is sign and symptom based throughout the entire protocol. The last stage being the actual competition. Should a rider experience symptoms or demonstrate symptoms during any stage of the protocol the rider will sit out 24-48 hrs and return to the ACTIVITY that produced the symptoms. That ACTIVITY could be competition. If the rider continues with symptoms a referral will be made to seek further medical advice.

Prior to our protocol being in place any rider who was diagnosed with a concussion sat out at least two weeks. This was until NEW RESEARCH came out stating that riders with proper follow up could return to competition within 7-10 days.
Perhaps you are using an old Commadore 64 or TRS-80 and not able to pull up the latest research so let me help you out again. Below is a trial study done recently that addresses your REST PERIOD.

To answer your other question about baseline tests. We require per the guidelines of the testing company that risers take a baseline every two years unless they suffer a concussion. We just finished our second cycle of testing.

Not sure what you mean by a false standard but if you mean what if a rider tries to game the system? That's why we have a rider follow up with a PHYSICIAN MD/DO who is trained in current concussion standards when taking their post concussion test.

Benefits of strict rest after acute concussion: a randomized controlled trial.
Thomas DG1, Apps JN2, Hoffmann RG3, McCrea M4, Hammeke T2.
Author information
Abstract
OBJECTIVES:
To determine if recommending strict rest improved concussion recovery and outcome after discharge from the pediatric emergency department (ED).
METHODS:
Patients aged 11 to 22 years presenting to a pediatric ED within 24 hours of concussion were recruited. Participants underwent neurocognitive, balance, and symptom assessment in the ED and were randomized to strict rest for 5 days versus usual care (1-2 days rest, followed by stepwise return to activity). Patients completed a diary used to record physical and mental activity level, calculate energy exertion, and record daily postconcussive symptoms. Neurocognitive and balance assessments were performed at 3 and 10 days postinjury. Sample size calculations were powered to detect clinically meaningful differences in postconcussive symptom, neurocognitive, and balance scores between treatment groups. Linear mixed modeling was used to detect contributions of group assignment to individual recovery trajectory.
RESULTS:
Ninety-nine patients were enrolled; 88 completed all study procedures (45 intervention, 43 control). Postdischarge, both groups reported a 20% decrease in energy exertion and physical activity levels. As expected, the intervention group reported less school and after-school attendance for days 2 to 5 postconcussion (3.8 vs 6.7 hours total, P
Mit12
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2/5/2016 8:44pm
4th grear Pinned.

Go to RacerX Racerhead #6. Brock Helper has a tweet that puts concussions more into perspective.

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