In 2010 Dr. Lager founded Cleared to Play.Org, Inc., a 501(c)(3) registered non-profit organization whose purpose is to raise awareness of concussion prevention and treatment, to perform free pre-season baseline testing, and provide comprehensive post-concussion management for local high school and college athletes. The greatest concerns regarding young concussed athletes are early diagnosis and prevention of premature return to play— players can die of second impact syndrome if they return to sports before they have fully recovered from a concussion. Cleared To Play. Org., Inc. and Gotham City Orthopedics, LLC work together with ImPACT™ and TRAZER HRA™ to perform pre-season baseline testing and post-concussion testing and rehabilitation.
Using ImPACT and TRAZER HRA in the pre-season establishes each player’s baseline brain and motor function. After a concussion has been diagnosed, the player re-takes both tests to determine how his/her brain function may have been affected and, along with a physician examination, are used as part of the criteria for assessing when the player has returned to pre-injury status and can return to play. All Gotham City physicians are ImPACT certified and can provide baseline testing and post-concussion ImPACT and TRAZER HRA testing, evaluation and treatment.
What is ImPACT?
ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the first, most-widely used, and most scientifically validated computerized concussion evaluation system, and is implemented effectively across high school, collegiate, and professional levels of sport participation. ImPACT was developed to provide useful information to assist qualified practitioners in making sound return to play decisions following concussions. The test measures multiple aspects of cognitive function in athletes, including player symptoms, verbal and visual memory, sustained and selective attention time, response, variability, non-verbal problem solving, processing speed and reaction time to 1/100th of a second. ImPACT takes approximately 20 minutes to complete. It is available as an on-line examination.
More on TRAZER HRA
Current post-concussion rehabilitation protocols follow the 2012 Zurich guidelines in which the athlete progresses from light aerobic activity, like the stationary bike, to full contact practice. These static exercises do not adequately prepare some post-con- cussed athletes for the rigorous game environments which require quick responses from several neuromotor pathways. TRAZER HRA immerses the athlete in game-like situations that replicate the rapidly changing nature of actual competition. TRAZER challenges the athlete’s vestibular-ocular, cognitive, neuromuscular and metabolic systems by eliciting sport-specific movement responses that elevate the athlete’s heart rate. TRAZER can simulate game environments without exposing the athletes to the risks of premature physical contact/impact. TRAZER provides a 7-phase, post-concussion rehabilitation program. Once rehab is completed, the athletes retake the TRAZER fitness test, which is then compared to their baseline test scores. TRAZER provides the physician with essential information regarding an athlete’s ability to safely return to play.
Concussions are now widely prevalent throughout team sports, and are not isolated to football—hockey, lacrosse, soccer, volleyball, gymnastics and cheerleading have seen rapid increases in concussion diagnosis. It is critical that young athletes suspected of having sustained concussions are treated only by physicians who are certified in concussion management and understand return to play guidelines and protocols.