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University physician researches concussions

CHRISTIAN MYERS | Friday, November 15, 2013

Boxing experts like to refer to the sport as “the sweet science,” but head University Physician Dr. Jim Moriarty is using the sport for some real science.

Moriarty said he has been studying the effectiveness of a variety of concussion diagnostic tests with members of the Men’s and Women’s Boxing Clubs as research subjects. 

Nate Walker, RecSports club sports program coordinator and boxing coach, said it makes sense for the boxing clubs to contribute to a better understanding of the “hot button issue” of concussions.

“There’s so much we don’t know about concussions, and we have a great sample size and the ability to collect data,” Walker said. “We’re hoping to be part of the solution, to be able to keep our boxers as safe as possible.”

Moriarty said the research project consists in administering common concussion tests, especially those medical professionals use during games, and then comparing the results of those tests to data collected from the bouts and reports of any confirmed concussions. 

The tests Moriarty evaluated are a computerized test provided by Axon Sports, the King-Devick test, the Sport Concussion Assessment Tool 2 (SCAT2), a balance test and a voice recognition test being developed by University researchers. 

Moriarty said it is important to determine just how accurate these testing methods are, how well they detect a concussion when one occurs and how well they rule out a concussion when one does not, so that team trainers and doctors can make the right decisions for athletes.

“Right now, these tests – King-Devick, SCAT2, balance, computerized assessment – are considered the standard of care, or the best procedure, for diagnosing concussions,” Moriarty said. “The key for us is if you’re a physician on the sidelines, you’d like to know the tests you’re running are reliable. There are symptoms that confirm concussions, but most people don’t have that. Most people have the lesser symptoms which cause you to have doubts whether you’re making the right choice or not.”

Two things that make this study unique are a control group comprised of boxers and getting “best effort” from the athletes, Moriarty said.

Moriarty said most concussion studies compare the test results of people with concussions to people who didn’t suffer any head trauma. He said this made the Bengal and Barak Bout study important because it compares people who received blows to the head and suffered concussions to those who received blows to the head and did not suffer any concussions.

“You have to have a similar group of people to see if the tests really work,” Moriarty said. “One ought to be able to tell the difference between those who were hurt and those who were not.”

It was also “critical” that all the boxers gave their best effort on the baseline and subsequent tests, Moriarty said. “Best effort” on all the post-bout tests was ensured by requiring the boxers to take the tests after every bout and not allowing them to advance to the next round without passing the tests. He said the success of their strategies to elicit best effort is reflected in the fact that the results for losers and winners were comparable.

The “practice effect” was also an important part of the study, Moriarty said. The practice effect is the intuitive fact that “the more times you take a test the better you get at it” and it is important to take it into account when comparing an athlete’s baseline to his or her later results. Moriarty said requiring testing after every bout ensured everyone experienced the practice effect and it could accordingly be properly accounted for and analyzed.

Walker said in order to evaluate the possible causes of the various test results, the matches were videotaped and microchips that wirelessly transmit information about impact and rotational forces were inserted in the headbands and mouthpieces of the boxers.

Two important questions the study sought to answer by comparing the tapes and impact data with test results were “Does the number of hits matter?” and “Does it matter how hard you are hit?”, Moriarty said.

Moriarty said that from his review of the data thus far there does not seem to be a significant correlation between the number of punches or the impact force and the occurrence of a concussion. He said the data seems to indicate instead that everyone may have their own inherent “threshold” that determines what amounts and types of force will cause them to experience a concussion.

Moriarty said Bengal Bouts participants have been studied the last three years and Baraka Bouts participants for the last two. This year he said he is analyzing the accumulated data before obtaining more, but he said the testing will likely start up again in the future.

Walker said the computer test was mandatory, since there had to be some way to monitor all competitors for concussion symptoms, while participation in the other tests for the research project was voluntary for all student boxers. He said on the whole they were “very receptive” toward the research.

“We had a great turn out for men’s and women’s, with 200-plus men and about 100 women who chose to opt in,” Walker said.

Moriarty said there were also students who helped in administering the concussion tests. He said the work of these students was “outstanding” and integral to the research project.

Walker said it is important to keep the boxers in Bengal and Baraka Bouts safe so the programs can continue their humanitarian mission.

“We’re here to give an opportunity to help Holy Cross missions through boxing, no one is going pro,” he said. “Ultimately, we are working to make this a safer program because we’re trying to make a global impact.”

Contact Christian Myers at cmyers8@nd.edu